Rahmethnissah Radjack

Introduction Health inequalities represent a major challenge in contemporary medicine, with some attributed to racial biases. Recently, in the United States, a call to combat discrimination in the field of health has resonated, particularly in the context of the COVID-19 crisis, in which minorities have been disproportionately affected. These calls...

L’identité des enfants de migrants présente une vulnérabilité particulière durant l’adolescence. Cet article explore l’impact de l’absence paternelle sur le développement identitaire de ces adolescents. À travers l’étude de deux cas cliniques rencontrés dans le cadre des consultations transculturelles, nous observons que les symptômes des adolescen...

En ce qui concerne l’adaptation des théories psychologiques et psychiatriques aux problématiques complexes que l’on peut rencontrer dans le travail avec les patients issus de la migration, il reste encore beaucoup de travail à faire aussi bien en soins qu’en recherche. Cet article basé sur des données cliniques et de recherche, issues d’une expérie...

Background: Academic instruction about the impact of culture on health care (through cultural representations of diseases, the body, and various treatments) is sparse in France, although this topic is widely taught in other countries with substantial immigration, especially Canada and United States. Medical students' reception of this instruction m...

L’adolescence de l’enfant de migrant(s) présentant une souffrance dépressive, semble être le théâtre d’une migration prise dans le processus de séparation-individuation, avec une menace de perte d’identité culturelle d’origine et des défauts importants de transmission de l’histoire familiale et migratoire. La culpabilité est entretenue par la « det...

Introduction Parents whom adolescents disclose sexual abuse face both a personal traumatic experience, and the need to support their child who is going through a grueling period and needs them. Many quantitative studies exploring the psychological impact of disclosure on parents have been conducted, but few have used qualitative methods. The object...

Les représentations du corps du bébé et de son développement varient d’une culture à une autre et déterminent les pratiques parentales. Les neurosciences culturelles nous apprennent que le corps, donnée biologique supposée stable et universelle, est modifié sous l’influence de la culture et de l’environnement. En situation de migration, les paramèt...

Introduction: Intimate partner violence occurring during pregnancy has a similar prevalence as usual obstetrical disorders that are routinely screened for. Referenced publications insist on the importance of adequate screening, but the proper course of action has yet to be defined. Aim of study: We qualitatively explored the different resources...

Introduction: Functional neurological symptom disorder (FNSD) is a common diagnosis among adolescents. However, we feel it is a difficult diagnosis to assess because of the diversity of its clinical manifestations, the rapid changes in its nosography over the years, and its common imbrication with established somatic diagnoses. We would like to il...

Introduction: Intimate partner violence occurring during pregnancy has a similar prevalence as usual obstetrical disorders routinely screened for. Referenced publications insist on the importance of adequate screening but the proper course of action has yet to be defined. Aim of study: We qualitatively explored the different resources and concepts...

Borderline personality disorders account for 50% of adolescent hospitalization cases in psychiatry. The severity and psychopathological complexity of these symptoms indicate the need for inclusive models of understanding. Adopting a holistic approach allows for the consideration of not only the patient's environment, but also their position within...

Objectives Migrant women face an increased risk of adverse obstetrical outcome and Caesarean section. The psychological experience of Caesarean section combines physiological, social, and cultural dimensions. This qualitative study explores the subjective experiences of first-generation migrant women who gave birth by Caesarean section. Methods Se...

Context Transcultural skills are especially useful for those involved in the perinatal period, when parents and babies must adapt to one another in a setting of migration a long a focus of transcultural clinical practice. Objective The aim of this article is to provide useful transcultural skills for any health care worker (e.g., psychologists, ch...

Background The health crisis led to numerus questions regarding health care measures, psychological experience of lockdown, and health care access inequities according to migration status during pregnancy. This qualitative study explores the subjective experience and cultural representations around pregnancy and mother-child bond among migrant moth...

