{"id":2475,"date":"2024-05-01T08:40:16","date_gmt":"2024-05-01T08:40:16","guid":{"rendered":"https:\/\/damianruiz.eu\/?p=2475"},"modified":"2024-12-17T11:39:45","modified_gmt":"2024-12-17T11:39:45","slug":"traitement-personnalise-de-la-dependance-a-la-cocaine","status":"publish","type":"post","link":"https:\/\/damianruiz.eu\/fr\/traitement-personnalise-de-la-dependance-a-la-cocaine\/","title":{"rendered":"Traitement personnalis\u00e9 de la d\u00e9pendance \u00e0 la coca\u00efne"},"content":{"rendered":"

Dami\u00e1n Ruiz<\/span><\/p>\n

 <\/p>\n

Le traitement de la d\u00e9pendance \u00e0 la coca\u00efne dans un cabinet priv\u00e9 est complexe car cette substance n’affecte pas seulement le fonctionnement normal du cerveau au niveau biochimique et neuronal mais aussi, au niveau symbolique, elle compense des carences, des aspects personnels qui n’ont pas \u00e9t\u00e9 int\u00e9gr\u00e9s ou \u00e9labor\u00e9s ou des modes de vie r\u00e9ellement insatisfaisants.<\/span><\/p>\n

La coca\u00efne cr\u00e9e l’id\u00e9e que sans elle, il est difficile de r\u00e9aliser certaines actions : profiter d’une f\u00eate, faire l’amour, se concentrer, se d\u00e9tendre, se d\u00e9connecter, vaincre la peur ou la timidit\u00e9, r\u00e9sister \u00e0 la pression du travail, oser prendre des d\u00e9cisions, etc. C’est une drogue que le cerveau adapte pour g\u00e9n\u00e9rer diff\u00e9rentes fonctions.<\/span><\/p>\n

L’abandonner peut \u00eatre facile ou tr\u00e8s complexe. Autour de cette substance, nous avons cr\u00e9\u00e9 un paradigme au niveau social : s’en d\u00e9faire est devenu une fa\u00e7on, m\u00e9taphoriquement parlant, de gravir l’Everest. C’est une t\u00e2che impossible qui n\u00e9cessite beaucoup d’infrastructures, beaucoup de volont\u00e9, beaucoup d’efforts et de pers\u00e9v\u00e9rance. Il en va de m\u00eame dans la plupart des cas.<\/span><\/p>\n

Si nous parlons du tabagisme, un probl\u00e8me mineur en comparaison, nous connaissons des personnes qui ont arr\u00eat\u00e9 du jour au lendemain, apr\u00e8s des ann\u00e9es de tabagisme consid\u00e9rable, sans rechuter, et d’autres qui ont besoin de longs processus cliniques avec l’intervention de diff\u00e9rents types de professionnels m\u00e9dicaux et psychologiques, et malgr\u00e9 cela, m\u00eame s’ils le veulent, ils n’arrivent pas \u00e0 s’arr\u00eater.<\/span><\/p>\n

Avec la coca\u00efne, on insiste beaucoup sur la volont\u00e9 de l’usager ou du toxicomane. Et bien qu’elle soit essentielle avant le traitement, une premi\u00e8re question est pos\u00e9e : voulez-vous arr\u00eater compl\u00e8tement de prendre cette substance ? Si le patient r\u00e9pond \u00ab\u00a0J’aime beaucoup en consommer, je viens ici parce que je pense qu’il faut que j’arr\u00eate\u00a0\u00bb, \u00ab\u00a0J’aimerais le contr\u00f4ler, pour pouvoir faire une ligne de temps en temps, m\u00eame si ce n’est qu’une fois par mois ou \u00e0 certains moments\u00a0\u00bb, alors il n’est pas pr\u00eat \u00e0 commencer le traitement, et il vaut mieux le reporter.<\/span><\/p>\n

 <\/p>\n

La personne confront\u00e9e \u00e0 ce probl\u00e8me doit remplir deux conditions pr\u00e9alables pour que la th\u00e9rapie soit couronn\u00e9e de succ\u00e8s : d’une part, elle a personnellement pris la d\u00e9cision d’arr\u00eater de consommer la substance, quelle que soit l’influence de son environnement, et d’autre part, elle veut l’\u00e9radiquer compl\u00e8tement de sa vie.<\/span><\/p>\n

