[Ambivalence, control, support. Caring for the elderly patient at a "good enough" distance]. / Ambivalence, emprise, soutien. De la difficulté d'entourer le patient âgé à « suffisamment bonne ¼ distance.

OBJECTIVES: In the wake of the Covid-19 pandemic, visits by relatives to Nursing Homes for the Elderly (EHPAD) and Long-Term Care Units (USLD) have been severely restricted or even prohibited in order to protect the residents and patients, especially the most vulnerable among them. This situation has revived the debate around the place and role of the relational entourage in caring for the elderly. The relevance of family ties in supporting the narcissistic and objectal cathexis of the elderly has thus gained recognition. There is, however, the risk of an emerging form of uniformization and idealization, which the present article seeks to address by highlighting some aspects of the intrapsychic and inter-relational dynamics that drive the inherent complexity of those bonds. METHOD: The authors seek to identify the psychic processes involved in varying forms of presence and of motivation of "natural caregivers" and "professional caregivers." Their approach is based on a psychodynamic analysis of the consequences of the Covid-19 pandemic and the changes induced in the links between the patient or elderly resident and his or her entourage. Complex movements fueling the dynamics involved in these links are revealed. A clinical vignette based on research in clinical psychology and psychopathology is provided. RESULTS: The pandemic context showed the creative strategies devised by relatives and carers to maintain forms of presence and links "at a distance" with isolated and confined elderly people. However, the various configurations of these arrangements also highlighted the tensions, sometimes tinged with rivalry, in the negotiations that inform the respective places and roles of family members and professionals around the subjects concerned. The caregiver's position is not self-evident and presupposes an involvement that cannot be construed on a merely functional and behavioral level. Rather, it requires a need for psychic work drawing on the identificatory and projective movements inevitably mobilized in closeness with the subject, without alienating oneself. Ambivalence, empathy, and support can then be deployed, where excessive control, covert hostility, and over-excitement are constant threats to such a necessarily close relationship. This disposition in the caregiver also encounters a singular psychic disposition on the part of the person being helped, informed by a lively conflictuality. This sometimes takes on surprising undertones, as in the case of Georges, an 86-year-old patient, where the caregiver as a "close-human-being" was fully recognized only on the condition that the relationship of help and care supported, sustained, and nourished unconscious masochistic needs. DISCUSSION: These perspectives are an invitation to ponder the plurality of figures of the "close-human-being" and to find one's place in a psychic and relational economy where the self-preserving and psychosexual registers are in constant interplay. They also underline the need to focus on working, individually and collectively, on the quality of the entourage's presence. This is all mediated by a complex organizational pattern anchored in the potential for reciprocal support between the family group, the caregiving group, and the institutional setting. CONCLUSION: These various propositions help clarifythe components of the psychic conflictuality implied, on the one hand, in the horizontal tensions existing between the various members of the familial and professional circle and, on the other hand, in the vertical tensions inherent in intergenerational dynamics. The elderly are far from being passive objects in this and their contribution is essential. The concern to ensure the close involvement of the elderly person's relatives and foster the quality of the ensuing exchanges is laudable, indeed vital. This should not, however, lead us to downplay the crucial and singular place the elderly subjects themselves occupy in individual, family, and societal dynamics, as full citizens, members of their relatives' entourage, and essential figures in the establishment of the great psychic organizing functions that structure the difference in generations and the psychic processes of identification.

