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Résumé Après l’urgence chirurgicale du traumatisme physique vient le temps de la reconstruction faciale, physique, mais aussi psychique, moins visible et parfois bien plus complexe. L’auteur se base sur le travail clinique d’un atelier thérapeutique autour du portrait, plus précisément en se référant à deux séquences cliniques de ce groupe pour examiner les liens étroits entre la création et la restauration de l’image de soi. Cette étude monocentrique a été menée dans une unité de chirurgie réparatrice à Amman (Jordanie), avec près de 200 victimes civiles de la guerre civile en Irak sur une durée de six mois. Ce travail sur le terrain permet de mettre à jour la diversité des mécanismes et des étapes par lesquelles passent les mutilés de guerre afin de se reconstruire une identité. À travers l’atelier portrait apparaît la symbolisation de la phase dépressive qui précède la reconstruction identitaire. Reconstruction comes after the surgical intervention for a physical trauma. The rebuilding of the face involves psychological as well as physical processes. The psychological aspect of reconstruction is less visible but more complex. The findings of therapeutic workshops based on the concept of “the face” have been invaluable. Clinically, the workshops referred specifically to an examination of the links between the creation of and restoration of self-image. This six-month long, mono-centric study took place in a surgical ward in Amman (Jordan) which treated almost 200 civilian casualties of the Iraqi civil war. The results improve our knowledge of the diversity of the mechanisms and stages that the casualties experienced to rebuild their identity. The first stage was to ask the patients to draw a self-portrait. All the patients portrayed themselves before their trauma. Then they were then asked to draw themselves as they were “now”, ie: after the trauma. Dira, a young burns patient, looked at himself in a mirror for the first time since the accident. For his second self-portrait he chose a variety of different papers and materials to portray the scars and the different textures of his skin. Another child used stickers to portray himself like a mosaic. Most of the patients started their work with a pencil paper and drew an oval. This portrayed the “real face”, the one hidden under the scars, the burnt skin, the bandages… Hidden, like in Dira's self-portrait, under the different layers of paper. By hiding his original face, which was still there but unattainable, he portrayed his loss and fragility. It can be seen from this workshop that the whole body image is modified after physical trauma. The intensity of the care, the pain, and the bandages is an emotional investment. They become a type of protection but also an obstacle to the process of restoring the body image. The perception of one's body as “damaged” causes a serious imbalance of the patient's self-image because of the emotional association with a deep feeling of fragility. In turn, this sense of physical fragility is closely connected to its mental equivalent. The patient's spirit goes through a destructive phase because of the external and internal emotional overload. This mechanism, which drives the body image, can slow down mental development when the patient is a child or a teenager. This destructive stage of recovery precedes the reconstruction of the patient's identity. The therapeutic workshop illustrates the symbolic importance of this stage by exposing the link between the wish to gather together the fragmented body image post-trauma and the cutting-out that Dira did for his post-trauma self-portrait. The patient rebuilds his self-image by gathering it together piece by piece. Therapeutic workshops and individual therapy enables patients to verbalize their anxieties. Therapy helps them to overcome their fear of the physical reality of their trauma and to reconstruct their psychological identity simultaneous to the surgical reconstruction. [ABSTRACT FROM AUTHOR]

Unlabelled: The word <> was created in 1977. It was first used to describe an extreme paraphilia concerning both the search for amputees as sexual partners, and the fantasies and wishes to be amputated linked to a sexual arousal., Clinical Findings: More recently, the number of self-demand amputations appears to have raised. Some amputations of healthy legs have even been performed in hospital settings, raising important ethical issues. A new category of trouble has been described: the Body Integrity Identity Disorder (BIID). Criterias for its diagnosis have been developed and submitted to DSM V task force. According to clinicians who support the existence of BIID, this disorder is not a paraphilia, don't overlap with other psychiatric disorders and could be in some ways compared to transexualism. The patient's health would therefore require the amputation of healthy limbs in order to <> themselves and to help them to become <> according to their <>. Still according to those clinicians, psychiatric symptoms would be either a consequence of the shame resulting from this condition, or a consequence of the doctor's refusal to perform these amputations. An ever growing <> litterature on the web support this opinion, but the scientific litterature is still very scarce., Literature Findings: In this paper, we analyse available scientific datas. This review does not support the existence of BIID as a discrete nor a specific condition., Case-Report: In a second part of this paper, we describe the case of a young woman who started asking for above-the-knee leg amputation after a minor knee trauma, while complaining for pain and leg rigidity. Her medical state worsened, probably because of repeated self-inflicted lesions and food restriction, leading to a severe undernutrition and life-threatening hypokaliemia. After some time, her medical state required amputation. This surgery did not resolve her psychological suffering. She never talked about amputation as a way to achieve herself. She did not meet the criterias for BIID. We consider her trouble as an association of a factitious disorder with a borderline personality disorder., Discussion: In the last part of this paper, we discuss the <> scientific litterature about apotemnophilia and BIID. We support the idea that BIID can be considered as a culture-bound syndrome, a contemporary frame for psychological suffering. We think that BIID does not have neither intrinsic nor unequivocal psychopathological meaning. It is a <> (Elliott), a common pathway for the expression of very different kinds of psychological suffering., Conclusion: Apotemnophilia and BIID are raising important ethical and practical issues for psychiatrists: their opinion will probably be requested by patients and surgical teams having to deal with patient asking for healthy limbs amputation.