La catégorie du HPI s’invite partout au xxi e siècle : écoles, milieux de soins. Pourtant, les professionnels ne font pas consensus autour de ce sujet. Des débats passionnés entourent le HPI et empêchent parfois de le penser. Ici, nous établissons un parallèle avec la figure du génie, en déclinant les différents aspects qui l’ont caractérisé depuis...

Résumé Objectifs Ce travail vise à questionner l’accompagnement des jeunes ayant commis une infraction pénale suivis à la protection judiciaire de la jeunesse dans le contexte d’implémentation prochaine du Code de la Justice Pénale pour les Mineurs. Méthodes Une recherche des textes et travaux associés à la délinquance juvénile a été effectuée à...

Background Unaccompanied refugee minors—or unaccompanied minors—are children and adolescents who have been separated from parents and other relatives and are not being cared for by an adult. Unaccompanied minors are a vulnerable population, with numerous stressors and complex psychiatric symptoms necessitating specialized mental health care. This s...

Medical termination of pregnancy when decided for maternal psychosocial distress is a new issue facing maternity field teams. Multidisciplinary work is required, as well as respect for the patients' temporality. The decision is collegial, estimating the least traumatic impact possible for them over the long term. The ethical principles of beneficen...

Background: The child psychiatry unit of the Cochin Hospital in Paris is specialized in a transcultural clinical approach and treatment of psychotraumatism. The clinical demands addressed to the service often combine several levels of vulnerability: recent migration, repeated and intentional traumas, isolation and breach in family bonds sometimes...

Objectives: The impact of psychosocial factors and social support in the transmission of trauma related to migration and the mother-child dyad has not yet been amply explored. This article examines this impact and the role that psychosocial factors may have in the transmission of the traumatic experiences of migrant mothers to their children. Patie...

In France, women can be incarcerated during pregnancy and can keep their babies with them in prison up to the age of 18 months. The small number of nurseries in France and their unequal geographic distribution as well as the high percentage of foreign prisoners often result in women's isolation from their usual cultural environment. Family members...

Migrant youth are vulnerable and face a risk of internalised disorders such as depression. This qualitative meta-synthesis explores migrant adolescents’ experience of depression. 14 studies (7 qualitative studies and 7 case reports) were selected after a systematic search of PubMed, Embase, Scopus and PsycInfo. Their quality was assessed with the C...

L’équipe de consultation d’adoption internationale de la Maison des Adolescents de l’Hôpital Cochin revient dans cet article sur sa pratique de séances par visioconférence avec les familles durant la période de confinement. Les observations cliniques révèlent pour certaines familles une période de régression, vécue comme harmonieuse et nécessaire,...

Les radicalités inquiètent, celles de nos adolescents en particulier. Or la radicalité, cette quête d’idéal et d’idéalité, est à lire du côté de la nécessité. L’adolescence est un moment fondamental de l’engagement, au sens de l’appropriation subjective d’une réalité jusqu’ici contemplée ou subie. L’adolescent nous dit avec force qu’il est de notre...

There are three periods of psychic vulnerability for a child or an adolescent coming from a migrant family: The perinatal period, the beginning of school, and the transition to adolescence. We explain how these represent periods of risk and illustrate it with short clinical vignettes. In clinical situations, taking care of these children requires u...

Objectif Cette étude se veut une approche compréhensive des conflits psychiques que rencontrent les jeunes femmes confrontées à des modèles culturels divergents. Elle relate des tensions traversées par Renuka, Tamoule née en France, dans ses choix matrimoniaux entre verticalité culturelle et métissage. Méthode Le parcours matrimonial de Renuka est...

Children and adolescents who grow up between two cultures (the culture of their parents, and the culture of the country where they live) are in a vulnerable transcultural situation. This chapter reviews three periods of vulnerability. At first, in the immediate postnatal phase, it describes the effects of migration on migrant women and their babies...

