The following is the full transcript of the workshop of the Centre Region Days Cross-National Marine Lille in September 2010, note written by Dr. Michael Lecarpentier.
It was not possible for practical reasons of publication to integrate this form into the issue of the Journal of Mental Health Practice devoted to those days. It seems interesting to propose here read the full version better articulated than that which has been shortened.
Lille WORKSHOP 5: report written by Dr. Michael Lecarpentier
PSYCHIATRY GENERAL HOSPITAL AT RISK : EMERGENCY (S) AND / OR CONTINUITY OF CARE?
250 to 280 people attended the two phases of the workshop by a lively sixty interventions and exchanges between speakers and audience. We chose to return them at best and not to censor the interventions to preserve their evidential value of land and real working tool that is to say how the professionals get to work their institutional analysis. Their quality will tell the quality of the questioning of these two days.
Dr. Oury recalled the history of the Federation Navy Cross he knew "two years before his birth in 1949" when the Centre Corporation was established by Dr. and Mrs. Doussinet Delaunay. This group followed the work of the Hospital of St. Alban Tosquelles initiated in 1940. "Healing Hospital" in the words of Herman Simon was working, Oury said: "no cell, no restraints, no quarter closed, and all patients had responsibilities regardless are their levels and pathology. Caring for people after they leave the hospital required first deal in the hospital, developing a permanent feature host of the most difficult, doctors, nurses, all patients, by distinguishing the existential register of home that of the inlet and its bureaucracy. And since its inception in 1953, Clinique La Borde was developed with the Hospital Committee and the Club Therapy, a hospitality function generalized. "
Serge Cadassou, nursing Unit for Sick difficult Cadillac presides as a cultural association for a year, Serge Beder works in another hospital unit and emphasizes the importance of this cultural association, civic association in the city and the hospital: "participating professional care of persons deemed sick and others interested in the report to others in their uniqueness and their differences, so many opportunities for meetings are available by spring of poets, painting workshops, exhibitions, debates, film, etc.. All this creates a mesh in the city which includes the hospital and treated silos, segregation and fear. The Director arrived earlier this year, Mr Jacques Laffor, supports these initiatives and Serge Beder diffuse, with his agreement, the text of his interview in the newspaper. He stressed that "it may take administrative functions today and think about skincare. It should know: his arrival changed the atmosphere in the hospital, formerly deleterious, as had been discussed during the days of Nancy in 2007. Is a director with whom you can say hello and replies to e-mails he received, apparently rare experience in this hospital we saw up to thirty CRS in a corridor not so long ... It is important that the atmosphere is changing today; indeed, there is still resistance to change in the hospital and all the difficulties that a group had tried to work three years ago by asking: "What if we cared?" How do humans know strung on a stretcher in an ambulance arriving, how to say hello in such conditions? How to make a living has few chances to turn into personal journey?
This raises the immediate question evocation of Mrs. E. representative of users UNAFAM: "Who will alert you when a patient goes wrong in the city? How continuity of care is organized she? "
Oury cites one case among hundreds:" A young woman arrives at La Borde at a hospital in Paris where she had been attached, Submissions had been sick when the great teacher shows a patient to the general public, labeled schizophrenic, false diagnosis: it was a very serious hysterical psychosis, of various TS, the latest by going from one place to another in the late afternoon (she still experiences the world when it comes late in the evening): open fracture of the femoral shaft after jumped from a second floor. She arrived one morning hysteria evident, we speak: "What would you do? - "Be a clown and ride a horse!" - "With crutches? At the edge there are horses, a woman takes care of the horses and another will be here tomorrow, she has trained clown for seven years. "She was delighted, there was a special touch. A month later, the terrible anguish at dusk must see every day, not alone, with the club: the best reception is made by patients who had received. Anxious, she drops from its height: neck fracture on the same side, fortunately, she had necrosis of the femoral head. It was a Sunday, the same evening it was made, we went to see her every day at the hospital, she was never so well in his life since that day. At the Borde it is never locked, when there is anxiety, it appears, he speaks, he gives a ... Tranxene weeks ago: "I'm afraid to hurt small children! ; - "Go to the nursery with someone." She went several days. A smile, emotional warmth, she is very happy to go there: should be with her, it's part of the intake function. "
Manon, a nurse coordinator SAMSAH" Hospitality is problematic emergency, the relationship between health and medico-social are not very good, "you're not a doctor, it is not you who will decide the hospital! - "I am a nurse, it has been two months since we work for this hospital ..."
