Ethics and humanization of care: Reflections in the teaching of French institutional psychotherapy experience.

French institutional psychotherapy, developed by Jean Oury and his team at the Clinic de la Borde, has played a significant role in the evolution of psychotherapeutic practice, highlighting the importance of considering the institutional context as a determining factor in understanding and treating mental disorders. This innovative approach, based on recognition of asylums' pathogenic effects, has placed particular emphasis on the humanisation of treatment and the application of bioethical principles within psychiatric institutions. This article aims to investigate the key elements of French institutional psychotherapy, analysing its relationship with bioethics and its contribution to the humanisation of care.

[Between body and soul: touch]. / Entre corps et âme, toucher.

A proverb from the Middle Ages says "hand games, naughty games". We would like to reverse it to "hands on games, good games" and show that, from the beginning to the end of life, touch, when practiced with tact, is care. In psychiatry, it takes on the specific meaning of listening, without any preconceived judgment or ideological or normative a priori: taking care, care rather than cure. It is futile to claim to treat mental illness without understanding the singular history of each of those affected. Already in the 18th century, Philippe Pinel and his assistant Jean-Baptiste Pussin had understood this: care is at the source of the "moral treatment of the insane", itself at the origin of institutional psychotherapy. A brief detour through the Middle Ages and the practice of thaumaturgy would confirm that the hand, more than any other sense, is healing.

Making People Autonomous: A Sociological Analysis of the Uses of Contracts and Projects in the Psychiatric Care Institutions.

This article aims at describing the tensions arising from working on and with someone in psychiatry, in order to make this person more "autonomous". First, through the example of the recovery, it acknowledges, the normative horizon of what is considered today as "good care": a negotiation between partners, aiming at increasing the possibilities for everyone to follow their own lifestyle. It then seeks to describe how this definition of good care is endorsed and applied in two institutions (in Belgium and in France) hosting people with severe mental health issues where the care teams are using three words ("contract", "project" and "autonomy"). The article analyses the difficulties encountered while putting into practice these demanding ideals and shows how and to what end the care teams take action in defining the "good" projects and, in a more general way, what patients can or should expect from themselves and from their future.

[Institutional Psychotherapy during confinement situation: Adaptation of the therapeutic setting in a day hospital. Towards a virtual mental institution]. / Psychothérapie institutionnelle en situation de confinement : adaptation du cadre en hôpital de jour. Vers une institution mentale virtuelle.

Within the context of the SARS-Cov-2 virus epidemic, the Ambulatory Care Unit of the Toulouse University Hospital Center, offering institutional psychotherapeutic care to people with severe and/or disabling psychiatric pathologies, closed its doors to patients on the 16th of March 2020. This article aims to document the necessary adjustments to the care setting during this extraordinary period. As it was, the team had to tell patients to stay at home and to respect rules of social distancing. An inescapable paradox when our work consists precisely in de-confining, connecting, being in contact with each other. Face-to-face meetings, group workshops, the array of our mediations were suspended; the challenge for us was to bring to light what is irreducible or essential in the institutional psychotherapeutic care for psychoses, what must remain active through the confinement. These modifications of the psychotherapeutic setting will be described in terms of constructing a virtual mental institution, based on a setting twisted by the distance but not abolished, telephone consultations opening up to a speculative but not disembodied psychopathological imaginary, and finally a blog as a quasi-materialization of a virtual space. This experience led the team of the Ambulatory Care Unit to radicalize the institution to keep it in its simplest apparatus: a virtual tree structure of the mental institution. The prior interactions between caregivers and patients have been translated (and thus re-created) virtually. As to respect their singular aspects, as well as their fundamental belonging to the collective that supports our institution. This virtual mental institution can therefore maintain the framework that structures our institutional care project, and can link the before and what will be the after of the confinement. For this study, we have conducted an "on-the-spot" analysis of the concrete arrangements of our therapeutic setting from an interdisciplinary perspective: phenomenological, systemic and psychodynamic.

Henri Collomb and the emergence of a psychiatry open to otherness through interdisciplinary dialogue in post-independence Dakar.

