et une explication signifiante du mal ou de la souffrance ne sont-ils pas de puissants moyens de rétablissement? Le dialogue se poursuit sur d'autres cas de ...
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HWXQHH[SOLFDWLRQVLJQL¿DQWHGXPDORXGHODVRXIIUDQFH ne sont-ils pas de puissants moyens de rétablissement? Le dialogue se poursuit sur d’autres cas de psychose, de dépression, d’alcoolisme ou tout simplement de mal de vivre, que ce soit à l’urgence ou en milieu externe. Je remarque le nombre de cas de patients immigrés de l’intérieur, venant de Chicoutimi, des îles de la Madeleine, de Gaspésie, par exemple, ou de l’extérieur (Algérie, Cambodge, Haïti, Inde, Maroc, etc.). Le déracinement et l’ambiguïté quant au retour à la terre natale semblent être le dénominateur commun au-delà de la pathologie décrite, pour plusieurs cas présentés. Cet aspect plus ethnoculturel des choses n’a pas été abordé; il aurait assurément enrichi le propos d’un éclairage plus ciblé et collant à la réalité actuelle de la métropole montréalaise, lieu de pratique de notre auteure psychiatre. Le spirituel peut se décliner bien différemment en fonction de la culture, comme nous le savons. Le but de ce livre n’est pas clairement explicité mais on devine qu’il veut introduire ou mettre en exergue et en valeur la dimension spirituelle dans la relation thérapeutique. Et il remplit ce but implicite que les auteurs se sont donnés. Cet intérêt est fort louable car la dimension spirituelle manque au modèle biopsychosocial et est bien souvent exclue ou annihilée sous prétexte de neutralité ou de traitement « apolitique ». Cependant, cette dimension n’est pas forcément une dimension religieuse au sens strict du terme, de surcroît chrétienne, dans une société multiethnique et multi-religieuse comme la nôtre. La spiritualité peut prendre bien d’autres formes. Donner un sens à la souffrance psychique est une entreprise GLI¿FLOHPDLVTXHELHQVRXYHQWQRVSDWLHQWVFKHUFKHQWDYHF énergie et détermination, et que la dimension religieuse ou spirituelle peut apporter en apaisant un malaise profond. Ce livre se lit facilement et ne présente pas de points très obscurs. Je dirai qu’il est plutôt destiné au grand public. Cependant, pour les professionnels de la santé mentale et les psychiatres, il cherche à nous rappeler que nos patients souffrent, que nous avons à être plus empathiques (au sens fort du terme) et à l’écoute de leurs souffrances, ce TXLGHPHXUHXQGp¿GHWDLOOHTXDQGQRXVVDYRQVFRPELHQ d’entre eux nécessitent des soins appropriés! Il faut prendre cet ouvrage comme un essai qui nous amène à UpÀpFKLUVXUQRWUHSUDWLTXHjXQPRPHQWRODQRXYHOOH FODVVL¿FDWLRQGXDiagnostic and statistical manual of PHQWDOGLVRUGHUV¿IWKHGLWLRQ,1 réintroduit la dimension culturelle. Espérons que la dimension spirituelle sera aussi « réhabilitée » dans une version future. À quand aurons-nous en psychiatrie un modèle bio-psycho-social et spirituel?
Bibliographie 1. American Psychiatric Association (APA). Diagnostic and statistical manual of mental disorders. 5th ed. Arlington (VA): APA; 2013.
