Cancer du sein, image du corps et Psychothérapie par Médiation Photographique (PMP)

International audienceComplementary therapies, such as oncology supportive care, combine care and support (psychological, physical, social, etc.). They are proposed to persons living with a cancerous pathology, during the illness and in addition to traditional specific treatments, when they exist. These unconventional treatments are more and more requested and used by patients who would like a complete and personalized assistance (as recommended by Cancer Plans 2 and 3). In 2012, 48,800 women developed breast cancer in France. Many studies have been done concerning the alteration of the body image for these patients: at the announcement of the diagnosis, then after the treatments (surgery, chemotherapy, radiotherapy) and its consequences (alopecia, mastectomy, etc.). The image of the impaired body modifies the relationship with illness but also social relationships and patients’ self-esteem. In order to investigate and re-appropriate this impaired body, the patient must, on the one hand, think about her body to represent it, and, on the other hand, be able to speak about it. The entire assimilation (both physical and psychological) of the changes must come from the whole patient. Psychotherapy by photographic mediation (PPM) is an entertaining complementary therapy between photographic medium and photolanguage. This process is in two parts: the first part is the photographing of patients during their treatment (chemotherapy, radiotherapy, when they go back to work after the treatments and at the one-year evaluation), the second part encourages patients to describe and comment on each photograph. The aim of this study is to evaluate the impact of the PPM on the body image and on the symptoms of the patient living with cancer (fatigue, decreased self-esteem, social relationships, etc.). Five patients between 38 and 54 living with breast cancer and on treatment (medical and psychological) at the Institut-Du-Sein (Drôme-Ardèche) took part in this study. A professional took the photographs and psycho-oncologist conducted semi-directive interviews. The study results confirm a positive impact of the PPM on the body image and on its aspects: physical (fatigue), psychological (emotions, self-esteem, etc.), social (relationships). Indeed patients body image, social relationships, relationship with illness, and self-esteem are evolving positively. PPM assistance encourages the self-investigation and helps to preserve femininity. Patients are becoming active in their assistance and aware of their evolution. Social relationships are changing; the patient is opening up to others. Concern and anxiety linked to the illness are put aside. Patients place more trust in themselves and in their future. Psychological well-being (self-image, self-esteem, etc.) improves gradually during the sessions. So, the PPM can be qualified as a support therapy, which provides patients space to express their emotions (by words and by their body). This process enables patients to keep a memory of their experiences so they can share it with other patients.Les thérapies complémentaires à médiation artistique ont démontré leur efficacité dans l’amélioration des symptômes (fatigue, diminution de l’estime de soi, altération de l’image corporelle, etc.) chez les patients atteints de cancers, en proposant des prises en charge adaptées et personnalisées. L’objectif de cet article est d’évaluer l’impact de séances de psychothérapie par médiation photographique (PMP) sur l’image corporelle (IC) de cinq patientes atteintes d’un cancer du sein. Des photographies des patientes ainsi que des entretiens semi-directifs ont été réalisés à plusieurs temps de leur prise en charge. Grâce au dispositif mis en place, l’IC des patientes évolue de manière positive au cours des séances : la féminité semble préservée et le corps est appréhendé dans son ensemble. La PMP, en travaillant sur l’IC, intervient directement sur les relations sociales, le rapport à la maladie et l’estime de soi. Ce dispositif encourage les patientes à conserver le contact avec un corps qui change sous l’effet des traitements. Il semble alors agir comme une thérapie de soutien sur l’IC ainsi que sur les dimensions psychologique, physique et sociale des symptômes présentés par les patientes atteintes d’un cancer du sein