Isabella "at the day hospital we have no answer either for all cases figure ... The families are in disarray, when an emergency occurs at home, the problem is known: the problem of the acceptance of care. A psychiatric emergency is when it goes up in tension for a very long time and it worked out for a very long time and has a hard time when we no longer know what to do, which is the family environment or SAMSAH it there is an ambivalence to care, enhanced due to confinement, the restraint that were often already experienced police, fire, etc.. These situations require other thing is the importance of active prevention.
Marie-Christine Hiebel stresses in this case is not made solution and concerned about the risk of hospitalization systematization of 72 in the draft Reform Act of 1990, depriving people of liberty for three days, ignoring the human issues most worthy of respect: the uniqueness of each and its history, freedom.
For Oury must historically situate this extraordinary degradation. In 1949, with the internship CEMEA, it was for George and Germaine Daumezon The Guillant to remove nurses to train and be able to leave the sick. Then many things happened: Philippe hinge, in 13 th arrondissement of Paris, which had 160 000 inhabitants dealt with his team of all emergencies, night and day, accused by the police, they talked with peers, family, neighbors, fellow bistro colleagues work, "vicinat" To come into contact with fairly and without violence. Cross Marine has changed the atmosphere in hospitals and the city. But in the '80s, began the degradation with the suppression of psychiatric nursing schools in 87, the numerus clausus in psychiatry since 1992, which is that there are now 1200 posts vacant psychiatric hospitals, restricting the teaching of psychiatry in DSM IV, behaviorism, cognitivism and neuroscience simplified, phenomenology, psychoanalysis, sociology, in the trash. The closure of hospitals that put the sick into the streets and in Italy after the Law 180 in 1978, were used restraining devices in family ... We see all this shows the logic and managerial bureaucracy that are part of this story . The UNAFAM develops, "we'll take care of the sick if you're not capable professionals!" The Minister of Health in 1983 in Los Angeles announced the abolition of money for the Sector. And it's not enough cells, restraints, cameras, fences, walls enhanced, vigils, this is what the money is used today.
Dr. Roger Foil cites the case of a couple living in northern France, at Bordeaux their son, his parents, in their embarrassment wanted to bring it to heal. Council of HDT, they waited six months and the situation worsened with reluctance, but their son could hear them a bit and has consented to treat, requiring hospitalization free. It gets better quickly and in eight days, he is outgoing; three weeks later he was in prior to hospitalization ... back to square one. Such situations are frequent confirm many of those present. One patient was returned to the streets in Libourne, without his family, who lived 60 km away is warned: "we would have gone for him." The only logical explicit restriction of beds, "come back when things go bad! .."
A young psychiatrist Lagny-sur-Marne protests: "We must say that the future of current patients is no longer the hospital, they get married, go right, children. It is true that lack of beds, but before, people who had mental disabilities were in the same place that people who need care, this mix was wrong, it means families, there is work well fact in psychiatry, it's much better now. "
A psychiatric nurse in the Pas de Calais:" we are talking about the emergency and continuity of care, we have to focus on hospitality persons requires a bias anthropologist, after a series of failures, the person must meet a personal perspective, our role is to offer him, and sometimes it is the families who deny or reject our response. The current system is consensual, afraid to face some conflicts. "
Patricia Carlier Paul Guiraud, Villejuif talks about the transition from health to medico-social hospitalized for long-term. Not easy to enter, not easy to get away with abuses safe: eg for involuntary admissions, the Prefect of our department requires a clearance ... Sometimes it is common sense and protection of the people to postpone hospitalization using a network strategy to introduce the logic of care in various devices. But I can only speculate on what happened before: there is a duty of memory. What did we have lifted the restraints, open the cells so that today we come back? We must question the citizenship dimension: when it comes to emergency care, consistent Medicine Surgery Obstetrics, the person is sédatée and directed, we must admit that the profit is zero for her. There is a drift with the law of 90, hospitalization of very short duration: it must re-examine the situation from the emergency power to build a different kind of care.
