CAIRN-INT.INFO : International Edition

1The supervised visit is a provision authorising the encounter between people (very often parent(s) and child(ren)) who have been separated by court decision and who are not entitled to meet outside a framework whose procedures and operation are guaranteed by appointed professionals. It proceeds from recognition of the advantage of allowing contact in an institutional environment, despite the risks such an approach involves (seduction of the child, exposure to non-continuity, risk of acting inappropriately or violently, etc.). The provision is used mainly for child protection.

2The question then arises as to the framework best suited to carry through the processes that develop during these encounters. From what technical and theoretical model can we gain inspiration to think out the container and content, and thus the framework? Such visits have as their main object the relationship, which leads to the need to devote special attention to the representations and affects in their dual locus of internal and interpersonal inscription. Moreover, as they very often take place in a constrained environment, the very idea of supervised visits arouses in the parents strong surges of the emotions as with anxiety, anger and suspicion that cannot but be directed towards the professionals. How then to listen to these experiences working on either side? And how to inject this into one’s work? Finally, do not these fraught relationships demand prior attention to ethical considerations from the professionals and their institutions, since it is they who will be faced with the need to make choices in a field where the interests of the family members concerned conflict, appearing sometimes to be irreconcilable? Such are the main questions we ask and to which we shall attempt to provide answers, starting out from a clinical situation.

History and ethics

3Supervised visits are associated with family placement. In France, this provision was developed during the Great War within the scope of paediatric psychiatry. For Myriam David (1989), the effects of separation and keeping at a distance, due to the child being hosted in another family than their own, require that thought be devoted to the notion of proximity between natural parents and children and the practical procedures for it being exercised. Family placement, like the supervised visit, is conceived of within the tension between these two poles. Preservation of the bond with the family of origin, when there is placement for example, may involve the organisation of supervised visits and should not be confused with preservation of the bond within the family (Berger, 2003a and 2003b) since in the former case the child’s removal is essential for its protection. Child-family bonds can thus be maintained, or even restored, outside the family environment.

4Parents separated from their children very often have the feeling they are being deprived of their rights and not recognised in their parental capacities. In order to contain this feeling, reference to the institutional third party and the capacity get it to operate by professionals working in contact with the family appear to us to provide for a major lever. For narcissistically damaged parents (even more so when they are prey to feelings of persecution), the institutional third party helps to provide a more reassuring framework: the parent is not merely commended to the appraisals, feelings and evaluations of the professionals working directly with them and their children. This explicit reference to the institution, in what it authorises or refuses, also constitutes an outside to this inside, the framework within which the parents are often forced to enter. In child protection, entering this inside occurs through a judgement, a court order.

5“You’re going to judge me!” is what this father, whose supervised visits to his daughter we shall consider, repeated angrily a number of times. In the evaluation stage, whose objective is to determine the feasibility of visits, we give a view that is none other than a judgement. It is just that this is a judgement that is duty bound to ensure its methodological (training, professional experience, space for reflection, striving to remain neutral, etc.) and ethical (respect for everyone’s rights, protection for all and to think out the constraints militating against this - see Morin, 2004) foundations.

6In ethical terms, the supervised visit poses a number of questions to the professional concerned: to what extent can you believe in the capability of abusive parents to change positively? Can you foster encounters asked for by a child with parents who reject them? Is the desire of an abusive parent to renew contact with their child enough to arrange encounters? Should you definitively cut off any relation between a minor and its parents when the latter have often proven themselves to be destructive towards that child? How these questions are addressed will shape the work in deciding on the links to be authorised or not.

Protocol and framework

7There is a necessary distinction between protocol and framework. In the clinical situation retained for the present article we have adopted the following protocol: once the contribution of supervision has been recognised and validated from the institutional perspective, work with the applicant parent starts by organising three encounters prior to any resumed contact with the child. These preliminary encounters are used to get to know the applicant adult, to understand their motivations, their psychic condition, the place they attribute to the child, their way of emotionally apprehending the supervised visits, their expectations, etc. The child and the parent having custody (case of separated parents) are called on and their agreement is to be requested and obtained.

