Comportements suicidaires à l’adolescence en situation de migration : expériences masculines - 12/09/20
Suicidal behaviors in migrant youths: Male experiences
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Résumé |
Objectif |
Le suicide est la deuxième cause de mortalité chez les adolescents. Les garçons sont plus touchés que les filles, mais déclarent moins de tentatives de suicide et recourent moins aux soins. Peu d’études se sont intéressées à l’expérience des idées et comportements suicidaires des jeunes garçons. Il s’agit d’explorer les spécificités de l’expérience suicidaire d’adolescents en France en prenant en compte les aspects liés au contexte culturel et au parcours migratoire.
Méthode |
Étude qualitative auprès d’adolescents ayant des idées suicidaires, avec ou sans passage à l’acte recrutés dans trois centres de soin d’Île de France. Les entretiens semi-structurés sont retranscrits puis analysés à l’aide de l’Interpretative Phenomenological Analysis.
Résultats |
Dix adolescents ont été inclus dans l’étude. Trois axes d’expérience émergent : le rapport à soi, le rapport à l’autre, le rapport à la mort. L’expérience des garçons apparaît singulière dans le récit autour de la mort, et dans le vécu d’une expérience parfois paradoxalement positive. Les difficultés dans la construction du lien à l’autre apparaissent centrales. La construction identitaire des adolescents interrogés est marquée par des difficultés dans le lien à l’autre, dont les spécificités liées au genre sont à considérer de façon dynamique afin de favoriser la mise en récit du mal-être.
Conclusions |
La prise en charge thérapeutique doit explorer et respecter les représentations de la masculinité de l’adolescent, pour ensuite les mobiliser pour amener le jeune à reconsidérer sa perception du soin et des comportements suicidaires. Une réflexivité de la part du soignant sur ses propres conceptions de la masculinité est pour cela nécessaire.
Le texte complet de cet article est disponible en PDF.Abstract |
Objectives |
Suicide is the second leading cause of death among adolescents. Boys are more affected than girls, although they report fewer suicide attempts and rely less on care. Few studies have examined the experience of suicidal thoughts and behavior among young boys. In order to improve their health care, it is necessary to consider the socio-cultural aspects and the construction of the meaning given by adolescent boys to suicidal behaviors in France.
Method |
This is a qualitative, complementary and inductive study. All teens included have presented suicidal thoughts in the months preceding the inclusion. The existence of self-mutilation and/or suicidal act is sought but is not included within the criteria of inclusion, the various contexts will enrich the data. Semi-structured interviews are transcribed and analyzed by the Interpretative Phenomenological Analysis.
Results |
Ten adolescents between 14 and 20 years old were included in the study. Three axes of experience emerge: the relationship to oneself, the relationship to the other, the relationship to death. Some themes are common to experiences of both boys and girls, others are more specific to the boys’ experience. The inner struggle, testing one's limits and an isolating unspeakable are thus common, highlighting the difficulty for adolescents to mentalize and verbalize emotions and feelings. Difficulties in connecting with others, and feelings of loneliness and isolation, are at the core of the participants’ experience. However, the experience of boys appears specific in the difficulty to represent the irreversibility of death which can lead to suicidal behavior without direct intentionality. The narrative of suicidal acts, in its formulation, is quite different from that of young girls. One can assume that the difficulty of expressing suffering could lead young boys to develop a discourse that overshadows the question of their death, or in contrast magnifies it in a rewarding stage from which they pride themselves. The fear of being isolated or rejected seems almost insurmountable for the boys interviewed. The fear of the judgment of peers or the family is mixed with the imperative to face the problem by oneself and reinforces the feeling of isolation in a retroactive loop. The story of the suicidal act can take a positive and enriching tone in the participant's stories. This only applies to adolescents with a history of suicidal gesture. The experience of acting out and its consequences seems to be integrated by the adolescent as elements which participate to a certain extent to the construction of their identity. This ameliorative feature can be compared to the hegemonic social models of masculinity. The sociological notion of gender identity makes it possible to think of this construction in a dynamic way and to propose adaptations of the caregivers’ attitude during the first interviews with a suicidal teenager. During the first meetings, the caregiver should explore the adolescent's representations of the suicidal crisis in a neutral, self-interested, and unbiased way, including when the representations are disturbing or shocking for the caregiver. For example, when the patient values or glorifies suicidal behavior or when care is experienced as a sign of weakness and vulnerability. Respect of these proposals can indeed support weakened narcissistic foundations and favor encounter and alliance. This can only be done with the conviction that these representations are not frozen, but in construction, and that they can be secondarily mobilized in the therapeutic relationship. For that purpose, a work of elaboration on the representations of the masculinity will be able to lead the young person to reconsider his perception of care and suicidal behaviors. Reflexivity on the part of the caregiver about his own representations of masculinity seems necessary.
Conclusion |
Therapeutic management must explore and respect the adolescent's representations of masculinity and then mobilize them to bring the young person to reconsider his perception of care and suicidal behavior.
Le texte complet de cet article est disponible en PDF.Mots clés : Adolescent, Tentative de suicide, Expérience, Sexe, Masculinité
Keywords : Teenager, Suicide attempt, Experience, Sex, Masculinity
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