Retentissements psychiques du cancer gynécologique pelvien sur la sexualité féminine

Abstract : Pelvic gynaecological cancer is a disease that fits into internal reproductive organs of women : vagina, uterus, cervix and ovaries. These cancers are treated in patients of the study by hysterectomy, extended or not (removal of genitals), chemotherapy, radiotherapy and brachytherapy. It is a castration that these women experience in the reality of a body that suffers. Cancer and treatments are corporal effractions that reiterate a psychic representation of the penetration as the passive reception of the other in oneself. This figure of the foreigner inside the ego summons fantasies, affects and penetrating representations that damage body image, generates passivity images and rekindles passivation experiences. Moreover, this effraction takes place specifically on the intimate sex place, where the growing into a woman and then into a mother incarnates itself, summoning the feminine of the woman in his plurality but also in his connections to feminity. After clearing, in a very broad literary repository, the few studies that put into perspective the effraction of the gynaecological cancer and its treatments with feminine sexuality, we set our own research in the approach of psychoanalytic psychopathology in its relations with psychosomatics. A consistent identification of psychoanalytic theory of the two major fields requested by the subject of the study ensues : feminine sexuality and body in the disease. The original methodology implemented fits into an exploratory process supported by the administration of two projective tests : Rorschach and TAT, along with clinical research interviews. This is a longitudinal methodology at three selected steps of the therapeutic course of these women. The results, treated initially in the singular dimension of the case study are then grouped according to the hypotheses to show the shared adjustments in these patients. The analogy between the situation of the infans and the women under passivity constraints accompanies the description of the three steps of the study. It responds to the hypothesis of a mobilization of psychic modalities specific to corporal effraction treating process which summon, mistreat, wound and remove internal genitalia. The study reveals specifically feminine primitive anxiety such as penetration anxiety, treated by limit modalities, narcissistic and anal around a holed body fantasy and a dangerous interiority. Finally, the study explores the entire set of drives in order to figure out fusion and defusion movements subtending the erotic decathexis of the genital, summoning the feminine in its passive potentialities and accompanying the reorientation of the object-relation under the death drive influence.
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Elisa Venturini. Retentissements psychiques du cancer gynécologique pelvien sur la sexualité féminine. Psychologie. Université René Descartes - Paris V, 2014. Français. ⟨NNT : 2014PA05H121⟩. ⟨tel-01196000⟩

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