Roger Foil: "there is still some fifteen years, something was suggested in situations where the emergency is looming: CMP consultation, home visits, but today the response is slow and sedation is the only proposal and orientation is unknown to the person who wakes up without knowing how she arrived where she is. Previously, he was put in links for people in relationship, because the future of care is being played at this level for an existential continuity is preserved. The doctor and nurses need to be specialists in emergency? Get sick and tell them to go elsewhere, is the home?
As for the theme of psychosocial rehabilitation, too often it is in six months to become citizens cured beyond six months, we can not do anything for you, then we are dealing with people who do not fit and can not live ordinary family. For rehabilitation, do we offer a real support? What is your life plan? Learn a trade, get a house, a job and find a woman or a man to share my life .. These myths are current available, or do we share this normative stereotyping because of our alienation granted? It is not possible to keep the necessary links with psychiatric services, since we cut this dependence and send off patients to become normal citizens.
As for ESAT, they offer workshops regular hours and civic and community life, often juxtaposed with a residence in homes priced around salary, minus the cost of meals, transport potential, the rest for some recreational activities, all of which are sponsored by a measure of protection. This lifestyle is appropriate to disabled individuals who are docile automation of work and an acceptance of the routines offered to their social life. The duration of their contract was for thirty years from the time of CAT, it tends to shrink because of new requirements for profitability of the work of ESAT where elders are leaving because they are no longer adapted to the new standards , about people with schizophrenia, after three or four years for the most obsessive too paranoid or persecuted, they leave the scene prematurely. Their pathology is more complicated disease processes remain active throughout their lives: how to keep their balance? Offer regular sequential hospitalizations before degradation is unacceptable? It is essential to maintain links with health and not to sever the social and health care. It is not necessary that each domain is transformed into turf, it is necessary to promote the movement of teams to talk about the person together, their freedom of movement built by these working meetings, so that people can find meaning psychotic tracking space to another, the articulation of these discontinuities in spatial continuity experienced by the structured logic complementary approaches to the condition that they may be making mental connections with each other. "
Serge Beder:" We must dismantle the emergency ahead: re-examine the history and its contexts, constantly put the psyche at work by passing people. Thus the person whose HO was lifted in order to come to La Borde after 8 months and 8 weeks in an isolation room. We can manufacture or nonexistent emergency. The remeshing discourse is very important.
words I facilitate a group of parents for 15 years, he expresses himself stories of humanity that does not take away from that place. Hence the title of days the Pau next year: families or resources. This upsets the performances. Abuse of emergency is also a consequence of the managerial model, we bet that it is not inexorable and that it can move. "
Marie-Christine Hiebel:" I think the danger is increased when we no longer speak as the logic of devices, the logic of the camps was a logic devices thus had their ideological rationale, objectives, their ways of speaking, after the war, we tried to recreate the very foundations of this catastrophe, human relations, to Borde, we are dealing with people, there are links of familiarity, knowledge, and the hospital emergency devices are anonymous, they forget the person and their history. The question of urgency around these issues. "
A Father:" My daughter told me: "I know what to say and what to say to get out" and often The hospital sent back because she knew the key phrases ... At the UAO units, reception and orientation, there were windows, blinds, and two people behind their screen. After 20 minutes, someone picks our daughter and give him a list of homes for public housing that takes positive steps. We knew that without drugs, the crisis was growing. We posed this problem and discuss the staff went into the office and after 10 minutes, a nurse comes up: "Your girl is quiet, hospitalization is not necessary!" We have insisted see a doctor, spoke to our daughter out, we waited with her and it did not evolve. I raised the various punches on my wife and me when I was trying to separate them. She said she knew what to say to get in, so I launched the subject and showed how far she was in crisis. But until then, in the quiet words, our request by our daughter and our parents, not enough for it to be heard in his distress. "
Patricia Carlier:" It is difficult for parents to think what strategy to deploy. Systematization of forced hospitalization and use of UMD in the wake of a passage to the act reflect the inability of the health care team to meet the patient's discomfort. At the exit, this stigma is always difficult to negotiate between the patient's family. "
