Indication de trachéotomie et positionnement du patient atteint de Sclérose Latérale Amyotrophique : enjeux de l'espace d'élaboration psychique en situation extrême

In such a situation, the psychic elaboration proposed by a clinical psychologist is part of a broader concept where the medical aspect of the question is over-ridden by the patient's personal needs and desires. Based on a clinical illustration, we recall here the fundamental principles of the notion of containment. In this framework of patient-centered decision making, the patient plays the role of author rather than subject. Thus, by progressively assimilating outside input, the patient will progressively integrate available information and come to a decision-making construct compatible with his-her own possibilities.