Vingt ans de débats législatifs sur la réglementation du titre de psychothérapeute en France

Abstract

The legislative debates that took place in France between 1993 and 2014 on the training and exercise of psychotherapists show the difficulty of legislating in a field linked by its very nature to engagement in practice; a field which is currently developing in France in a highly varied landscape. The questions discussed at the National Assembly and in the Senate were oriented around five poles: supervision of the training of psychotherapists; control of their exercise; recognition of the skills of those professionals who are neither psychologist, psychiatrist, or psychoanalyst, and who train outside universities; control of abuse of weakness; and sect movements. Today, the legal framework that these poles have given rise to has failed to prevent the continuation of psychotherapeutic practices that fall outside the zone of regulation, whether they are sectarian or otherwise, abusive or otherwise. However, when one takes a step back to look at the debates that have been published in their entirety in the collected proceedings of the National Assembly and the Senate, at the various Bills and their amendments, at the different versions of the implementing decrees, and at the reports from the government commissions or collective expert teams that they drew on (the report on the inter-ministerial mission for combating sects from 2001; the collective expert assessment Psychotherapy: Three Approaches Evaluated, by the Institut National de la Santé et de la Recherche Médicale, INSERM, from 2004; the 2013 inquiry Therapeutic Excesses and Sectarian Excesses: healthcare in danger; and the 2013 government mission on mental health and the future of psychiatry), we can see how, at the heart of the problematics concerning statutes, institutions and public healthcare policy which have been brought to the fore, the question is also that of the structural points of opposition between, on the one hand, research that objectifies disturbances, and, on the other, their subjectification, the treatment that is carried out, and inter-subjective encounters. These oppositions are being experienced in psychiatry as especially sensitive contradictions, but they also exceed these oppositions by encompassing the wider contradictions between objectification and subjectification, between inter-subjectivity and care, and between clinical construction and the knowledge/power relationship. In order no longer to be divided and opposed, but rather thought through and articulated in all their complexity, these oppositions call upon an ethical mode of questioning. In the direction that psychiatry is currently taking, these oppositions run the risk of supporting normative and prescriptive attitudes that are devoid of subjectification and, on the other hand, empirical empathic positions which, when matched together (rather than being debated on the basis of their opposition) characterise precisely those dynamics of sectarian excess that were in question during the first legislative debates.