Cadassou Serge:" We welcome people to the UMD, often as a result of very complicated situations, which are often unrelated to one patient. When teams do that confinement to offer, they can do it once or twice, but then it becomes increasingly difficult, even impossible, so we get sick more often than not dangerous, but disrupting the units where they come from. Our service is impressive: the walls are 4 meters thick, is afraid to enter after passing the second door ... We take time to analyze what part of the behavior, disease, and to offer these people the best path that will allow them to return to their hospital. But back in the units is not simple, the UMD suggests that the person is dangerous and those who sent the resume to the isolation ... It's really a mistake, I say. Much of our work is to prepare the UMD person as soon as possible: "you have to struggle against the prejudice that you're a time bomb ... We would meet with teams to train them in the relationship, but we do not have the budget for it. There are also patients genuinely dangerous, those that must be wary are rare and account for 5% of cases. "
Oury:" Last year, Cadillac had a nurse talked about the atmosphere UMD. Just as Dr. Eve Marie Roth, who had worked 20 years Sarguemine amending the atmosphere by the methods of institutional pedagogy, power up, with the agreement of the authorities, get grants for travel therapy with patients UMD of the Ballon d'Alsace. If in services, we applied these methods, we send fewer patients to Cadillac where the atmosphere is much better than in some hospitals. "
medic Digne, in Day Centre is as nursing dinosaur with envy to continue his job he has always done with joy, but he said: "I'm still going to retire! I'm angry! What we did in 10 minutes, it should be done in 5 minutes today, and we can not know, nor argue the need to do as we do even If this sounds time-consuming: should all have an electronic bracelet? Anxiety attacks at night, we need to listen. We make a schedule of therapeutic activities, and last week, I heard myself saying "it takes away something for everyone, otherwise we will not bring in new patients. A patient can not claim to have 3 trips a week in VSL, when one is mentally ill, you should not live in a backwater! "I do not want to continue with what is happening in this country with the mentally ill. A person close to me made a schizophrenic crisis persecutory delusion, I had to bang on the table so that it is allowed, my sister had to take her home my nephew 25 years, because the duty doctor at the hospital said: "Should not bring yourself, but call the SAMU. I had to ski back to bring him, he was faced with a huge fear psychosis. "
Marie Christine Hiebel tells the story of Andree between emergency and continuity of care: Andree is on the Board Administration of the Navy Cross county, she lives in the city, not very away from the general hospital and day hospital, she has a history of self-injury, aggression, a difficult and eventful life in his report to health care. I get, "she said, a call from another professional caregiver who is also involved in CA:" carers Andree are concerned, it whitewashes the floor of urine to drive away evil spirits. , "We talk to many, without being intrusive and decided to go to his home. It sounded, she sees the nurse hesitated ... I talk to him through the door, I'm Marie-Christine (I am the driver when it comes to board meetings), it opens the door. I am struck by the pungent smell, it would be really difficult for household help ... We are talking about the Navy Cross, the next Board, they soon learn that a person squatting in his apartment ... his costs, we propose to meet household help, she agrees. Recently, a few days ago, she went to hospital emergency she knows, toll free, it's not bad, after discharge, she agreed to come one day a week in hospital day. There was more relational network CATTP in, it was isolated, it could have been an emergency, our response has renewed contact with a shared history, statutory dimensions are quite ineffective in this situation where the delusion prevails, it is bits of ancient history that led to reconnect with her and put in motion on a psychological level. "
Serge Beder:" History at UMD: there is normally receives that emergency and medical-legal issues, but it happened that persons seeking admission to UMD. The first hospital had run away from his home, fortunately the doctor has agreed to host it. It was not easy, many people saw in this home that problems could arise, for example, to strengthen its brand power: he was not indicted, he is conquered territory, It will do this or that, and so on. One day I pushed a bite. "But what's wrong with welcoming someone?" That has cast a pall. This can pose a discrepancy in the environment was very beneficial to this patient, it lasted a year and then he asked leave to return to his hospital, the doctor has accepted the UMD, but that its industry has refused to resume. It has been six months waiting, we said we're going to have any life ... He committed murder, etc.. We finally managed to think what was happening: he had a significant problem and that "someone wants to feel it, it would help to ask" We ended up finding a service which takes in exchange for another person. Some had bet that do not take more than a fortnight, it has been eight months since he is there ... We have spoken to many, talk about his depression, massive that it could talk, and talk to us. Many of which have left their home phone number. It is well. The reception is fundamental for someone to be there and hold. "
Beatrice Benatar:" We must treat the places where we work, we need to invent new products to treat what does could not articulate "
Tomorrow, all unions of public psychiatry will launch a strike against the destruction of industry and reform of the 1990 Act.
