Infidelity

Infidelity is one of the most complex challenges a couple can face. Beyond the guilt often felt by the one who commits the act and the deep sense of betrayal experienced by the partner, there is an opportunity to seek meaning within the act, the disclosure, and the ensuing crisis. Such situations can serve as a message to decode — a chance for both partners to reflect, process, and sometimes transform their relationship. Infidelity: A Signal to Explore While an affair is typically seen as a betrayal, it can also serve as a signal. From a relational perspective, infidelity may point to unmet needs, unresolved conflicts, or patterns of disengagement within the couple. Esther Perel argues that "infidelity does not always reflect a rejection of the partner but may instead represent a search for a lost part of oneself." This reframing opens the door to a deeper exploration of relationship dynamics. Examples of Meaning-Seeking Emotional distance and resentment: Marie discovered her husband Paul had been unfaithful after struggling for years to express her emotional needs. In therapy, they uncovered patterns of avoidance and a lack of vulnerability in their communication. They decided to work toward rebuilding trust and emotional intimacy. Craving novelty or rediscovering identity: Marc, married for 15 years, admitted to an affair to "feel alive" after years of monotony. Therapy helped them reframe the infidelity as a wake-up call to address stagnation, ultimately rediscovering a stronger bond. Leading to separation with awareness: Julia discovered her partner's repeated infidelity. Therapy supported Julia in finding closure. They ended their relationship respectfully, allowing both to move forward with clarity. The Role of Couple Therapy Therapy for infidelity is not about assigning blame — it is about uncovering what the affair reveals about the couple's dynamics and needs:Creating a safe space: A therapist helps both partners express their emotions without fear of judgement. Decoding the act: Exploring the meaning behind the infidelity. Was it an escape? A cry for help? A breakdown of boundaries? Rebuilding trust: Transparent communication and small, consistent actions help re-establish trust over time. Transforming the relationship: The therapist guides the couple in examining shared goals, unmet needs, and vulnerabilities.When Infidelity Leads to Separation In some cases, infidelity reveals deeper, irreparable rifts. Often, the separation is not solely due to the affair but reflects pre-existing signs of disengagement. Here, therapy focuses on helping both partners navigate the separation with respect and understanding — finding closure, addressing unresolved emotions, and allowing each person to envision their future with clarity. Conclusion: From Crisis to Growth Infidelity is a seismic event in any relationship, but it does not necessarily signal the end. The goal is not to erase the hurt but to integrate it into a narrative that allows both partners to move forward — together or apart — with greater self-awareness and purpose.

Parent in Residential Care Facility

The admission of a parent into a Residential Care Facility for Dependent Elderly People (EHPAD) can act as a catalyst in family dynamics. Sibling relationships undergo reevaluation. The responsibilities surrounding elder care — including emotional management and major decisions — can intensify existing family tensions or generate new conflicts. Aging is a natural process, but it is often accompanied by loss of autonomy and the need for appropriate care. When home-based support becomes insufficient, facility placement emerges as a necessary option, though it creates emotional turbulence involving guilt, grief, and occasionally relief. Guilt and the Decision to Place The decision to place a parent in a facility frequently generates guilt. Therapeutic intervention helps families clarify motivations, examine alternatives, and accept their choice with compassion. Psychological support proves invaluable during this demanding transition. The therapeutic approach involves: thorough assessment of each family's circumstances; clear, empathetic communication about admission necessity; creating non-judgemental spaces for expressing intense, often contradictory emotions; and validating feelings as foundational relief work. Anxieties of Transformation "The parent's transfer to the facility can raise deep anxieties related to the fear of no longer recognising one's parent." This transition also prompts adult children to contemplate their own mortality and reassess parent-child relationships. Therapists additionally guide relatives in preparing meaningful conversations with their parent entering the facility, facilitating connection during this significant life stage.

