D’une institution à l’autre : de l’hypercomplexité de l’hôpital à la place singulière des psychologues institutionnels référés à la psychanalyse

Abstract

ContextThis article aims to open a debate on how our contemporary societal context, both psychically and structurally, shapes the essential institution that is the public hospital. ObjectivesTo achieve this, the authors start with a clinical construction that allows them to highlight the hypercomplexity of the situations encountered daily by those who inhabit these spaces, including patients, their relatives, and the diverse healthcare providers. Following this, they focus on the unique role of the institutional psychologist who is referenced to psychoanalysis. MethodThe situation that opens this text, providing both its starting point and framework, is a clinical fiction. This narrative is composed of fragments from real, recurrently observed situations in our practice, supervision, and research settings – in other words, from foundational cases (Fustier, 2020). We align ourselves with a Freudian tradition, adopting the principle of analytical construction, positing that this situation is an initial level of interpretation of the hypercomplexity we aim to explore throughout this text. ResultsThe hypercomplexity observed and described in this clinical fiction led us to formulate numerous hypotheses and highlight the essential presence of psychoanalysis in hospitals. Psychoanalysis offers the necessary perspective to elaborate and impart meaning to otherwise unthinkable situations. InterpretationsFrom the conjunction of subjective experiences of somatic illness to the institutional issues unique to hospitals – intersected by the divergent representations of healthcare professionals – we emphasize the unique position of the psychodynamically oriented psychologist within this complex system.