Marie-Christine Hiebel "policy positions are important, as the development of medico-social while the health field is limited, this corresponds to a certain conception of human ill."
Maguy Monmayrant: "A young man of 27 years died a month ago. He had made four TS. I intervened to say I was very worried. He had jumped from 5 th floor, the diagnosis had poorly argued: "it's just a crazy time, but not a TS!" He jumped off the bridge over the canal, his life was hanging by a thread, it no longer holds. , "A nurse
a SAMSAH:" I worked then as CHS Outpatient Setting, I knew the difficulties, the VAD and CATTP canceled, I retired before age and I work in a psychiatric SAMSAH. I thought they gave us the means but not the same job: one addresses to people out of care, sometimes for a very long time. The disease appears to no longer dominate, they have a mismatch in their social ties, their homes ... Their problems are low noise, they do not disrupt society ... It's the same audience, but not at the same time, they live in incredible special conditions of sedimentation. There is a problem of means of public hospital: there were more resources in the CMP, there was no more activity was dire. There are ways in SAMSAH ¾ of the public attending the CMP. Social workers are supposed to work complementary care, but we must establish links with the hospital. "
A Psychiatrist:" You can not work properly in the industry, how to find the means? Madmen are not dangerous, and not a public health problem: just listening and being able to echo, as Bonnafé said. How do we make of budgets? Should we play the card of safe?
Sector taking the time, was able to reduce the number of acting out potential. I'm for humanism, but this approach to our society comes from Anglo-Saxon: Wild digit gains in all sectors, the bureaucracy too. Numbers, should we offer and say "there is 32.8% improvement, the sector works, here's the proof!" The management of care is questioned, what Does the medico-social? In many institutions, medical monitoring is done by people passing, temporary, interim CDD sometimes lasting a day, what meaning can it have? In accommodation services specialized as the DSS, for accompanying physical care, psychological support but is less good. "
" When someone is hospitalized for a month, there is great risk that it loses its housing, said Dr. Peter Vaneecloo must develop associative houses as permitted under Article 93 of the Act of 2002, but today, psychiatrists Valencia for example, no longer willing to intervene, and patients it can maintain healthy enough without this therapeutic intervention, we are forced to close some of these houses, colleagues current will not reflect the history, their training takes them to a strict approach symptomatic. "
Oury: 'The problem of partitioning is not new: 35 years ago to Caen, in the studio Navy Cross with animations that we Tosquelles, he spoke of the sector and already there was a degeneration as early as 1975: there were nobles, those of the city, and the ignoble, of those hospital, the dump. The organization of the sector, he said, must be managed within the same Club Therapy, for there is no gap. It is not only in psychiatry that the problem of partitioning arises, the division is part of the bureaucratic problem. "
To resume our work on Tuesday morning when these are as numerous as the day before, Serge Beder presents a clinical vignette: "Alain is three years in a service entrance, it is not too restless, very sick, he may still be there, his story seems forgotten. With the race to bed, it must give way, move into the hospital, Alain agrees to move, he does it at full speed, as requested, and said: "I do not want a story!" And he began a crisis that is customary: he dismantled, is taken three or four days in contention, with injections, a real baby Gulliver tall and corpulent, he can hurt by clastic awkwardness or hurt herself autoagression, our doctor friend is in trouble, although it is in the Room isolation. It was programmed it to go into a foster family he knew to have been placed in his childhood. He was in a trance and we also did its reputation, as if we had gone around his personality and that our institutional transfer could not be questioned: he always manages to defeat them ... We supported decide to try to talk to him about what we have in mind about him, he calms down. A few days after the return of appeasement, he takes the train to go into the family home, but on his return from Orleans, he had a fit in the train and were found to emergencies where we will look at 450 miles from Cadillac, a colleague and me.
