Psychoanalysis is on the decline all over the world. Everywhere ? No, because a few rare countries still give it credit, in particular Argentina, the French-speaking regions of Belgium and Switzerland and, above all, France. A strange peculiarity. Especially since the ineffectiveness of psychoanalysis in the treatment of autistic, psychiatric or personality disorders – apart from a few rare exceptions – has been demonstrated for years in numerous scientific studies. His refusal to make a diagnosis can even prove to be dangerous and lead to delays in adequate care. So why this exception in a country whose medicine is based on science?
France was not the favorite to become the great country of psychoanalysis. Born at the end of the 19th century in Vienna, it first established itself in Berlin, then in the Anglo-Saxon world. It particularly flourished because the Austrian neurologist Sigmund Freud had the merit of bringing an attractive new approach: taking the time to listen in detail to the lives of patients, offering consultations at home – psychiatrists performed them in asylums – and eliminate guilt from sexual practices and the fantasies of dreams. “It was useful, because many people are afraid of their intrusive ideas and try to repress them, which can develop obsessions”, explains Jacques Van Rillaer, psychotherapist, professor emeritus at the Catholic University of Louvain, ex-psychoanalyst and fine connoisseur of its excesses.
We can also credit psychoanalysis with promoting the idea that we should not systematically adopt a punitive attitude when children do not do well in school or adopt strange behavior, but rather to try to determine if they are suffering or are experiencing psychological difficulties that require consultation. “Apart from that, you still have to note that she favored the idea that everything was of psychological origin, whereas this is not the case, in particular for a whole series of dysfunctional disorders – dyslexia, dyscalculia , dysorthography – for which real treatments are necessary”, continues the Belgian professor. Gradually, Freud’s theory, stereotyped around the search for the Oedipus complex or repressed homosexuality, is undermined. Its influence gradually diminished from the Second World War onwards, as psychiatry and scientific psychology proved to be more effective.
Dolto, Lacan and the Journalists
Freud’s discipline then found refuge in France, where it experienced unparalleled growth thanks to the emergence of Jacques Lacan and Françoise Dolto. The first has the particularity of having practiced, from the 1950s, sessions of increasingly shorter duration. Instead of the 45-50 minutes devoted by international psychoanalytic authorities, Jacques Lacan goes to 30 minutes. Then the time of the analysis becomes very variable, “sometimes half an hour, most often three or four minutes divided into two or three sessions in the same day”, says François Dosse in Gilles Deleuze Felix Guattari. Cross biography (ed. La Découverte, 2007).
The French psychoanalytical society takes umbrage and the International Psychoanalytical Association decides that the didactics of Jacques Lacan have no value. In retaliation, the psychoanalyst founded his own school where he continued his analyzes at high speed and granted the title of psychoanalyst to students who had neither a diploma in psychiatry nor in psychology, which had been compulsory until then. “He could see 60 people a day and not just patients, since he trained hundreds of psychoanalysts in this way, and the latter in turn trained other followers, explains Jacques Van Rillaer. Thousands of Lacanian psychoanalysts have then flooded the market.” Psychoanalysis being very often their only livelihood, they had – and still have today – every reason to fight for their practice to be recognized as a serious science.
The other success of Jacques Lacan is to have seduced many intellectuals, priests, Jesuits, or journalists. “He was friends with Françoise Giroud, to whom he granted 400 20-minute sessions – an exceptional amount of time at that time – when she was suffering from severe depression after her separation from Jean-Jacques Servan-Schreiber [NDLR : les deux ont fondé L’Express]“, adds Jacques Van Rillaer. What the latter has never failed to salute during her career.
Even today, many media present psychoanalysis as a reliable science, and its proponents as credible sources capable of shedding light on all societal debates: education, news items, politics. France Inter, for example, gives a Sunday broadcast to the psychiatrist and psychoanalyst Juan-David Nasio, a former student of Françoise Dolto and Jacques Lacan. Public radio also offered 40 programs, broadcast since the beginning of July, to Caroline Goldman, the new psychoanalyst in vogue. In recent months, the daughter of the famous singer has seen the red carpet rolled out in many newspapers, where she has launched an offensive against positive education. His words shocked many researchers and doctors, as L’Express reported last June. Within the radio, the teeth grind, in vain. An internal source tells us that Adèle Van Reeth, the director of France Inter “is a big fan of psychoanalysis”. Moreover, she has entrusted in 2020 to JDD that she has been in therapy for more than eight years.
