Meeting of the AUCTION, Reims 25 and June 26, 2010 .
The Making of care. Creating and Democracy
Workshop 4
Poiesis of an institution and by political Bénédicte Maurin
When Patrick Chemla representing the auction organizers asked me to speak here, he did it by stressing the importance of this cultural association to invite young people to participate in this event. From the outset, the auction raises ethical and political act by assuming a duty of care transmitting its commitment at a time when the training of all "psychics" leaves to be desired.
's my turn now to try to realize what I sent and the 39 others, all these meetings with me and support me in institutional work daily with children with autistic and psychotic but also to the team. A painstaking, almost invisible, extremely slow, the effects are not immediately apparent but which tend to question the practice of articulation of social alienation and insanity.
Hence the title, poiesis and political institution.
from the Greek poiesis poiein, meaning making, produce, create. Or how in manufacturing, the creation of an institution, the RAI (Meeting Home and Institutional), within the institution Day Hospital is a political act, through what can be undertaken.
Previously, children were in day programs. They participated in group therapy closed and more individualized care, but also more time to interstitial and collective. At that moment, prevails in the day hospital care psychoanalytic conception of letting it roll to a minimum institutional life based on some time host interstitials. The dimension of the political meaning of everyday life seemed to be suffering. With the advent of inclusive education, special classes, the SESSAD, the assumption becomes sequential. Children are now on short time. The day hospital to adapt to these changes, has removed the group shortly, retreating into small groups and workshops cleaved from each other. Children are mostly enrolled in small fixed groups meeting three times a week. From what they show, the team will provide care instructions to be validated and syntheses that will lead workshops on such tales, basin, land, psychodrama, etc.. It is thus closed groups and workshops that take place in well defined areas where it does not like that. Circulation of children are not favored by this arrangement of care. Given the increase in institutional violence, work days are held leading to the establishment of the RAI, a revolution in the day hospital, which is imposed by the Director. Revolution rather limited. This new body, on Monday from 16:00 to 17:30, includes most of the children cared for by the institution and do not necessarily intersect during the week and all the team members, maintenance workers and women Household understood through the teaching staff, psychologists, speech therapists, the psychomotor, the director, secretaries, doctors, the teachers. Following this meeting / weekly tasting, children fall freely in activities they themselves have proposed and subsequently implemented by the entire team present at the meeting. There followed a recovery team of a half-hour. RAI contrast sharply with any healthcare organization's day hospital: children raise themselves and their own statements and "trace" their way.
Imagine my joy! Coming in a place as a result of reflections on violence, an attempted arrangement of a club set up! Except that this little meeting seemed "natural" in a place of care was not at all self, resistance would emerge. Tosquelles wrote that "the resistance phenomena are triggered by geometric progression in our therapeutic action, when one moves from individual psychotherapy to the psychotherapy group and the institutional psychotherapy.
Anyway, the RAI is then established, and the team will have to walk with, grope, examine, get involved. I therefore propose, through this text, to follow our first steps, while emphasizing how Arnaud a psychotic child, took up the space.
Arnaud is greeted at the day hospital since his six years. It now has ten. When he arrived he was greeted at the school, ITEP and was placed in two foster homes. He had three weeks in one and spent the fourth in another. Gradually, the child has exhausted his interlocutors. At seven, he is de-schooled of Education, is no longer allowed in ITEP and the family home receiving the one week a month failed to resist. So he returned, this time there with her mother, who requested placement. His unique place for socializing and meeting with other children is the day hospital. The team held at all costs, supporting the attacks of that child. Still exhausted, she decided that at the beginning of 2009, Arnaud was no longer allowed on time groups because it makes them explode and undermines the other children. Arnaud therefore benefits from the month of September of class time in the hospital and individual therapy workshops.
early September, then, on Monday, the day hospital reopens after the summer holidays, the RAI stands at tea made especially for this occasion by one of the weekly children's hospital. At this first meeting, the director, who was the project to re explained to all the framework and basic rules of the collective moment: everyone in the school participate in the RAI apart from the little ones who are likely to be troubled by the large group. Oddly, the ladies of services and the maintenance officer was missing, we obviously "forgot" to invite ... This "forgetting" that I tip discreetly at the meeting of recovery that followed mark the work we have to do to move from a division office work to a collective sharing of work. The three ladies of service and maintenance officer joined us the following Monday for the meeting / lunch. Naively imagined that it was only the team "caregiver" who survive mainly on sharing basis with the healthcare team "maintenance." However, only two of the interview were included in activities. But two, it is a start. It allowed me a few weeks later to ask why they were not involved in recovery time and development around the RAI. Thus Aziza, Fabrice Latifa and Christiane are entering the meeting on the half-hour devoted to the RAI. Two months later, they expose us their difficulty: they appreciate being involved in the RAI and activities resulting from this fact but they do not have time to do their chores. We agree that at the end of business, we will hand broom. Initially we were 4 and we will stick, then three, then two ... and then two new recruits arrived so I caught, telling them that one of the first act of resistance to do here is to get the brooms! This RAI is slowly starting to work Team on the status issue opening on shared features.
