De Freud à Benedetti : variations sur la distinction soi non-soi dans la situation psychanalytique avec des patients schizophrènes

Abstract

AimsThe strict boundary between “self” and “non-self” appears obvious, in the same way as the subject-object dichotomy. The distinction does not however hold for long under scrutiny, in particular in the area of intersubjectivity. Psychoanalysts working with schizophrenic patients are particularly sensitive to these issues, since the type of transference entails considerable influence of the psychic functioning of the patient on that of the therapist. Experiences arise where the two psyches seem to communicate closely, and not merely by forming a common unconscious, mainly studied by Gaetano Benedetti. The aim of this work was to return to the conceptualisations of the main authors in order to demonstrate the specificity of psychotherapeutic work of psychoanalytic orientation with schizophrenic patients. MethodsThe theories and theorisations of the main analytic authors describing their practice with schizophrenic patients will be recalled and contextualised in an attempt to perceive the logic. ResultsIt appears that these authors overall consider that the specificity of transference with schizophrenic subjects resides in a transfer of “psychopathology” (according to Benedetti), arising not in relation to any possibility of realisation of a desire on the person of the analyst who then embodies an imago, but based on archaic movements that the analyst needs to take in and process. This processing of the archaic, which is unconscious, leads the analyst to find himself inhabited by the experiences of his patient, and his efforts will be directed at decoding and detoxifying them so as to return them in a form that is organised by his own creativity. The very principle of the therapy is based on the deliberate subversion of the usual distinction between “self” and “non-self”. DiscussionWhat emerges from these elements is a particular ethic that is inherent in therapeutic work with schizophrenic patients: acceptation of the unconscious psychic intrusion, or in other words a refusal to take refuge behind a “caregiver negativism”, overly rational or too “professional”. This type of work requires supervision, enabling certain aspects of the psychic content that may have escaped the therapist to be retrieved, and the instatement of appropriate care. ConclusionThe specific nature of psychotic transference implies a mode of practice that brings the therapist to “take on” his patient's psychosis in his own psyche, to make it his own illness to be cared for, in a complete subversion of the boundaries between “self” and “non-self”.