Can the inestimable work be assessed?

Abstract: This article presents the practical-theoretical context in which the issue’s authors asked themselves the question of the assessment of the inestimable work, a concept proposed by Jean Oury that puts in tension both the ethics of care and the economic rationality. In fact, this question is part of a collective approach which combines care and action-research devices with the desire to formalize current practices located somewhere between accompanying and care through a “collective monograph”.

From therapeutic work to inestimable work. “Don’t separate pure theory from what’s going on”


This article articulates therapeutic work as discussed in the 1960s by psychiatrists of the institutional psychotherapy movement with the inestimable work conceptualized by Jean Oury in the 2000s in response to managerial evaluation. Inestimable work is understood at the therapeutic, economic and ethical levels. This last dimension appears to be linked to the rise of a perfectionist approach to care. Its development and transmission over several decades around the notions of daily life and “caring function” are essential in front of the analysis of other aspects linked to hierarchical relationships and the division of labour between employees, an analysis which is also essential but which is left to others.

Work and poetry in a psychiatric writing workshop



This text presents a doctoral research about the notion of poetry with the movement of institutional therapy as its theoretical basis. We wonder what “work” is then produced in a writing workshop in psychiatry. The research was based on a qualitative approach, using two methodological tools: four interviews with professionals who lead workshops in psychiatry as well as a six-months writing workshop in an association for people with mental disorders. The text presents how a participant invests the workshop and how to theorize it as a “work”.

Anteriority of ethics on the collective work


In a cross-reading of psychodynamics of work with institutional psychotherapy, the author questions the relationship between the collective – conceived as an agonistic space – and the underlining of ethics. She analyzes the relationship between courtesy as a social rule and kindness as an ethical rule and stresses the limits of the Aristotelian model of collective deliberation, when one needs to think about the dynamics of the caring collective taking into account its heterogeneity. Ethics is considered as a condition of the collective around a “necessary minimum” that makes possible the conflict and the elaboration of ethical rules for action. The article concludes with the questions raised by the articulation between the peer group and the function of director.


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


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.

About the opportunity of updated sectorised psychiatry


Sectorial organisation of psychiatry and institutional psychotherapy were founded 60 years ago. Sectorial organisation of psychiatry is based on closeness and continuity. It is a matter for a constant presence and availability of health care team, in a centralized place for treatment. This centralized device is especially helped by means of transport. Interlocutor’stability reassure patients suffering of psychics insecurity. We combine to this centralized device with the management of these cognitive remediation therapy measures in groups. This will make metacognitives, neurocognitives and social cognitives functions’s work. We may think and apply these principles with help from institutional psychotherapy paradigm’s and psychanalytic approach of psychosis. So, we help to bring toghether shizophrenic dissociations with the symbolising symbol through a health care team meetings. (cross-sector, dissociated transfert, club function). Sectorial organisation of psychiatry psychosocial reabilitation and cognitive remediation connect themselves in a coherent whole.

How Jean Oury, a giant of psychiatry, can help us to practice a humane psychiatry

Summary :


Jean Oury is one of the main creators and actors of the mouvment of institutinnal therapy. Along his professionnal life, he created many and important conceptions for the practice and theorisation of human psychiatry. Some of his inventions (double alienation, dissociated transferance, transferancial constellation, « collectif »,…)are studied in this paper and give an idea of his importance, on the psychopathological way and also on the societal and politic way.

institutional psychotherapy, a permanent creation

Abstract. This text reflects a long-term practice with psychotic patients and the establishment with them of a system in the city of Reims.
Structure mainly based on the ambulatory by Antonin Artaud Unit, but also hold by 5 therapeutic clubs present in various places of the service.
From a transmission / reinvention where patients but also seniors as Roger Gentis and Jean Oury played a crucial role , the essential concepts of institutional psychotherapy are being revisited and acted in a permanent recreation.
The heterogeneous as a founding principle, but also “the club function” contribute to the setting in motion of the Collective, and help the reconstruction for each of a livable and desirable world.
This also assumes a working gathering conscious of psychic continuity, essential to fight against fragmentation and cleavage.
Putting on an equal footing patients and caregivers will thus allow a instituting praxis, and the creation of an patient association named Humapsy.
Keywords: therapeutic club, club function, “phoric” function, Collective, permanent recreation, heterogeneous, institutional psychotherapy.

The collective in itself

Abstract. Institutional therapy includes a vast and heterogeneous set of practices, ideas, thoughts, writings which are particularly inspiring at this moment in time. This article illustrates thoughts about institutional work in an out-patient hospital receiving adolescents and young adults with symptoms from autistic spectrum.

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.

Function of the institution in consultations


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.