As múltiplas cores do arco-íris: despatologizando a diversidade sexual / The multiple colors of the rainbow: depathologizing sexual diversity / Los múltiples colores del arco iris: despatologizando la diversidad sexual

Estamos vivenciando na contemporaneidade a manifestação de uma vasta gama de apresentações da sexualidade, compondo metaforicamente as cores de um arco-íris, como o que é representado nas bandeiras e imagens do movimento LGBTQ+. Muitas dessas configurações sexuais atuais não são novas e estiveram sempre presentes na história da humanidade. Entretanto, tornaram-se novas em sua visibilidade e em suas reivindicações de respeito, compreensão e acolhimento. Por outro lado, as sexualidades, que se mostram tão fluidas e cambiantes, parecem ser de aparição mais contemporânea. O autor propõe-se a questionar porque ocorre uma resistência tão violenta contra as manifestações das diversidades de gênero e de orientação sexual na atualidade. Busca compreender essas resistências nas instituições psicanalíticas e também dentro de nós mesmos. Inicia com a nova visão biomédica e da saúde mental que despatologiza a diversidade sexual. Considera a diferença entre as gerações como um dos fatores envolvidos na resistência às novas apresentações da sexualidade. Salienta a nossa tendência a generalizar e a pensar de maneira binária e não complexa, levando a uma insistência na binaridade sexual. Finalmente, discute a resistência presente nas teorias psicanalíticas que tendem a normatizar a sexualidade, considerando que tanto os analistas como as instituições psicanalíticas persistem ambivalentes em relação a normatizar a sexualidade em oposição a uma visão mais singular e específica de cada pessoa (AU)

In our present-times we have been experiencing sexuality been manifested in a wide range of presentations, metaphorically representing the colors of a rainbow, as in the banners and images of the LGBTQ+ movement. Many of these current sexual configurations are not new and have always been present in human history. However, they have become new regarding visibility and in their urge for respect, understanding, and acceptance. On the other hand, sexualities, which present themselves so fluid and changeable, seem to be more contemporary in appearing. The author intended to question why there is such a violent resistance against the manifestations of gender and sexual orientation diversity in our days. He seeks to understand these resistances inside psychoanalytic institutions as well as inside ourselves. He begins with the new biomedical and mental health vision that depathologizes sexual diversity. The author considers the difference between generations as one of the factors involved in the resistance to the new presentations of sexuality. He highlights our trend towards generalization and thinking in a binary instead of complex way, leading to an insistence on sexual binarity. Finally, discusses the resistance present in psychoanalytic theories that tend to systematize sexuality, considering that both analysts and psychoanalytic institutions persist ambivalent in relation to systematizing sexuality as opposed to a more particular and specific sight over each person (AU)

Actualmente estamos viviendo la manifestación de una amplia gama de presentaciones de la sexualidad, componiendo metafóricamente los colores de un arco iris, como lo que se representa en las banderas e imágenes del movimiento LGBTQ+. Muchas de estas configuraciones sexuales actuales no son nuevas y siempre han estado presentes en la historia de la humanidad. Sin embargo, se han vuelto nuevas en su visibilidad y en sus reivindicaciones de respeto, comprensión y aceptación. Por otro lado, las sexualidades, que se muestran tan fluidas y cambiantes, parecen de emergencia más contemporánea. El autor se propone cuestionar por qué existe una resistencia tan violenta contra las manifestaciones de diversidad de género y orientación sexual en la actualidad. Busca comprender estas resistencias en las instituciones psicoanalíticas y también dentro de nosotros mismos. Empieza con la nueva visión biomédica y de salud mental que despatologiza la diversidad sexual. Considera la diferencia entre generaciones como uno de los factores involucrados en la resistencia a las nuevas presentaciones de la sexualidad. Destaca nuestra tendencia a generalizar y pensar de forma binaria y no compleja, lo que lleva a una insistencia en la binariedad sexual. Finalmente, discute la resistencia presente en las teorías psicoanalíticas que tienden a normalizar la sexualidad, considerando que tanto los analistas como las instituciones psicoanalíticas persisten ambivalentes en relación a normalizar la sexualidad en oposición a una visión más singular y específica de cada persona (AU)

Feminino pela experiência do enigma da vagina / The Feminine by the experience of the enigma of the vagina / Femenino por la experiencia del enigma de la vagina / Le féminin par l'expérience de l'énigme du vagin

RESUMO O autor aborda o feminino como substantivo neutro, correspondendo ao estádio da vida mental do recém-nascido. Conceitua os termos feminino, feminina, feminilidade, mulher e mãe com especificidades diferenciadas, elaborando conceito próprio em torno do que denominou enigma da vagina. Segundo a observação, a aquisição cognitiva proporcionada pelo meio empático-cuidador moldaria a mente da menina em uma fonte imaginativa de crenças oriundas do enigma da vagina em teorias próprias. Também repensa o complexo de castração da menina.

