Signifiants culturels dans le travail d’élaboration de la maladie chez les patients en réadaptation cardiaque

Abstract

Our study is entitled: « Cultural signifiers and the work of illness elaboration in cardiac rehabilitation patients ». The onset of heart disease leads to psychological suffering in the patient. This onset is the state of crisis that leaves in the face of the patient in the state of disarray, where, powerless in front of their illness, the develop depression, past traumatic stress an anxiety. Observation of patients undergoing cardiac rehabilitation has enable us to note that they are deeply rooted in their culture: they speak of their illness as being the result of witchcraft, maraboutism, the evil eye, a curse, the will of God ; they also spoke of the armoring done to their bodies, of ancestral ritual practices such as cult of skulls and washing, and of the prayer and exorcism sessions they now engage in. In relation to the work of elaborating their illness, these patients talk about their suffering in a banal way « this illness is an illness like others », simplifying it « it is a simple illness) and developing a positive discourse on their state of health ‘in spite of everything, i assure you that I’m not thinking about death, I’ll get thought it ». However, metallization theories base their work psychic elaboration on two processes, namely, representation and symbolization, which are the products unconscious. Ethno psychologists see culture as a container for making sense of situations and phenomena, but metallization theorists have not paid much attention to it. We therefore set our objective of understanding the role of cultural signifiers in the elaboration of illness in patients undergoing cardiac rehabilitation. To achieve this, we used the clinical method. Data were collected by means of semi-directive interview with three people suffering from cardiovascular disease at Polyclinic les Promoters de la bonne Santé. The data were analyzed for content. The results show that cultural signifiers such as cultural protection, consultation of healers, persecutory interpretation and recourse to rituals are units of meaning that culture offers to the patient and that help him to make sense of their illness. The results were interpreted by the metallization theory and discoursed in the light of previous work.