Soigner la psychose. Le cadre de soin extrahospitalier : un objet à utiliser

The present article examines, through the evocation of a transference relationship between the author and a psychotic patient, the effects of an outcare setting based on the model of a Therapeutic Club. This structure was created during the institutional psychotherapy's era and was seen as a fundamental way of transforming the psychiatric institution. The personal decision of the patient to attend this kind of specific structure, i.e. without the interference of therapeutic injunction but with the nursing staff notifying this initiative, allows, in our opinion, to make a direct link with Winnicott's use of an object theory. This analysis puts emphasis on the dynamics articulating the inside and the outside and allowing thus to build, destroy, rebuild the outer setting towards the identification as object. The main hypothesis is that the process would help the psychotic patient towards re-entering into a libinal and progressive subjectivation by orchestrating an interaction between the patient and the object. The extra-care of the nursing staff, corollary with an internal need of reparation, leads to the emergence of a containing function. It works like a central component for the patient in the progress of self-individualization, in terms of indicator of his use of an object process.