Prise de décision : l'importance des idées permissives

The professionals are often confronted with the analysis of the process of decision-making that is present in repetitive pathological behaviours, provoking great suffering. These behaviours are often addictive (with or without substance abuse), but the carrying out of aggression or self-aggression, and generally avoidance behaviour or repeated failures are also frequently observed. The patients sometimes refer to automatism or habit, insisting notably on the fact that there is nothing to be gained from such behaviour. Management of these patients will give more insight into these processes and render them visible and criticisable. An extract of a case report of a patient suffering from trichotillomania is used to illustrate the problems of decision-making.