Another example relates to the presidential office of this meeting. During the first months she was held de facto by the Director. But a Monday morning, he announces that he will be with us at the meeting with institutional children. Here is a new opportunity presented to me in the triad requestionner Role / Status / Position: but then, who will occupy the presidential office? I propose that it is now shared by all adults, not excluding the fact that it may one day be possible that children themselves can hold this position.
Upon implementation of the RAI part was given to children by the team: one does not strike another, whether child or adult. It is forbidden to harm others or oneself. The children were immediately seized this point, speaking and referring to what was forbidden, "it is forbidden to strangle everybody", "it is forbidden to shake," "we have no right bumping his head. " This illustrates how children are able to immediately take up this space to talk and conflictualize the difficulties they encounter in their lives. The following week, were read the sentences pronounced by the children about it. A teacher had the good idea to open a notebook specifically for this meeting. Children were particularly attentive during this reading, waiting for their words are repetitions. One of them even mentioned that his sentence had not been placed on the notebook.
He also explained that children at the RAI, one can turn to speak, make proposals that ask for some to be studied in more detail by the team to consider their feasibility. If needed, the return on reflection will made. This shows that workers are struggling to release their grip on children and create a degree of freedom showing poiesis and co-construction in pain.
Finally, it was offered to children to think about activities that take place after the RAI. Adults and children then made numerous proposals. Many children, supported by Arnaud, asked sports, mainly football. These children are among the older and more agitated. A debate within the team then took place about the benefit or not to propose a time of football: "they already play at recess," "mostly, they exclude the younger," "it goes wrong, they hit each other, can not play together '," the court recreation, concrete, is in itself an indication-cons to the practice of a sport "," sport is not really a choice for children, they were influenced by Arnaud ", etc.. All team members had in mind Arnaud. I argue that it took Arnaud, who just asked to do a team sport, was so far deprived of collective time because he did not wanted, making derail the groups in which it was registered, whether in school, ITEP, or day hospital. This time team sport could be considered as a possible space to be together because supported by his desire. Submit this time sports would certainly not easy but working with these children is also stuck with their difficulties. Upon reflection, we decided to increase the number of professionals attending the workshop multisport or 4 people who have volunteered: the director, a psychologist, a psychomotor and myself. I did not particularly want to participate in sports right now, instead wishing to establish a newspaper, but the support seemed necessary, so I registered. The maintenance worker, once he was invited to the RAI, was also included in this activity.
The team had already planned the activities they would like to propose, but after that meeting, the majority of the team decided to leave the children's proposals: asking them why they think so after the fact we do not keep account? The proposals are children, mostly become real activities. The desire is their speech which is then taken into account. The establishment of the RAI is indeed a beginning of a therapeutic club, opening on empowering children
Moreover, children are a Monday to the next shift activity and even move from one activity to another to realize what is happening. Soon, this group can "open" for these activities came to question members of the team, used to work from closed groups. Some colleagues ask so that their activity does not remain open to new children when it was started. Colleagues highlight the break in the growth of activity and the effect of intrusion that may have previously formed the group. What activities can remain open, accommodating any time a child is not a problem to the team from when others remain closed. After a year of experience of the RAI, it is clear that all activities were re-opened and this time of RAI is one element that makes us work on the institutional divisions.
By the second meeting, the children had also thought about this new space they were proposed because some responded by asking if there was a "swing activity," "speech activity", it was possible to go "with Chris," a teacher who does not work because it can not be present on Monday, or "with Fabrice," the maintenance man, "for a real job." The children then link the issues that we had not considered: we can choose the activity not on the media nor the status but according to the person who holds it, so depending on the transfer? One is obliged to enroll in an activity? This question was taken in a meeting and we agreed it was possible that some choose to do "nothing" or "to swing", that choice was respected, it was a rare moment " do nothing "they were allowed. Three team members have thus become "flying" that is available to children who do not wish to choose work or not is yet to make a choice.
Finally, the organization of care is emphasized, for example, Arnaud, the fact that we are not always able to play with others, it's not serious and that is the possibility to do something else, which does not prevent us from returning to their chosen activity the following week. There may be sidelined from an activity without much to exclusion or isolation room of appeasement because others are there to "greet" the child concerned, who can either build on wheels, or incorporate another activity. The meeting
RAI is often a huge mess. Difficult to hear and speak. Also difficult to keep children attentive when they have finished snack: they tend to play out in the yard, to move back and forth, stirring up. Little small, we try to adjust the lines of this meeting by proposing that the time allowed to take place at the taste, while the kids eat. We try various facilities of the tables in the room, use the blackboard to record the agenda, etc.. Without success, hence a certain discouragement.
A colleague points out that we had set as a basic rule that the children were not forced to participate in this meeting. They know they have their place, they can come there, that's where things are said. But they can not reach. Some children, when they will not well, protect themselves and protect others by staying in the yard. Other children simply can not, for now, where they are entering a room grouping so many people. And yet, he arrived as team members keep children out of the room, thereby amplifying the excitement of these children but also by other contagion.
