A therapeutic mediation program for abused children in Cambodia. From the imperceptible traumatic experience to the containing form: the clinical contribution of psychic envelopes.
Author: Landbeck, Alicia
Under the direction of: Alexandra Laurent
Bourgogne Franche-Comté University
Texte français
Keywords: Psychology, Cambodia, Trauma, Interculturality, Children, Cambodia, Therapeutically mediated devices, Psychic envelopes.
Abstract
Introduction : Following the Khmer Rouge genocide in Cambodia, many international associations have been set up to help children in vulnerable situations. These NGOs try to implement psychic care programs for the children they support. The objective of this thesis is to understand and evaluate the effect of a therapeutic program developed for abused children in an intercultural context. This program is based on the hypothesis that psychological trauma is the result of the breaking down of psychic envelopes and the presence of early trauma. It was based on therapeutic mediations and their containing aspects, relating to both the body and the culture. Methodology : During a year, ten children were welcomed in the NGO Komar Rikreay and benefited from the therapeutic program we developed in the framework of the thesis. Our research methodology is based on two pillars. On the one hand, a structural axis of evaluation, with the passing of the Child Behavior Checklist with the caregivers and drawings with the children, at three times of the device. On the other hand, a processual axis of analysis of the processes and psychic reorganizations within the therapeutic device. This axis is based on a scoring grid of psychic processes elaborated with the help of the literature on psychic envelopes and tested within the framework of a thematic analysis on Nvivo. Results : The first stages of the therapy are marked by adhesive processes. Then, the children begin to explore new combinations on the basis of the mediations. The processes of construction and structuring lead to the introjection of a container object and to the use of new mediations. Scenarios and new characters then appear. In parallel with the therapeutic follow-up, the behavioral problems at the CBCL increase for most of the children, underlining the reorganization and their involvement in the environment. The graphic productions become richer and more complex throughout the different periods. Discussion : The support of the concept of psychic envelope and the emphasis on the processual dimension allow us to reexamine the clinical forms of trauma and the processes at play in the psychotherapeutic environment. The symptomatic dimension proves to be insufficient to account for a trauma that is played out at the level of both the early bonds and the secondary modalities. Each process originates in the previous one, retracing the first moments of the psychic life. Initially, during encounters, the defenses mechanisms observed are adhesiveness, negativity and the expression of raw elements. The interpreter and the therapist participate in the psychic reorganizations by a psychic as well as bodily engagement. Conclusion : This thesis highlights the importance of the construction and reconstruction of a psychic space when it comes to the clinical forms of trauma, by means of an intervention centered on the container rather than on the contents. The scoring grid allows us to grasp the imperceptible processes at play in the encounters and their oscillations. In this way, it can provide a reference framework for the clinician in an expatriate situation and in the grip with intense counter-transferential experiences.
