Collaboration entre cliniciens et chercheurs autour de la «consultation systémique» : une situation de violence intrafamiliale

Cet article vise à illustrer la collaboration et l'enrichissement mutuel qu'apportent aux chercheurs et aux cliniciens l'utilisation de la «consultation systémique». Cette dernière, demandée soit spontanément par les parents, soit par le(s) thérapeute(s) qui suive(nt) la famille, a pour but l'évaluation des interactions familiales. Lors d'une première rencontre, les questions qui motivent les parents et/ou thérapeute(s) à consulter sont formulées et la famille est invitée à faire des jeux familiaux semi-standardisés qui sont filmés. Lors d'une deuxième rencontre réunissant les mêmes personnes, un visionnement d'extraits des films sert de base à une discussion ainsi qu'à l'élaboration de réponses aux questions posées, en partant des observations des chercheurs. Après une description de la consultation systémique standard (principes, objectifs, procédure et situations d'observation), une vignette clinique atypique, concernant des violences intrafamiliales, illustrera la variété et la richesse de ces consultations. Les observations micro et macro-analytiques des interactions données par les chercheurs, auxquelles s'ajoute la compréhension clinique des thérapeutes, montrent qu'une collaboration entre eux est fructueuse pour toutes les parties concernées.

Victimization in Childhood of Male Sex Offenders: Relationship between Violence Experienced and Subsequent Offenses through Discourse Analysis

This study aims at better understanding how the form of childhood violence experienced and the type of offense subsequently committed affect how sex offenders recall punishments and difficult events. Fifty-four male perpetrators convicted of sexual offenses against children (SOCs) or against adults (SOAs) were interviewed in France, Belgium, and Switzerland using the Lausanne Clinical Interview (Entretien Clinique de Lausanne or LCI). Almost three-quarters of the sex offenders reported having been victimized during childhood. The correspondence analysis identified several factors that differentiated them. Their appraisal of the distressing event, method of coping with and distancing themselves from it, and how they dealt with emotions varied markedly depending on whether they recognized having experienced various forms of violence during childhood and on what type of offense they subsequently committed. Victimization can be identified as much by the events experienced as by their effect on the sex offender's discourse. Identification of these discursive indicators may lead to an improved therapeutic approach for potentially traumatic childhood experiences.

La violence ou le traumatisme médical dans une consultation pluridisciplinaire spécialisée [Violence our medical trauma in specialized multidisciplinary consultation].

In this article a particular patient/physician relationship is described and analyzed: The described interaction between patient and physician during a consultative investigation by several specialists differs markedly from the common trustful relation between a patient and his family doctor. In this context the term and phenomenon pain is discussed and the necessity for an understandable, patient-oriented presentation of diagnosis and hypotheses considering the patient's individual bio-psycho-social dimension is stressed. Consequences for student education are mentioned.

Alcoolisme et violence: dangerosité et relation médecin-malade [Alcohol and violence: reflection on care and responsibility].

Violence and aggression in human drinking society, either physical, psychological, sexual or resulting from neglect are not only debilitating both for the victim and the offender but extremely prevalent and pervasive. While being on the frontline to identify and rate auto- and hetero aggressive behaviour risk, the general health practitioner remains keen to protect his special relationship. When a history of violent behaviour becomes apparent, discernment must be thoroughly assessed and a critical exploration of its larger impact on family, children, co-workers and everyday fellow citizen should become compulsory.