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1.

Objectives

For paranoid patients, the confrontation with a neutral face is a perceptual and interpretative challenge. Since birth, faces seem to be the favorite visual stimulus of humans, and unexpressive faces tend to provoke discomfort (according to the still face paradigm). Considering their symptoms, this discomfort might be particularly strong for paranoid adult patients. Images of neutral faces are often used in eye-tracking studies to mesure scanpath impairments, but almost only draw a comparison with expressive faces. A short review of eye-tracking studies, in which neutral faces are presented to paranoid patients, could allow a first interpretation of visual exploration impairments and their relational consequences, through the prism of the paranoid symptoms revealed by the unexpressivity of the face.

Materials and methods

Studies focusing on the relationship between delusional symptomatology (in schizophrenia or in the general population) and visual exploration of neutral faces, seem to offer an interesting area of research. According to those studies, and to others showing the existence of varying degrees of delusional paranoid thoughts in healthy subjects, we have selected eye-tracking studies including clinical (schizophrenic) and non clinical subjects with paranoid delusions, looking at images of neutral faces. Those eye-tracking data were then confronted with clinical elements of paranoia, such as threat anticipation, or jumping to conclusion biais.

Results

The confrontation with a neutral face begins with hypervigilance toward ambiguity (extensive visual scanning style to the neutral face features). Then the pattern becomes similar to a visual exploration of a threatening face, to end up with a gaze avoidance. The need to avoid ambiguity, which is unbearable for paranoid patients, is influenced by a hasty and conclusive information processing, focused on proattitudinal, threat-related informations. Contradictory results concerning the extent of the exploration, the duration or the number of fixations could be related to a fluctuating dimension of the paranoid clinic. The gaze on a neutral face seems to represent, at a basic level, the frequent failure of relational interactions of those patients. The visual exploration of healthy patient's first degree relatives is similarly impaired, which might show pathological shared cognitions on which the attention of patients and their relatives risk to rely.

Conclusion

Social isolation due to those interactional failures is a major problem for paranoid patients. Building a therapeutic relationship represents the possibility of a gaze change, that might help those patients to stay in a relational world.  相似文献   

2.

Objective

The starting-point of this article consists in considering what is contemporary as being post-contemporary. Like the present, what is contemporary is something that cannot be pinned down. It requires hindsight in order to analyse it. Our first objective is to approach our post-contemporary age as being characterised by radicality. This takes the form of a search for origins, which shows up in a return of the religious, alongside the emergence of an anguish reducing things to nothingness. Solitude is a characteristic of this radical position, raising the issue of an otherness that turns anguish into hatred, whether of oneself or of the other. Indeed, the post-contemporary subject acts-out when faced with social ties and a culture that can no longer uphold him. Our second objective is to demonstrate that the effect of this radical position leads the subject to use his body as the only way out. Having become an external organism, the body comes to represent that which is intolerable for the subject. In order to escape anguish turned into hatred, the subject excludes himself from his own body. Finally, the third objective is to show how the free radical subject is a product of ‘liberal’ society, seeking to create his freedom at every moment.

Method

Our method uses clinical practice. We work from two contrasting clinical fields; on the one hand acting out in the form of acts of murder or suicide, on the other hand acts of passage from one gender to another.

Results

Acting out and acts of passage both relate to these free radical subjects who shape their own body, or who shape the body of the other as though it were their own.

Discussion

We will discuss the points of convergence and divergence between these two situations.

Conclusion

Our conclusion demonstrates that acts on the body of the other and acts on one's own body coincide. Acting out in the form of murder or suicide masks the wish for an act of passage, which is however impossible. The act of passage from one gender to the other requires an acting out that sometimes cannot be countenanced. With those whose aim is an act of passage, it is an acting out that must be sought. Similarly, with those who act-out, the need is to try to restore, in the aftermath, the possibility of an act of passage.  相似文献   

3.
AimThe aim of this article is to present the preliminary results of a multidisciplinary research project, which focuses on the potential effects of lock-down on intra-family and domestic violence. More specifically, it is a question of considering the effects of confinement on the precipitation of the violent marital bond, in order to consider the difficulties and levers identified by the perpetrators as well as the victims to get out of the violent circularity.MethodQuestionnaires were widely distributed on social networks. Some are intended for perpetrators, others for victims. All question the evolution of the marital bond in the test of lock-down and the way in which the subject positions himself in the couple relationship. Interview grids have also been developed. Perpetrators and victims of domestic violence were therefore able to be met in the context of semi-structured interviews aimed at evaluating the impact of confinement on the dynamics of the violent bond between the two partners.ResultsThe first trends indicate a magnifying effect on the effects of influence in the couple, increasing the expression of violence, whether pre-existing to the lock-down, or revealed by them. The hold in the relationship and the attempt to master the other are, it would seem, to be read from the angle of a counterbalancing of the experience of passivity linked to the fact of feeling “locked in”, subject to constraints. imposed spaces. The resources to get out of this violent circle and the process of constraint, do not seem to be able to be mobilized, as if lock-down removed any possibility of seizing the levers likely to stop the violent process.  相似文献   

4.

