Starting from the traditional aetiology of mental illness in Sub Saharan Africa, the author questions the concept of ” ancestor child ” in the interpretation of mental disorders with African adolescents belonging to the first generation of migrant adolescents. Starting from an ethnopsychoanalytic reading of two clinical vignettes, the author stresses the reintroduction of the symbolical function of the father, erected as it is on that very traditional etiology, with two families exposed to acculturation. The author evidences the therapeutic efficiency of that ethnopsychological method which enabled both these adolescents to substract themselves from the denial of a fialitation ascribed by such a cultural logic in order not to be sacrificed to such a ” status ” of an ” ancestor child “.
In the 19th century the Bible suggested a new approach of the human body to the Merinas who were the most powerful and most evalized kingdom in Malagasy. Christianism was supposed to inspire them towards an integration into ” civilization “. Some ancestral institutions, believed to be adverse to the new traditions were given up. Yet, the ” carnal need “, which was the neologism by which the missionaries defined lust remained insensitive to the christianization of the customs. The Merinas used sexuality as a field for resistance, confronted as they were to the fear of a total seizure of their identity by the Westerners. Whether it be amid the royal family or with common people, the actors were mainly adolescents : their behaviour had been approved by their parents.
The Aids epidemics that does not seem to regress in Africa has a catastrophic impact on children, adolescents and adults. The consequences of such a situation are sanitary, economic and demographic. The adolescents, who are more than a billion in the world, are very concerned, particularly in Africa where only very few of them go to school and who for many of them either remain in the streets and/or prostitute themselves. Anti-Aids committees have been organized among school children and teachers, information and education in terms of prevention try to move as far as the rural villages. Associations try to help the authorities. People suffering from Aids themselves try to inform and by telling their stories promote a decline of denial and exclusion. Yet medical and psychosocial help and care should be better, for, if they weren’t, the discourse on prevention would be totally useless.
An episode in the life of S. Freud, i.e. the engagement of his daughter Sophie with Max exmplify how counter-transference affects about identity come in contact with the working through surging in the adult when their children discover and show off a liable genital sexuality, thus experiencing love feelings and emotions.
The study of the intermediary states or physiological determinants of a liability to emotional behaviour at adolescence necessarily calls forth the psychology of development and endocrinology of behaviours. If one holds on to hormon biology, and sex hormons in particular, both levels of significant effects may be summed up in an activating influence, contemporary to puberty and a far prior organizing influence, contemporary to the ante- and peri-natal period. According to both these levels of influence, one should be able to distinguish between the direct and indirect effects, knowing that all of them are at work simultaneously, in proportions that are of course diverse and often very difficult to precise. The data we have at present suggest that we should relativize a far too simplistic image of a ” hormonal storm ” wherefrom an emotional ” storm and stress ” specific to adolescence would result. These data stress important differences according to the sex and also stress the joint part played by the several factors coming from the environment.
In the fight against HIV-Aids, prevention strategies are a determining stake. Can one however be satisfied with devices that would not be submitted to a critical assessment ? From the point of view of its impact and consequences, prevention must be both at once efficient and respectful of the person in its rights and values. The adolescent should be able to be granted an access to all information allowing him to have a series of autonomous choices at hand and which also would enable him to stress his own responsibilities whereas at the same time his frailties would be taken into account.
In the course of prevention network in CRIPS, the author presents a research carried out on the the language underlying the actions of communication and prevention of Aids towards young people. The aim was to analyze, amid every single act of communication the representations covering words in order to guarantee that the messages that are emitted do indeed refer to the realities and values that organize on the one hand the sociolinguistic universe of the adults and on the other, that of the youths. The question thus asked is whether the modes of expresion can be transposed one from the other.
The elaboration and organization of health educational programms with youths should meet precise criteria. Here, the author discusses prevention in terms of HIV and drug addiction. Only a credible information, adapted to the public aimed at, may exercize some positive influence : it should be given mainly to vulnerable subjects but also to the whole community. International cooperation in that field is more than ever on today’s agenda.
The ” ethical questions ” raised by Aids are not specific to it. Yet, though not specific to it, they may take an examplary character as is evidenced by the clinical situation which we present here. The latter, by confronting the doctors to a specific impossible choice, and putting the ” paternal function ” directly at play, enables us to define what we suggest to call an ” ethical position “, as opposed to the concepts of deontology or morals, and stress its essential link with the ” clinical ” touch understood as an art of the ” case-to-case “, i.e. a place where the singularity of the subject is to be revealed.
In this paper, the author comments two epidemiological studies on the use of condoms with youths between 15 and 18 (H. Lagrange, B. Lhomond, and the ACSJ team) and the risk frequency rate of Aids among the young drug-users (F.Lert). She draws the following conclusions :
– adolescents are responsible subjects who do respond to health messages,
– prevention actions may be useful and efficient,
– however the actions with high-risk youths should be thought over more carefully.