Résumé Un nouveau dispositif transculturel adapté à l’accueil en soins des mineurs non accompagnés a été mis en place à la maison des Adolescents de l’hôpital Cochin suite aux résultats d’une recherche action menée pendant quatre ans. Cette recherche visait à améliorer le lien des éducateurs avec ces jeunes, à favoriser l’émergence de leurs compéte...

Objective The prevalence of anorexia nervosa (AN) increased in Western societies during the second part of the 20th Century, mostly affecting females during adolescence. Cultural considerations were frequently associated to anorectic figures but as geographical prevalence variability evolves, we must adjust our vision of the links between AN and cu...

La psychiatrie transculturelle s’intéresse à l’impact de la culture sur la santé mentale et la maladie et remet le patient au centre de la relation en respectant ses manières de faire et de penser, individuellement mais aussi collectivement. La culture définit les représentations ontologiques, les théories étiologiques et les logiques thérapeutique...

Les mineurs non accompagnés sont des enfants et des adolescents qui ont quitté leurs pays et se trouvent sans adulte référent dans un pays étranger. Ils présentent un taux élevé de symptômes psychiatriques avec des intrications complexes au niveau psycho-traumatique, transculturel, familial, éducatif et judiciaire. Le dispositif clinique NatMIE a é...

Over recent years, more and more unaccompanied minors have been arriving on French territory in search of a better future. As a result of their complicated journey before, during and after the migration, these youngsters have specific psychological needs which are not always recognised by the professionals working with them. Research has highlighte...

Background: Cultural context substantially affects the experience and clinical expression of psychiatric diseases, while cultural factors limit both access to and effectiveness of care, especially for migrant families requiring specific types of services. We conducted a scoping review on psychiatric services adapted to cultural diversity, to compar...

Objective This study is a comprehensive approach to psychic conflicts encountered by young women confronted with divergent cultural models. It relates the tensions experienced by Renuka, Tamil born in France, in her marital choices between cultural verticality and interbreeding. Method Renuka's matrimonial journey is explored through in-depth semi-...

Objectives The article presents the clinical description and discussion of a 17 years old Moroccan unaccompanied minor who migrated on his own to France. This case illustrates the complexity of the foreign unaccompanied minors' trajectories and the challenges of the clinical and institutional accompaniment provided in France. In the lights of the r...

In a cross-cultural consultation, a young girl of Tamil origin born in France seeks the love of her parents by oscillating between two cultures. Through group development and translation, the daughter and the mother are brought to understand each other's suffering and discover that they share the same deep love, even though it is expressed differen...

Being parents is an adventure in itself. Being parents in a cross-cultural situation, in exile, away from family and friends, is a double challenge. Today, we know more about the risks and the potential. Let's explore the key ingredients for early childhood: how to live through pregnancy, welcoming the child, being father and mother, building a fam...

What place should be given to puberty? In France, it is an intimate act that belongs only to the young girl. In Sri Lanka, it is a family and collective act that is ritualized and celebrated. Young girls born into Tamil families living in France have to make these very different logics cohabit. Analyse of a young girl's great suffering at puberty a...

Background The number of migrant youth traveling without parents continues to rise in Europe and North America. Some of t hem leave their home countries on their own and find themselves in a new country, separated from their family and cut off from their cultural roots. Besides those who leave to study, work, and pursue a better life, others are es...

The aim of this paper was to review the literature on adolescent psychiatric disorders related to the COVID-19 pandemic and lockdown. Stressful life events, extended home confinement, brutal grief, intrafamilial violence, overuse of the Internet and social media are factors that could influence the mental health of adolescents during this period. T...

Children of migrants develop and grow up with two languages, that of their family and that learnt at school, and within the two corresponding worlds. This transcultural situation entails a degree of vulnerability, and these children need to learn to reconcile the two worlds. In the setting of care, these different worlds and languages should be tak...

Background: Cultural context substantially affects the experience and clinical expression of psychiatric diseases, while cultural factors limit both access to and effectiveness of care, especially for migrant families requiring specific types of services. In France, Transcultural Psychotherapy is an original method conceived for therapy for immigra...

