D. Albarracin

There Is No Cure for Existence: On the Medicalization of Psychological Distress

The current model of biological psychiatry assumes that mental suffering results from cerebral/neuronal disturbances yet to be identified. Under this model, the lowering of diagnostic thresholds or the invention of new disorders are surprising given that there have been no major etiological findings for decades. No clinical or epidemiological research demonstrates biological causes for problems defined as mental disorders, no more than research validates the numerous categories that supposedly describe them. The diagnostic spiral leads to the increasing prescription of drugs, sometimes for life, even if they have not been shown to have any substantial positive effect on any measure of “morbidity” for mental disorders. Today, the lives of children and adults are punctuated by the consumption of psychotropic drugs prescribed by physicians who are pushed to diagnose, treat, and control their symptoms. We aimed at showing that, despite these inarguable failures, the scientific and media discourse gives the public a warped view of reality where progress in biological psychiatric research is unceasing. Therefore we call for a paradigm shift in mental health: critical thinking, openness of mind, and analysis of the scientific and institutional discourse must be encouraged among all practitioners because their ethical commitment to their patients demands it.

Narcissism and Object Relations in Hypochondria

Hypochondria remains little studied from a theoretical point of view. Whereas psychoanalysts know how difficult it is to handle hypochondriac subjects, the few works studying the relationship between patients and physicians resort to a cognitive-behavioral approach. These latter conclude that the quality of this relationship is more important than the disappearance of the symptoms. The aim of this work is to show how psychoanalysis can conceptualize hypochondria as a disruption of narcissism, leading to an apparent relational deadlock. Considering hypochondria as a narcissistic transference constitutes a useful contribution of psychoanalysis to medicine and psychotherapeutic care.

An event in medical life, or the advent of a belief?

Freud’s ambivalent relations with medicine are well known. Based on his relatively unknown text, A religious experience, published in 1928, the authors present an analysis of the internal reasons for this conflict. Responding to a letter from an American doctor, who tells him about his reactions to an autopsy and the influence it had on his religious faith, Freud suggests an analysis that leads him to make a surprising slip. This slip reveals the conflicts inherent in the practice of autopsy, considered as a peculiar event in medical training that puts a strain on the future medical practitioner’s subjectivity. Based on the analysis of unconscious impulses and fantasmatic activity, the authors demonstrate that Freud’s theory is still surprisingly relevant today in the light of testimonies from contemporary doctors confronted with autopsy during their training or daily practice.

De l'écriture comme combat

A partir de situations cliniques aussi diverses que le transsexualisme et le recours addictif au tchat, je propose une reflexion sur la maniere dont l’acte d’ecrire – et, en particulier, l’auto-observation – apaise l’angoisse d’une sexualite genitale conflictuelle. Au service des aspirations de l’Ideal du Moi, l’enveloppe imaginaire de l’ecriture permet de restaurer le narcissisme fragilise par la puissance du sexuel.