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Les médiations thérapeutiques comme dispositif de prise en charge pour les enfants avec un trouble du spectre de l’autisme : Une approche neuropsychologique et psychanalytique

Abstract : In France, several controversies about the psychoanalytical cares of autism have resulted in a proposed law dated October 2016 forbidding all kind of psychoanalytical practices and obliging therapists to apply the ABA method as the preferential way of taking care of autism spectrum disorders. The aim of these thesis is to help align these divisions through the modelling of the therapeutic mediations based on a neuroscientific and psychoanalytical approach. We hypothesized that the symbolization processes (semantical and metaphorical recategorizations) supported by the transference relationship improve autism spectrum disorders through an increasingly complex elaboration of the Real. After having brought to light a Freudian epistemological break which causes the repression of the psychoanalysis’ neuroscientific origins, we have reinitiated dialogue with neurosciences. Thus we have introduced the autism spectrum disorder as a neurodevelopmental locked-in syndrome caused by an unique adaptation of the neural network of the Ego (dynamic core) under crippling conditions caused by this neurodevelopmental disorder. The therapeutic mediations enable us to highlight the fact that the symbolization process in creative process depended on the simultaneous activation of neural network used by language and art, facilitating the synaptic strengthening between the representations of the two areas, what allows the patient to communicate his painful experience through an artistic/metaphorical language. The repeated expression of his experiences would allow reorganizing of the dynamic core of the Ego into a non-pathological way. Finally, five therapeutic mediations allow us to argue that it is possible to integrate the subjectivity into structured and theoretically motivated interventions, proposing a real means of evaluating their efficiency without affecting the quality of the care.
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Frédéric Di Bisceglie. Les médiations thérapeutiques comme dispositif de prise en charge pour les enfants avec un trouble du spectre de l’autisme : Une approche neuropsychologique et psychanalytique. Psychologie. Université Côte d'Azur, 2018. Français. ⟨NNT : 2018AZUR2037⟩. ⟨tel-02373096⟩

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