This article is a contribution to the understanding of abuse in geriatric practice. Our thesis is that the institutional idealization of the possibilities of action, that is the denial of limits, favors the appearance of abuse of oneself and of the patients. We will begin by clinically assessing the situation of staff in contact with patients and by listening to their own analysis of the dynamics that lead to acts of abuse. For them, abuse arises when they feel that they “are not up to the task,” or when they have got caught up in professional “routine.” These two subjective situations are frequent in an institution which, by idealizing its possibilities of action, implicitly formulates a prescription of omnipotence for its staff: they must be “up to” an ideal. Either they subscribe to this ideal—and we shall see how they can believe and subscribe—or they protect themselves from it. The former case seems to lead to abuse through a feeling of helplessness (not being up to the task), the latter to abuse by negligence (being in a routine).
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