8The objective of these preliminary encounters is to pronounce as to the feasibility of visits. The applicant parent is informed of that objective as from the first discussion. As appropriate, rules relating to the supervision of visits are discussed, explained and adopted, while later evaluations are scheduled with the protagonists every third visit. The time devoted to evaluation allows for an exchange on the interactions experienced during the encounters, and possible changes in the situation of the adult and/or the child to be addressed. It thus affords time for the professionals to give their views as to how the visits unfold. The basis for the rules of the framework and the way they change operate thus.

9The practical and technical foundations of the framework, this non-process (Bleger, 1967) whose container function allows the work process to take shape and unfold, can be summarised in two words: safety and facilitation. This arrangement has a concern of preventing an inappropriate act being perpetrated and the other’s psychic space being encroached on. Benevolence does not preclude the need to establish rules aiming to protect the protagonists. The set-up should integrate injunction and constraint: the court injunction and the attention of the professionals intervening during visits; the instability and ambivalence of wanting to meet their parent felt by the child and reciprocally. Injunction and constraints must be named and their effect on the encounters addressed. Moreover, the element of constraint also weighs on the professionals who can be destabilised in their professional ideal. Certainly there is a need to facilitate interactions, protect and assist, but also to watch over and, if necessary, put an end to a relation on the spot.

10As far as the formal aspects are concerned, supervised visits unfold over an hour in an institutional space. They are held at regular intervals, although their frequency may vary from one situation to another (in our case, this was monthly), and with supervision being ensured by a couple of professionals who proceed to exchange their observations, interventions and experiences after each session. As far as we were concerned, the meetings took place in a department of an associative educational action out-patient structure (or AEMO) that has neither a specific authorisation for supervised visits, nor an institutionally defined protocol.

Clinical case

11Elona was 5 years old when the children’s magistrate ordered supervised visits between her and her father, Mr Didier. The latter was 29 years old and separated from Elona’s mother, sharing his life with a young woman of 24 from whom he was expecting a baby daughter. Elona’s mother, Simone, also 29 years of age, was married to a 31 year old man. The couple had a 3 year old daughter and was expecting another. Mr Didier showed a more or less compensated and untreated psychosis. Simone was intellectually limited and regularly displayed hypomanic fits sometimes leading her to behaviours likely to compromise the balance of her couple and family. Elona’s parents separated on Mr Didier’s imprisonment, following serious incidents of maltreatment of Elona, then aged 3 months, for which he was found guilty by the court. Elona was then put into placement before joining a new maternal family four years later.

12Having served his prison sentence, Mr Didier called on the children’s magistrate a number of times to meet his daughter. Two years before our intervention, he obtained the right to supervised visits as organised by a special service, but, as he only rarely kept to his appointments, Mr Didier himself defeated the resumption of contacts with his child. Some months later, following a psychological examination of the parents emphasising her mother’s psychological fragility and the father’s pathology while also advising a resumption of father-daughter contacts in the interests of Elona’s psychological development, the children’s magistrate ordered further supervised visits. It was in this context that we implemented the protocol described above. The young girl has now been benefiting for more than a year from psychotherapy at the Medico-Psycho-Pedagogic Centre (CMPP).

13Three professionals teamed up to run the visits. A first specialised educator from our department continued the educational monitoring she had been ensuring for a year with Elona and her mother; she was not present during the visits and had no contact with the child’s father. A second specialised educator knowing the family was involved in the visits alongside myself, as the psychologist. I personally established no working relationship with the child’s mother, adopting an attitude of reserve and courtesy towards her. The educator involved in the visits retained the possibility of meeting Elona and her mother whenever it appeared to be necessary, which was the case during the evaluation stage and, later, at a time when the mother’s commitment seemed to slacken. The number of such encounters was reduced to the strict minimum. The educator from the AEMO took part in regular meetings with the psychologist and the educator entrusted with the visits in order to evaluate how the young girl and the family situation of each of the parents evolved. She ensured co-ordination with the other services (medico-psycho-pedagogical centre or CMPP, medical-social centre or CMS, etc.), thus protecting the space of the supervised visits. From that perspective, her position recalls that of the consultant in health services (Robert, 2007).