The newspaper The world is not to be outdone, since he was one of the first to grant an interview to Caroline Goldman. The leading French daily also publishes the bi-monthly column, “The couch of the world”, of the psychoanalyst Claude Halmos, who worked for twenty years on Franceinfo. As for France Télévisions, its program The Kindergarten House done regularly the spotlight on psychoanalysis, not hesitating to devote an entire program to “Françoise Dolto, the magician”. The list is still long.
From universities to private practices and hospitals
Another factor explaining the success of this discipline in France is its learning at school. “The population is educated, prepared to receive psychoanalysis, in particular because, at the end of high school, it has philosophy courses devoted to the unconscious and therefore to Freud, remarks Jacques Van Rillaer. And even if some teachers have a critical reading, others admire it.” Above all, it keeps the rating at the university, in particular in the training of clinical psychologists or specialized educators. According to a 2018 analysis by the late Joel Swendsen, ex-professor of clinical psychology at the CNRSout of 26 French universities responsible for training clinical psychologists, half provided substantial psychoanalytic training and 9 offered an exclusively psychoanalytic approach.
“Even last year, a higher school for teaching and education (ex-IUFM) brought in a psychoanalyst to talk about autism, and when an interministerial delegation contacted the university to let him know , she replied that she was independent and could do what she wanted”, laments Isabelle Rolland, president of Autistes sans frontières (ASF) who denounces, like almost all patient associations, the damage of the psychoanalysis in the treatment of autistic children. Many master trainees also refuse to do their internship in structures that do not offer a psychoanalytic approach, such as ASF. “Faculties oppose us for the same reason, adds Isabelle Rolland. A psychoanalytical monopoly to which the French government and the presidents of the universities turn a blind eye, according to these experts.
Unsurprisingly, this university tradition can be found in the field. “In France, psychoanalysis is only legitimized because it is promoted by figures of authority and maintained by circles of power and influence”, denounced Joël Swendsen in an article published in 2020 in the BJPsych Bulletinthe journal of the British Royal College of Psychiatrists, in which he worried in particular about the influence of psychoanalytically trained psychologists, “10 times more numerous than psychiatrists and occupying a large number of positions in clinics and hospitals treating autistic children”. If the French High Authority for Health (HAS) issued, in 2012, recommendations for autism treatment that excluded psychoanalysis, these are still not mandatory. “Psychoanalysis is declining, but many psychiatrists and child psychiatrists with psychoanalytic training continue to practice”, abounds Héloïse Junier, doctor of psychology and early childhood trainer. They are still present, in large numbers, in medico-psycho-pedagogical centres, maternal and child protection, institutions for child offenders and even in certain hospitals.
“Psychoanalysis persists in child psychiatry, confirms Dominique Campion, hospital psychiatrist at the CHR of Sotteville-lès-Rouen, director of a neurogenetics research group at Inserm and author of The Freudian Unconscious: is there anything to save? (ed. Odile Jacob). In my service, several families come to consult after having had catastrophic experiences with Lacanian psychoanalysts who made them believe that their child’s schizophrenia was the fault of the mother.” Nathalie Groh, president of the French Federation of DYS – dysphasias, dyslexia and dyspraxia -, does not say anything else: “We still have far too many testimonies of families who fail to obtain a diagnosis, on whom family psychotherapy is imposed, or whose children are seen for years, without medical care. suitable,” she laments.
If the experts interviewed believe that not everything is to be thrown away in psychoanalysis, they consider that it should be limited to the treatment of mild disorders in adults. “Human beings need to believe in things like psychoanalysis to give meaning to their lives, which is not to be condemned, because it is at the heart of being human. But when it comes to apply it to children who have not asked for anything, it becomes a problem, and we must sound the alarm”, concludes Dominique Campion.