Objective: The psychoanalytic concept of specular image refers to the complex construction that associates the body image with the language coordinates of the individual, thus making him/her a human subject. The acquisition of this specular image implies the loss of corporeal exchanges between mother and child, i.e., the "neutralization" of those body parts or extensions where these exchanges take place. These conceptions of body image and subjectivity lead to the hypothesis that neurological disturbances of body schema may alter the patients' subjectivity and their relation to the lost "object" insofar as they alter body image., Material: In the present paper, we present two patients aged under 50, with a unique first ever stroke due to ischemia in the right middle cerebral artery territory and asomatognosia., Methods: On one hand, Bisiach's protocol was used to assess hemiplegia, sensory troubles, visual troubles, hemineglect and anosognosia, and adapted to assess asomatognosia. On the other hand, subjective data were gathered during a semistructured interview and a self-portrait test., Results: This showed that asomatognosia was accompanied by a destructuration of body image and aberrant oral manifestations involving the paralyzed hand., Discussion-Conclusion: The psychological positive phenomena accompanying asomatognosia might correspond to the intrusion of the lost object in the patients' psychic reality, due to the alteration of body schema and body image.

The reason this research topic is of interest lies in the fact that the first year after birth is a major transition for all parents, especially for the mothers. Thus, the objective of the present paper is to analyse certain psychosocial factors surrounding new mothers during this period and the way in which they can accentuate feelings of incapacity and powerlessness that can contribute to the development of low self-esteem and a negatively perceived body image. These factors can adversely impact the postpartum period. Furthermore, this topic has been very little explored in the Romanian population.

Résumé Objectifs Jusqu’à ce jour, l’estime de soi sexuelle a essentiellement été étudiée auprès de populations touchées par des problématiques spécifiques. Bien qu’un lien semble évident, peu de chercheurs se sont penchés sur le rôle du BMI, de l’image corporelle et de l’influence des médias sur l’estime de soi sexuelle des femmes. En se basant sur l’analyse des facteurs pouvant améliorer ou limiter l’estime de soi sexuelle féminine, l’objectif principal de cet article est de proposer une meilleure compréhension des facteurs cognitifs, corporels et sociétaux impliqués dans sa genèse et son maintien. Matériel et méthode Analyse de la littérature de 1996 à 2015 dans les bases de données suivantes : PsycInfo , PubMed , ScienceDirect , ProQuest , Google Scholar . Résultats Au travers des études qui font lien entre BMI, image corporelle et divers aspects de la sexualité féminine, cet article fait apparaître l’importance du regard subjectif que les femmes entretiennent vis-à-vis de leur corps, de l’impact de ce regard sur leur estime sexuelle, et ce, indépendamment de leur poids réel. Dans un second temps, la revue de la littérature met en évidence l’impact des médias de masse sur la construction de l’image corporelle, notamment via les processus d’internalisation de l’idéal de minceur, de comparaison sociale et d’objectalisation du corps de la femme. Conclusion Il serait intéressant, dans la recherche future, non seulement d’investiguer l’impact du rapport au corps sur l’estime de soi sexuelle des femmes mais également d’élaborer un outil visant à améliorer celle-ci. Cela inclut la promotion d’une image corporelle positive et une meilleure compréhension du rôle de la société et des médias dans la construction des standards de beauté et d’apparence. Summary Objectives Until today, the sexual self-esteem has been studied for people with specifics problems. Despite the fact it is bounded, few researchers have investigated the role of the BMI, the body image and the influence of the mass media on the women sexual self-esteem. Based on factors which improve or limit the women's sexual self-esteem, the principal aim of this study is to bring a better understanding of the involving of cognitions, body and society's factors in the understanding of the women's sexual self-esteem. Sources and methodology The analysis of the written papers from 1996 to 2015, in the following database: PsycInfo , PubMed , ScienceDirect , ProQuest , Google Scholar . Outcome Throughout studies that bound BMI, body image and various female sexual effects, this article highlights the role of the subjective view that women have about their bodies in relation to their sexual esteem, independently of their real weight. In a second time, this review highlights the impact of mass media on body image construction, including the thin ideal internalization process, social comparison and body woman objectification. Conclusion It would be interesting, for future researches, not only to investigate the impact of the relationship of the body on sexual self-esteem, but also to create a tool that improves the women's sexual self-esteem. It includes the promotion of a positive body image and a better understanding of the role of the society and mass media in the construction of standards linked to beauty and appearance. [ABSTRACT FROM AUTHOR]

For schizophrenic patients, memory and desire are not bodily experiences. Mnemonic traces can be mobilized only at the cost of acute psychotic disintegration of the Self. This paper emphasizes the importance of understanding the Ego structure, the narcissistic economy and psychotic defenses (denial, splitting) as a psychosomatic the organization. Indeed, during somatic illness we observe a reintegration of the body as the hinge between emotional and symbolic aspects of subjective experience. The author suggests that the psychosomatic viewpoint is particularly useful in understanding the clinical evolution of schizophrenia, in psychotherapeutic management of transference and in the elaboration of psychiatric care policies for such patients.

Authors propose a definition of dyschronia in childhood through paper review and clinical study using several criterions. Dyschronia is a cognitive disturbance linked to a disturbance in the construction of body image. Dyschronia appears as a specific developmental disorder at cognitive register and psychodynamic register. Clinical study shows that it informs about psychic spaces, body image and about the rhythm of psychic mechanism. [Copyright &y& Elsevier]

Copyright of Sartre Studies International is the property of Berghahn Books and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)