[Psychoanalysis and psychometric evaluation]

Concerning the quality of life of former cancer patients both psychometric tests and psychoanalysis lead to better knowledge of problems. However neither their effects nor their efficiency can be compared. While psychometric tests are largely used to establish intellectual and affective attitudes, one must not forget that they are intended for diagnosis. The danger of defining profiles which are too acute or too precise has then to be exposed. Several questions must be raised: is the medical offer compatible or not with the patient's demand? This question opens the space of promise for the doctor and of delusion for the patient. Within this space, there is a place for psychoanalysis including the search of truth about oneself. But too whom should psychoanalysis be suggested? For the patient himself or his relatives? Regarding my own experience in a children's cancer ward where I have worked for more than ten years, I shall say that any psychoanalytical work, long or short, with the mother, the father or members belonging to the medical staff, clearly increases the child's quality of life. Why? Because fears of separation such as fantasies enclosed in the feeling of precariousness can be recognized and analyzed. It is not necessary to be a psychoanalyst to be aware of the role of subjectivity and of over-determination within the evolution of an illness like cancer. Precariousness has no place in the subconscious. That is why, not being able to believe in recovery, as it is often the case of parents or former cancer patients themselves, proves the importance of inner movements which have been hidden by medical reality for a long time. The announcement of recovery has, then, to be considered as a turning point where feelings of omnipotence are mixed with the sensation of being impotent. Fascinating is the former cancer patient regarding his victory over death. Becoming aware of this fascination is relevant to psychoanalysis.