D'un possible dépassement de la plainte

The purpose of this study is to identify specific characteristics of complaints observed in the palliative care setting and to propose a patient-physician relationship that would help the patient go beyond the complaint. In the context of terminal illness, a physcian's words are cast beyond the patient's power of representation. The patient's anticipated knowledge of his-her own death undermines his-her narcissistic foundation, particularly the part of his-her psychic life which refuses to die, the psyche's point of infinitude. Thus, the words exchanged between the patient and the physician are inscribed in the patient's psyche without repression. This is the point of trauma expressed in the patient's complaint. However, in my opinion, the patient's complaint is also a subjective reaction. In this light, the complaint can be seen as a developing subjective experience. Indeed, by expressing a grievance, the patient resists subjugation and attempts to unfetter the throngs of death. To get beyond the complaint, I propose a relationship with psychoanalysis where the goal is to transform the non repressed inscriptions into psychic conflicts. This method, centered on the symbolic efficacy of speech, and which takes into account the transfer, aims at nevrotizing the complaint. The patient is accompanied in his-her search for meaning to gain an ultimate moment of subjective self-control. The coconstruction method allows psychic conflicts related to the patient's history to emerge. Progressively, the patients' words release him-her from the trauma of the announced death, creating a new temporality anchored in the relation of uncertainty: the complaint loses its power.