Représentation de la maladie et travail d’élaboration de la souffrance physique chez les patients en réadaptation cardiaque

Abstract

This study entitled: "Representation of the disease and work on the elaboration of psychic suffering in patients in cardiac rehabilitation", is based on the fact that cardiovascular diseases are somatic diseases that interfere with the psyche of the person affected. This will generate a suffering that must be elaborated so that the psyche thus shaken does not collapse. Some researchers approach this question under the prism of mentalization without however taking into consideration the representations which have a primordial role in the process of psychic elaboration. However, according to the phenomenological, psychoanalytical, or even anthropological approaches, cultural beliefs, thoughts, perceptions play a role in psychic elaboration. From there, this study raises the problem of the work of elaboration of psychic suffering in patients with heart disease with regard to the representation of the disease that it is made. From this problem arises the following research question: How do the representations of the disease account for the work of elaboration of psychic suffering in patients in cardiac rehabilitation? As an answer to this question, we have formulated the hypothesis that: Through their process of mentalization and symbolization, the representations of the disease participate in the work of elaboration of the psychic suffering in patients undergoing cardiac rehabilitation. Thus, our objective is to understand the processes of the work of elaboration of psychic suffering on the representations of the disease in patients in cardiac rehabilitation. For this, we used the clinical method. The data was collected through semi-structured interviews with three people suffering from CVD met at the cardiac rehabilitation department of the polyclinic promoters of good health. These data were analyzed on a case-by-case basis, followed by a thematic content analysis. The results obtained show that among the participants, psychological suffering manifests itself in several ways. There is, for example, a narcissistic wound that makes them vulnerable; the disease considerably reduces their ability to act and this results in infantilization. The results also show many unpleasant emotions and distressing sensations such as helplessness. Faced with all of this, participants interpret the occurrence of CVD as the result of their cultural beliefs, thoughts, and perceptions. Following this interpretation, the participants resort to the consultation of healers, priests to ward off evil spirits. This develops in them the conviction that nothing can happen to them, despite the attacks because God and their ancestors protect them. These results were interpreted from representation theory and discussed in the light of previous work. This gives clinical relevance to our starting hypothesis.