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Que reste-t-il de leurs amours ? : étude exploratoire, clinique et projective de patients traités pour un cancer de la prostate

Abstract : A disease affecting older men, prostrate cancer requires treatment that renders patients impotent, sometimes permanently. Psychically speaking, this resonates with the fear of castration, which does not await the advent of this quasi-reality to emerge as one of the psychic driving forces of men's anxiety and of their identity-related, narcissistic and objectal dynamic. In today's society, prostrate cancer is a taboo subject; men suffering from the condition are thus forced to suffer in silence. We met 17 patients with prostate cancer and, in a comparative way, 2 patients with kidney cancer and 2 healthy patients. Using projective methods and semi-directive interviews, we attempted to discern how this forbidden distress could partly explain why patients chose to adopt a hyperphallic stance ("Ain't scared, ain't sad, doing just fine !"). Claiming to be neither affected nor shaken by unfolding events would allow these men to mitigate depressive decompensation, which might be the worst thing for them because it would be unmanly insofar as a man must never fall, collapse or complain. Drawing from the studies undertaken by C. Chabert and F. Neau, we thus put forward the notion of "masculine hypomania". This would not only be a defense against unbearable melancholia (construed as the narcissistic treatment of loss), but would also be the reversal of passivity into action against the penetrated being (by disease and medical explorations), the permeated being (by anxiety and the passing of time) and the excited being (by the other and his desire). Driven by narcissistic hyperinvestment, this solution would be costly and mortifying on the one hand, and life-saving and nourishing on the other, moving boards between normality and pathology. Indeed, it would enable patients to defend themselves against depressive decompensation, to support shaken male identity, to defend themselves against melancholic movement and, at last, to contain excitation of the sexual drive through the death instinct in its anarchist valency. The performative dimension of manhood allowed to consider the clinical perspective of test administration (but also clinical relationship and transference during interviews) as a potentially traumatic space (because it could reveal a sensitivity to castration behind the implicit of performance), but also as a transitional and therapeutic space, which seems very important for the construction of therapeutic projects for these patients in the future.
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Submitted on : Wednesday, September 4, 2019 - 12:51:06 PM
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  • HAL Id : tel-02278365, version 1


Anne-Sophie van Doren. Que reste-t-il de leurs amours ? : étude exploratoire, clinique et projective de patients traités pour un cancer de la prostate. Psychologie. Université Sorbonne Paris Cité, 2017. Français. ⟨NNT : 2017USPCB202⟩. ⟨tel-02278365⟩



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