14During the first working session with Mr Didier alone, the professionals involved arrived with a pre-conception of the man and his request, the main content being the father’s psychiatric disorder, the extremely serious maltreatment of his child, the inconsistency of his request to resume contact with his daughter and his tendency to jeopardise the procedure he himself had called for. We also soon discovered that Mr Didier also came in with his own picture of how we were: we were going to judge him unfavourably, he did not need us, he had been betrayed by other professionals like ourselves, and so on. This father was convinced that on first contact, his daughter would avoid him like the plague and seek shelter behind us. The paternal projections were massive and his speech was delirious. Our apprehensions too were not free of projections and our working framework was not dedicated to caring for the father. Elaboration of how the boundaries were to be set immediately became an issue: the father’s internal boundaries and their failings, the containment of the framework and awareness of its limits, the risks of encroachment, etc. This elaboration was sustained during the sessions, this providing the father with enough clues to help him construe the nature of the work offered him. It was also supported by post-session exchanges between the professionals, their respective past experience strongly informing the framework. Transferential dynamics were thus taken up in the work.

A gap feared and sought for

15In addition to his anxiety at being unfavourably judged and not recognised in his quality as a good father, Mr Didier feared we would use what he had to say against him by telling it to “everyone”. This involved an anxiety that became manifest right from the start of accompaniment and then permanently at each session. Our reaction to this was to state a rule in the form of a metaphor: “Nothing coming from us will leave this room without your being advised of it”. This rule was nevertheless accompanied by the reminder that a written statement relating the bare bones of our exchanges would be addressed on each due date (every six months) to the magistrate having ordered the supervised visits. It was these reports that were to be very frequently questioned and as if tested by the gentleman.

16Indeed, Mr Didier was convinced that we had a poor image of him, since, as he put it, his ex-partner had talked to us about him, denigrating him – she was also likely at any time to open the door of the room we met in to say bad things about him. Elements of the protocol and the framework (the professionals, especially the psychologist, conducting the supervised visits, had no particular link with the child’s mother) had since then allowed for a minimal elaboration of these anxieties, or at least their temporary containment. It is as if the anxiety of persecution and perforation of his internal envelopes had been projected onto our framework, this other inside we sought to protect.

17As for the feared encroachment of his ex-partner onto his space (the discussion room, an external object, as a metaphor for his psychic space, an internal object), our role as sentinels, or guardians at the door (gardiens de la porte), formed a metaphor for a protective shield system: “We are the guardians at the door” we often said to Mr Didier. That door refers back to a condensation of the idea of the physical object (door) and the metaphor [2] of the boundary protecting against intrusion. The anxiety of intrusion experienced and expressed was to link up with the image of closure (representative-representation) that the metaphorised object of the closed and protected door authorised. The switch from the concrete object “door” to its metaphorisation (limit and closure) made for considerable progress in our exchanges with Mr Didier.

Effective father-daughter contacts and the meaning of the protective barrier

18The first time father and daughter were effectively brought into contact took place after validation of the scheme by the magistrate in presence of the family and the two educators. This was three months after the evaluation appointment. The birth of two new sisters for Elona took place during this interval.

19Right at the start of the first session, Elona, who was seated at a small table, threw a look in her father’s direction as he said hello and asked for a “kiss”. She turned away from him and retorted “No!”, a position she was to maintain for a long time whenever he called on her for something (meanwhile, the father maintained his physical distance from his daughter and did not seek to touch her). In a second stage, Elona accompanied the gesture (kicking in her father’s direction, but failing to make contact) with the word “No!” His response was “Oh yes!” and this too went on for some time. In a third stage, Elona hid under the chair of the educator seated in the corner of the room. Elona was then as if protected by the legs of both the chair and those of the educator. To the “No” accompanied by kicking out was thus added a new protective barrier. Some instants later the little girl was herself met with another “No!” this time from the educator telling her to stop kicking. So here we have a protective interdict for the father and the imposition of a limit to the child’s aggressiveness. The anxiety of being intruded on calls on a need to symbolically and even physically erect a barrier against bodily contact.