Weeks later, a Saturday morning at 6 o'clock, we go to La Borde with another patient. Alain me: Serge, Blois, not far from Orleans!? Surprisingly, he who never asks anything of Orleans, he tells me about this family home: I'm tired of taxis, I can not come with you? After 3 years without a plan ... "Dr. Michael
Lecarpentier:" This event makes us think the big difference between having to accompany someone in a geographical area and act psychotherapeutic of sharing knowledge of a place and be with someone to build a sense of continuous existence (Winnicott) between this place and invested another. The speech opens with a topology that articulates the existential discontinuity experienced in transference continuity in dialogue. "
Serge Beder:" Absolutely, and we do this trip soon after and when we go on the bypass Bordeaux, he said: "This building there, and my mother lives with my stepfather, we went shopping together!" Arrived Chambord, light attack his eyes is gone, the crisis ... We keep our presence degradation and go to the scheduled appointment at the Clinic Saumery. The first contact with the doctor is on the ground, Dr. Fontaine sits on the floor beside him, they were able to talk a little, for a few minutes in this position and Antoine Fontaine him: "You could Maybe spend a month here in a while? "He must go with us in his family home near Orleans, and therefore we leave by car. The crisis continues, we must stop repeatedly to make a fifty km in the Sologne in this beautiful Sunday ... But now a phone contact whenever necessary with Michel Lecarpentier which luckily was not working that day ... And patiently, 13:30 to 21:30, we have put into words what was happening, and able to coordinate as much as possible words and body, he eventually escape and slept in the family home, and we also ... The next day he returned to Saumery standing.
Back to Cadillac, "I could call my mother?" I was amazed, four years he had had no contact with her, he knew his phone number by heart. "I'll call you because it will soon be your birthday! .." I had a little contact with this lady. I negotiate a meeting ... It is a story in narrative signifiers turn 33 years without being able to say "fall, hospital, death." About her first husband, the father of Alain "Alain was a child when he was sick, he fell, was found to emergencies the hospital and I went to see the impression not to recognize death, now that I did not know so much ... "Her second husband:" He fell down in the room, he died, he had won, I did not supported. Then Alain fell, SOS doctor came, it was 4, my second husband died the 16 "since he had not seen his mother, and was not going to the funeral of his stepfather . Shortly after, his mother takes him, he buys flowers "for my mother, "we take the road by car, because" you have to turn right is the cemetery ... "And he will place the flowers on the grave of his stepfather. He did not speak to his mother.
For his departure for Saumery, he is packing a suitcase choosing long before offered by his mother ... We crossed the gate of the clinic, he sits beside me in the front seat and said: " ; Do not worry, I'm happy now! (N't'en not, I'm happy now!) And between singing this song ... Afterwards, he resumed contact with his half-brother, which is 20km long stay there, they had not seen for 15 years. He invites me to lunch with his mother, his sister, with whom the bridges were broken ... Work Area expanded, with the important fact that someone is there in flesh and blood, to graft a quilting point, an entry which will allow it takes more sustainably. Now he travels between various places articulated with each other: the Home Life of his half-brother Orleans Saumery his Foyer de Vie in Cadillac, consultations, visits to her mother ... "You know, before I was panic attacks, is in the past, I make more!"
This brief monograph provoked many thoughts about body image and its manifestations in relation to the elaborations of Gisela Pankow (The body as a structural model of space and the therapeutic space as what can structure the body image), the importance of continuity of care assets, collective questioning when difficulties raise an embarrassment and does not cease when a nurse or a professional spell with a sick person in town they leave with the institution, with the psyche of others behind, and Serge Cadassou remembered what humanist which we refer in our actions: we must include in this reflection to keep a sense of what we do and that makes us be closer to the difficulties of patients in their relation to language, it is not only to adopt the role corresponding to our own graduation, but beyond that, to be taken on the basis of our speech humanity.
Several speakers expressed their concern of having to question or even exceed their statutory role and their place in the organization of work. They perceive as differences in degree of value and guarantee recognition reassuring without being provided assigned to a particularly insane. Others have said the contrary part aliénatoire feel so heavy.
Serge Beder confirmed that indeed driving the car, he could be seen as biting their job to staff the garage, but in the transference field, another logic became prevalent: Dating in everyday life are beyond accounting logic, the basis of therapeutics, and a hostess of a home came with him to find a patient Borde, to facilitate continuity testing existential discontinuity spaces. He stated: "We must support the availability of those in contact with a person to revive the desire, communities are often on the side of boredom and the psychic death, the assumption of the exchange transfer atmosphere, the atmosphere in the Collective. Allow people to move in a structured relational fabric respecting their way of being and expression their desire that the meetings can make up ground toward greater psychological autonomy dynamic. "
Someone said forcefully:" The qualifications structure our society democratic and republican. "and another person noted "the return of charity."