Les auteurs de cette étude ont exploré les conceptions de la notion de mineurs non-accompagnés (MNA) au Sénégal et analysé les ressources et stratégies d’adaptation de ces mineurs confrontés aux traumatismes migratoires. Les entretiens menés auprès des principaux acteurs de la prise en charge de ces mineurs ont montré que ces derniers sont perçus c...

Background: Cultural context substantially affects the experience and clinical expression of psychiatric diseases, while cultural factors limit both access to and the effectiveness of care, especially for migrant families requiring the construction of specific types of services. We review the international literature on mental health services that...

Unaccompanied minors are particularly vulnerable due to their pathway marked with multiple bereavements and constant uprooting. They find themselves confronted with the ordeal of mistrust due to administrative contradictions between the need to protect and immigration control. They are particularly at risk of developing psychiatric pathologies. Car...

Transcultural consultations receive unaccompanied minors experiencing psychological distress as a result of their personal history in their country of origin, their harrowing journey until their arrival in France and their vulnerable situation. Presentation of the mental health pathway and identity issues of one of these young unaccompanied foreign...

Pregnancy and motherhood are additional ordeals for young unaccompanied girls, a particularly vulnerable section of the population. They are marked by the revival of the traumatic valence, the need to reconstruct themselves through the pregnancy and the importance of establishing a relationship of trust with the professionals supporting them. A qua...

Les mineurs isolés étrangers nécessitent une prise en charge bienveillante du fait de leur vulnérabilité. Le cadre thérapeutique doit prendre en compte les différentes temporalités à l’œuvre : la réalité de leur temps psychique, mais aussi les temps administratif et éducatif. Les bonnes pratiques supposent de se dégager d’un souci de vérité, d’étab...

Maternity professionals are sometimes required to provide care to migrant women in precarious circumstances. Decisions regarding the future and the social and medical support provided to these mothers and their babies must be made quickly and be efficient and effective, despite having to contend with a lack of resources. A qualitative study focused...

Depuis plusieurs années, des jeunes isolés étrangers, dont la minorité est contestée par la justice, se retrouvent en dehors des dispositifs de protection de l’enfance. Privés d’hébergement et d’accompagnement éducatif, ils atterrissent, à Lyon, au sein du Collectif jeunes de resf. Quel accompagnement psychologique pour ces jeunes ? Une activité gr...

Everywhere children are considered precious and we try to protect them and find the right way to grow them harmoniously. Yet everywhere, they are subjected to traumas on a daily basis. We will first analyze the major works in anthropology and psychology and psychoanalysis on the interactions between babies and their parents. We will then show how c...

L’accueil et la prise en charge sociale et psychique des jeunes isolés étrangers déroutent, questionnent nos pratiques et nous invitent à modifier nos dispositifs d’accueils et de soins. Cette recherche s’inscrit dans l’étude pilote « Recherche-action sur les compétences transculturelles des professionnels travaillant avec les mineurs isolés » init...

La « radicalisation » émerge dans le discours parental comme motif de consultation pour leurs adolescents. Dans les trois situations cliniques, elle apparaît comme un médiateur utilisé par les adolescents pour se séparer et combler un vide dans la transmission transgénérationnelle. Le « métissage traumatique » sera discuté comme opérateur dans le p...

Il existe autant de risques de basculement dans l’engagement radical, que d’histoires singulières des adolescents. Nous avons mené une étude en population générale sur les représentations des jeunes et la radicalité. Nous analysons l’entretien d’une jeune femme musulmane franco-algérienne. Son récit permet de montrer les liens entre sa quête identi...

The theme of growing up is addressed through the presentation of the support group for around twenty hospitalised adolescents at the Maison de Solenn. In this weekly group, the subjects discussed are diverse in terms of their content and tone, depending on the atmosphere or changes: sharing daily life in hospital, the tastes and ideas of each parti...