20Respect for that barrier, as manifested and even defended by the child, by ourselves and by the father, was a decisive indicator in the pursuit of the visits. Moreover, Elona’s aggressive form of expression did not, contrary to what we had feared, put her father off. The need for each to protect their space and its boundaries that was first manifested in Mr Didier during first discussions was replayed through actions by the child as from the first time she was brought into contact with her father. Words and attitudes from the professionals protected the father from his anxieties as to intrusion as they also protected the girl and father against the aggression, whether acted out or potential, coming from either of them. This pragmatic approach to the relation was often accompanied by support of the paternal account relating to the experience in situ.

My dad’s my other dad

21During the second visit, the interactional dynamic remained more or less identical, but this time against a background of distress shown by the child. Indeed, Elona arrived late for the appointment and was crying. This was the last day in the school year and Elona was carrying her schoolbooks and a favoured toy. It was hot and the child was tired and anxious. Mr Didier arrived late too. He had brought some clothes as a gift for his daughter. Throughout the session, Elona remained in the educator’s arms. She refused any exchange of looks with her father, but nevertheless regularly gave him a discrete glance. The main verbal exchanges hinged around the father talking about his filiation (he had been doing genealogical research on his family since the age of 15). Elona listened, tucked away into the arms of the educator. When the latter let go, Elona grasped her arms and again wrapped them around her. During the same session, the little girl blurted out in a mixture of anger and sadness that her real father was the one down in the waiting room, that is her stepfather. Before the supervised visits, Elona had a father in her mother’s partner. Now, she had a second one, flanked by an educator and a psychologist.

22During the same session, Mr Didier stretched his arms out towards his daughter as if to take her to him, forcing an exchange. This fatherly gesture was met by a “No!” and a spontaneous movement of avoidance from the educator who thus maintained a barrier against bodily contact. Mr Didier accepted this. Supported by the psychologist, he talked of his parentage and the results of his genealogical research. Protected and contained, the small girl listened to his story as told by a father contained and able to reach out to her emotionally. At the end of the session, the educator accompanied Elona back down to the waiting room. Both families were there. They left the service together and Elona accepted being carried in her father’s arms. From that session on, the two families continued to meet each other regularly in the waiting room. Without explicitly authorising this, we did not forbid it either.

23During the first evaluation interview, Mr Didier mentioned problems with his partner, Ms. A. He was no longer living with her. The couple had been accommodated by the latter’s parents after having left their own accommodation against a background of feeling persecuted by their neighbours. Mr Didier was worried that his partner should deprive him of seeing their baby and threatened her with “big problems” if she tried to do so. However, his evaluation of the meetings with Elona seemed to us to be coherent and as if preserved against delirious discourse: he feared being rejected by his daughter. He noted with satisfaction that she came over to him at the end of the session. We discussed this matter, praising his tendency to respect his daughter’s “resistance”. We then talked about forthcoming visits, validating the pursuit of the supervised visit programme.

24The visits continued at their usual frequency. The first in the new series was characterised by its serene atmosphere. Father and daughter played together, Mr Didier respecting the physical distance Elona craved. He adapted to his child who increasingly accepted exchanges. In this process of tuning of the emotions, Elona controlled the exchanges and the father accepted the passive role his daughter and our framework imposed on him. Meanwhile, we remained very much in the background, well nigh detached from the interactions that unfolded in our presence. As we relaxed, we relinquished our ordinary stance (educator being closer rather to the child and psychologist closer rather to the adult) and observed without intervening.

Evolution of father-daughter interactions

25Above, we described how the concern to preserve the closure of each person concerned constituted an efficient element in organising visits and in how these evolved. This work took several months (six visits), pacified the father-daughter dyad and reassured the educator-psychologist duo. This was a true milestone.

