The group treatment of drug users with mediating object: the application of Photolangage
Interview with Claudine Vacheret
by Giorgia Morgese
Question. Professor Vacheret, what do you think about the treatment of drug users? What therapy is more appropriate, a group therapy or an individual one?
Claudine Vacheret. It is clear with drug users that a group therapy is better as they tend to have big difficulties with mental thinking. They prefer to act rather than mental thinking. Since they cannot speak about their own feelings and affects then we have to organise a setting with a mediation to help them. In this way, they speak about the object and not about themselves.
Question. What about Photolangage and its application to drug users?
Claudine Vacheret. Our experiences in different countries with drug users show that Photolangage© is a very good method with them. It was used in France, specially in prisons, or in Montevideo in Uruguay, for example.
Question. Khantzian (1985) talking about modified dynamic group therapy tells about the difference between the psychodynamic approach (to facilitate the understanding of the self) and cognitive-behavioral approach (to change the behaviour of drug use).
In which of these approaches could you locate Photolangage? Is it a primary approach to drug users’ treatment or an integrated approache?
Claudine Vacheret. Of course, Photolangage© is a psychodynamic approach to individual subjects and groups. This method is very well connected to the analytical French theory about groups that was founded by Didier Anzieu and developed by René Kaës. According to this point of view it is an integrated approach.
Question. Bergeret in “Le psychanalyste à l’ècoute du toxicomane” (1999) presents the emotional immaturity of the drug users and considers his addiction in relation with the pain caused by the loss of a relationship. Could the end of the Photolangage group experience represent for the drug users the repetition of a painful event?
Claudine Vacheret. No, because the end of the group therapy is planned from the beginning and all the work is organised to help the patients in living separations and loss. As Bergeret says they have very few chances to identify with their caregivers since they were not able to take really care of a child. Their first identifications are not established or are not efficient enough.
Question. What is the group partecipants reaction to the choice of the photo chosen by the conductor? And what happens when the conductor choses the same photo as one of the partecipants?
Claudine Vacheret. The choice of a photo by the conductor shows that it is possible to play with a mediating object without any danger. Also the conductor can share with the patients his own thoughts or way of thinking and his imagination through the photo he chooses. Choosing the same photo is a good opportunity to exchange images and imaginaries and identifications with him or her.
Question. Referring to Khantzian (1985), it seems that persons who usually feel anger and rage prefer opiates instead persons depressed chose stimulants. Is Photolangage compatible with these differences? I’m thinking about narcotics or cocaine anonymous.
Claudine Vacheret. No this difference is not interesting. All the addicts have the same problems which are narcissistic ones.
Question. At last, do you think it could be possible applying Photolangage to drug users and their family?
Claudine Vacheret. No I don’t think it would be a good idea to mix patients and their families. It is better to have the group of drug users by themselves, but I also think that a Photolangage© group can be very useful for the families, parents, sisters and brothers, due the suffering faced by those families who find themselves powerless in front of a very difficult situation. Speaking about what they feel may be very important in the frame of an institution tha can welcome them each week or each month with others families. For them also the mediation by a photo is a good way to facilitate talking about their difficulties facing this pathology.
CLAUDINE VACHERET, is full professor of the Institut de Psychopatologie et Psychologie Cliniques, Universitè Lumiere Lyon 2. She is also member of the Paris Psychoanlytical Society and of IPA.
C. Vacheret promotes the use of Photolangage in Italy and other countries, becoming author of several books that treat about this method.
Anzieu, M. (1983). L’Io-pelle, Roma: Borla, 1987.
Bergeret, J. (2001). Chi è il tossicomane, Bari: Dedalo.
Bergeret, J., Fain, M., Bandelier, M. (1999). Lo psicoanalista in ascolto del tossicomane, Roma: Borla.
Kaës, R. (1976). L’appareil psychique groupale, Paris: Dunod.
Khantzian, E. (1985). The self-medication hypotesys of additive disorders: focus on eroin and cocain dependence, The American Journal of Psychiatry, 142:1259-1264.
Vacheret, C. (2002). Groupes e mediation, Paris: Dunod.
Vacheret, C. (2009). Foto, gruppo e cura psichica. Il foto linguaggio come metodo psicodinamico di mediazione nei gruppi, Napoli: Liguori Editore.
Vacheret, C. (1985). Photolangage et thérapie, Psychologie medicale, 17, 9: 1353-1355.
Vacheret, C. (1995). Photolangage ou comment utiliser la photo en formation et en thérapie, Art thérapie, 52, p. 88-89.