Joint Consultation for High-Risk Asthmatic Children and Their Families,with Pediatrician and Child Psychiatrist as Co-Therapists: Model and Evaluation

Although a very common disease, childhood asthma can be a life-threatening condition. Psychosocial determinants have been acknowledged to trigger severe asthma. The authors review current knowledge about how psychosocial factors influence childhood asthma, with a special focus on compliance with treatment and family interaction. The authors describe their experience of joint treatment of high-risk asthmatic children and their families. The pediatrician and child psychiatrist work as co-therapists, and the results of this intervention are investigated. Forty-one high-risk asthmatics and their families were followed in the joint-consultation program. Two years after the onset of joint consultation, a significant improvement was found in symptom score, treatment score, and compliance score. The number of hospital admissions and of days spent in hospital decreased significantly. The cost of care was subsequently cut by two-thirds, despite the added cost of psychiatric care. The authors conclude that it is possible for doctors of the body and of the mind to share consultation work, with a positive impact on both the patient's health and the cost of treatment.     

Between Baghdad and Birmingham: Minorities--Christian and Muslim

This paper deals with majority-minority relations that very much condition relations between Muslims and Christians. The first part gives some factual data about Muslim minorities in Europe and Christian minorities in Muslim countries and makes some comparisons between their situations at present. The second part questions the very idea of speaking of Muslims and Christians in terms of majority and minority, since this imposes a political scheme on human reality, neglecting existing diversities within the communities and in the relations between them. More important questions are: what have Muslims and Christians done with their religions in minority and majority situations? How can a model of participation in civil society replace the traditional Middle Eastern model of social separateness with religiously justified antagonisms? How can the positive potential of minorities be better appreciated? The author pleads for practical realism and enlightened participation instead of fixing and quantifying Muslim and Christian religious communities as closed social entities.     

Constructing the truth From ‘Confusion of tongues’ to ‘Constructions in analysis’1

The author hypothesizes that the papers Freud wrote in the period 1934‐9 constitute a fi nal turning point in his work resulting from an attempt to work through, by means of self‐analysis, early traumatic elements reactivated by the conditions of his life in the 1930s. The author emphasizes that the ups and downs of Freud's relationship with Sándor Ferenczi and the mourning which followed his death in 1933 played an important role in this traumatic situation. He suggests that through these last works, Freud pursued a posthumous dialogue with Ferenczi. This working through led Freud, in Moses and monotheism, to an ultimate revision of his theory of trauma, a revision which the author examines in full, in the light of the works of the Egyptologist, Jan Assmann. A new analytical paradigm emerges: that of constructions in analysis developed in the article of the same name. The activity of construction appears as an alternative to the mutual analysis proposed by Ferenczi and is closely bound up with the notion of historical truth. In psychoanalysis, it would mean constructing a historical truth whose anchoring in the material truth of the past is essential, though it should not be confused with it.