The various traumatic events experienced by young isolated foreigners can weaken them psychologically and cause psychiatric decompensation. A qualitative study, carried out by the Maison de Solenn and the Avicenne hospital, aimed to provide better understanding of the conditions for initiating psychiatric care with these adolescents. The different...

In the framework of cross-cultural assessments, the nursing team is instructed by the family court judge to provide a clinical assessment taking into account the cultural dimension of the young person concerned. The aim is also to define appropriate psychoeducational support for certain migrant families, notably those describing a brutal confrontat...

Radicalisation resonates with the psychological vulnerabilities of adolescents. The ups and downs encountered as they attempt to construct their identity and their need to dominate favour the destructive nature of young people lacking a sense of filiation and belonging. An adolescent's engagement corresponds to a search for limits, with an adherenc...

Close observation of the interactions between a traumatised mother and her infant son provides information on the modes of transmission of psychic trauma in the mother–infant dyad. Following the presentation of a current literature review on the theme, the subject of “radioactive residue” and counter-transference in the transmission of psychic trau...

Rahmeth Radjack et ses collègues présentent leur belle expérience de la prise en charge en consultation des jeunes étrangers isolés, au cœur de la « Maison de Solenn », Maison des adolescents de l’hôpital Cochin. Travail difficile mais conduit avec exigence et une grande humanité par l’ensemble des professionnels.

The detours of trauma when providing care for isolated foreign minors Isolated foreign minors are a category of young people that is encountered increasingly by child protection workers. A certain number of them suffer from complex post-traumatic pathologies and require a specific form of care. In the context of the transcultural framework Natmie o...

Résumé La clinique des migrants est parfois difficile dans un cadre classique, notamment pour ceux issus de sociétés traditionnelles où la médiatisation par un groupe est requise pour résoudre un conflit. Une adaptation du cadre de thérapie, en présence d’un interprète et d’un groupe de thérapeutes formés à l’approche transculturelle, permet l’émer...

Les jeunes dits « radicalisés » ne consultent pas ou très peu dans les structures sanitaires. C’est sur le terrain et dans les structures sociales et pénitentiaires que les professionnels les rencontrent. L’objectif de cette recherche était d’étudier la manière dont les professionnels, psychologues et éducateurs étaient impactés par la « radicalisa...

Supporting unaccompanied foreign minors requires a different clinical approach. These youngsters must be given individualised support to help them make the transition from exile and loss, to an existence as an individual, yet still a son or daughter. The drawing, as a transcultural and atemporal imprint, constitutes a tool enabling these young peop...

Les représentations parentales sont déterminantes dans le développement de l’enfant. Leur part culturelle est importante. La migration, par son caractère vulnérabilisant, peut mettre à mal représentations culturelles et techniques de maternage. Le rôle du thérapeute n’est pas de cantonner la parentalité d’autrui à ses propres représentations. Il ne...

Résumé Introduction La « radicalisation djihadiste » reste un sujet d’actualité brûlant, en ce milieu d’année 2016. Ce phénomène interpelle de nombreux spécialistes, parmi lesquels les sociologues, qui ont mis en évidence une diversification des méthodes de recrutement terroriste ces dernières années. Un nouveau profil de jeunes « radicalisés » ém...

The menacing uncertainty affecting unaccompanied refugee minors: study of a phenomenon and its psychological consequences Who are the Unaccompanied Foreign Minors ? The reasons for leaving their homeland are complex and numerous next to those who leave voluntarily to study, to work and pursue a better life, others are escaping war-torn countries, d...

Educational accompaniment of unaccompanied refugee minors: discourse and representation of educators General perspective : Professionals working with unaccompanied foreign minors are faced with a certain number of difficulties which require both specific and complex skills. How to facilitate acquiring these skills ? What role can a transcultural cl...

The life path of foreign unaccompanied minors received in France is sown with multiple obstacles and contradictions. Assisting these young people in developing properly poses a great challenge for the professionals in charge. La Maison des adolescents of Cochin Hospital has begun research on the relationship between the minor and the educators on t...