26The rigidity in the opposition between Elona’s “No!” and Mr Didier’s “Oh yes” became transformed into a subtle game between father and daughter, just as with how physical proximity was managed. Meanwhile, Elona’s discrete, almost stolen look towards her father managed to evolve towards prolonged exchanges. Playing construction games together then became possible. The interactions harmonised (the little girl’s drawings remained non-figurative$$$)… on condition that Elona kept control, guided things, and that the father accepted fitting in with his daughter’s rhythm, adopting a certain passivity. This favourable evolution was then to be interrupted by Elona’s more and more pronounced tendency to exert control over the exchanges. This change came to its acme in repetitive games (most often in building/knocking down Lego constructions), cornering the father and the professionals into no longer having an impact on the way in which what occurred in their presence unfolded. The father was rejected when he attempted to take part in his daughter’s game and what the professionals said was ignored. Educator and psychologist started to find that the father’s passivity was now contributing to maintaining the rigid behaviour shown by his daughter. Above all, we started to harbour doubts as to our own ability to help Elona and support her father as also to the adequacy of our framework with the new relational configuration.

27Following one of these harrowing sessions, we proposed to meet up for the next session around a board game, introducing a mediator [3]. So, the next time, Elona played a game suited to her age with her father and the educator, while the psychologist remained in the background. The idea was to construct words with letters. Mr Didier tried to get his daughter to write her first name, as he had seen us do on a board right at the start of the visit. The atmosphere was calmer than usual. But the next session, the little girl refused to play and became agitated. The psychologist was invited to play dominos. All three adults played while Elona approached and settled in calmly.

28The relative relaxation that mediation through the game contributed did not allay our fears as to the child’s repetitive behaviours. However, the sense of relief gained was accompanied by what we considered to be major progress from the child with the emergence of the figurative drawing and the capacity to be associated through it. The affirmation of this improvement was one of the signs announcing the imminent end of the supervised visits. Another sign, this time concerning the father, reinforced that idea: his ability to seek support from us. Indeed, the game of letters had already heralded this change as Mr Didier became more attentive to our ways of being and acting with his daughter. He took on as his own some of our questions, our way of taking an interest in the games and drawings and in some of Elona’s behaviours. He seemed to appropriate and thus internalise what he had retained from us. This trend was confirmed during the family discussions. Note finally that at this stage of the visits, in session, M. Didier seemed no longer to be prey to his delusions.

29This progress was to close a second stage in our work with the dyad and announce a change in the framework in favour of family discussions. Our decision to thus push forward our framework was validated by the children’s magistrate who received the family at a hearing. These discussions included not just the dyad concerned but also Mr Didier’s partner with their baby (the couple had got back together shortly after the crisis described above). These meetings rook place once a month, lasting one hour.

Family discussions

30Ms. A. always appeared calm. She tempered her partner’s words and verbal outbursts. She seemed powerless and fragile, but she was affectionate with her daughter and Elona and reassured her partner. The adults’ discourse relating to the time spent with Elona outside our meetings was impoverished and only related factual matters. The first discussions proved tedious for us. We found they tended to drag on. We imagined the same feelings being entertained by the family. The change came from Elona as she became agitated and rigidified her attitudes. She seemed to have strongly reinvested in the defences we thought had been loosened up.

31We harboured doubts and brought our framework into question; Mr Didier had however shown no negative sentiment towards us, all the appointments were also kept to and the time slots respected. He again took up the story of his genealogical research and mentioned a “murdered” ascendant; his partner expressed her desire to start similar searches. Clearly, what the latter was interested in was to find the trace, in “the newspapers of the time”, of acts of violence, murder and suicide committed in former generations that she did not yet know about. Mr Didier retorted to his partner that such research was a source of pain and added “I know what I’m talking about”. We emphasised the advantage such research could afford one of them in the concern to protect the other. Our attention was then taken away from the pattern of repetition in Elona’s behaviours. We were less worried as past history was being talked about and Elona was listening.

32We shall later address the place Elona occupied in the wider family constellation and the improved relations between her parents… Ms. A returned to her desire to know about the traumatic past of her ascendants and her partner warned that “it might hurt to open that door”. Exchanges were fluent. Mr Didier’s painful memories (the dead and his place in his own family) came back too fast but no longer undermine him as before. Elona listened, played more and more with her sister who was now more than one year old, sketched and started to tell stories about the figures drawn. Mr Didier continued to base his behaviour on how we were with his child, indeed his children. Calm prevailed and the relational re-adjustment acquired persisted.

