La psychiatrie dans ses rapports avec l’institutionnel et le familial. Réflexions sur le futur

Abstract

Psychiatry, like all areas of existence, is made up of the different dimensions of time, the present, the past and the future. We will discuss the reflection on future trajectories in two areas corresponding to our experience : on the one hand, Psychiatry in the dynamics of various medical-educational and therapeutic establishments (rehabilitation, rehabilitation, socio-psychotherapy etc.) for the child, the adolescent the adult (diversified social protection). And on the other hand, the issues concerning the support of families in the light of our studies and our practice of university training of professionals. Of course, the future of our profession is dominated, as we know, by two main general areas : The regulation of problems and conceptions of ethics from the beginning to the end of life on the one hand, and on the other hand the consolidation of structuring Humanism in the midst of currents wanting to deploy transhumanism. In this study, we will start from concrete and conceptual current realities. From an Institutional point of view, we will focus on two important areas for the future. The need for continuity in the function of psychiatry and its practices even within the diversity of personal situations, even within the Institutions and in relation to the different clinical approaches carried out (from the youngest children to adults). And on the other hand, the importance of the coordination of psychiatric practices and conceptions in the face of the current fragmentation and compartmentalisation of practices. Psychotherapies have of course to respond to very specific and well adapted indications and this need for coordination is already well recalled. But it should certainly also correspond to modifications of the training programs of psychiatry developing versatility in future psychiatrists and taking more into account the plurivalence of people as well as the philosophical and anthropological reflection capable of promoting the most complex coordinations. From the point of view of family issues, faced with the constant worsening of disruptions, professionals will have to consider family situations in a different way, taking more into account the modalities of diverse pathological family expressions than is necessary. It will act more to consider systematically in the forms of ordinary models, but as manifestations of dysfunction and suffering for children and for adults, calling for diverse and specialized help. These considerations bring us to the urgent need for measures to prevent family disturbances in the development of modalities for structuring education for young people. All these areas will need to be further supported by general epistemological and anthropological conceptions. It will be a matter of further developing integrative epistemology capable of taking account the different psychological and psychopathological conceptions (development of the child psychologies of consciousness and the unconscious, cognitivism, systemic understanding, etc.) to take more into account the structuring anthropology allowing to consider the child, the teen ager and the adult in a constructive dynamic of all the physical, psychic, noetic and spiritual components of the personalities capable of helping them to regain control and meaning of their existence.