Dangerosité, délinquance et passage à l’acte : psychopathologie et prédictivité

RésuméNotre société manifeste une anxiété croissante face aux comportements de délinquance et cherche à établir les critères de dangerosité prédictifs. La dangerosité dans le sens criminologique du terme est composée de facteurs criminogènes individuels et situationnels. C’est l’analyse phénoménologique et qualificative de ces facteurs qui seront les meilleurs indices de prédictivité de passage à l’acte. La dangerosité psychiatrique se base sur la connaissance de risques évolutifs et paroxystiques des maladies mentales : la schizophrénie, les troubles bipolaires, les états confuso-oniriques, les troubles de la personnalité et enfin, la consommation de substances psycho-actives. Envisager l’état dangereux dans une perspective prévisionnelle impose de se donner les moyens d’intervenir avant le passage à l’acte supputé. Ces interventions se composent de mesures médicales, relativement bien répertoriées et réglementées et celles du droit qui se préoccupent de plus en plus des idées de prévention et d’intervention prédélictuelles, malgré les risques de porter atteinte aux libertés de la personne. La conceptualisation des phénomènes de passage à l’acte et acting-out, auxquels nous confrontent les comportements délinquants et violents, trouve tout son intérêt pour analyser les modes de fonctionnement répétitifs, voire sériels de certains délinquants, malgré leur tentative d’y résister. La répétition d’une même conflictualité peut se manifester de façon polymorphe, et l’analyse du modus operandi (mode opératoire) et du modus vivendi (mode d’être) est une piste de travail potentiellement riche où les cliniciens et les professionnels des droits peuvent réunir leurs connaissances.

“Dangerousness” in the criminological sense of the term is composed of individual and situational criminogenic factors. The best way to predict an acting-out is through a phenomenological and qualitative analysis. Psychiatric dangerousness is based on the understanding of the evolutive and paroxysmal risks of mental illnesses: Schizophrenia, bipolar disorder, confuso-oneiric states, personality disorders, and finally, the consumption of psychoactive substances. To predict and evaluate a danger state requires that professionals have the means to intervene before a suspected acting-out occurs. These interventions can be both medical – with measures that are relatively well-identified and regulated – and legal – with measures that are more and more attuned to ideas of prevention and pre-delinquent intervention, despite the risks of infringing on personal freedoms. Recent legal texts do not escape this dichotomy; however, they demonstrate a clear tendency towards medical, specifically psychiatric, jurisdiction. The confrontation between a theoretical conceptualisation of acting-out, and actual delinquent and violent behaviours allows us to analyse the repetitive, even serial, modes of functioning exhibited by certain delinquents, despite their attempts to resist these behaviours. The same conflict can manifest itself polymorphously, and the analysis of a patient's modus operandi and modus vivendi can be a fruitful meeting point where clinicians and legal professionals can share their knowledge. The concept of dangerousness opens up the question of primary and secondary prevention – the former in the sense of the prediction and eventual prevention of a violent act in an individual with no history of violence – and the latter in the sense of avoiding recidivism. Different approaches nevertheless both alternate between the analysis of permanent, endogenous factors, and situational, exogenous factors that call into question the relation, that is, the contact between an individual and his environment. Psychiatric patients who may be considered dangerous at a given moment of their pathological histories find themselves in sometimes startling institutional trajectories, at the mercy of medical and legal inconsistencies. A statistical analysis of dangerous pathologies is, in this case, hardly operational. The crimino-dynamic approach to psychopathological dangerousness proposes that individual psychic problems come to resonate with traumatic situations. In the case of the mentally ill, criminogenic situations are those that suggest, that evoke, that enter into resonance with older traumatic experiences of the confrontation with death. In these cases, it is imperative to uncover the deeper meaning of the crime. From the theories considered, we arrive at the idea that the danger state represents a “psychological risk”, in other words, a state of imminent impulsive decisions that gives the impression of being ‘just before’ a psychic breakdown.