Treating a patient without his/her consent : a dialogue or "psychiatric language plays"?

Zespół pracujący w oddziale zamkniętym podejmuje krytyczną dyskusję z tezami ruchu antypsychiatrii i psychiatrii postmodernistycznej jakoby w takich warunkach jedyną możliwą formą rzeczywistości były "psychiatryczne gry językowe" z pacjentem. Dyskusja toczy się w oparciu o przedstawiony opis kazuistyczny.Anti-psychiatry as well as various schools stemming from social constructionism used to criticize psychiatric inpatient wards and their practices. Antipsychiatrists have pointed the violence taking place on these wards, which consists in turning the free subject into an object, yet social constructionists have underlined the disabling power of language practices (so called ‘psychiatric language plays’), which ‘takes off the ability to speak’ from those who are diagnosed as mentally ill. The aim of this article is the discussion with the mentioned above critique from the perspective of the team working within the context of the psychiatric inpatient ward. The example presented here shows the chance for dialogue with the patient even in the case of actual forced treatment undertaken/applied according to the legally binding Act of the Protection of the Mental Health

Jacques Lacan and his Linguistic Conception of Psychoanalysis

Jacques Lacan, the founder of the linguistic conception of psychoanalysis, has brought about the last, as we think, split within the psychoanalytic movement. He himself defined his work as a reinterpretation of the idea of Sigmund Freud. The Lacanean school, however, may be perceived as an original theory, developing psychoanalysis on the basis of the output and methods of linguistics and structuralism, a theory which treats language as the principal object of analysis. The paper presents a professional biography of Lacan, a history of the institutions he has founded and of his conflict with the psychoanalytic milieu; it presents the basic conceptions of the Lacanean theory: the mirror stage and its role in the forming of the subject (as opposed to illusion which is supposed to be ego); desire as a consequent of the basic lack, an effect of the dialectic of need and request through its dissatisfaction a constant source of psychic energy; unawareness of the language structure as well as the main mechanisms and laws which govern it − metaphor, that is condensation, and metonymy, that is shift. He points at some implications of the Lacanean theory as to the understanding and therapy of psychic disorders

L’analyse du cours sévère et triplement atypique de la psychose catatonique-paranoïde

The paper describes the difficult course of catatonic-paranoid psychosis which began with symptoms similar to the myasthenia. The growing symptoms of catatonia (in this oral mechanisms with the compulsion of mastication, injuring with teeth of the mouth, tongue biting and damage, such as lockjaw) brought about choking which was followed by aspiration pneumonia. The patient had to have pharmacological coma induced, along with muscle relaxation and artificial ventilation in the conditions of the intensive care department. Despite treatment with high doses of neuroleptics, the repeated trials of bringing the patient out from the coma caused recurrence of the catatonic symptoms. a decision was made to go along with electroconvulsive therapy. During one of the ECT treatments there were complications in the form of circulation cessation which required defibrillation. The paper contains basic information about the serious complications of the electroconvulsive therapy. It moreover carries out the critical analysis of the whole treatment period