Usages et fonctions du numérique dans les (auto-)traitements psychotiques

Abstract

ObjectivesIn the last fifty years, digital devices have been the subject of many disciplinary studies in the humanities and social sciences. Various theoretical approaches have thus been mobilized, to delimit and highlight the effect of digital device on subjects. However, published research about the uses of these devices and their psychic effects for subjects encountered in a clinical setting are still infrequent. This article aims to reflect subjective logics that can be developed through digital activities, when they are brought by the patient in a clinical setting. It is also about providing clinical positions to support the work of the patient with these new devices as closely as possible to the logic of the subject. Thus, this article proposes to examine, in the light of three clinical cases, the uses of digital objects and virtual worlds that can be made by certain psychotic subjects within the framework of the elaboration of (self-)treatments. MethodsThis approach, considering the psychotic structure as potentially a (self)treatments resource, is in line with the Freudian tradition of delirium considered as an attempt to recover. We also provide a brief overview of the many follow-up and contributions made to this thesis (M. Müller, J. Lacan, J.-A. Miller). The three clinical cases are encountered in two different clinicial settings: a private and multi-disciplinary office and a weekly digital workshop with a child psychiatry unit. We propose that digital may be a new place of this attempt for (self)treatement of psychotic symptoms (Trichet, 2011), thus, it implies discussing the therapeutic benefits that clinicians can extract from these practices when they are carried out in clinical settings. ResultsDigital devices and digital constructions can be both a support for the patient (according to the logic of (self-)treatment) but also for the work with the therapist, where it is a question of identifying with the subject the support that this creative activity can provide for him. We will then distinguish these uses according to the psychic “externalities” at stake, and the degree of stability that they can induce for the structure of psychoses. These “three externality” are described par Miller (Miller, 2009) and imply the body, the social bond and the subjectivity as a personal construction. Theses dimensions are identified also from the three clinical cases exposed. ConclusionsDigital devices, and in particular the “screen”, can provide the subject with a kind of intimate space, necessarily linked to fantasy, as Freud had conceptualized it. In psychosis, the lack of this fantasmatic functioning leads the subject to confront some anguishing phenomena, which affect the limits of the body, the regulation of the link to the others, and the stability of identity. If studies in the human sciences have clearly shown that digital technology was involved in all these aspects, clinical psychology still has to take into account the singular uses that can be established by certain psychotic subjects in this context. For some of them, and based on their testimonies, we could then talk about digital self-treatment.