Is it fair to prioritize the suffering associated with confinement?
A carte blanche from Judith Dereau, Gérald Deschietere, Philippe de Timary, Paul du Roy de Blicquy, François Georges, Anne Toussaint and Francesca Vellozzi. Psychiatrists from the same GLEM (local medical evaluation group).
Is it fair to prioritize the suffering associated with confinement? Would a social group be more to be pitied?
Young people ? Adults teleworking? Frontline caregivers? Self-employed people deprived of work? The world of culture? The elderly in nursing homes? Covid patients in hospitals? Those who have no or no longer work? Rulers and experts, so often criticized? The ones we forgot in this inventory?
The proliferation of white cards testifies to the ambient distress and tries to bring them to light. When some plead their cause (s), others speak up, especially young people.
The impact of speech
If the intentions are laudable, this necessary and incessant focus on suffering youth asks us: what are the effects and the limits of these discourses? What do they imply when they speak of a sacrificed generation? Don’t they end up producing an anxiety-provoking speech? Does the expressed concern, although legitimate, offer prospects to this generation which had been able to embrace the issue of the climate challenge so well?
Starting from the potential risk of emotional contagion among young people, what is the impact of these alarmist and potentially deterministic speeches? Do they not enclose these young people in a necessarily traumatic experience? By placarding everywhere that “everything is screwed up” and in particular in the media, that there is a catastrophe, do not these pleas run the risk of locking these young people in a state of astonishment? By announcing a tsunami of psychic decompensations, do not the comments made help to shape a mental environment conducive to them?
In our opinion, it is a question of emphasizing the great diversity of individual responses, varying over time, which are declined in a lasting weakening of the social network for some and in sometimes more sustainable arrangements for others. We cannot imagine exposing our concerns for youth without also highlighting the adaptive and creative resources of much of it.
The melancholy weight
We regularly hear a nostalgic speech, about the “loss of the world before”: as if the youth had to live according to certain protocols, obligatory passages, in particular festive ones. But no one can appropriate their future: they have to create their own future. Several generations before us have shown adaptation in the face of hardship. As adults, let us prevent our nostalgia (comforting and reassuring) from turning into a melancholy burden for young people because the outcome of a crisis is never to return to restitutio ad integrum. The challenges of this youth will be as immense as their talents.
If the consequences of the restrictions are felt for most of us, and there will be damage as a result of the health crisis, hindsight alone will allow us to take stock of the lasting effects on the mental health of the population. . More than a direct link between confinement and distress, suffering and decompensation, as psychiatrists, at this stage, we have above all observed that this year has above all acted as a catalyst for inequalities, whether social, family, economic or psychological. This had the effect of a more acute, more rapid outbreak of fragile, partially compensated situations and an urgency to take care of them.
But isn’t there a confusion, in current discourse and circumstances, between mental health and psychiatry? Where psychiatry is intended to deal with mental illness, it seems to become the designated receptacle for all psychic suffering. This certainly highlights the clear insufficiency of current means and societal responses. Articulating the resources and the subjective responsibilities to the collective destiny should make it possible to give more means to the preventive line, but also “alternative”, so as not to confirm psychiatry as the only answer of last resort to the question of mental health.
By presenting deconfinement as a remedy for the current psychic suffering, we would come to a reductive vision of the origin of much of this suffering. What place do we leave then for those who will not get better, or even worse? We saw in June of last year that deconfinement brought its share of difficulties, in particular for people who had experienced the constraint (reduction in social pressure and the eyes of others, among others). To put it simply, we know that deconfinement will not be the only treatment for the suffering exacerbated by the current crisis. Indeed, the psyche has its own rhythm, which does not correspond to the epidemic tempo or to political agendas.
Nuanced speeches
Finally, we wonder about the societal impact that a vision of society divided into age groups could create (the choice of vaccination, the prioritization of suffering, etc.). Will there not be consequences in setting the generations against each other in this way?
In the absence of a psychic vaccine which would be very hazardous, qualifying the current discourses would be for us the best remedy for the surrounding disarray and that probably consists in an interminable work of culture, the very one which makes Camus write in Caligula: “Despair a young soul is a crime that passes all he has committed so far. “