During decolonization, Henri Collomb was appointed to the first Chair of Psychiatry at the University of Dakar. Using a neuropsychiatric approach, he quickly made significant advances in the field, despite the colonial era's poor legacy of assistance facilities for mentally ill people. Through alliances with professors and researchers from the university Departments of Psychology and Sociology, an original interdisciplinary dialogue was set up to build up a research team which would develop rich and varied activities in the fields of transcultural psychiatry, medical anthropology and psychoanalytic anthropology. The methodological and theoretical contributions of such an approach are well illustrated in the book Œdipe africain by M-C and E Ortigues and in the journal founded in 1965, Psychopathologie africaine.

[(Community) psychiatry, a parenthesis?]. / La psychiatrie (de secteur), une parenthèse ?

Beyond an a priori antagonism between these two notions, alienism and mental health cultivate analogies as to the place to which they assign mental health. Is community psychiatry not therefore simply a parenthesis in the history of psychiatry? The question is raised therefore regarding the place given to subjectivity and complexity. What must be done to ensure that this parenthesis of community psychiatry does not close? It is perhaps a case of making use of the tools which institutional psychotherapy has developed to keep the community psychiatry spirit alive.

[Work in psychiatry: a political question]. / Du travail en psychiatrie : une question politique.

In the experience of Saint Alban, therapeutic work is a major focus of institutional psychotherapy. What is the place today of work in the therapeutic projects led by caregivers? The principle of reality concerning our society clashes with the importance which the caregiving team attaches to work as a principle of reintegration. New opportunities for sociability and integration must be designed and bridges must be co-constructed by nurses and patients towards associations and activities in the community.

Autismo e parentalidade / Autism and parenting / El autismo y la parentalidad

As patologias autísticas são complexas e requerem uma atenção especifica para cada criança. Na organização que preside os tratamentos, a Psicoterapia Institucional tem uma grande importância devido à sua larga experiência com as psicopatologias graves como o autismo e a psicose. No projeto terapêutico da criança, a implicação e o papel dos pais são determinantes para sua orientação e indispensáveis para dar-lhe sentido. Contudo, por razões distintas, alguns pais podem desenvolver sentimentos negativos frente aos profissionais, que devem ser considerados.(AU)

Autistic disorders are complex and require a specific treatment for each child. For the organization that presides over the care, Institutional Psychotherapy movement is important because of its vast experience with severe psychopathology, such as autism and psychosis. In the treatments proposed to the child, the place of parents is crucial in terms of guidance and essential to reassign sense. However, for various reasons, some parents may develop negative feelings in the presence of professionals that should be considered.(AU)

Las patologías del autismo son complejas y se necesitan de una atención específica para cada niño. En la organización que ofrece atención, es importante el movimiento de la Psicoterapía Institucional debido a su larga experiencia con las psicopatologías graves, tales como el autismo y las psicosis. En los tratamientos propuestos al niño, el lugar de los padres resulta crucial en términos de orientación y es indispensable por reasignarles sentido. Sin embargo, por muchas razones, algunos padres pueden desarrollar, en los profesionales, sentimientos negativos que deben considerarse.(AU)

Autismo e parentalidade / Autism and parenting / El autismo y la parentalidad

As patologias autísticas são complexas e requerem uma atenção especifica para cada criança. Na organização que preside os tratamentos, a Psicoterapia Institucional tem uma grande importância devido à sua larga experiência com as psicopatologias graves como o autismo e a psicose. No projeto terapêutico da criança, a implicação e o papel dos pais são determinantes para sua orientação e indispensáveis para dar-lhe sentido. Contudo, por razões distintas, alguns pais podem desenvolver sentimentos negativos frente aos profissionais, que devem ser considerados.

Autistic disorders are complex and require a specific treatment for each child. For the organization that presides over the care, Institutional Psychotherapy movement is important because of its vast experience with severe psychopathology, such as autism and psychosis. In the treatments proposed to the child, the place of parents is crucial in terms of guidance and essential to reassign sense. However, for various reasons, some parents may develop negative feelings in the presence of professionals that should be considered.