www.TheCJP.ca
Psychotherapy Transference and Countertransference Today. Robert Oelsner, editor. London (GB): Routledge; 2013. 361 p. US$54.95 Reviewer rating: Excellent Review by Paul Ian Steinberg, MD, FRCPC Vancouver, BC This tribute to Heinrich Racker’s classic Transference and Countertransference1 begins with an effective introduction by Robert Oelsner. Racker shows how the content of the countertransference reaction can demonstrate the content of the transference situation. Oelsner has collected a group of experienced FOLQLFLDQVDEOHWRUHÀHFWWKRXJKWIXOO\DERXWWKHLUH[SHULHQFHV and articulate their understanding of various aspects of transference and countertransference in a clear manner. This is an important contribution to the contemporary SV\FKRDQDO\WLFOLWHUDWXUHDQGD¿WWLQJWULEXWHWR5DFNHU Horacio Etchegoyen emphasizes that the analytic task does not consist only of an analysis of the transference, which risks splitting the present and the past, usually idealizing the analyst and denigrating the parents. He stresses the importance of the patient’s realization that what happens to him or her with the analyst also happens at home, at work, and happened as a child in the house of their parents. Haydée Faimberg notes that when the analyst has repeated GLI¿FXOWLHVLQOLVWHQLQJWRFHUWDLQDVSHFWVRIZKDWWKH patient says and cannot say, and cannot overcome these GLI¿FXOWLHVLWVHHPVULJKWWRLQIHUWKHLQYROYHPHQWRID neurotic resistance from within the analyst’s own psyche. Abel Fainstein observes that the analyst’s perception of countertransference feelings serves as an indicator of the analysis’ progress. Feeling bored may be a sign of resistance, while perceiving a patient’s aggression may be understood as progress in so far as the patient can express their aggression. Robert Hinshelwood uses 3 criteria WRGH¿QHDFRXQWHUWUDQVIHUHQFHPRPHQW WKHSDWLHQW¶V transference, indications of the psychoanalyst’s emotional responses expressed indirectly, and some untoward action of the analyst appropriate to their linked emotional state. This chapter will fascinate all readers interested in Freud’s case histories. Heinz Weiss develops Money-Kyrle’s ideas regarding evasive manoeuvres directed against aspects RIUHDOLW\WKDWDUHHVSHFLDOO\GLI¿FXOWWREHDULQFOXGLQJ dependency on the breast as an external source of goodness, the recognition of the parental intercourse as a supremely creative act from which the child is excluded, and recognition of the inevitability of time and ultimately death. Alessandra Lemma creates a very useful metaphor contrasting pedestrian and equestrian views of analytic work. Yolanda Gampel considers the effects of social
The Canadian Journal of Psychiatry, Vol 60, No 1, January 2015 : 37
Books Received
political violence in children, the analyst, and the analytic process. Mirta Berman-Oelsner provides a good introduction to concepts important in child psychoanalysis and describes special challenges for child analysis. James *URWVWHLQZULWHVRIKXPDQVDFUL¿FHDVWKHKLGGHQRUGHURI transference–countertransference in a fascinating chapter in which he shares his reminiscences of Wilfred Bion. Arnaldo Chuster develops Freud’s critique on Otto Rank’s use of the notion of birth trauma. Theodore Jacobs focuses on nonverbal behaviour on the part of analyst and patient. Steven Cooper notes that patients recruit us into particular kinds of familiar internalized object relation patterns DQGXQFRQVFLRXVFRQÀLFWVDQGIDQWDVLHV7KHDQDO\VW must understand how he or she experiences this form of recruitment and participates in its development. Franco Borgogno and Massimo Vigna-Taglianti observe that enactments are inevitable, and emphasize the analyst’s willingness to experience all the roles that every analysis UHTXLUHVWKHDQDO\VWWRWDNHRQKHOSLQJWKHSDWLHQW¿QG his lost emotional experiences or sometimes experiencing WKHPIRUWKH¿UVWWLPHSURPRWLQJWKHLQWHJUDWLRQRIZKDW has been dissociated and the healing of the patient’s psychic wounds. Adrienne Harris describes inaugurating a supervision group in which they found themselves in the presence of ghosts bidden and unbitten, spectral intruders, the ghosts of a patient and of an analyst. By ghosts, Harris means the transitional spaces in which we explore the legacy of violence, phobic hatred, and other