33We took advantage of the door metaphor of the past that opens up or closes to talk about a possible end to our encounters: “We shall close a door on a part of your story. We’ll be leaving but we won’t just disappear.” Mr Didier’s genealogy strongly evoked a sense of loss for him; indeed it was under the sign of loss and violence that his partner wanted to outline the discovery of her own family tree. Our proposal evoked the separation that is so much part of life. Mr Didier now knew that he could call on us if he needed to. We remained in the room, as a sign of permanence. At the last-but-one session, the man explained that his family name was of Germanic origin. It meant “to begin”…

34Supervised visits, whose termination was validated by the children’s magistrate as also the end of educational accompaniment (AEMO) requested by our department, gave way to the parents themselves organising the procedures for visits and accommodation of the child at her father’s.

Discussion and conclusion

35Can identity be said to provide the framework (Racamier, 1998)? Permanence, differentiation, proximity and non-confusion are needed to care for serious narcissistic wounds. These principles find physical expression in the centre for care devised by Racamier known as “La Velotte”. However relevant this shortcut reasoning may be, identity and framework have in common the function of ensuring permanence and continuity. They also have to ensure a demarcation, a differentiation between spaces (internal/external; within/without). When it comes to the framework, permanence, continuity and demarcation are all the more necessary in so far as the subject’s fragility is pronounced. Entering into contact with Mr Didier worked through that fragility. Clarification of the framework for visits did not cure Elona’s father, but it enabled him to identify a container aiming at elaboration [4] of what is deposited here and now.

36Indeed, limiting work to what unfolds here and now in the space of the visits by sheltering it from the tensions that can feed off it from the outside (extended family, social institutions, etc.) delimits the field for professional intervention and, above all, contains the process that limit generates. Mr Didier’s delusional projections and associations first took those limits as a support. Stemming the effects of this way of working on the father’s side had as a corollary a holding back of the excitation and aggressiveness coming from Elona. The anxiety of intrusion and encroachment seemed to shape the dominant affect in the dyadic psychic space. It constituted an undercurrent that swept through most of the sessions, a current feared more or less consciously by the father, the daughter and the professionals. Moreover, the narcissistic fragility in the dyad is such that on more than one occasion it hardly failed to emotionally tax the couple of professionals and tested the consistency of their gestures and words. It is in these relational and transferential meanders that elaboration during the sessions and the post-session discussions takes on its full significance through exchanges on one’s experience, doubts, hesitations, rigidity, concerns, etc. The perspective thus takes on board the internal attitudes of those concerned, their resonances as well as their being shared, that is the transfer/countertransfer/intertransfer links.

37The ability to play was a decisive criterion in the positive progress made during the visits. It initially emerged by the recognition and the protection of the fragile limits of each protagonist. The stiffness of the paternal “Oh yes” and the child’s “No!” observed as from the first session was commensurate with the massive nature of the anxieties weighing on the integrity of each of their egos. The gradual loosening of the opposition “Yes/No”, with the beginning of the game, required as a condition the relative appeasement of those anxieties. An appeasement related moreover to the stability of the framework, since, as soon as a certain internal and intersubjective freedom was confirmed between father and daughter and a change in framework was operated via the switch from supervised visits to family discussions, the defensive rigidity initially there to protect the child once again re-emerged.

38The protective limit of the ego’s integrity for each person involved is ensured by what we referred to as the “loops of the framework”, being represented by limitation of the work on what occurs during the session but also through a concern to delimit the contours of listening. Indeed, pursuing exchanges as to each person’s history is necessary to sustain psychic circulation in the dyads and the families. However, there is also a need to protect the framework by not giving in to the temptation of devoting too much attention to what is recited, which could skew the work devoted to interactions. Addressing to a greater extent the subjectivities and peripheral interactions is more appropriate to the broader and more flexible framework of family discussions (Robert, 2007).

