No abstract

Avec Winnicott, nous pouvons décrire un certain travail psychique de monadisation qui permet le passage de l’ensemble individu/environnement à la troisième topique. Chemin faisant, grâce au fil rouge de l’hallucinatoire et de ses destins, nous mettons au travail certains concepts fondamentaux de la métapsychologie de Freud afin de mieux dégager une complémentarité entre les modèles de la pulsion et les modèles de la relation d’objet.

FiligraneUn nouveau regard sur la pulsion, le trauma et la méthode analytique. Première partie : une théorie de la psyché

The majority of patients suffering from emotional problems are treated by non psychiatric physicians. In this context, the improvement of health services to those patients requires the involvement of general practitioners trained in appropriate therapeutic skills. At the present, general practitioners often feel unprepared to treat those patients with non-pharmacologic methods and tend to overuse psychotropic medication. The psychological therapeutic skills expected to be acquired by physicians, are often described in very general terms and remain under evaluated in medical schools. The improvement of these aspects of medical training requires them to be evaluated systematically, similar to the more traditional medical skills and biological knowledge. Such an evaluation is facilitated if the learning objectives are specified. This paper proposes specific learning objectives describing the psychological therapeutic skills expected from medical students at the end of their studies on the one hand, and from family physicians at the end of their family medicine training on the other. The authors' goals are to faciliate the discussion of this complex matter between the many medical (psychiatric or not) groups concerned and, in this manner, to clarify this issue which is fundamental to the teaching and implementation of the biopsychosocial model in clinical practice.