The " psy " in ligne.arnaque or réalité ?
	C'est following numerous discussion with colleagues psychologists but also with " psychothérapeutes s" and " psychanalyste s" exercising their art on the net that I decided to write this small paper.
&#Does 9;Que can one to propose by the slant of internet or the minitel ? Are the consultations possible, do sessions of psychoanalysis can them exister ? Is an on line psychotherapy possible and souhaitable ?
	Dans the various sites that I visited concerning on line consultations one finds all, of the more " classique s" to the silliest granular.
	
In first, would I like to say that I am surprised to see many sites maintaining a doubt on the identity of the interlocuteurs.des psy.mais of the shrink quoi ? Some sites let hover voluntarily this doubt or even makes disinformation while speaking of consultations made by psychologists whereas actually the " psy s" don't have any right to pretend to psychologist's tître as he/it is regulated since 1985. A striking example on the site of Mrs. P. of which one learns that she/it is graduate in psychology.. She/it is for as much psychologue.la answer is no. I didn't see a site or a psychiatrist proposed her on line consultations, in France can be because of the regulation on the advertisement governing the physicians.
In second, I would like to point some things surprising enough as some site of the " psy s" inquiry, or mixes itself therapy, support, analysis, religion,etc. I think that numerous sects or sectarian groups can have resort to such processes in order to have under the hand of people in psychological distress.
Finally and it is the the very c.ur of this article, I would like to interrogate on the sense that it can have, or on the contrary not to have.
He/it is right to separate the things and to give back the sense to the word.
1) what is proposed
	*Des psychotherapies
	* " Des advice "
	*De monitoring
	*Des psychoanalyses
Concerning the psychotherapies, does it depend on this that one calls psychotherapy, under what forme ? Psychotherapy of support, psychoanalytic inspiration psychotherapy, systemic psychotherapy, humaniste,etc. psychotherapy?
	Je thinks that of the support psychotherapy are possible and I would even say can be of other shapes of psychotherapy, but he/it is right to ask the questions of the impact of the distance then, and of the regularity of the consultations. Can work be the same that in cabinet and in relation of facing face ? To my sense the question arises less if one has recourse has the visiophonie because one sees and one hears the other a little as if it was in front of us. But the consultant must become aware that he must behave then like if he was in a non virtual way in presence of his/her/its therapist. It implies some things for example as the dressing, or the chosen place for cannot be disturbed. Personally I don't see some what this technique could be less operating than a consultation in the face to face.
Concerning monitoring and " les conseils ", it also depends on the intervening party's deontology some don't hesitate indeed to take some decisions instead the other, or to bring it to take the decisions that seem good to him. He/it is right to choose a person who has a strong formation therefore and that is either psychologist is a psychiatrist.
The most surprising remains surely from afar the offer of psychoanalyses. The I confess that I am a little surprised and that I don't see too how it is possible because the " analyste " should see analyzing it then but this last no, and how to manage the sound of the voice that will come of ou ? In short I don't say that it is impossible, but all rest to think and on the day of today and with our present technologies, it seems again too premature to me. Especially as the meeting with oneself even requires can be in a first time a meeting with the other..
2) the modes
Some sites propose the consultations or sessions by the slant of promenade or cat, of others by telephony or visiophonie.
In what concerns me I think that the only consultations that are suceptibles to have a minimum of seriousness are those that operate themselves therefore by the voice by the slant of the telephone or the visiophonie (son+vidéo). These are indeed, those that come closer the more of the normal conditions of consultation in the face to face. How to work with a writing in an efficient way, what return to the thoughtless person's level with the temporal shift between to say him and the entendu ?
	Avec the system of visiophonie, in a relation in the face to face I don't see what could be bothersome to do an efficient work too much. With the classic telephone without vision, the only therapies that seem possible to me are the psychotherapy said of support, sometimes permitting to make emerge a demand and to make be born in the other the desire to undertake a work then classic psychothérapique.
	Peut being is him here necessary to redo a small detour of the side of the theory between desire, demand and need.