39As a general rule, during supervised visits, the dimension of the act and action is significant in so far as the provision does not aim as a priority to foster speech production, as is the case for the interview for example. The provision aims right from the start to protect the protagonists against acts from other parties. The protagonists, especially adults, enter the arrangement to meet and re-engage with their child. The need to touch and hug is often there with its harrowing corollary: the fear of failure and of being rejected. In all, the encounter has its dose of ambivalence. The act adopted conceals within it the desire to get closer, to give and/or receive affection and recognition, to test, and sometimes to charm. Whence the need for a framing of things from the professionals: defining in the evaluation phase a set of rules including those providing a boundary for the procedures adopted for interactions, especially during the first visits. It is essential that physical privacy, and thus psychic privacy too, be preserved by such rules, but also by verbal and if necessary physical intervention from the professionals (cf. our gestures to protect Elona). It is up to the professionals to plan the limits to be prescribed to the procedures for contact so that speech (putting into circulation representations and affects that the spoken word facilitates) can be produced in safety. Safety and facilitation appear thus to be nested into each other. They lie at the core of the provision.

40When the outcome is positive, the end of visits is announced by the reduction of intrusions, a sign of recognition of the existence of the other with their desires and anxieties and with boundaries to be respected. This reduction is observable clinically in the extent to which the forcing of interactions and of the other becomes less frequent, or even disappears completely. The interactions then become sufficiently fluid, parent-child recognition appears to be reciprocal and a space for play becomes possible. Conversely, the insecurity felt by any protagonist that accompaniment fails to eradicate makes for a strong signal that should lead either to a rearrangement of the framework, or a suspension or even a halt to the visits.


  • [*]
    Khalid Boudarse, psychologist,
  • [**]
    Martine Dodelin, specialised educator,
  • [1]
    Article received by the editors on 2 March and accepted on 24 May 2011.
  • [2]
    Lebovici states that the metaphor is a powerful therapeutic lever but that it is not a scientific tool (Research seminars on the infant, Bobigny). Indeed, his posthumous work is entitled Le bébé, le psychanalyste et la métaphore (2002). Meanwhile, Lemaire writes that in therapy the metaphor is more effective than explanation (2007).
  • [3]
    As with any mediator, the game introduced has a function of serving as a medium for exchanges and elaboration. The proposed mediator is structured by the rules (this is a game in Winnicott’s sense of the word).
  • [4]
    The relevance of the analogy between the container / transformer of the framework function when psychological care is involved and the function of maternal reverie as understood by Bion are valid for supervised visits, even if the framework for the latter is different from that of care. The analogy is significant in elucidating the function of the framework and its complexity.

The supervised visit is one of the mechanisms used by professionals in the medical-social field to allow for contacts between parent(s) and child. However, unlike the interview and observation, it does not benefit from a precise theoretical and clinical reference framework. How therefore to devise a protocol and a framework for the supervised visit? What conception of the relation of assistance can we mobilise to think out our ways of being and working, to consider the different levels of interactions the beneficiaries of such visits engage in and grasp the emotional and imaginary transactions the latter develop with us as professionals? This is the specific framework for the supervised visit that the article investigates, taking as an example a provision adopteed to restore contact between a father suffering from psychosis and his young daughter who had suffered from violence at his hand when she was an infant.


  • supervised visit
  • child protection
  • maltreatment
  • family
  • framework

De la visite médiatisée – Étude clinique

La visite médiatisée fait partie des outils utilisés par les professionnels du champ médico-social afin de permettre des contacts entre parent(s) et enfant(s). Contrairement à l’entretien et à l’observation, elle n’a pas de cadre de référence théorique et clinique précis. Comment donc concevoir un protocole et un cadre à la visite médiatisée ? Sur quelle conception de la relation d’aide pouvons-nous nous appuyer pour penser nos manières d’être et de travailler, pour penser les différents niveaux d’interactions qu’engagent les bénéficiaires des visites et pour saisir les transactions affectives et imaginaires que ces derniers nouent avec les professionnels que nous sommes ? C’est ce cadre spécifique de la vm que l’article interroge en s’appuyant sur l’exemple d’un dispositif mis en place pour restaurer le contact entre un père souffrant de psychose et sa petite fille, victime de violences paternelles quand elle était nourrisson.


  • visite médiatisée
  • protection de l’enfance
  • maltraitance
  • famille
  • cadre


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  • David, M. 1989. Le placement familial. De la pratique à la théorie, Paris, ESF.
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Khalid Boudarse [*]
Martine Dodelin [**]
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Uploaded on on 19/01/2017
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