ABSTRACT The author approaches the feminine as a neutral noun, corresponding to the stage of the newborn's mental life. He conceptualizes the terms feminine, femininity, woman and mother with different specificities. He elaborates his own concept around what he called the enigma of the vagina. Cognitive acquisition provided by the empathic-caregiver, would mold the girl's mind into an imaginative source of beliefs arising from the enigma of the vagina in her own theories. The girl's castration complex is rethought.

RESUMEN El autor desarrolla el femenino como un sustantivo neutral, correspondiente a la etapa de la vida mental del recién nacido. Conceptualiza los términos femenino, femenina, feminidad, mujer y madre con diferentes especificidades. Elabora su propio concepto en torno a lo que llamó el enigma de la vagina. La adquisición cognitiva proporcionada por el cuidador empático moldearía la mente de la niña en una fuente imaginativa de creencias que surgen del enigma de la vagina en sus propias teorías. El complejo de castración de la niña repensado.

RÉSUMÉ L'auteur aborde le féminin comme un nom neutre, correspondant au stade de la vie mentale du nouveau-né. Il conceptualise les mots : féminin, féminité, femme et mère, à partir de spécificités différentes, en élaborant son propre concept autour de ce qu'il a appelé l'énigme du vagin. L'acquisition cognitive, fournie par l'empathie du soignant, ferait de l'esprit de la jeune fille une source imaginative de croyances issue de l'énigme du vagin dans ses propres théories. Le complexe de castration de la jeune fille est aussi repensé.

Pubertal timing predicts adult psychosexuality: Evidence from typically developing adults and adults with isolated GnRH deficiency.

Evidence suggests that psychosexuality in humans is modulated by both organizational effects of prenatal and peripubertal sex steroid hormones, and by activational effects of circulating hormones in adulthood. Experimental work in male rodents indicates that sensitivity to androgen-driven organization of sexual motivation decreases across the pubertal window, such that earlier puberty leads to greater sex-typicality. We test this hypothesis in typically developing men (n = 231) and women (n = 648), and in men (n = 72) and women (n = 32) with isolated GnRH deficiency (IGD), in whom the precise timing of peripubertal hormone exposure can be ascertained via the age at which hormone replacement therapy (HRT) was initiated. Psychosexuality was measured with the Sexual Desire Inventory-2 (SDI-2) and Sociosexual Orientation Inventory-Revised (SOI-R). In both sexes, earlier recalled absolute pubertal timing predicted higher psychosexuality in adulthood, although the magnitude of these associations varied with psychosexuality type and group (i.e., typically developing and IGD). Results were robust when controlling for circulating steroid hormones in typically developing participants. Age of initiation of HRT in men with IGD negatively predicted SOI-R. We discuss the clinical implications of our findings for conditions in which pubertal timing is medically altered.

The otherness of sexuality: Exploring the conflicted nature of drive, desire and object choice.

This article explores how the psychoanalytic drive theories of Freud, Laplanche and Lacan elucidate the conflicted nature of desire and object choice. In a close reading of Freud's Three Essays on the Theory of Sexuality (1905), I emphasize the inherent tension in Freud's thinking between the non-object-relatedness and object-relatedness of drive, as well as the conflictual path of object choice. Through discussion of Laplanche's theory of the origin and nature of the drive, I underline the significance of the unconscious, enigmatic messages of the object. I argue that Freud, Laplanche and Lacan, although in different ways, convey an idea of sexuality's otherness. This otherness may contribute to highlight divisions in the sphere of love, e.g. splits between sexuality and attachment so often encountered in clinical practice, when erotic desire comes into conflict with the need for a safe and stable relationship. The article aims at explicating the clinical value of a listening perspective entrenched in drive theory for understanding the ambivalence, conflicts and paradoxes of human object choice.