\u00c0 partir de l\u00e0, le travail s\u00e9rieux peut commencer.<\/span><\/p>\n

Mon approche, dans ce cas, n’est pas bas\u00e9e sur la volont\u00e9 du patient.\u00a0<\/span><\/p>\n

Je comprends qu’il fera de son mieux au d\u00e9but, m\u00eame si l’alliance th\u00e9rapeutique entre les deux est bonne, il est tr\u00e8s probable que pendant une premi\u00e8re p\u00e9riode, cela servira de motivation pour se maintenir sans consommer.<\/span><\/p>\n

Mais… t\u00f4t ou tard, la frustration, le besoin de consommer, le deuil de l’absence de la substance, le fameux \u00ab\u00a0craving\u00a0\u00bb, si bien connu de ceux qui ont suivi diff\u00e9rents traitements, peuvent commencer.<\/span><\/p>\n

Et comment travailler contre cela dans une consultation psychologique si le patient peut avoir un acc\u00e8s imm\u00e9diat \u00e0 la substance ?<\/span><\/p>\n

Dans mon cas, je base mon travail sur deux aspects : un progr\u00e8s soutenu ax\u00e9 sur la r\u00e9duction des apports et des quantit\u00e9s, o\u00f9 la volont\u00e9 et le contr\u00f4le sont impliqu\u00e9s mais de mani\u00e8re plus mod\u00e9r\u00e9e, et deuxi\u00e8mement, la recherche, dans la vie r\u00e9elle et inconsciente, des facteurs qui ont pr\u00e9cipit\u00e9 ou pr\u00e9cipitent cette consommation, au-del\u00e0 des aspects biochimiques d\u00e9j\u00e0 crypt\u00e9s au moment de l’addiction. Cette derni\u00e8re t\u00e2che est plus complexe, mais si l’on commence \u00e0 les d\u00e9tecter et \u00e0 essayer d’y rem\u00e9dier en les faisant \u00e9merger dans la conscience et en transformant les actions \u00e0 entreprendre dans la r\u00e9alit\u00e9 et m\u00eame en transformant le style de vie.<\/span><\/p>\n

Ma formation psychanalytique jungienne (bien que cette th\u00e9rapie soit \u00e9clectique) et un caract\u00e8re r\u00e9solu qui comprend que la connaissance d’une chose ne la transforme pas d’elle-m\u00eame et qu’une action est n\u00e9cessaire, me conduisent \u00e0 rechercher, avec le patient, ce changement n\u00e9cessaire.<\/span><\/p>\n

 <\/p>\n

Je suis bien conscient que quelqu’un qui abandonne la coca\u00efne ne peut pas devenir une personne normative, monotone, enferm\u00e9e dans des habitudes standard, m\u00eame si sa vie et son environnement semblent apparemment heureux et r\u00e9ussis. Il s’agit d’une personne qui aura besoin d’un niveau de stimulation, voire de passion dans la vie, bien sup\u00e9rieur \u00e0 la moyenne. Elle peut m\u00eame avoir d\u00e9velopp\u00e9 une certaine intol\u00e9rance \u00e0 la frustration. Tout cela sera pris en compte.<\/span><\/p>\n

 <\/p>\n

En r\u00e9sum\u00e9, la th\u00e9rapie d’arr\u00eat de la coca\u00efne que je suis ne sera pas bas\u00e9e, comme je l’ai dit, sur l’activation de la volont\u00e9 du patient mais, comme je l’explique dans le livre que j’ai \u00e9crit sur le sujet, sur sa capacit\u00e9 \u00e0 la transcender, \u00e0 ne pas en avoir besoin parce que des aspects m\u00e9connus ont \u00e9t\u00e9 int\u00e9gr\u00e9s et \u00e9labor\u00e9s et qu’un nouveau style de vie plus motivant a \u00e9t\u00e9 g\u00e9n\u00e9r\u00e9.<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

Dami\u00e1n Ruiz   Le traitement de la d\u00e9pendance \u00e0 la coca\u00efne dans un cabinet priv\u00e9 est complexe car cette substance 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