L’importance du discours intérieur dans la sémiologie psychiatrique

Abstract

ObjectivesEntangled in a semiology that aspires to imitate medical semiology, psychiatry does not take seriously enough the question of internal discourse, while many psychiatric phenomena relate to the articulation between internal discourse and external discourse.The intention of this article is to draw the attention of psychiatry to the issue of internal discourse, which is insufficiently addressed within the discipline. Psychiatric semiology should be more interested in and should approach this issue of internal discourse differently. For this, it could integrate the contribution of modern linguistics and rediscover Jacques Lacan's theory of language. MethodThe article first recalls the basic principles of psychiatric semiology based on the work of Lanteri-Laura, Henri Ey, and, more recently, that of Steeves Demazeux. He shows how psychiatry has moved from a classical semiology based on the body to that of mental faculties, more or less attached to bodies. The question of internal discourse does not find its place in these approaches. DiscussionHallucinations, delusions, obsessive and melancholy ruminations… All these phenomena are related to the question of inner speech. This does not mean that they are similar or should be approached in a comparable way. ConclusionHuman beings seem to be both speaking through their outwardly directed speech and partly spoken, through their internal speech. This must be taken into account not only from a semiological point of view but also when it comes to organizing care.