Psychopathologie de crise : chronique des tensions ordinaires en situation sanitaire extraordinaire. Phase 1 : la réorganisation anxieuse

INTRODUCTION: Humanity is facing a global pandemic at the start of 2020. The health systems of each country are reorganizing to cope with an influx of patients. This crisis reorganization is the source of psychological tension that can lead to symptomatic manifestations in many caregivers. This situation is similar in many points to that encountered by soldiers on external operations (loss of usual bearings, feeling of threat, focusing of attention on the crisis, deterioration of living conditions with limitation of the possibility of taking breaks). The aim of this work is to describe at the hospital level the changes in the professional and personal environment linked to the crisis likely to cause stress and then to describe the clinical manifestations observed both on an individual and collective level. ANALYSIS OF THE SITUATION: In this chapter, after having described the reorganization of the hospital in which we operate, we try to identify various factors likely to have psychological repercussions such as: the perceived urgency of the situation, the achievement of privacy, the reorganization of the work tool and the exercise of unusual tasks in newly formed teams, but also the fear of lack, the anxiety linked to contamination, the uncertainties linked to the threat. CLINICAL DESCRIPTION: In this chapter, we describe the clinical manifestations observed in the caregivers of the hospital in reaction to the crisis. Rather than decompensations, they are mainly anxious manifestations characterized by an increase in somatic concerns, an accentuation of verification rituals, an increase in snacking and the consumption of certain psychoactive substances (coffee, tobacco) and for certain people a character stiffening. On a collective level, it was mainly the misuse of social networks reflecting the group's anxieties (search for meaning and responsibility, need for certainty) that was observed. CONCLUSION: We then conclude with a description of the approach that led to the establishment of a support system by offering a graduated response, re-assessable over time, compatible with the maintenance of usual activity while maintaining a therapeutic distance.