Hypersensitivity

In my practice as a clinical psychologist, the term "hypersensitivity" frequently arises in patients' narratives. Many self-identify as "hypersensitive," often through spontaneous self-diagnosis. This word, while commonly used, carries diverse meanings and can serve multiple functions. Far from being a pathological label or clinical symptom, hypersensitivity, to me, is a valuable indicator — a gateway to exploring what manifests in the patient as anxiety or anguish. Beyond a Self-Diagnosed Label When a patient describes themselves as hypersensitive, it often reflects an overwhelming emotional or sensory experience that they cannot yet precisely define. This intense feeling is neither a medical diagnosis nor a sign of superior intelligence. It is a singular expression of their lived experience, revealing a unique way of perceiving and reacting to the world. My work is to move beyond this self-label to understand what hypersensitivity signifies in their personal history. Is it hypersensoriality, where noise, light, or touch become intrusive? Or is it emotional intensity linked to past memories or lived situations? Some patients articulate their hypersensitivity through a pronounced ability to verbalize their emotions, while others, marked by alexithymia, express it somatically or withdraw emotionally. Anxiety and Anguish: Two Sides of the Same Distress It is crucial to distinguish between anxiety and anguish, two emotions often associated with hypersensitivity. Anxiety is a diffuse worry, oriented towards the future and marked by a constant sense of alertness. Anguish, on the other hand, manifests in a more raw way, often somatically, with sensations of oppression or imminent threat. Hypersensitivity here acts as a kind of "psychological sensor," signalling to the patient that a point of tension demands attention. A Rich and Nuanced Exploration Hypersensitivity is not a uniform concept. Some patients focus on physical sensations; others experience great internal agitation fuelled by rumination or hyper-intellectualisation.Clara feels sensory overload in noisy environments like crowded supermarkets. Antoine is overwhelmed by incessant ruminations after conversations, feeding his social anxiety. Sofia, unable to verbalize her emotions, expresses her hypersensitivity through unexplained bodily pains.Psychological Support In therapeutic support, I view hypersensitivity not as an endpoint but as a starting point. My role is to work with the patient to decode what this heightened sensitivity reveals about their coping mechanisms. This work includes:Identifying the emotional or sensory triggers unique to the patient. Easing the sense of overwhelm through techniques like mindfulness, deep breathing, or relaxation exercises. Framing this sensitivity by assigning it a function and meaning that aligns with the patient's personal history.Research on "Highly Sensitive People" (HSP) conducted by Elaine Aron has shown that "hypersensitivity is often linked to heightened neurological activation, particularly in the amygdala" (Aron, 1996). These findings provide valuable scientific insights, but should not overshadow the uniqueness of each individual's experience. Conclusion Hypersensitivity is neither a weakness nor a pathology; it is a rich and complex human trait. For the psychologist, it is a valuable key to understanding and supporting the specific forms of anxiety and anguish experienced by the patient. Through attentive listening and a structured therapeutic framework, patients can transform what may feel like an overwhelming sensitivity into a resource that illuminates their functioning, their self-perception, and their relationships with others.