Oury spoke, "the risk of history:" There is often atrophy of the story today questioning the internal Daumezon Who? Who is Tosquelles? This is not to forget the words of Pierre Legendre, we're in a post-Hitler, it is not finished. He uses this concept, he shares with Unamuno, the sedimentary history. For a month, there were nearly ten dead: Hélène Chaigneau, 90, who has played a fundamental role in the training of nurses and a host of doctors. I met her in March 1955 during an internship CEMEA which included the initiative and Germaine Daumezon The Guillant, nurses and teachers. It is very important for the formation and continuity in the work. Philippe Koechlin, who in 1952 proposed the name of institutional psychotherapy, and has worked with Chaigneau. The death also of Solano, a personal friend of Tosquelles, who had been general secretary of the POUM, a Marxist critical of the Stalinist positions, Trotskyists and anarchists during the English war. We are mortal, but must work on the development of immortality, which is a historical work everyday, Kierkegaardian position which is the historical basis of the actual history, and allows to place something in order to oppose the bureaucratic logic that has caused many deaths in hospital today. It should be possible to consider the elaboration of Freud who died in 1939, Lacan, who died in 1981, not the past: there is no past when it comes to ideas, or what counts is related to the concept of unconscious. If it does not highlight these things, it is difficult to locate work in practice every day. Irrespective of the Transfer, there is not much.
Today, we hesitated to go to Paris to meet our present someone who died in La Borde, Josée Manenti, who was the wife of Fernand Deligny and I've written a text to be read at the ceremony. It reads: "... Josée Manenti meeting there almost 60 years already! In the aura of Fernand Deligny after" effective Vagabonds, "" Seeds of crooks "...
Street bakers in Paris , near the Republic Square: a kind of secretariat for the "Great rope" ... A passion while discretion. Then the Massif Central and the long adventure in the Cevennes: the 'wandering lines' movies' this kid then, "the slightest gesture" Participating in this ... adventure, handling camera and staging.
Then the years to Borde. Deligny's passion and discretion with her, "Jo" Manenti. And Paris, once again, the Ile de la Cité. We went regularly to her for evening with studious people already "famous" ... She taught at the University, in all modesty ... And his encounter with Lacan, helping materially to prepare spaces for groups of the Freudian school ...
An impressive number of meetings, always with the same availability. Should resume the history of " Verzy Street "in Paris: the final meetings of the" GT Psy "groups of" AFGERI "with Felix Guattari ...
His sincerity, serenity, despite the events ... through the quarrels, the whispers, it was always there, welcoming. You notice that one can hardly limit such a list.
... And our trip to Corsica, a few years ago, at the Psychiatric Hospital near Ajaccio
... She had become used to come regularly to Borde. She was interested in all activities, organized reading groups. We thought a group dedicated to unpublished Fernand Deligny ...
She often lived in his home in Trouville ...
But in recent months, exercise patience uncommon before the inevitable: suffering, physical alteration progressive, in full consciousness.
Many people, among his dearest friends could not come today. It would be more able than me to testify to his character worthy and attentive 'every move' of each other.
I write these lines on their behalf, for testify before his departure for Corsica, François join his son in the cemetery north of Ajaccio.