"The desire outlines itself in the margin where the demand tears itself of the need. "
J. LACAN Écrits
The man's desire is the desire of the Other"
J.LACAN Écrits
In the Freudian dynamic conception, one of the poles of the defensive conflict: the unconscious desire has the tendency to come true while re-establishing, according to the laws of the primary process, the signs bound to the first experiences of satisfaction. The psychoanalysis showed, on the domain of the dream, how the desire meets in the symptoms under the shape of compromise. " The desire is in French a term that often returns to disparate ideas. In German, Wunsch rather has the sense of the wish (different from Lust for example). For Freud, the need is not the desire. Indeed, the desire is bound to mnesic traces and find his/her/its achievement in the" hallucinatory reproduction of perceptions become the signs of these perceptions ". He/it speaks besides in this sense of Wunsherfüllung (achievement of desire to the singular). The quote of Lacan (the man's desire is the desire of the other ") caused quick questioning. This sentence, exit of the theory hégélienne, puts in direct hold the child in the mother's desire. To try to explain the desire according to Lacan is a complex thing and is not the goal of this work. Indeed, it would be necessary to review the topology of the core, the algorithms, brief, it would be necessary to browse all l'. uvre of Lacan.If" the man wants because the satisfaction of his/her/its needs pass by the call addressed to another, this call makes itself demand, demand of love ", then, the demand appears, it, like a joint of the need and the desire. In this context, the demand addressed by the patient appears like a non demand ("it is necessary that I know, or that it (or it) knows "). Only the need is processed, point the desire.
Thus, the patient's demand is subordinated if need be ("I am not able to some anymore "). One can also wonder about the veracity of such a demand. It is not "truly" a knowledge that is wished, it is something else. All the interest of our work consists exactly in making to a "true" demand lead in this sense that it supported herself/itself on a desire and no on a need. Besides, this demand she/it is not a demand of love", like me since I cannot like myself myself ".
One can look for a definition of the need, one doesn't find some, except the" need of punishment maybe ". Would this be to say that the need doesn't concern the psychoanalysis?
There is a contiguity of the need and the biologic. The need requires to be satisfied and obeys the principle of pleasure.
Freud opposed the need and the sexual impulse in Impulses and destiny of the impulses, refering to the bodily needs. For him, the need of food is opposed to the sexual impulse. The need has a real object and no an object intra psychic (as it is the case of the desire).
As nursing, must we answer this" demand" based on the need? Can lean on this demand to hire a therapeutic reflection" ", to show that one is capable to hear what says itself to half-word?
The paradigm is the one of the patient hospitalized that complains of difficulties to sleep. Leaning on the need, the nurse or the physician could answer while giving a quarter of lexomil.. Passer-by has rating of the desire that can be a need to speak thus or a fear, a non expressed anguish, (facing an operation for example, or to the death).
So therefore, the on line consultations can permit about to elaborate somewhat the desire and to have like finality a work " vrai " psychothérapique. To answer the existential questions, to have a direction in his/her/its life, to be guided, etc. These first telephonic interviews can permit exactly while not answering the demand to make emerge something else.
3) to whom it himself adresse ?
	Selon the sites has some criterias, or sometimes none concerning the patients who can or no to consult. Some criterias reflect the anguishes of one (not of no one with suicidal ideas for example), of others an attempt to limit a little the population who could benefit from on line consultations. I want to say each makes what he/it can with the theory and the lack of data that we possess in this domain. For my part I tried to propose brief or longer consultations but in very precise cases (example of people that cannot move, of the expatriate people, etc). Because I think that it is not discriminating to permit the economy of the meeting with the other. That it happens thus when there are not any other possibilities is not shocked at all and I even think that it can be rather an alternative interesting, under the condition to ask the questions on his/her/its practice, what of course should be the case for us all that are clinician..
	En what concerns me I think that every person who can consult classic way must privilege this option, and that the recourse to the therapies or to the on line consultations must be exceptional. The site in him even must clarify the things also and make not the soliciting to the patients as it is sometimes the case. Finally the mercantile side is sometimes very present and I think that if the use of these technologies has a cost, it must remain reasonable.
In conclusion, I would say that he/it is right to be present on internet not to let more or less to people formed and more or less honest a gap that, it is on will develop himself anyway in years to come. He/it is right to specify our stocks and formations, the modes and the people to whom it applies then. He/it is also of our duty to put in guard the internauts on some practices that seem us to the limit of the charlatanism, of the swindle, or to be the fact of sectarian groups..
&#March 04, 2002 9;							Le
Sebastian NICOLAS Psychologist clinician
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