Psychose, suicide, secret et transmission

Abstract

The main objective of this article is to discuss the question of heredity and psychic transmission of depression. Although the exact origin of this disorder is not yet completely understood, many studies have suggested a biological etiology. This causal question is commonly raised by parents and future parents in our psychological consultations. Based on clinical observations, we discuss the influence of a family secret and the nature of the difficulties faced by a parent diagnosed with a genetically transmitted psychiatric disorder from a systemic perspective. The case study of a 7-year-old child presenting a psychotic-like condition illustrates how a medical diagnosis (in its hereditary component) runs the risk of freezing transitory behaviors which are secondary to a complex environment charged with guilt into stable symptoms. More specifically, it shows how the well-kept family secret of this child's maternal uncle suicide was a major influence on his internal representations. We conclude that the systemic approach enables clinicians to establish a more differentiated diagnosis by taking into account several levels of understanding of the symptom. The family interviews facilitate the formulation of the secret; they encourage all family members to acknowledge and come to terms with the past in a context of security.