Les capacités d'élaboration : concept transdimensionnel

Abstract

In everyday clinical practice, the term “ability of elaboration”, an empirical concept, is supposed to assess the mind's construction and structure. In psychiatric literature, terms with similar meaning exist, but they are not clearly defined. Does ability of elaboration have a conceptual strength? If so, is it a trans-dimensional concept? The empirical state of this concept frequently used at the end of a psychiatric examination justifies language, the translation of the patient's symbolic activity, to be considered as the beginning of our reflection. Subjects use symbolization to attribute subjective meanings to traumatic or non-traumatic events, language being the usual way of expression of this symbolization. It could result from the patient's ability to adapt. It would vary because of structural and contextual factors as affective maturation or emotional, psychological and physiological contexts. The way symbolization is processed can be modelled in different ways according to main psychiatric currents. Considering psychoanalysis theories, symbolization would result of complex mechanisms (meaning, coherence, psychic development). Psychic development links signifier to signified, restores symbolic activity, its main expression being language. Language gives the subject the possibility to transmit his psychic work. In clinical practice, psychic elaboration is predominant because trauma is intrinsically meaningless and cannot be spontaneously symbolized. Defence mechanisms could operate to make this trauma meaningful. The ability to put words on traumas would be a consequence of the ability of elaboration. But the ability would be insufficient or absent if language did not permit intelligibility. There would then be other ways to express elaboration: psychosomatic or behavioural signs. Ability of elaboration should be considered as the result of dynamic and protean tools. These tools would be necessary to resolve internal or external psychic conflicts. They would help to constantly adapt the subject to his environment. This would justify their importance in clinical assessment for diagnosis and prognosis. Ability of elaboration, empirically used, may finally be a trans-dimensional concept.