Utilisations de l'Épreuve d'Anticipation en clinique du sujet âgé chuteur

• Published in: Annales médico psychologiques 2004-11, Vol.162 (9), p.722-730
• Main Authors: Fromage, B., Gardey, A.-M., Guesné, S., Berrut, G.
• Format: Article
• Language: fre
• Subjects: Anticipation; Chute; Death; Elderly fallers; Fall; Mort; Phenomenology; Phénoménologie; Psychologie. Psychanalyse. Psychiatrie; Psychométrie. Systèmes d'aide au diagnostic; Psychopathologie. Psychiatrie; Sciences biologiques et medicales; Sciences medicales; Sujet âgé; Techniques et méthodes
• ISSN: 0003-4487; 1769-6631
• DOI: 10.1016/j.amp.2003.10.021

La chute de la personne âgée est un événement fréquent qui a des conséquences importantes. La chute peut aboutir au syndrome postchute dont l'élément central est la peur de tomber. Toute action est alors comme inhibée par le futur. L'anticipation définie comme capacité du sujet à se projeter dans le futur est ici étudiée à l'aide d'une épreuve projective, l'Épreuve d'Anticipation. L'étude de cas relate comment l'Épreuve d'Anticipation peut être utilisée dans une démarche diagnostique et thérapeutique auprès de sujets âgés chuteurs. The fall in elderly is a frequent event which has serious consequences. The fall can end up to post fall syndrome of which the central component is the fear of fall implicating walking inhibition. The person is depressive, without plans. The future perspective is an essential variable of post fall syndrome like if future was absolutely negative. Future builds behaviours of faller or in another direction, actions are inhibited by future. The anticipation defined like ability of person to project himself in future is studied with a projection test: anticipation test (AT). In this test the person formulates with images that she does not want become and that she wants become in another life, everything except a person. Then in a procedure of twelve stages, she specifies her desire and her refusal in two opposite existential plans: positive plan, negative plan. From a diagnostic point of view, pathology is incapacity for the person to establish psychic relations between this two plans (positive and negative). In fall syndrome, the death problematic is really present. The case study is about an old woman (88 years) hospitalised after a fall. She has a grave post fall syndrome with a great anxiety about her moving. In the first test the death is recalled with images like bones, worms, tomb in the negative existential plan. Refuse, this plan is very active in psychism. During two discussions this negative plan is elaborated. Using images from protocol, it is showing that the end of a life is not the end of life and the husband continues to live in children and grandchild like a tree which seems dying in autumn with the fall of leaves… The second test shows a relation between two opposite plans. The person has a mediating object which can hold antagonists notions in a same symbol. These results are confirmed by a decreasing of post fall syndrome.