Édipo intimidado: de profano a profanado / The Intimidated Oedipus: From Profane to Desecrated / Edipo intimidado: de profano a profanado / OEdipe intimidé: de profane à profané

Os autores consideram o caráter inovador dos complexos de Édipo e de castração, conceitos que romperam com a hegemonia da sexualidade genital, propondo a bissexualidade psíquica, a psicossexualidade. Lançam seu olhar sobre a atualidade, tempo de múltiplas sexualidades, que muitas vezes propõem uma ruptura com a história do sujeito e negam a castração. Questionam-se: uma história sem história? Um tempo sem tempo, em que o velho Édipo de Freud de profano passou a profanado? Vivemos uma época de um Édipo intimidado? Estamos, os psicanalistas, intimidados diante desse desafio cultural? À luz dessas ideias, os autores debatem uma reportagem sobre uma família que propõe criar os filhos com gênero neutro. Como sustentar as vicissitudes dos complexos de Édipo e de castração como estruturantes da sexualidade infantil e do anímico? Como relacionar a bissexualidade com vicissitudes dessa tragédia do destino na contemporaneidade?

The authors reflect on the innovative nature of both Oedipus and castration complexes. Concepts that broke with the hegemony of genital sexuality by proposing the psychic bisexuality, the psychosexuality. The authors look at the current time, a time of multiple sexualities which often propose a rupture with the subject's history and deny the castration. The authors ask: is it a history without history? Is it a time without time, when the old Freud's Oedipus has changed from profane to desecrated? Are we living in a time of an intimidated Oedipus? Do we, psychoanalysts, also feel intimidated when facing this cultural challenge? In the light of these ideas, the authors discuss a tv report about a family who proposes to raise their children gender neutral. How to support the vicissitudes of both Oedipus and castration complexes as what gives structure to infantile sexuality and the soul? What is happening to the identification process? How to relate bisexuality to the vicissitudes of this tragedy of fate in contemporaneity?

Los autores consideran el carácter innovador de los Complejos de Edipo y de Castración. Conceptos que rompieron con la hegemonía de la sexualidad genital, proponiendo la bisexualidad psíquica, la psicosexualidad. Lanzan una mirada sobre la actualidad, tiempo de sexualidades múltiples, que muchas veces proponen una ruptura con la histórica del sujeto, y niegan la castración. Cuestionan: ¿Una historia sin historia? ¿Un tiempo sin tiempo, en el que el viejo Edipo de Freud de profano pasó a profanado? ¿Vivimos una época de un Edipo intimidado? ¿Estamos, los psicoanalistas, intimidados ante ese desafío cultural? Debaten, con base en esas ideas, un reportaje sobre una familia que propone crear sus hijos con género neutro. ¿Cómo sostener las vicisitudes de los complejos de Edipo y de castración como estructurantes de la sexualidad infantil y del anímico? ¿Estaría declinando el proceso de identificación? ¿Cómo relacionar la bisexualidad con las vicisitudes de esa tragedia del destino en la contemporaneidad?