May I, with all these people, bring it down there in silence, in peace. "
This is not a piece of literature. When installed a dictatorship, it's the story is removed, it is not far. Speaking of the Transfer, to resume his relationship with Freud, Lacan and even, locate it outside of all these horrors and current surveyors who pass like evil spirits ... The patients in dying and not even know they are sick. The Navy Cross remains a gathering place can always do something. "
SAMSAH a Nurse:" This morning we put up with our true values and the historical dimension. We listen, we hear. I have a course in psychiatry, I liked all his wealth, all its resources. At the hospital, there is the best and the worst, patients get there, there are associations with trained people and not others, it works excellently with some sectors and with others not at all. It is important to piece together a story with a team and take the pace persons. "
Someone:" The diploma has little weight, it was known even before the folly of having a book in your hands today, it becomes more and more academic ... "
UNAFAM A lady of the Somme:" Today, the institution, the hospital outsources ... "
Daniel, a nurse at Chalon- sur-Saône: "The degree does not guarantee competence, it can share the work with different degrees, nurse, I work on the social bond between CHS and medico-social, to allow each other to be approached to ensure that there is the meeting about investment projects to take out the psychic patients. I put in contact with other teams, it is still the order of reception. "
A discussion on working together, the importance of a history of hosting team the story of a sick person, take care of each other in order to care for the sick, a nurse has learned his trade from the team ISPs, the issue of training is the theme, March 26, 2011 Day of the Federation of Cultural Associations in Lille with Pierre Delion (Revue Institution, site of Michel Balat).
Roger Foil: "About the importance of history speaks Oury is especially important that the bursting of the history of psychotic people is now confront Bursting deleterious stories of teams. How to restore a social bond that recreates a shaping body image separated and allows the resumption of a frame personal history? In the Dordogne, a psychiatrist has retired, replaced by a younger colleague who did not take into account the history, suicides have reappeared ... That's what worries me the most for a young woman patient at which said: "You no longer have your place in the hospital!" It is a fact that the division to make a backyard, the story broke that person again, it can not to move freely between spaces where she built with the teams. Patients refer us and what we produce. We have no degree of compassion, the pain with how to design the suffering if you yourself are unaware of the suffering of others? What is this pain? What makes me to myself to witness the pain of another? This dimension is crucial, whatever our diploma or our volunteers. "
Nurse Dax:" I graduated in 1986, this issue of individual or collective commitment is essential because no prepared to meet with psychosis or with the management or control of the transfer. I learned my trade with educators, philosophers like Francis Jeanson, who left us too, the neighbors who attended the psychotic, etc. ... that is all they taught me. "
a flower: "It is in the actual work, the sharing of this responsibility that we can build with people suffering from psychosis or schizophrenia. And it should not be isolated, but working with others who also attend that person is a collective construction. "
Veronica: "I am a nurse since 1981, I worked in a place of life Brétigny in Essonne. The issue that concerns me today is the hospital: the fences going up, doors that close. "
Cadassou Serge:" Of course, the UMD is a closed environment, but it closes in society, it will close in people's heads. We can no longer make therapeutic outings, the Prefect said no, without giving a reason, and we have police escorts when we go to town with the sick. We see police cars on the course ... it was almost amused if it was not a terrible social symptom. Nevertheless, the relationship between time in therapy account, and the UMD, we have time, length of stay is not necessarily reduced, we have activities and little by little, people are rebuilding their own history ... Their concern grew when it comes out of the UMD to return to their hospital sector, because they know the mood, they already had the experience before coming to Cadillac, is much harder repressive, demanding, because there is not enough active therapeutic activities. They want more from the UMD, it's still ironic! "
Oury finally stated:" This is the managerial and bureaucratic logic to which we are subjected in recent years. During all these reorganizations hospital, trade of antipersonnel mines continues scary, do not believe there is no logical correlation. In the classical period, it said that we should accommodate the insane. The fools are not always those that believe. It the structure of organizations is concerned, there are many conceptual blends because of technocracy whose degenerate mixture neopositivism meaning and significance. Our work is the social bond and sense, not meaning that confuses presence and form of presence. Lacan speaks of pretense, which is the agent of discourse, and providing access to meaning and to produce social ties. Committees with the Navy Cross Hospital and Therapeutic Clubs, the Federation had, through Tosquelles developed this double articulation for structuring that we are all speaking beings. Humanly speaking, and be it the same thing. It is not clear that the Navy Cross today to regain ground on the issue of language and structure. A La Borde, collectively we rework the Hospital Restructuring Committee. The Navy Cross Review No. 3 of 1958 features the very interesting report Tosquelles the Days of Social Psychiatry on 14 and 15 June 1958 organized by Henri Ey Bonneval. "
We will be in Pau in 2011, c 'is here, during days of 1953, had taken the direction that would lead to the drafting of the famous circular of February 4, 1958 ... The workshop Centre region will work on the theme of concrete collaboration with families in the therapeutic process.
Dr. Michel Lecarpentier
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