Quelle définition du délire dans la psychose ? Pour une approche fonctionnelle du processus délirant

Abstract

In referring to various theories from psychoanalytic epistemology, the author develops a definition of psychotic delusion as operating as possible. To do this, he compares, on the one hand, a conception of delusion based on the relation to reality with, on the other hand, a functional approach of delusional activity that takes into account subjective issues of delusion. Different theoretical paradigms are discussed in order to identify the respective implications of a realist conception of delusion and an approach of delusion from their subjective features. In this perspective, delusion is less regarded as an abnormal way of perceiving the world than as an attempt of solution to the resurgence of an unthought primary trauma. From a qualitative methodology based on a clinical case study, the author highlights three main functions achieved by the delusion in its attempt of self-therapy resolution. The first, conceptualized under the term “containing function”, carries out the shaping and the significant transformation of what could never be symbolized of the traumatic experience. The second, called “localizing function”, tries to locate outside of the subject the instinctual overflow inherent to the primary trauma. The third, named “identifying function”, enables the delusional person to assume an identificatory principle which, in a self-created way, compensates for the enigma of his senseless history. Furthermore, the analysis of clinical data underlines that these three functions of the delusional activity are not randomly accomplished but are organized according to a particular logic. From its triple operation, it appears that psychotic delusion tends to develop into a “delusional process”, by which the subject can make thinkable and bearable the trauma he has experienced during his history. Finally, referring to the various results of this study, the author proposes to reconsider the issues of clinical devices with delusional patients. Instead of trying to suppress delusion, it would be possible to accompany the subject in the development of inventive potentialities that sustain the delusional process.