Delphine Bonnichon

Between Sigmund Freud and Paul Federn: culture as a shared path of sublimation

ABSTRACT Freud’s interest in culture and its various manifestations – one could even call it a passion of his – is well known. We examine the correspondence between Freud and Paul Federn – which consists of 147 cards and letters, some of them completely new, and includes Freud’s letters to Federn’s wife – in order to show that their relationship too was based on their shared interest in culture. Federn was more than a colleague: he was both Freud’s right-hand man institutionally in Vienna and a trusted person to whom he referred some of his patients. This correspondence has not only historical significance but also brings to light the theoretical stakes in issues that continue to remain central to psychoanalysis.

La trachéotomie : face à l’urgence des troubles physiques, émergence de troubles psychiques

This article presents a clinical case of an adolescent suffering from Duchenne’s muscular dystrophy who, while under cortisone treatment, developed for several months a non-dissociative psychotic state with affective disorder after the announcement of the necessity of a tracheotomy. At first refused, this procedure was performed under emergency circumstances after respiratory failure. After several months, the psychotic state disappeared. This article describes the treatment of the psychotic episode by psychotherapy and medication pre- and post-tracheotomy. The authors discuss the principal factors that set off the psychotic episode: the traumatic nature of the announcement of the tracheotomy and its function of recalling previous traumas, adolescence and its transformations and the cortisone therapy. The function of the delusion is analyzed as a solution to a situation of psychic conflict and archaic anxieties, notably feelings of being attacked with corporal transformations generated by the menacing symbolism of the tracheotomy. The article emphasizes the complexity of the treatment of patients suffering from neuromuscular diseases in the case of the prescription of anti-psychotic medications, notably with regard to their secondary respiratory and cardiac effects.