Étude des formes de rupture entre le soma et la psyché dans l'âge avancé à la lumière du concept de Spaltung

Spaltung, stemming from the German verb “spalten”, relates to different division processes. In the clinic of advanced age, this concept is translated according to its nosological position, sometimes by dissociation, or by cleavage. Thus Spaltung represents the major risk of rupture of the elderly's somatopsychic unity. In a monistic approach, based on the inseparability of body and mind, and to articulate this concept in psychiatric nosology, identification of the psychopathological mechanisms involved in the different types of division of the soma and psyche is required. Through literary and clinical examples, this article examines the evolution of the Spaltung concept, in order to propose a therapeutic approach of the elderly patient with the aim to transcend the theoretical-clinical divisions.