Pascal-Henri Keller

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.

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.

Discours neuroscientifique, discours psychanalytique

La rencontre entre neurosciences et psychanalyse se passe difficilement d’un retour aux sources de la neurologie freudienne. Les travaux de deux chercheurs en neurobiologie sont explores egalement ici, a partir de leurs procedures argumentatives. Theorisation par Edelman d’une origine neuronale du psychisme humain, d’un cote, deductions de Damasio pour une approche neurologique de l’emotion, de l’autre, la reflexion psychanalytique autorise l’auteur a en eclairer certains aspects discursifs, sur le plan theorique mais egalement clinique.

L'analogie et le vrai en psychosomatique

Las teorias en psicosomatica fueron elaboradas por confronto del psicoanalisis con la medicina. A pesar de los progresos de la medicina tecnico-cientifica, los trabajos actuales en psicoanalisis, realizados en el contexto de esa fecunda confrontacion, aportan regularmente nuevos elementos de reflexion. La busqueda que aqui se presenta, se propone acrecentar al “instante de decir”, nocion desarrollada por M.-J. Del Volgo, la nocion de “analogizacion”, fundada en el analisis de la figura del discurso que es la analogia. La presentacion del caso de una paciente afectada por un eczema permitira dar toda su consistencia a esa nocion cuyos efectos pueden finalmente renovar la vision “defectologica” propia de la corriente llamada “psicosomatica”.

Propos sur les troubles dits "psychosomatiques"

The author presents here an epistemological reflection concerning medicine known as “psychosomatic”. The first observation is that of the disappearance of the teaching of medical psychosomatic at the Institute of Chicago which was founded by Franz Alexander. The second observation is the persistence of the use of the term “psychic factor,” and “psychosomatic medicine,” whereas, from the point of view of the international scientific community, their contents were still not defined. The surprise which this situation causes is analyzed based on the thought process of Karl Popper. The stakes that are discussed in this context are those of a change in psychosomatic paradigm, in line with new data from the clinical method in psychology.