Psychology Institute, University of Lyon 2, Bron, France.
Int J Psychoanal. 2021 Aug;102(4):689-709. doi: 10.1080/00207578.2021.1908832. Epub 2021 May 25.
Although psychosis and psychoanalysis have been closely linked since the earliest Freudian theories, the psychoanalytic treatment of psychotic states still presents major difficulties. The establishment of a therapeutic situation allowing the deployment of psychic work is still uncertain. The resumption of the work of S. Freud and DW. Winnicott associated with the development of the theorization of a metapsychology of the process of symbolization by the French school (Green, Roussillon) allows a revival of the reflection on the stakes of the establishment of the therapeutic situation. This theorization of representative processes makes it possible to consider the psychotherapeutic approach to psychoses from the angle of a "psychopathology of the psychic apparatus" and thus to model the psychic dynamics involved in psychotic problems which initially appear in a chaotic form. The apparent failure of the psychic processes, in their linking and transforming activity with which the psychotic states are confronted, can then be thought of as the seat of a particular psychic work that can provide essential support to the therapeutic work. Two cases studies illustrate these processes.
虽然精神分析与精神病学自弗洛伊德最早的理论以来就紧密相关，但对精神病态的精神分析治疗仍然存在重大困难。建立一个允许部署心理工作的治疗环境仍然不确定。S.弗洛伊德和 DW.温尼科特的工作的恢复，以及法国学派（格林、鲁西永）对象征化过程的元心理学理论的发展，使得对治疗环境建立的利害关系的反思得以复兴。这种代表过程的理论化使得我们可以从“精神器官的精神病理学”的角度考虑精神疾病的心理治疗方法，从而对涉及最初以混乱形式出现的精神病问题的心理动力进行建模。与精神病态状态所面临的连接和转化活动相关的精神过程的明显失败，然后可以被认为是特定的精神工作的所在地，这可以为治疗工作提供重要的支持。两个案例研究说明了这些过程。