Introduction

In recent years, in order to respect the principles of the 1993 Hague Convention, international adoption has focused on children with “special needs”. These children are difficult to adopt because of their personal situation or their state of health. International adoption leads adoptive parents to move to a foreign country with unknown language, customs, culture and administrative formalities, leading to a feeling of loss of control, placing them in a vulnerable position. Some international adoptions cause real suffering for both the adopted child and his/her parents, especially when trauma disrupts the filiation process.

Objectives

The objective is to understand, from a clinical vignette, how filiation process is implemented in case of trauma. It means, to understand how parents can integrate the real child and recognize themselves in him or her and how the adopted child with traumatic injuries can build a bond of love and trust to others.

Material and methods

Clinical observation concerns a girl, abandoned at birth by her mother and who was victim on the second day of life, of an attempted murder with machetes. The child has been placed in an orphanage since that day. The aggression had serious after effects, not only physically but also psychologically. Thus, since the age 3 years, she has developed self-destructive behaviors with endangerments, including life-threatening situations. The first meeting between this child, aged 6, and her adoptive parents takes place at the orphanage. Not supported in this approach, parents are confronted with the relational difficulties of their adoptive daughter. Very isolated in a foreign country, they feel a deep uneasiness and they question the validity of the adoption process, causing shame and guilt and even suicidal ideation. Once in France, the girl adapts quickly to the culture of her new country. Psychotherapy undertaken to put into words the emotions and the behaviors allows an appeasement in the family relations and the disappearance of violent agitations. But the process of filiation, still hampered by the trauma of this violent first meeting, requires the pursuit of psychotherapy to allow parents to accept the loss of the object, here the imaginary child and the parental ideal.

Results

From this clinical observation, it appears that the first interactions between parents and adopted child play an important role in the construction of relationship. The parents welcome the child with a set of fantastical representations that reveal the place that has been given to him. Adaptation will be done by psychic movements, by comparing and relativizing the imagined child with the real child. It is a double movement of adaptation of both parents and child. In the mourning of the imaginary child, there is also the mourning of the perfect parent; it is in the articulation of these two losses that the depressive state of the baby blues arises. This baby blues can evolve into psychotrauma in case of confrontation with the violence of reality. Thirty percent of adopted children have, at the time of adoption, disorganized attachment patterns; but adoption would most often enable recovery through the mobilization of parents’ psychic abilities and their own attachment patterns. Hence, a necessary assistance for parents.

Conclusion

In the current context of international adoption, it is important to provide prevention with specialized places and trained teams in order to recognize critical situations, help families and enable filiation process to take place.  相似文献   

5.
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7.
The present study aims at analyzing the attributes of the applicant validating or invalidating the request for hospitalization of a third party (hospitalisation à la demande d’un tiers — HDT) and thus, the hospitalization of the patient under that rule. Based on a clinical case of initial refusal of a hospital management to pronounce the hospitalization at the request of a third party of a patient, followed by its retraction, this study re-examine the text of the law No. 90-527, of June 27, 1990, modified, relating to the rights and the protection of people hospitalized for mental disorders and to their conditions of hospitalization, in particular the article L. 3212-1 of the public health code, taking into account its original version, the notices, the circulars, various administrative documents by reconsidering the practical scope of the article, in support of the precedents. Fulfilling the third party request for hospitalization, a compulsory component for validity of the process of hospitalization at the request of a third party, proves sometimes to be a difficult stage, source of great teething troubles and cancellation of many hospitalizations, not to say start of legal proceedings.  相似文献   

8.
This article provides a protocol for an interdisciplinary assessment of perception and praxis for children. Understanding the term “dyspraxia” was a key point to our approach, with the purpose of providing better help for the children we work with. Most of these children have cerebral palsy with relatively preserved intellectual capacities. First of all, we have elabored a theoretical model based on recent scientific data. This has served as a guideline in selecting standardized tests and developing the protocol. Which brought out in this way, multiple fields of perceptual functions and praxis. We will also discuss the testing of “vision” (central and peripheral vision, oculomotricity, eye-hand coordination, visual scanning and exploration strategies) which is essential in measuring perceptual and praxis functions. Then, a reflection on the assessment of visualspatial, visual-perceptual and visual-constructive processing is proposed. Finally, we will discuss ideomotor and ideatory aspects of the praxis functions as well as the relevance of assessing bucco-linguo-facial praxis functions in this context. The benefit of this protocol is the fact that it combines diverse scientific data and interdisciplinary clinical experience (neuropsychologist, occupational therapist, speech therapist and physiotherapist) to make a precise diagnosis for to target and efficient intervention.  相似文献   

9.
From the essential notion, clinical and theoretical “breakdown”, the authors present in this text the observation of a teenager aged fourteen. This young girl “triggers” at the beginning of her pubertal metamorphosis, at the age of twelve, paralysis of the lower limbs. The psychotherapeutic technical work undertaken reveals a massive, intrapsychic and intersubjective tension in the maternal and more largely family environment.  相似文献   

10.
11.

