Productions corporelles dans les derniers stades de la maladie d’Alzheimer comme expression subjective ?

• Published in: Annales médico psychologiques Vol. 176; no. 10; pp. 991 - 998
• Main Authors: Brossard, Frédéric, Caron, Rosa
• Format: Journal Article
• Language: French
• Published: Elsevier Masson SAS 01.12.2018
• Subjects: Alzheimer's disease; Body; Cas clinique; Clinical case; Communication; Corps; Maladie d’Alzheimer; Psychanalyse; Psychoanalysis; Psychose; Psychosis; Stereotypic gestures; Stéréotypie; Maladie d’Alzheimer; Stereotypic gestures; Cas clinique; Clinical case; Corps; Psychose; Psychosis; Psychoanalysis; Psychanalyse; Stéréotypie; Alzheimer's disease; Body; Communication
• ISSN: 0003-4487; 1769-6631
• DOI: 10.1016/j.amp.2017.06.010

Les mouvements insolites que sont les stéréotypies, dans le très grand âge, nous invitent à convoquer divers auteurs qui se sont penchés sur cette problématique d’un point de vue gérontologique, voire neurologique. Nous prendrons également appui sur des références psychanalytiques pour approcher ces comportements. Sans aucun doute, ces apports permettent d’ouvrir une voie réflexive sur l’investissement du corps dans une dimension psychique par le malade. Ils nous permettent d’envisager des liens intéressants entre le corps et le langage, et de poser l’hypothèse que le corps peut être véritablement pris au mot. L’analyse d’un accompagnement psychologique, mené auprès d’une centenaire présentant des mouvements stéréotypiques, nous servira de fil conducteur pour réfléchir à cette hypothèse. Currently, the research on Alzheimer's focuses more on the neurological aspects than the psychological aspects of the disease. Even though its neurobiological basis is widely accepted, the psychical apparatus is affected greatly by this pathology. Since we know that for the patient, the words seem non-existent and the body does not have the capacity to respond, the clinical meeting can become a real challenge. The patient may shout, use imitative or stereotypic gestures, and the patient's behavior can become very confusing for the clinician. We are going to set up our hypothesis from these stereotypic gestures. We support and defend the idea that the patient intentionally sends us signals which mean something to the Other. In the context of doctorate research, four clinical support tests were carried out, whose periods ranged from a few weeks to approximately two years. We would like to share the results of one particular support session which came to us as a surprise. It took place over a period of two months and included eleven sessions. Each session lasted between fifteen to twenty minutes. Since the patient had reduced mobility, the sessions took place in the resident's room. After each session, a thorough report of what happened during the session was written. We observed a definite articulation between stereotypic gestures and verbal stereotypes. By studying verbal stereotypes, we were able to bring meaning to stereotypic gestures. If the verbal productions, no matter how small they are, come to testify that language is still present, more surprising is the fact that stereotypic movements bring substance to the words. Like in the case presented by Jung, where movements become accurate definitions of the words, through a process that we will see later, other researchers reveal interesting links between body and language. We could easily say that the body is really taken at its word. But if this hypothesis looks plausible, it also comes to show another possible aspect: the subject is limited to being a signifier. From a Lacanian point of view, we can discuss the consequences and forecast such psychical blocking. However, our study shows that, contrary to what was expected, words and language come back and confirm our basic hypothesis. The thinking body is inhabited by words and testifies to the presence of physical and linguistic connections while the intellectual faculties seem to be massively failing. The subject still manages to express himself either through his or her body or words when the other allows him to express his desire.