SC. Colloque 2019. Working with the Impossible par Avi Rybnicki

En préparation du Colloque Psychiatrie-Psychanalyse des 26-27 septembre, Avi Rybnicki, membre du GIEP-NLS et de la New Lacanian Field Austria, enseignant à Dor-a Section clinique de Tel-Aviv, répond aux questions de Pamela King, enseignante à la Section clinique d’Aix-Marseille.

Psychoanalysis and Psychiatry – Working with the Impossible

The romance between psychiatry and psychoanalysis has existed since the latter was founded, and is rather similar to a love-hate relationship. Freud criticized the fact that psychiatrists and neurologists are content with the categorization of psychological suffering, while psychoanalysts have the task of influencing it. An interesting point of view, since it accused psychiatrists of an ethical problem, in the sense that they do not really have to commit themselves to their words, as if they were without a commitment to the real (if a diagnosis or categorization has no practical consequences, there is no real commitment). Many will reply to this statement that it was made before the invention of psychiatric drugs and that since then the role of psychiatrists has changed from that of administrators to that of healers. Has the existence of psychiatric drugs dissolved Freud’s ethical objection?

I don’t think so, but it displaced it, and in a sense even exacerbated it. There is no doubt that psychiatric drugs sometimes have an influence on the subject’s mental state, but it is a question of when, which kind, and under what conditions. The answer lies in the ethical attitude of the psychiatrist. Here is a brief personal testimony:

In 1978, I was 21 years old, a new immigrant in Israel, could hardly speak Hebrew, and studied psychology at the university. I was bored during my studies and was looking for something else. Through an acquaintance I had the opportunity to meet with the director of a psychiatric day clinic, psychiatrist Jehuda Fried, and I asked him if I could work on the ward as a volunteer. He looked at me and said, « Come for a week and if you don’t disturb the patients, you can stay. » I stayed two years, four times a week, I hardly saw the university. I learned from Jehuda Fried classical psychiatry, Bleuler, Kraepelin, Clerambault, Jaspers. I also learned to listen carefully to the language of the patient, the phenomenology of clinical signs in the best sense and much more. Above all, I learned to respect the singularity of each patient and their dignity as a human being, not as part of a classification. My analytical path also began there.

This attitude stands in stark contrast to a psychiatry that would rather make itself a bureaucrat of the DSM scales, a servant of the pharmaceutical industry and thus itself superfluous.

From time to time we psychoanalysts in acute cases need the help of psychiatrists to enable the subject to speak. However, we need psychiatrists of an ethic, like for example Jehuda Fried had who acknowledged the existence of a lack and considered that speaking and listening were necessary and valuable. Unfortunately, these are increasingly rare in this moment of capitalism, of globalization. For this very reason, however, psychiatrists need psychoanalysts more than ever today in order to preserve something of the subject in themselves.

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Catégories :Colloque Psychiatrie-Psychanalyse