- 作者：P. Duverger phduverger@chu-angers.fr
- 关键词：Transmission ; Gé ; né ; tique ; Pé ; dopsychiatrie de liaison ; Diagnostic pré ; natal
- 刊名：Neuropsychiatrie de l'enfance et de l'adolescence
- 出版年：2012
- 期刊代码：303_02229617
- 类别：med
- 出版时间：June, 2012
- 卷：60
- 期：4
- 页码：283-290
- 文件大小：292 K
By way of this round table's introduction about 鈥渢ransmission and genetics鈥?and before the conference of professor J.-M.聽Mandel, we propose some thoughts round fundamentals questions of innate and acquired, risks of predetermination, dangers of some predictions. A clinical illustration supports our questioning about stakes of prenatal diagnosis, hazards of genetics鈥?diagnosis and effects of a predictive diagnosis. In fact, our experience as consultation-liaison child psychiatrist in paediatrics allows us to observe the different viewpoints applied to children: those of science, of genetics, those of neonatology, of paediatrics, of psychoanalysis. If tendency has long been to pit the science's child against the psychoanalysis one, it appears to us that this opposition is becoming obsolete; clinical medicine itself imposes such a correction. The matter is no more to pit but to make up. Besides, it is probably no accident that psychoanalysis is more than ever topical. The more science progresses, the more the question of singularity is obvious. Neurosciences and genetics seek universal mechanisms that finally produce something singular, making still relevant what is peculiar to psychoanalysis. But the confusion is frequent between history and destiny of the child, between anamnesis and destiny, between prevention and prediction, between knowledge and certitude. We insist on the trap of causalities and determinisms (genetic, epidemiological, paediatric, sociologic and even child psychiatric determinisms) specifying that 鈥渇uture is not written鈥? Always, there is a radical hiatus between a state of the brain and the subject, which is going to deduct (brain plasticity and unconscious), a distance between IRM and the subject, between the disease and the subject who suffers, between genotype and phenotype鈥?And it is in this distance that it's possible to offer a space of freedom, to leave opened the question of the subject, including in the extreme situations. In this debate about the transmission and the predictive diagnosis, the child psychiatrist's has a place. We discuss this place, specifying why the child psychiatrist's is a practitioner of the unexpected, an artisan of the meeting.