Hallucinations multi-sensorielles et clinique infantile

Abstract

AimsThis article explores the particular status of hallucinations in paediatric psychiatry. Hallucination in children, whether it is an effect of trauma, a xenopathological phenomenon, or belongs to the hallucinatory functioning of children, acts as a kind of interface between psychopathological manifestations and the normal course of normal psycho-affective development. Because of the relative frequency of observed cases and the considerable difficulties raised for the diagnostic process, the psychopathological value of hallucination in children is a highly controversial clinical field. Yet hallucinations in children, one of the main symptoms for the diagnosis of childhood schizophrenia, do not possess pathognomonic value for this condition. MethodsThe article identifies certain fundamental clinical and psychopathological elements relating to hallucination in children, while at the same time distinguishing hallucination as a psychopathological formation from the hallucinatory mode of functioning procuring the satisfaction of a desire, and the failure thereof, which underpin the psychic activity organising relationships with reality. In a second section, the article uses a clinical fragment from the cure of a girl aged nine to broach the question of the psychopathological status of hallucination. The multi-sensory hallucinations of this patient are discussed in the light of meta-psychological elements in Freudian theory. ResultsThe analysis of clinical, transference and psychopathological elements enables us to position this patient's hallucinations in the clinical field of trauma rather than in that of childhood schizophrenia. DiscussionThus at the epicentre of our discussion is the Freudian notion of the verbal trace and its psychic outcome. The hallucinatory reactivation of the verbal trace is the pathway for the construction of a relationship with reality. In line with the hypothesis set out by Freud, it is by “hallucinating” verbal traces that human beings learn to speak, since the hallucinatory activity of mnemonic traces fixes the elementary marks of language in the body, enabling it to become the libidinal body. ConclusionThis article focuses particularly on the issue of diagnosis in presence of hallucinations in children. The conclusions offered, although necessarily specific to the reported case, do have more general interest, suggesting ways in which to approach the phenomenon of hallucination in children.