The Obligation of Care in France

In France, the obligation of care is a legal measure that requires an individual to undergo medical or psychological treatment, often as part of a judicial decision. This mandate, outlined in Article 132-45 of the Penal Code, can be imposed before or after a trial and applies to various conditions, particularly psychiatric disorders or addictions. But what does this obligation represent for the therapist welcoming such a patient into their private practice? And more importantly, can someone truly be treated if they are forced to be there? Statistics and Context In 2023, healthcare spending in France reached €325 billion, with a notable increase in outpatient care. However, psychiatric institutions are struggling to meet the growing demand, leaving many patients under an obligation of care to turn to private practitioners. These patients often arrive with a phrase heavy with meaning: "I'm obliged to be here." The Ethical and Therapeutic Challenge The obligation of care raises a fundamental question: can someone truly heal if they are not there by choice? The answer lies in the art of transforming this constraint into an opportunity. The therapist must welcome the patient without judgement, acknowledging the obligation while creating a space for dialogue. The goal is to evolve the obligation into a felt need, and ultimately into an active request for care. The philosopher Emmanuel Levinas, in his ethics of responsibility, reminds us that "welcoming another should be done without preconditions, respecting their individuality." This approach is mirrored in clinical practice: it is about deciphering what the obligation reveals about the patient — their resistances as well as their unspoken needs. From Obligation to Need: A Pathway One of the challenges of mental health conditions is that the individual often does not perceive themselves as being unwell. The law may enforce treatment, not for their benefit, but for the impact it could have on others. The therapist's role is to refocus care on the patient, addressing their own need for healing. Actor Robert Downey Jr., mandated by the courts to undergo treatment for his addictions, provides a well-known example of how an initially imposed pathway can become a personal journey of rehabilitation — demonstrating how obligation can be transformed into a process of self-betterment. Legal and Ethical Considerations The obligation of care brings forth complex issues:Respect for Individual Freedom: A mandated medical intervention can be perceived as an infringement on fundamental rights. Collective Responsibility: The measure aims to protect society, but the therapist must ensure the patient is not reduced to merely a "case to be managed." Professional Confidentiality: Practitioners often navigate between judicial requirements and the medical confidentiality owed to the patient.Conclusion: The Art of Therapy Under Constraint Transforming an obligation into a voluntary process is both a challenge and an opportunity. By welcoming the patient with compassion and working on the meaning of this constraint, therapists can help them progress toward an authentic request for care. As Carl Rogers once said, "The curious paradox is that when I accept myself just as I am, then I can change." The obligation of care, far from being an obstacle, can become a lever to uncover a deeply buried need. This is the art of therapy: turning constraint into openness, and obligation into suggestion.

Suicide of a Loved One

The loss of a loved one is always a profound and challenging experience, but when the death is by suicide, the grief can be particularly complex and intense. Individuals mourning such losses encounter distinctive emotional obstacles and may struggle with guilt, isolation, and trauma. Working Through Guilt and Ambivalence One of the most pervasive emotions following a loved one's suicide is guilt. This sentiment is especially acute in younger people, who may believe they could have prevented the tragedy or failed to notice signs of distress. Unconscious guilt, disconnected from actual events, can originate from deep fantasies about causing the death or personal inadequacy. These feelings may trigger protective psychological mechanisms like denial or excessive idealisation of the deceased. Conflicting feelings toward the deceased are common. Individuals may experience resentment, anger, or even relief, juxtaposed with love and longing. Psychotherapy creates an opportunity to explore these contradictions, helping patients integrate conflicting emotions and progress toward healthier grief resolution. Feeling Different: The Isolation of Suicide Bereavement Those grieving suicide frequently experience estrangement from people who have experienced other types of loss. This sense of being "different" can lead to profound isolation. Suicide stigma intensifies this disconnection. Therapists facilitate connections to specialised support networks, with group therapy or support groups for suicide survivors providing community and mutual understanding. Processing Trauma: Finding Words for Violent Images Bereaved individuals often contend with distressing mental images connected to the death. Engaging in trauma-focused therapy can be instrumental in helping individuals articulate these experiences. This approach enables people to diminish image intensity and incorporate experiences into their life narrative, restoring emotional balance and personal agency. Building on Individual Strengths: A Path to Healing Beyond addressing guilt, isolation, and trauma, recognising personal strengths matters significantly. Every person possesses unique capabilities and resilience that can be harnessed to navigate the arduous path of mourning. Customised therapeutic approaches emphasise inherent resilience and foster renewal. Conclusion Grieving the loss of a loved one to suicide is a multifaceted and deeply personal journey. Through addressing guilt, recognising distinctive bereavement features, processing trauma, and developing strengths, therapy offers frameworks for recovery. Seeking support and embracing personal resilience enables individuals to navigate this challenging experience with compassion.

