Contenu du sommaire : Addictions et temporalité

Boredom as an Experience of Time
Boredom is not simply a burden one has to be rid of, nor a bad experience from which we try to escape – and to where? It may be an opportunity, provided we hear what it has to tell us, about ourselves, human condition and our temporal nature. Boredom will only bare fruit when related to “interior leisure” – the true meaning of school (skholè) in ancient Greek.

Time to forget the present through consumption
The mutations taking place over the recent decades have a direct effect on temporalities, and especially in younger people. For this population that is going through identity construction in a liminal position, uncertainty and insecurity about the future generate stress and fear. Moreover, the quest for self-confidence and the mobilization of resources for coping are not eased by the stigmatising perception and views from the adult world. The present is largely geared towards a future that requires the effort of composing and structuring, which is also felt as a burden. In this context the effects of addiction are perceived as time-outs which allow the reduction of the pressures of everyday life and temporarily erase fears through amnesia. Given these results, and current prevention practices, largely based on a medicalized approach, beg the question of the efficiency of actions and mediations directed toward this target population.

In Vino vieillissimo : “never again” the last pleasure, the ultimate taboo? About old addicts
It seems almost indecent to talk about addiction and temporality as people reach old age. However, epidemiological and clinical studies speak for themselves and conflict with the lack of healthcare specifically adapted to the elderly. How can we explain this denial and the lack of investment in screening and treatment? Addiction makes sense for the psychopathology of aging. Addictive behaviors in elderly people seem related to problems of grief and loss, which can no longer be overcome. When facing the unavoidable, it is tempting for medical staff to consider these requests as petty and to evoke needs and pleasure, thus protecting themselves from a feeling of anguish. In this time, when the longevity revolution clashes with the communication revolution - in an opposition of temporalities - addicted elderly people suffer even more, as a consequence of the lack of appropriate social solutions. Sadly, this situation exemplifies the growing inequalities in public healthcare policies.

Addiction and temporality care's time: now or never!
The teenager vividly questions the issue of temporality. Between the ‘never‘ and ‘always‘, the ‘not enough‘ and ‘too much‘, meeting a teenager challenges the therapist: the immediacy of the request, the instability of the contact, the temporal disorganisation. Jostled by puberty, engaged in a period of radical changes but asked not to remain stationary for too long, the teenager is shaken by temporal conflicts taking place within them. ‘I've got no time‘ rapidly emerges: what time are we talking about? The chemical temporality would then be a time out of time, a-temporal, related to infinite repetition. Sometimes the clinician should dare to be uncomfortable in immediate contact whilst signposting the encounter, creating space for a temporal place to open/letting a temporal place open. The treatment time is extremely fragile, a mere nothing could destroy it. This time needs to be constantly adjusted; adapt it ‘as it goes‘ seems necessary to let the talking exist. It is through clinical situations that I invite you to think about these questions about encounters with teenagers.

Prevention and temporality
Prevention accompanies every steps of life, be it primary, secondary, tertiary or quaternary prevention. It is everybody's promise, while awaiting disease, as well as during and after pathology. There is no idle time regarding prevention. For all that, the addict is aversed to take a temporal approach, which requires to renounce the present, in the hope of an unspecified future.

Scheduled hospitalisations: a way of giving back time its motion?
In order to ensure true therapeutic continuity and quality work with patients requiring long term care, we developed “scheduled hospitalisations” in our addictology department in Brest. This article submits a reflexion based on temporality and assesses the benefit of scheduled hospitalisations. Scheduled hospitalisations are specific care terms, regularly submitted to our patients addicted to alcohol. This article's aim is to demonstrate that, by re-organising the temporality of the care process, we provide them new prospects through enhancing the perception of time, which is frequently considered as motionless. Furthermore, another specific part of our program is based on the fact that abstinence is not a requirement between scheduled hospitalisations, which give these a real therapeutic dimension. Hence, scheduled hospitalisations open a new therapeutic “space”, which allows the patient to become a “subject” and therefore permit him to “desire”.

Hyperactivity and addiction – therapeutic prospects
From the starting point of a notion of time, the author proposes to address hyperactivity problems in adults, despite having initially been diagnosed in children. He describes the case of certain cocaine addicts, who were in fact undiagnosed hyperactive children. He proposes some therapeutic solutions for this type of addicts.

The new social networks on the internet
The new networks feed on desires which have always existed: to valorise our life experiences, to never be forgotten, or to be able to hide or show ourselves at will. But these networks introduce new possibilities: universality of exchanges, immediacy, and the association of intimacy of intention as opposed to spatial intimacy, desire of “ex- timacy” open to the entire world. At the same time, web 2.0 gives rise to new forms of relationships, networks and communities. And finally, in this new landscape, avatars seem destined to play an ever increasing role.