Résumé
Les chercheurs contemporains tendent à présenter le mauvais fonctionnement psychosocial dans la schizophrénie comme le résultat de forces biologiques et sociales. Malgré la progression de notre base de connaissances, nous sommes encore dans l’attente de récits complets des dimensions en première personne de la maladie. Ainsi, le risque est de ne pas pouvoir saisir la schizophrénie comme un trouble interrompant la vie de personnes qui doivent continuer à lutter pour trouver et créer de la sécurité et du sens. Alors que la littérature a exploré l’expérience de soi dans la schizophrénie depuis de multiples sources, une limite à la production d’une synthèse plus large et à l’application de ce travail est qu’il reste encore difficile de savoir si, et dans quelle mesure, ces différents points de vue de l’expérience de soi sont compatibles. Pour exposer ce problème, cet article passe en revue six différents types de récit de l’expérience de soi, une dimension fondamentale en première personne de la schizophrénie. Ces six points de vue sont: la psychiatrie classique, la psychiatrie existentielle, la psychanalyse, la phénoménologie, la réhabilitation sociale et la psychologie dialogique. Après avoir comparé et contrasté ces six points de vue, nous concluons qu’il y a un large consensus, bien que partiel, qui suggère que de nombreuses personnes souffrant de schizophrénie s’éprouvent elles-mêmes comme diminuées comparativement à leur « soi » plus ancien, autrement dit, après le début de la maladie, ces personnes font l’expérience d’elles-mêmes comme moins capables de s’engager de façon efficace dans le monde, ce qui accroît leurs angoisses face aux interactions de la vie quotidienne. Cependant, un désaccord significatif existe en ce qui concerne l’émergence et le cours naturel de ces difficultés. Précèdent-elles la maladie ? Est-ce que la guérison est possible et si oui, sous quelles conditions ? En conclusion, nous proposons un programme de recherche pour créer une description plus riche de l’expérience en première personne de la schizophrénie.
Abstract
Contemporary researchers have tended to present psychosocial dysfunction in schizophrenia as a result of biological and social forces. While this has greatly advanced the knowledge base, we are still without a full account of the illness’s first-person dimensions. As such, there is a risk of failing to grasp that schizophrenia is a disorder that interrupts the lives of people, making them struggle to find and create security and meaning. While literature from a range of sources has explored self-experience in schizophrenia, one barrier to the creation of a larger synthesis and application of this work is that it remains unclear whether, and to what degree, these differing views of self-experience are compatible. To address this issue, this paper reviews six different accounts of self-experience, a fundamental, first-person dimension of schizophrenia. They are early psychiatry, existential psychiatry, psychoanalysis, phenomenology, psychosocial rehabilitation, and dialogical psychology. After comparing and contrasting the six, we conclude that there is a wide ranging, in general consensus, which suggests that many suffering from schizophrenia experience themselves as diminished relative to their former selves—that is, after onset, they experience themselves as less able to engage the world effectively, which intensifies their anxieties in the face of everyday interactions. However, significant disagreement exists regarding the emergence and natural course of these difficulties. Do they predate the illness? Is recovery possible and if so, under what conditions? In the end, we suggest a program of research to create a richer account of first-person experience of schizophrenia.
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Article traduit par Jean-Arthur Micoulaud, Michel Cermolacce, Jean Naudin. Pôle de psychiatrie « Solaris », CHU de Sainte-Marguerite, 270, boulevard de Sainte-Marguerite, F-13009 Marseille, France.
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Lysaker, P.H., Lysaker, J.T. La schizophrénie et les troubles de l’expérience en première personne: convergence et divergence de six points de vue. Psychiatr Sci Hum Neurosci 9, 31–40 (2011). https://doi.org/10.1007/s11836-010-0151-x
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DOI: https://doi.org/10.1007/s11836-010-0151-x