Las patologías del autismo son complejas y se necesitan de una atención específica para cada niño. En la organización que ofrece atención, es importante el movimiento de la Psicoterapía Institucional debido a su larga experiencia con las psicopatologías graves, tales como el autismo y las psicosis. En los tratamientos propuestos al niño, el lugar de los padres resulta crucial en términos de orientación y es indispensable por reasignarles sentido. Sin embargo, por muchas razones, algunos padres pueden desarrollar, en los profesionales, sentimientos negativos que deben considerarse.

O pioneirismo de Louis Le Guillant na reforma psiquiátrica e psicoterapia institucional na França: a importância do trabalho dos pacientes para a abertura dos hospícios / The pioneering spirit of Louis Le Guillant on Psychiatric Reform and Institutional Psychotherapy in France: the importance of the work of patients for the opening of the hospices

O artigo apresenta elementos da vida e da obra do psiquiatra francês Louis Le Guillant relativos às suas contribuições no campo da nascente Psicoterapia Institucional / Reforma Psiquiátrica na França, em particular nas décadas de 1940 e 1950. O método baseou-se em busca exaustiva da produção escrita de Le Guillant, de seus críticos, de psiquiatras próximos a ele e da geração seguinte, analisando cada um dos textos referidos, cruzando as informações entre si e, sempre que necessário, com a história da França e internacional no século XX. Demonstra que ele exerceu uma prática e levantou questões teóricas que podem ajudar a compreender problemas que se enfrentam hoje na Reforma Psiquiátrica brasileira, no que diz respeito a temas como saúde, trabalho, moradia, organização, entre outros. Deste modo, este artigo busca colaborar para conhecer parte da riqueza da obra deste autor, insuficientemente conhecido.(AU)

This article presents elements of life and work of French psychiatrist Louis Le Guillant for their contributions in the field of young institutional psychotherapy / Psychiatric Reform in France, particularly in the 1940s and 1950s. The method was based on exhaustive search of the written production of Le Guillant, its critics, of psychiatrists coming to him and the next generation, examining each of these texts, crossing the information among themselves and, where necessary, with the history of the France and the international in the twentieth century. Shows that he had a practical and theoretical issues raised that can help understand on problems that are facing today in the Brazilian Psychiatric Reform, regarding issues such as health, work, housing, organization, among others. Thus, this paper works to know that wealth of works by this author are insufficiently known.(AU)

O pioneirismo de Louis Le Guillant na reforma psiquiátrica e psicoterapia institucional na França: a importância do trabalho dos pacientes para a abertura dos hospícios / The pioneering spirit of Louis Le Guillant on Psychiatric Reform and Institutional Psychotherapy in France: the importance of the work of patients for the opening of the hospices

O artigo apresenta elementos da vida e da obra do psiquiatra francês Louis Le Guillant relativos às suas contribuições no campo da nascente Psicoterapia Institucional / Reforma Psiquiátrica na França, em particular nas décadas de 1940 e 1950. O método baseou-se em busca exaustiva da produção escrita de Le Guillant, de seus críticos, de psiquiatras próximos a ele e da geração seguinte, analisando cada um dos textos referidos, cruzando as informações entre si e, sempre que necessário, com a história da França e internacional no século XX. Demonstra que ele exerceu uma prática e levantou questões teóricas que podem ajudar a compreender problemas que se enfrentam hoje na Reforma Psiquiátrica brasileira, no que diz respeito a temas como saúde, trabalho, moradia, organização, entre outros. Deste modo, este artigo busca colaborar para conhecer parte da riqueza da obra deste autor, insuficientemente conhecido

This article presents elements of life and work of French psychiatrist Louis Le Guillant for their contributions in the field of young institutional psychotherapy / Psychiatric Reform in France, particularly in the 1940s and 1950s. The method was based on exhaustive search of the written production of Le Guillant, its critics, of psychiatrists coming to him and the next generation, examining each of these texts, crossing the information among themselves and, where necessary, with the history of the France and the international in the twentieth century. Shows that he had a practical and theoretical issues raised that can help understand on problems that are facing today in the Brazilian Psychiatric Reform, regarding issues such as health, work, housing, organization, among others. Thus, this paper works to know that wealth of works by this author are insufficiently known