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Impasses de la solution paranoïaque

Abstract : Objectives: This article investigates a reconciliation between a psychodynamic approach – taking into account the discovery of the self-therapeutic potentiality of delirium – with the challenge of paranoia: for the subject, for her/his entourage and for the clinician. Methods: We explore the birth and development of the idea that delirium may be a solution, from the first Freudian discoveries to Lacan's indications. From this observation, we expose some problems posed by paranoia: we examine both classical psychiatry and its descriptions, as well as some clinical cases from literature and from our practice. Results: If paranoia is considered by some as a “successful” psychosis, with the persecutory delusion localizing the jouissance of which the subject complains, it is not limited to the delusional phenomenon. The dead ends of paranoia are caused by the deliurim's inability to contain the elementary phenomena of psychosis. The defense it constitutes can be overcome or can result in harmful outcomes. Furthermore, the body of the paranoiac is not free of jouissance. Discussion: While the paranoid delusion cannot be considered an elegant solution, because of the impasses it encloses the subject in, its status, however, as a subjective solution cannot be denied. The Freudian hypothesis is still valid if we consider that it sometimes protects the subject from a melancholic position, or from disorganization, for example. Conclusion: We conclude that the paranoid delirium commemorates the articulation of a persecutory big Other with the objet petit a, the latter of which is inseparable from the subject. Indeed, the delirium does not allow another relation to jouissance to be established. We suggest exploring the follow clinical leads: encouraging productions that aim to support the subject rather than the ego, those that allow a certain separation from the objet plus-de-jouir and that face the existential emptiness on which megalomania is built.
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https://halshs.archives-ouvertes.fr/halshs-03430093
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Submitted on : Tuesday, November 16, 2021 - 9:29:17 AM
Last modification on : Thursday, November 18, 2021 - 3:21:47 AM

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Gwenola Druel, Mickaël Peoc’h. Impasses de la solution paranoïaque. L'Évolution Psychiatrique, Elsevier, 2021, 86 (4), pp.725-736. ⟨10.1016/j.evopsy.2021.04.001⟩. ⟨halshs-03430093⟩

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