Beyond IQ Test Results

Giftedness, defined as advanced intellectual development and early potential, is a fascinating phenomenon that deserves special attention. As psychologists, our mission goes beyond the mere administration of IQ tests such as the WAIS (Wechsler Adult Intelligence Scale) and the WISC (Wechsler Intelligence Scale for Children). We must delve deeply into the results to fully understand the patient's overall functioning and support them in their specific challenges. IQ Tests: WAIS and WISC The Wechsler scales are valuable tools for assessing overall intellectual abilities. However, limiting ourselves to the general IQ score would be reductive. Analysing the subtests allows us to identify various cognitive profiles, revealing both strengths and weaknesses. The subtests evaluate specific skills such as working memory, processing speed, and verbal and non-verbal reasoning. Through conversations with our patients, we contextualise these results to uncover particular aspects of their intellectual functioning that may impact their daily, familial, social, and professional lives. Interpreting Beyond Results IQ test results are merely a starting point for structured and in-depth discussions with our patients. We don't just share numbers: we interpret these scores to reveal potential and areas requiring particular support. Giftedness often comes with specific challenges, such as motivation issues, self-esteem problems, or difficulties in social relationships. By building on a thorough understanding of our patients' abilities and limitations, we develop support strategies tailored to their particular needs. Our approach does not limit itself to the individual; it also includes the family, school, or professional environment. Giftedness is a reality experienced in interaction with others. The Therapeutic Relationship A solid therapeutic relationship is essential for this process. Creating a space of trust and listening allows patients to express their feelings, questions, and aspirations. By considering individual projections and relational challenges, we help each person get to know themselves better and develop adaptation strategies that highlight their unique traits. For adults, this may involve work on self-assertion, stress management, and improving relational skills. For children and adolescents, close collaboration with parents and educators is often necessary to implement appropriate educational supports and accommodations. Conclusion IQ test results, whether general or from subtests, only make sense when integrated into a holistic and contextual view of the individual. As psychologists, our duty is to support our patients in understanding their giftedness in relation to the challenges and opportunities of their daily lives, providing them with tools and strategies to better harness their unique potential. Supporting giftedness is a process where each step matters, and where the fine understanding of test results and the subjective realities of our patients come together to create a therapeutic framework of support and growth.

Health of the Child to Be Born

Pregnancy is a period of profound transformation, marked by physical, emotional, and psychological changes. For some women, this period can be accompanied by stress and anxiety, which can have repercussions on their own mental health as well as that of their unborn child. Psychoanalyst Daniel Stern refers to the term "psychic transparency" to describe the state of emotional vulnerability and heightened receptivity to emotions and unconscious thoughts during pregnancy. This transparency can make pregnant women more sensitive to stress and negative emotions, which can affect their mental health and that of their baby. Prenatal Stress and Fetal Development The scientific article "Maternal prenatal stress phenotypes associate with fetal neurodevelopment and birth outcomes" explores the various types of prenatal stress in pregnant women and their impacts on fetal neurodevelopment and birth outcomes. Researchers identified three prenatal stress profiles: the healthy group (HG), the psychologically stressed group (PSYG), and the physically stressed group (PHSG). The results show that prenatal stress can influence birth sex, birth complications, and the development of the fetus's central nervous system. Epigenetic Dimensions Research on microRNA maturation regulation demonstrates that disruptions in this process could have significant implications for understanding various diseases, including cancers and neurodegenerative diseases. MicroRNAs are small non-coding RNA molecules that play a crucial role in regulating gene expression. Another research area involves genomic imprinting, an epigenetic mechanism where the expression of certain genes depends on their parental origin. Anomalies in this mechanism could lead to genetic syndromes, developmental anomalies, and certain cancers — specifically, growth syndromes, certain cancers via abnormal methylation, neurodegenerative diseases, and metabolic disorders such as diabetes and obesity. The Importance of Psychological Support It is important to continue research in this area longitudinally, to better understand and prevent these conditions by also measuring the mental health of parents. In parallel, it also seems essential to provide adequate psychological support to pregnant women to mitigate the negative effects of prenatal stress. This psychological support allows the detection and treatment of mental disorders — such as anxiety and depression — that may occur during pregnancy, and helps develop a healthy and harmonious mother-child relationship.

Overcoming What?

