Voies nouvelles en thérapie familiale psychanalytique : enjeux cliniques de l’associativité formelle

Abstract

ObjectivesThis article proposes a new perspective for the clinical and theoretical approach of psychoanalytic family therapy, which aims to treat a subject with the help of the familial therapeutic group. The originality of this work–a form of joint treatment of a patient and of her/his family environment–consists in its focus on clinical material that is often disqualified, or labelled as destructive, chaotic, or nonsensical. Family therapists approach this material in a paradoxical way, underlining its extreme richness and releasing its symbolic potential. It is no longer just a question of highlighting unconscious organizing fantasies, according to the traditional theorization of psychoanalytic family therapy based on the psychoanalytical model of dreaming, but of focusing on primary forms of symbolization. MethodOur method consists in exploring the therapeutic process, using an example of psychoanalytic family therapy. Both verbal and non-verbal language, as well as the therapists’ counter-transferential experiences, are analyzed. This method of analysis focuses on the primary symbolization processes at work, with particular attention paid to formal aspects : forms of verbal language, forms contained in the narrative, and assessment of the state of representations in the neo-group. The originality of this method is threefold: a close clinical listening to the forms of discourse within a group's chain of associations; the deployment of the concept of formal associativity; and the invention of a specific methodology for these forms of listening. This analysis is carried out from the registers of the archaic to those of the primary and secondary logics of symbolization. ResultsTwo qualitative evaluation tables of the processes at work in psychoanalytic family therapy are proposed to the practitioners, in order to identify, in particular, the register of the primary symbolization. The first (1) consists in an evaluation of the primary symbolization processes, by focusing on the forms of verbal narrative discourse, in the “narrating narrative” and in the “narrated narrative.” The second (2) evaluates these process focusing on non-verbal narrative discourse. Research shows clearly how the unconscious psychic organizers of the neo-group are arranged according to the same formal logic. Beyond the chaos and emptiness often spotted by clinicians, a narrative at work in the group, with its own organizational logic, appears. This article thus exposes the coexistence and the dynamics of different registers of symbolization. DiscussionThe discussion focuses on what these forms of primary symbolization, approached in their organizational logic, express or “tell,” provided that they are accepted as language by clinicians. In clinical work with borderline and other “extreme” pathologies, these archaic expressions symbolize both an experience of encounter or non-encounter with the object; at the same time they allow the subject, or the group, to self-represent its own process of symbolization. From this perspective, this approach to formal signifiers in their associative sequence makes it possible to hear the story of the desymbolization of an experience, in connection with a trauma. ConclusionThis article highlights, in an original way, the unconscious psychic organizers of the psychoanalytic family therapy group, which are not based on fantasies, but on pictograms and above all on formal group signifiers, which can take shape in words, in bodies, in acting-out on the framework, in sensations, and in thoughts. Far from rejecting the traditional model of the dream at the basis of the theorization of psychoanalytic family therapy, we instead choose to complement it by deploying the logics of primary symbolization and by showing the cohabitation of primary forms of symbolization and fantasies. In general, this modeling of symbolization processes in psychoanalytic family therapy makes a new contribution to the understanding of borderline and extreme pathologies.