ZD\VRIFRQ¿JXULQJORVV0DULOLD$LVHQVWHLQLOOXVWUDWHVWKH importance of not being afraid to use one’s own emotional storms or somatic signs, especially with patients with somatic, borderline, or psychotic patients. The chapters are all very well written and of high quality. This is an excellent book that bears close study. Readers who have some familiarity with the work of Wilfred Bion ZLOO¿QGWKLVERRNPRUHDFFHVVLEOHDOWKRXJKWKH DXWKRUVGH¿QHWKHLUWHUPVFOHDUO\,WZRXOGEHKHOSIXO before reading this text to read the text that inspired it, which is a must-read for all psychiatrists interested in transference and countertransference, which, in this reviewer’s opinion, should comprise all psychiatrists in clinical practice. Racker was decades ahead of his time in anticipating contemporary understandings of transference of countertransference, observing that no analyst is exempt from countertransference and enactments, and noting that incorporating some form of supervision as part of our own lifelong clinical work has become increasingly common. This can include supervision by a senior colleague, mutual supervision with peers, and study groups in which cases are presented to colleagues. Psychoanalysts frequently do this. This could be done among psychiatrists, providing not only clinical ideas but also support.
Reference 1. Racker R. Transference and countertransference. Madison (CT): International Universities Press; 1968.
CanJPsychiatry 2015;60(1):38
Books Received The following books have been received; the courtesy of the sender is acknowledged by this listing. Books of particular interest to readers of 7KH&DQDGLDQ-RXUQDORI 3V\FKLDWU\will be reviewed by selected individuals. Not all books are available for review. Cognitive Impairment in Schizophrenia: Characteristics, Assessment, and Treatment. Philip D Harvey. Cambridge (GB): Cambridge University Press; 2013. 328 p. £60.00 The Genetic Basis of Sleep and Sleep Disorders. Paul Shaw, Mehdi Tafti, Michael Thorpy, editors. New York (NY): Cambridge University Press; 2014. 413 p. Can$135.00
Mental Health Issues: The University Student. Doris Iarovici. Baltimore (MD): Johns Hopkins University Press; 2014. 264 p. US$34.95 Sante mentale sante spirituelle: dialogue entre une psychiatre et un theologien. Odette Bernazzani, Benoit Lacroix. Montreal (QC): Mediaspaul; 2014. 200 p. Can$24.95 Explaining Abnormal Behavior: A Cognitive Neuroscience Perspective. Bruce F Pennington. New York (NY): Guilford Press; 2014. 272 p. US$45.00 The Positive Side of Negative Emotions. W Gerrod Parrott, editor. New York (NY): Guilford Press; 2014. 304 p. US$45.00
Mental Health and Poverty. Rob Poole, Robert Higgo, Catherine A Robinson. New York (NY): Cambridge University Press; 2014. 192 p. Can$85.00
Les troubles bipolaires. Marc-Louis Bourgeois, Christian Gay, Chantal Henry, Marc Masson. Paris (FR): Lavoisier; 2014. 620 p. €49.00
Bipolar Disorder: A Guide for Patients and Families. Third Edition. Francis Mark Mondimore. Baltimore (MD): The Johns Hopkins University Press; 2014. 304 p. US$19.95
Handbook of Positive Emotions. Michele M Tugade, Michelle N Shiota, Leslie D Kirby, editors. New York (NY): Guilford Press; 2014. 527 p. US$110.00
Risk: Assessment and Management. Second Edition. Chris Webster, Quazi Haque, Steve Hucker. Mississauga (ON): Wiley Blackwell; 2014. 250 p. Can$50.00 38 : La Revue canadienne de psychiatrie, vol 60, no 1, janvier 2015
Health Inequalities and People With Intellectual Disabilities. Eric Emerson, Chris Hatton. Cambridge (GB): Cambridge University Press; 2014. 173 p. Can$56.00 www.LaRCP.ca
