The work of “entours”, an everyday life’s clinic in institutional care

Abstract

Work daily life in institution is subtle and delicate. The author, recolling a clinical situation and moments of  daily life in a day hospital, tries to illustrate this work of the atmosphere, the “entours” of which Jean Oury speaks.
These little unexpected moments that disturb and surprise us, make us perceive the complexity, the difficulty but also the wealth of what the patients deposit in the interstices of the establishment.

For this the Therapeutic Club, operator of change is a valuable tool. A stimulating opposing-power to the hierarchical functioning of the institution, its movement helps to strive routine and inertia.

Psychoanalyst in institution: an impossible neutrality?

Summary. Sometimes the psychoanalyst is requested to intervene in institution in various forms. The reference to the groupal psychoanalysis allows to think institution as a specific group with its history, myths and specific functioning. Through clinical examples, we wonder here about the place that the psychoanalyst can take in a listening of the Unconscious when the external and organizational reality sometimes seems to cover the access to the sense. More than ever, a rigorous training is necessary in this working.

The playing area of foundational praxis

Abstract. The institution, in the meaning of the act of instituting, is made possible by the creation of multiple play areas (in oneself, inside the group, inside the society). In the daily clinical work, that introduces a fight against the naturalization of the psychotic processes and the institutional phenomena. To open to the complexity of the human relationships and to the consideration of the weaknesses of institutions and people, to put them into the work, is the stake in the instituent praxis.

Institutional dynamics and groupal process : screenwriting and story-telling

Abstract: The author offers an afterthought on the meeting points between institutional therapy and therapeutic mediations. What are the common inspirations that lead these two points of view to defend a certain idea of caregiving institutions? What are the acquaintances and resemblance between these two ways for institutional caregiving? From the example of an institutional workshop as it is set up within the adolescent inpatient unit of the Villa des Pages Clinic, the author tries to articulate these two approaches of institutional psychological care.

Function of the institution in consultations

Abstract:

How the practice among schizophrenics patients would change the listening  to the neurotic people or other patients ? Experience as a practical institution in consultation is illustrated by the therapeutic work continued with a patient .One could argue that institutional psychotherapy today is a psychotherapy of social link. 

What the patients pass on to us

Abstract: Our purpose will be an attempt to put into perspective the elements of a logic of transmission so that the transmission itself, as logical position in relation to knowledge or even more to non – knowledge. From a first point is the encounter with a patient, will be unfolded and articulated the question of otherness, that of instituting separation, position relative to a point of no knowledge. The knowledge is not there to hear their differences with misleading knowledge, as knowledge on the side of learned ignorance. Through clinical notes will be discussed accepting to be moved and transformed by a  patient, the ability to ex- position in relation to the institution but to get out of the fascination generated by the statements of some patients. This sometimes  invisible transmission from patients may question our know how of psychoanalyst but also our clinical know how of practitioner in institution and our responsibility.

Psychiatric care and Other’s treatment

This article has two goals: the first one is to expose how the institutional therapeutic work in psychiatry based on psychoanalytic patterns constitutes in the same time a treatment of the patient and a treatment of the Other in a lacanian sense, which includes the treatment of the institution itself. We would like on the other way to put in perspective this psychoanalytic approach with the most classical medical act of the psychiatrist which is the pharmacological prescriptions, not as usual, to oppose it to psychodynamic approach, but really to integrate them.