Christian Mille, Daniel Sibertin-Blanc, Thomas Henniaux : impact et impasses of « politics » in treatment facilities for suffering adolescents

The increasing occurrence in adolescents of behavior disorders, risky conducts, addictive appetence, depression, and suicidal gestures signals an entrance into the pathology of bonds and of dependence. Politicians are not blind and deaf to this issue and to what is at stake, which is vital to the future of all. They have been aware of it for more than twenty years, making adolescence a public health priority. New ideas have thus emerged, giving rise to new hopes and innovative initiatives, but also bringing difficulties and failures. The experience of a psychiatric ward for adolescents shows in an exemplary way the limits of « regulating » politics when it comes to the psychical care of adolescents in a « borderline » register. Administrative restrictions tied to outmoded regulations or to new recommendations supposed to promote good practices paradoxically hinder their working. One should not underestimate the defensive aspect of administrative tasks and discourse, like the clout of some currents of thought which denigrate the psychodynamic bases of « relational treatment ». The risk may be linked to the irresistible rise of the « technocratic model » which presents itself as a new utopia, ignoring its inscription within the « positivist » current of thought and the subtle use that can be made of this by the powers-that-be. However, the « psychists », through their direct interventions or their « interstitial practice » (Roussillon, 1991), must undoubtedly retain a decisive place in the care facility, which can not do without their vigilance regarding the « unthought » aspects of the structure, the ephemeral passions that run through it and the defensive strategies it resorts to.

Adolescence, 2009, T. 27, n°2, pp. 469-485