Aims

This article sets out to demonstrate the heuristic value of exploration of a notion that originated from clinical observation in a particular psychiatric domain, that of the schizographia/schizophasia dyad, and its effects on the history of psychoanalysis, via the conceptualisation by Lacan. It also looks at the way in which this history contributes to what was at the time the avant-garde of poetry and literature.

Method

A survey was conducted on publications in which authors were exploring the verbal and written expression of mentally ill subjects, which began in the 19th century among authors such as Moreau de Tour, Simon or Lombroso, and continued into the 20th century with Régis, Rogues de Fursac, etc. This interest led to full-scale exploration and questioning around the notion of schizographia with Lévy-Valensi, Migault and Lacan, alongside a certain convergence with the exploration of how poetry works, focusing on the avant-garde production. Lacan was to cast new light on this common theoretical reflection, derived from his experiences in the field of psychoanalysis, by introducing the concept of the lalangue, which underpins an interpretational technique that is to some extent related to Jakobson's thoughts concerning poetry.

Results

Expounding an itinerary has epistemological value. Clinical observation affords the opportunity to identify robust notions through which a relationship with reality is maintained, beyond the hypotheses that vary over time. This relationship with reality is determined via a specific act, that of interpretation.

Discussion

Setting the forms taken on by the symptoms alongside those taken on by poetry raises the issue of where the differentiation between the two can be found. Here, Lacan's question “was Joyce mad?” can be seen as a paradigm.

Conclusion

This article looks at the extensive and intensive trends in the production of localised knowledge in scientific discourse where Alexandre Koyré holds that causality is a “hole in our knowledge”.  相似文献   

12.

Aims

The purpose of our reflection is to identify the contributions of the “narrativist” approach in psychoanalysis, and to show how they derive from a fundamental philosophical heritage, Paul Ricoeur's work on time and narrative. In this perspective, the psychic functions of the narrative are presented and differentiated. This reflection adopts a clinical and ethical approach, which explores the notion of “narrative identity”.

Method

This article provides a critical exploration of the notion of narrative and the theories of narration through the analysis of the positions of Roy Schafer, Donald Spence and Paul Ricoeur. The psychoanalytic theories of narration are considered in their relationship to Ricoeur's phenomenology.

Results

This research distinguishes and presents the eight psychic functions of narration: catharsis, linking, sharing, historization, construction, creativity, interpretation, subjectivation. The relationships between these functions are not relations of opposition, but of complementarity and superimposition. Ricoeur's philosophy makes it possible to explore essential notions (“life”, “fiction”, “narrative identity”), to rethink narrative and to propose an epistemological subversion of the concept of the subject.

Discussion

The notion of narration is discussed from theoretical, clinical and ethical points of view. The contributions of the “narrativist” approach in psychoanalysis are discussed and related to their source (Paul Ricoeur). The discussion shows how Ricoeur's approach belongs to a “hermeneutical” dimension that renews our representation of the subject. The narrativist position is a major turning point in contemporary psychoanalytic thought. This epistemological shift is explored. The notions of “narrative identity” and “time” are the subject of specific consideration.

Conclusion

The complexity of the narration concept derives from the different “models”. The question of narration is repositioned in the metapsychological field. Narrative activity is thus related to the issues of “psychic life” and “life drive”. Ricoeur's philosophical radicality consists in linking or even identifying one to another “life”, “subject” and “narration”. From this point of view, narration is basically a process of subjectivation. “Narrative identity” is envisaged in its ethical dimension. The detour by phenomenological notions is essential to envisage narrative as mediation, subjectivation and a life process.  相似文献   

13.
The treatment of the mental illness in the psychiatric institution raises the question of the human condition within the social body. Filmakers use shortcuts or caricatures, they convey myths and prejudices, but they can also expose a part of realities… Three movies talk about impasses of psychiatry and related issues: Mommy, by Xavier Dolan (Quebec 2014); One Flew Over the Cuckoo's Nest, by Milo? Forman (USA 1975); Shutter Island, by Martin Scorsese (USA 2010). Beyond the storyline, these three films recall the limits of psychiatry: first in relation to its role of societal control, then regarding some of these therapies, coercive or invasive practices, such as deprivation of liberty or lobotomy. They also force the psychiatrist to look at the problems of normal or pathological when offering psychopathological models on the edge of madness.  相似文献   

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