As caregivers, can we truly talk about fighting against a disease or an emotion? Often, we hear or see posters using this term in the context of battling autism, cystic fibrosis, cancer, or diabetes. On a smaller scale, we hear it in speeches addressing fears or loneliness. Does this warrior-like language not contribute to a dichotomous view of the world, dividing the strong and the weak, the winners and the losers, the survivors and the deceased? Can such rhetoric imprison illness or emotion in a binary narrative, where those who succumb are perceived as having fought poorly? It would imply that courage can be measured, endurance quantified, and that death, in the most severe cases, represents failure. The inability to overcome one's fears or loneliness would then be solely attributed to the individual, without considering their context, history, and what their symptom reveals. For example, must cancer or diabetes only be perceived as a war against an external adversary seeking to annihilate the patient? Could it also represent a part of oneself that has gone astray, a defect within oneself? Naturally, this does not mean one should submit to it, but it is important to view this transformation for what it is: a brutal upheaval that requires reevaluation. The real question would be to think of the symptom as something that does not define the person in their entirety, but as a testimony, a call initiating questioning. It would then be a matter of knowing how to coexist with this part of oneself in imbalance while continuing to move forward. Are illness or emotion immutable, or can health and well-being be reimagined otherwise? Not as a return to the previous state, but as a newfound serenity, a capacity to face uncertainty without being entirely defined by it. Health then becomes a way of being, a balance that does not depend on organic or emotional perfection but on the calmness of the mind and faith in the future — or at least giving meaning to something that sometimes appears abruptly in our lives. Illness often represents to our patient a defect of something, a sudden rupture in the natural course of events, a crack in our daily sense of security. It destroys our illusion of constancy and confronts us with a reality that sometimes defies initial logic. However, at the heart of what may seem like absurdity, there lies a freedom: the freedom to determine how to live with this new reality, to understand it in order to move forward. These trials and upheavals do not define us. It is essential to delve into the details of life, to linger on those suspended moments where everything changes silently. After the collapse, one learns to walk towards oneself again, sometimes with the slowness of those who relearn or discover something intimate — to come out stronger. Thus, without being a victory, it becomes part of an affirmed and meaningful life story.

Falling in Love via an App

This reflection was presented at the Saint-Anne Colloquium in May 2024, examining the potential differences between virtual encounters and those occurring in physical settings. The Phases of App-Based Romance The process of falling in love through a dating app involves distinct phases. Initial engagement focuses on crafting an appealing profile with visual and textual elements to attract matches, allowing people to "project their desires and search for a mirroring effect." This phase is characterised by a form of self-curation: one presents an idealised or curated self, raising questions about authenticity and projection. Direct communication progresses through calls and video to deepen connections and verify initial impressions. The transition from text to voice to face marks a gradual movement toward embodied presence. The Economy of Availability App abundance creates "a more calculated approach, often involving statistical considerations." This constant availability can reduce abandonment fears, but raises concerns about whether users seek control over fate — and whether partners become commodified, treated like online products in a marketplace of desire. Word choice and even typos reveal character, potentially helping users clarify preferences while reducing serendipitous encounters. The curated nature of app communication differs markedly from the accidental revelation of self that occurs in physical settings. Ghosting and Attachment Being "ghosted" — suddenly cut off without explanation — triggers significant emotional responses, especially for those with attachment difficulties. The abruptness of digital disappearance reactivates early relational wounds in ways that a more gradual distancing in physical settings might not. Family dynamics and early relational patterns replay in virtual interactions just as in physical meetings. The medium changes; the unconscious does not. The Body in Virtual Space A central question concerns how the body engages differently in virtual encounters. Physical absence does not prevent excitement — textual communication can "erotize interactions," moving from visual to auditory engagement. Yet something is withheld, deferred, until bodily co-presence. Conclusion Ultimately, the emotional experiences of excitement or loss in app-based relationships mirror traditional dating once relationships establish. The screen is a stage, not a destination. What plays out on it — desire, hope, fear, disappointment, connection — belongs to the same repertoire of human longing that has always driven us toward one another.

