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The mind and body are closely connected.
When the body suffers, so does the whole being, including one’s psyche. This is why it is important to have psychologists working in hospitals.
When a patient is hospitalised, a psychologist discusses the patient’s subjective experience with him/her, and displays neutrality and support as he/she listens to the patient. The support a psychologist can offer relates primarily to what the patient is experiencing, regardless of his/her objective medical situation. When the services of a psychologist are expected, or even requested, he/she co-develops with the patient a construct of the somatic suffering that the patient can then include in his/her life story. The psychologist becomes the catalyst of this construct (Gori, Del Volgo, 1991).
If necessary, or if the patient so wishes, the psychologist is also available to provide support to the patient’s relatives.
There is another aspect of the psychologist’s work that is not so well known: this is the work conducted within healthcare teams. The psychologist lends support to the team and helps its members consider subjective dimensions of the patient’s health. Healthcare teams are often torn by requirements of objectivity and rationality on the one hand, and by what the patients says and how he/she uniquely experiences events on the other hand. The overriding purpose is to provide adapted healthcare that takes into account the uniqueness of the patient. This work stems from a close collaboration with doctors and healthcare teams, and from the observations and interactions the psychologist entertains with the patient, the latter serving to better understand the person in question. The healthcare provided is therefore as broad as possible. Obviously, the utmost professional secrecy surrounds the healthcare thus provided.
The intervention modalities of the psychologists can vary: they can intervene at the request of the patient or at the request of the healthcare team, but in every case the patient’s agreement is required. In some units, the psychologist can offer his/her services spontaneously to a patient, which the patient is free to accept or decline.
Following a hospitalisation, the patient might be required to come back as a day-patient (rehabilitation, dialysis...). The patient can then ask to see the psychologist for a consultation.
The framework is therefore similar to that of a conventional consultation, where the patient comes with a specific request or is referred to the psychologist by a doctor. Relatives can also be seen if the patient so wishes.
The role of the psychologist is to listen and to accept the request of the patient along with his/her mental suffering. The entanglement of somatic and mental suffering provides a different view of the situation, which can be used to help the patient feel better and find the resources to accept his/her illness; the patient is then able to better adapt to his/her condition or to painful personal situations. If necessary, efforts are implemented to combine the psychologist’s work with that of the healthcare team, subject to the patient’s approval.
When the patient is hospitalised in the psychiatric ward, he/she consults with a psychologist, whose work is to listen, support and provide help in terms of creating a mental construct relating to the patient’s issues. Depending on the pathology or the issue, some techniques can also be implemented, such as cognitive restructuring, progressive desensitisation, systemic therapy (in some cases, couple therapy and/or therapy for the patient’s relatives)... The patient is also offered adapted group therapy with techniques such as mindfulness, self-confidence building, sophrology... At the end of the hospitalisation, the patient can come back for day-patient consultations.
In some cases, the psychological work can be implemented within support groups for patients who share the same type of issues.
Neuropsychology is at the crossroads of psychology and neurology. Neuropsychologists study the manner in which the different regions of the brain “drive” or affect our behaviours.
This specialisation, which forms an integral part of the psychologist’s job description, is based on the connection the practitioner tries to draw between the structure and the functioning of the brain and the behaviours and psychological functioning of the patient. Neuropsychologists work with patients (children and adults) who suffer from pathologies or brain damage, for example after a stroke, brain trauma, a neurodegenerative disease (e.g. Alzheimer’s disease), encephalitis or meningitis, a brain tumour, etc. They also take care of patients whose issues are not directly associated with a disease of the central nervous system: e.g. learning disorders, developmental disorders, attention-deficit disorders, burnouts and mental exhaustion, psychopathological disorders, etc.
Faced with these problems, neuropsychologists are not only trained to provide a diagnosis, but also to monitor the evolution of the condition. For this purpose, the interventions available to the neuropsychologist range from the clinical interview to cognitive testing. A neuropsychologist will endeavour to identify cognitive disorders, and determine whether the patient is prone to difficulties relating to language, memory, concentration, or reasoning. Once the diagnosis is achieved, the healthcare professional can establish causal relations between the disorders and their origin (brain damage or other), assess the patient’s capacity for autonomy, establish a prognosis, or implement a re-education programme.
These practitioners also play an important role for the relatives of the patient. They explain the illness and its consequences. They work on finding solutions to the problems that arise.