Fondation de Nant

Le psychodrame analytique est une technique thérapeutique basée sur le jeu. Elle fait appel à la créativité, à la spontanéité, à la sensorialité et au corps en mouvement. Proposé aux patients de tout âge, son utilisation est un atout dans la pratique clinique avec les adolescents. Nous voulons montrer l’utilité de cette technique sur trois séances dans le but de compléter une investigation classique en vue d’une indication thérapeutique. Deux vignettes cliniques sont proposées avec des jeunes patients qui ont profité d’un psychodrame d’investigation en présence de leur psychiatre référent.

Empathy is the epicenter of the theoretical and clinical interest of many different scientific domains, constituting a common term in different fields as these of psychology, psychiatry, clinical psychopathology, neuroscience, psychotherapy and psychoanalysis. Studying the phenomenon of empathy requires distinguishing the empathy as a method of observation of psychological phenomena from the empathy as a component of the therapy of psychopathological phenomena. In this case, beyond the empathic understanding, the optimum responsiveness of the therapist is included. Empathy means sharing the psychological and emotional state of another as if you were able to sense one's private world. This emotional sharing is a temporary situation and concerns the quality but not the quantity of the emotional experience. The modern scientists of neurobiology and neurobehavior distinguish three types of empathy: the emotional, the cognitive and motivational which help the interpersonal relations occurring in complex groups of society where the transgenerational relationships between parents and offspring are essential for the survival of species. Jaspers introduces, already by the beginning of the 20th century in his monumental work ''General Psychopathology'', the notion of empathy as an interpretative and a diagnostic tool in psychiatry and psychopathology. Meanwhile psychoanalysis, mainly during its early course, was not impressed by this term. The answer to this seems to be that the term empathy is related to the intersubjectivity and the interpersonal relationship, fields that were not really attractive at this point of time for the psychoanalytical theory which during the period of the founder of the psychoanalysis was initially mainly focused on the "intrapsychic" field. However, during the course of time and chiefly with the contribution of Kohut and Greenson, the importance of the concept of empathy is emphasized in the clinical psychoanalysis and efforts are made regarding the clarification of the nature and the psychological mechanisms that operate in this complex intuitive (feeling the other through the interpersonal communication) form of knowledge. The quality of the relationship between the therapist and the patient (therapeutic alliance) plays a fundamental role in the positive outcome in any form of psychotherapy. Empathic understanding plays an important role in the quality of the therapeutic relationship. In the field of general psychiatry, the focus of research for the role of empathy and the potential of its application, has been until today limited. The lack of a model for the application of empathy in psychiatric and psychotherapeutic practice is an important challenge for the training of the new psychiatrists.

Patients with Parkinson's disease (PD) may benefit from deep brain stimulation (DBS) to improve motor and medication-induced symptoms. Yet mixed evidence regarding the outcome of successful DBS on couple satisfaction has been highlighted in the literature. Thirty patients diagnosed with PD were included in a study investigating couple satisfaction (MSS-14), depression (HAD-D) and anxiety (HAD-A) at four measurement times: before DBS and 6, 12, and 18 months post-surgically. Sixteen spouses/partners were included as well. Couple satisfaction from the patient perspective was never associated with depression or anxiety. However, poor marital adjustment (i.e., difference and absolute difference between patients and spouses/partners MSS-14 scores) predicted patients' pre-operative depressive mood. Longitudinal analyses showed that couple satisfaction (n = 9) worsened at 12 months and 18 months compared to pre-DBS scores, F(2.047, 16.378) = 8.723, p = .003, and despite concomitant motor improvement. Growth curve analyses showed that couple satisfaction worsening occurred between 6 and 12 months post-operatively (b = 2.938, p < .001). Thus, couple satisfaction did not increase along with motor improvement and deteriorated after the adjustment period following DBS.

The Interpersonal-Psychological Theory of Suicide (IPTS) has been increasingly studied over the last years, responding to the demand for a valid framework addressing suicidality. Yet, only a few studies have explored the function of personality in the IPTS and none with clinical patients. We aimed to contribute to fill this gap in investigating the relationship between personality as conceptualized by the Five-Factor Model, the IPTS constructs, and a dimensional measure of current suicidal ideation. We conducted correlation, multiple linear regression, and path analyses based on a trait-interpersonal framework in a sample of 201 individuals visiting the psychiatric emergency room of a general hospital with current suicidal ideation. Neuroticism (positively) and openness (negatively) predicted perceived burdensomeness, while neuroticism (positively) and extraversion (negatively) predicted thwarted belongingness. Higher conscientiousness and lower extraversion were both predictors of the acquired capability for suicide. However, none of the models involving path analyses with IPTS variables as mediators of the relationship between personality traits and suicidal ideation was adequately adjusted to the data. Thus, it appears that personality plays a significant albeit modest role in suicidality when considered from an IPTS perspective. As personality is frequently assessed in the clinical routine, health professionals should consider it as complementary to detect individuals at risk of or presenting suicidal ideation.