Maintaining this institution remains precarious. One day, the RAI almost did not happen. During the tasting, nobody spoke. The children are then taken out. We were more than a few to expect. It took out, sound the recall of adults and children for the meeting takes place. Nobody was allowed to take the presidential ... This has had very little to the meeting goes out the window. Tired, I sat down and had ensured the conduct of meetings.
In return, we'll talk about the climate of violence. The team is tired, tense and worried about his working tool. The accreditation approach, protocols may appear on the horizon, the psychiatrist we troubleshoots a half day per week on a full-time because we can not recruit, the hospital is fiscal consolidation, Post disappear, we can not do our job as we would like to do, etc.. Children feel our worries? How does that play there on their behavior?
The following week, again, missed the meeting has to be retracted. Opting for the secretary, I installed when tasted with the meeting book, among the children. Time passes. Nothing. Children start to finish eating, some are already out. I am speaking to a colleague who takes the presidential office? His answer floored me: let go, we'll see. More and more children are out, adults with them. I turn around and speak Two other colleagues: we do not have the meeting? Again, the answer is disturbing: Yes, well, it's been three weeks since it slips, the director has to be there! A feeling of loneliness I traveled. But why consider that this meeting may take place in the absence of the director? Holding or supporting this meeting? I resigned myself to write the book that there had been no meeting that day and went to the store.
Fortunately, another colleague responded and went to fight the recall. I get out my notebook and reinstall.
In return we decide creating a collective presidency of the meeting.
The team decision seems necessary for some colleagues who thus feel legitimized to take this function. This new attempt at arrangement did not last long: the other felt completely disengaged from the conduct of the meeting, leaving us to stew in the semolina. To get out, I decided to lean on children, referring to that meeting their demands, using the specifications, nor for the record of the meeting but for the establishment of order the day. Arnaud helps me: at my suggestion, he picked up the book to say that educator he has spoken ill, he proposes an exit alley, he enrolled himself in the name of a child who would not dare ask to watch the match of the World Cup, etc.. Meetings are always difficult but I am beginning to have allies among both children and adults who perceive that this space can become an area of say, a space where there can start discussions and decisions that will not delayed by a recovery team. This would not have been possible in September. The team first need to walk with this new tool. Delion Peter reminds us that "accountability of caregivers do can be achieved by allowing the establishment of an independent progressive group functioning. The definition of the democratic structure given by Kurt Lewin is found here: directivity in procedure and not directional in terms of content. "This structure enables the personal reappropriation, the alienation by the rediscovery of what Moreno calls the creative spontaneity."
In a moment of anxiety about its survival, the day hospital cleaves and stiffens his care organization removing the functionality of its joints. The dialectical role-status-function is blocked in a device penetrations into the hierarchy reinforced by the statutory procedures for accreditation.
The creation of the RAI is a first step from what Delion called "the statutory hierarchy" on the side of the object container to the "hierarchy subjectal" on the side of meaning, purpose content , ie the subject. Recently, the team plans to rethink its development tool, that can again practice the "metaphorical function" well down now. Indeed, elaborations spaces are modeled on the areas of care, they are also cleaved and it does not work: each time with a child care must have a recovery time between professionals engaged in this task. Then, for the same time these same professional care and should be put in place a regulation with an additional psychologists of the day hospital. Finally, meetings should take place international workshops bringing together all professionals animating groups and workshops around a child, always with the presence of a psychologist. Finally, the summaries have leagues, bringing the whole team and putting the care instructions. If a member of the team involved in a child is absent or workshop, or if the psychologist animating regulation or meeting international workshop is absent, then these are set aside time for reflection. We spend so much time not to mention children.
The RAI has put a little oil and play Arnaud, during a RAI, said that the Director is absent but that the activity will take place multi anyway. It comes to show that it is extremely sensitive to the continuity of this activity. He points that the organization of work allows us to host it.
Admittedly, a lot of work remains to be done to continue the deregulation, encourage circulation and bring all these scattered pieces of the care each other. RAI, so I come to speak of the interest meetings constellation. They would gather transplants transfers scattered here and there. They would tend -1 function shared by all and not vested in our psychologists. By refocusing work focuses on the child and not on the issues of narcissistic and caregivers take into account the effect Stenton and Schwartz. Some still cling to their device "pull" of meeting, but others seem to begin to take on this idea. In any case, a debate was launched.
This week, a record of the year RAI has occurred. While I expected to have to fight for its renewal, colleagues surprised me: they have adopted and are even beginning to go further in their thinking, wondering whether it would be useful there may have other areas in the week, echoing this institutional work. Gradually, the RAI is small and my proposal for a workshop open daily all the time after meals interstitial interested.
To conclude, it remains difficult to convey such practices and policies for home care madness. The slow and institutional inertia are sometimes seen often daunting. Hence the importance of having an elsewhere, places like the Other Auction to relax and regroup, for example by doing work on his work. This is how I can accept some solitude while continuing to sweep the resistors together dust.
Bénédicte MAURIN
educator specializing
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