Passage à l’acte incestueux : psychothérapie et obligation de soins

RésuméLes dispositions françaises de l’obligation de soin sont présentées au travers de l’exposé du travail psychothérapique mené dans le cadre d’entretiens réguliers d’un « agresseur sexuel » auprès d’un thérapeute. Les conditions du passage à l’acte de nature sexuelle d’un père sur sa fille seront abordées à partir d’une manifestation hallucinatoire. La situation d’inceste agi permet aux auteurs de revisiter la question de l’inceste dans sa version du passage à l’acte au regard d’une clinique orientée par la référence à la psychanalyse. Le dispositif orienté par l’obligation de soin pris dans la conception d’une « enveloppe psychique » a pu permettre la relance de la position subjective du patient.

The point of compulsory care and its effects are presented here through the description of psychotherapeutic work undertaken in the form of regular discussions, lead by a therapist, with a “sexual attacker” who committed acts of incest on his daughter. The authors provide a wide-angle analysis of therapeutic attitudes (in and out of prison) related to sexual behaviour: legal and ethical questions raised and the cornerstone of the psychopathology of such disorders is criticized. It allows the authors to revisit the situations of incest with regard to the clinic care oriented toward psychoanalysis. We must move towards the through-making process itself the place of de-subjectivation. This means that the therapist's role is fundamental in a relationship from subject to subject. This paper presents the various devices utilized for the compulsory care. The recounting of the occurrence of incest shows a method of committing the act, which is borderline to psychosis. The analysis of resorting to sexual acts has more to do with a theorical mapping of the perverse act (for a psychopathological clinic of the transgressive act); the underlying personality structures, being varied, can be revealed by the positioning of the subject faced with his act in the after-event. The plan implemented through compulsory care allowed the re-evaluation of the subjective position of the person on trial.