When a Child Seeks Their Own Path: Understanding Without Confining

When a Child Seeks Their Own Path: Understanding Without Confining

In my consultation, parents sometimes arrive with a word already placed upon their child: autism, ADHD, “behavioral disorder.” Sometimes suggested by school, sometimes by a hurried professional, sometimes born from an anxiety that has grown too large. They arrive with this word as one arrives with an explanation that reassures as much as it unsettles. They are trying to understand what, in their five‑ or seven‑year‑old child, resists, overflows, withdraws, opposes, or agitates. But at this age, not everything that resembles autism is autism. And not everything that resembles a disorder is one. Frances Tustin wrote that true autism is rooted in a particular way of perceiving the world, often from the earliest years of life, as if sensory experience itself became overwhelming. Meltzer described a difficulty in transforming raw experience into representation. Geneviève Haag spoke of children engaged in a silent struggle to maintain a fragile internal cohesion. These descriptions do not apply to all children who oppose, who move constantly, who dream, who withdraw, or who struggle to adapt to school. Some children, very lively, very sensitive, very reactive, may evoke what is sometimes associated with ADHD. But René Misès reminded us that agitation can be a language, a way of expressing discomfort, fear, fatigue, or even boredom. A child who moves constantly is not necessarily “hyperactive.” He may be a child trying to regulate himself, to reassure himself, to feel alive in a world that moves too fast for him. Other children, more solitary, more absorbed in their interests, more sensitive to routines, may evoke traits sometimes associated with discreet autistic profiles. But again, caution is essential. Some children are simply very observant, very focused, very introverted. They love details, precise universes, rituals that soothe them. Daniel Stern reminded us that each child builds their inner world in their own way, and that this way is never a disorder in itself. Serge Lebovici emphasized the importance of understanding the child within their context, their history, their relationships. Didier Houzel described parenthood as a living space, sometimes fragile, sometimes wounded, but always transformable. Winnicott reminded us that a child can only develop if they find a sufficiently good environment, capable of holding them without overwhelming them. In this landscape, words circulate quickly. They sometimes reassure, because they give shape. They sometimes worry, because they freeze. They can become an involuntary way of stepping back from what the child is trying to express. As if the word were enough. As if it explained everything. As if it relieved us from meeting the child in their singularity. A five‑ or seven‑year‑old child does not express their distress with words. They express it with their body, their behavior, their refusals, their anger, their silences. Sometimes through agitation, sometimes through withdrawal, sometimes through opposition. They express it as they can. And it is up to us, adults, to help translate that language. Sometimes a child seems to have a cork in their mouth. Something that prevents them from speaking, thinking, symbolizing. That cork may be fear, anxiety, school difficulty, family tension, hypersensitivity, emotional immaturity, or a fragile bond. It is not always a neurodevelopmental disorder. It is not always a diagnosis. It is often an enigma. Supporting the child means unfolding that enigma. Meeting them where they are. Observing them play, draw, invent, hide, return. Play, as Winnicott wrote, is the first space of care. It is where the child shows what they cannot say. It is where they replay their fears, their conflicts, their desires. It is where they invite us, sometimes timidly, into their world. Support is always a team effort. Psychologists, child psychiatrists, teachers, educators, speech therapists, psychomotor therapists — each brings a piece of the puzzle. None holds the truth. All try to understand. All try to support the child’s development, whatever name — or no name — is eventually placed on their difficulties. For parents, the task is immense. They must learn to look at their child differently, to hear what they are trying to express, to not be crushed by words that circulate too quickly. They must accept that a diagnosis, if it comes one day, will never be an end but a beginning. They must be supported, accompanied, recognized in their doubts, fears, and exhaustion. A child is never a disorder. A child is a subject in becoming. A subject seeking their place. A subject who sometimes bumps against the world. A subject who always deserves to be met with time and care. ​ REFERENCES  Dolto, F. (1985). When the Child Appears. Paris: Gallimard. Haag, G. (2000). The Autistic Child: The Baby and the Mother. Paris: PUF. Houzel, D. (1999). The Stakes of Parenthood. Paris: PUF. Lebovici, S. (1983). The Infant, the Mother and the Psychoanalyst. Paris: Bayard. Meltzer, D. (1975). Explorations in Autism. Perthshire: Clunie Press.