Les auteurs considèrent l'aspect innovant des complexes d'OEdipe et de castration. Des concepts qui ont rompu avec l'hégémonie de la sexualité génitale, en proposant la bisexualité psychique, la psychosexualité. Ils jettent son regard sur l'actualité, temps de sexualités multiples qui proposent très souvent une rupture avec l'histoire du sujet et qui nient la castration. Ils questionnent : une histoire sans histoire ? Un temps sans temps, dans lequel le vieil OEdipe de Freud est-il passé de profane à profané ? Vivons-nous une époque d'un OEdipe intimidé? Sommes-nous, les psychanalystes, intimidés en face de ce défi culturel ? Ils discutent, à la lumière de ces idées, un reportage à propos d'une famille qui a l'intention d'élever ses enfants au genre neutre. Comment soutenir les vicissitudes des complexes d'OEdipe et de castration en tant que structurants de la sexualité infantile et de la psyché? Comment rapporter la bissexualité aux vicissitudes de cette tragédie du destin dans la contemporanéité?

[Birth and separation, questioning caesarean deliveries on maternal request]. / Naissance et séparation, interroger les césariennes sur demande maternelle.

Clinical practice and literature highlight the emergence and the growth in the number of caesareans carried out on the request of the mother without medical indication. For some women, a vaginal delivery is an anachronism, while for others it is a necessary passage towards motherhood. A reflection was carried out to illustrate the singularity behind these requests and attempt to overcome the 'for' and 'against' divide.

Das origens da sexualidade feminina ao feminino nas origens da psicossexualidade humana

Este trabalho tem como objetivo desenvolver algumas reflexões sobre a construção da subjetividade feminina em psicanálise, tendo como respaldo a Teoria da Sedução Originária ou Generalizada de Jean Laplanche e a proposta de Jacques André da existência das origens femininas da sexualidade. Nesse sentido, queremos assinalar que a Teoria da Sedução Originária nos possibilita ver a psicogênese do feminino desde um ângulo bastante diferente. Posto que pensar a sexualidade feminina sobre as bases de um endogenismo da pulsão sexual ou de uma sexualidade infantil que todo sujeito traz consigo, como traria consigo um inconsciente, presente desde o começo, não é o mesmo que colocá-la sobre a base de uma constituição exógena da pulsão sexual. Dessa maneira, observamos que a Teoria da Sedução Originária e a Teoria Tradutiva do Recalque modificam completamente a forma de ver as fundações do inconsciente, do aparelho psíquico e da origem da psicossexualidade humana, em especial, da feminilidade.(AU)

This work aims to develop some reflection about the construction of feminine subjectivity in psychoanalysis supported by the Original Seduction Theory or Generalized from Jean Laplanche and also the proposal from Jacques André into the origins of feminine sexuality existence. In this meaning, we would like to mark that the Original Seduction Theory makes enables to see the feminine psychogenesis from a very different view. Thinking of feminine sexuality in an endogenism of sexual drive basis or a childish sexuality basis that everybody has itself, as it would bring an unconscious, present since the beginning, it is not the same of putting it in an exogenous formation of sexual drive basis. In this way, we observed that the Original Seduction Theory and the Traductive Theory of Reiterate completely modifies the way we see the unconscious foundations, the psychic system and the human psychosexuality origin, specialty, the feminity. (AU)

Corpo somático e psiquismo na psicanálise: uma relação de tensionalidade

Apresenta-se a hipótese de que a condição humana, entendida psicanaliticamente como processo de constituição psicossexual, encontraria como dinâmica própria aos processos de subjetivação o que denominamos "tensionalidade somatopsíquica". A pulsão, enquanto conceito fronteiriço entre as dimensões somática e psíquica, é o eixo que permite superar a lógica dicotômica entre estes dois termos, que não podem ser concebidos como entes autônomos e independentes, mas em sua articulação-disjunção.

Somatic body and psychic on Psychoanalysis: a matter of tension. On this paper we present the hypothesis that the human condition, understood by psychoanalysis as the process of psychosexual constitution, would find what we designate 'somatic-psychic tension' as the dynamic particular to the process of subjectivity. The notion of sexual drive, as a borderline term between the somatic and the psychic dimensions, is the axis which allows us to surpass the dualistic logic between soma and psyche, two terms that can't be understood as independent entities, but only in their simultaneous articulation-disjunction.