Psy-Cause a été fondée en 1995 par Jean-Paul Bossuat, psychiatre des hôpitaux à Avignon, et Thierry Lavergne, psychiatre des hôpitaux à Aix en Provence, pour promouvoir la théorisation de la pratique de terrain en santé mentale, et contribue aujourd’hui à faire savoir les savoir-faire des psy du monde entier

Une recherche togolaise et béninoise sur le « Dji Kui »

Il s’agit d’une recherche psychopathologique et anthropologique menée conjointement par des psychiatres de Lomé (Togo), de Cotonou et de Parakou (Bénin). Cette étude concerne l’aire culturelle Adja Fon et Adja Ewé située au sud de ces deux pays. Elle a été coordonnée par notre rédacteur (depuis décembre 2014) togolais, le Dr Kokou Messanh Agbémélé Soédjé, en binôme avec le Dr Guy Gérard Aza-Gnadji du Bénin, et fait l’objet d’un article dans le numéro 67 de la revue Psy Cause dont la parution est prévue dans quelques semaines. Cet article associe d’autres auteurs : pour le Togo, notre rédacteur Pr Simliwa Kolou Dassa ; et pour le Bénin, notre rédacteur Pr Mathieu C Tognidé, les Prs Josiane Ezin-Houngbé et Grégoire Magloire Gansou et les Drs Anselme Djidonou et Lucrèce Anaganou.

 

03-Ouidah-17.2.08Le contrat social, nous disent ces auteurs, exige dans cette aire culturelle d’avoir un enfant. La stigmatisation de la femme stérile y symbolise cette obligation. L’article précise : « L’incapacité de certaines familles à assurer la descendance à cause des décès prématurés à répétition ou « le retour des enfants » retirés par la mort aussitôt arrivés dans le monde des vivants, ont des interprétations particulières. Cette situation amène à poser souvent des questions : qui est cet enfant qui vit ou « qui s’arrête dans la vie » après plusieurs avortements spontanés ou décès précoces malgré son destin funèbre ? Cet enfant au sud Togo s’appelle un « DJI KUI » dont la traduction littérale est « Nous avons fait un enfant pour la mort ». »

 

Les auteurs rapportent un cas clinique, celui d’un Dji Kui, c’est à dire d’un individu dont la naissance a fait suite chez une mère à une succession de fausses couches et de morts précoces de ses rejetons. Ils le dénomment Victor. « Victor, âgé de 30 ans, infirmier exerçant au bloc chirurgical, d’ethnie Mina, syncrétiste de religion, était reçu en consultation psychiatrique en Août 2011 au service de psychiatrie du Centre National Hospitalier Universitaire de Cotonou, accompagné par son frère, pour céphalées, insomnie totale et anxiété. Le début des céphalées remonterait à 20 ans. De manière périodique, environ trois fois par trimestre, s’associent des insomnies, une anxiété et des palpitations. De multiples démarches de soins dans les centres conventionnels de soins généraux, chez les christianistes célestes et les féticheurs guérisseurs n’ont pas eu de résultats favorables. » L’aggravation des symptômes amène une double consultation traditionnelle et psychiatrique. Dans un premier temps, une consultation traditionnelle « a révélé que « le maintien de Victor parmi les vivants » a été possible grâce à un rituel sur un autel consacré de son arrière grand-mère qui fut esclave de son arrière grand-père. Les maux dont il souffrait seraient du à l’abandon de ce rituel qui devait être perpétué. »

 

04-Trone-des-ancetresLes auteurs relèvent que « le cas Victor semble être celui du « Trône des ancêtres » ou « Togbé-zékpé » non honoré. » Cette catégorie d’autels est reliée « à la notion d’achat de personne ou esclave qui symbolisait autrefois la richesse. Il est recommandé d’élire un autel ou un trône à vénérer pour non seulement apaiser les esprits de l’étranger mais aussi faire accepter la personne achetée par les esprits résidants. L’achat d’une personne est un acte sacrilège sévèrement puni par les entités surnaturelles par l’infertilité dans la descendance si aucune cérémonie n’est pratiquée. Cet autel reste le garant de la pérennité de la descendance et de sa prospérité financière. »

 

05-Fetiche-AdjaLa consultation psychiatrique a mis en évidence une surprotection du patient pendant son enfance, génératrice d’une dépendance anaclitique où le sujet est en lutte continue contre la dépression. « Le patient, autrefois enfant à destin funèbre, a choisi un métier où il est confronté à la mort au quotidien. » Il naissait après six décès consécutifs et bénéficia à sa naissance d’un rituel pour qu’il reste en vie. Ce rituel de promesse à un fétiche s’était accompagné de marques sur le visage destinées à lui fournir son identité de Dji Kui protégé. Les auteurs proposent une interprétation culturelle des céphalées ressenties par le patient : il s’agit d’une manifestation du spectre de la mort présent chez le Dji Kui : « vu la valeur anthropologique de la tête chez les Adja, les céphalées peuvent être interprétées comme ce spectre car il existe des cérémonies, de « Ta tro tro » ou « Ta wo wo », c’est-à-dire littéralement de reprise de la tête, indiquées pour ramener le mourant ou le condamné à la vie. »

 

Les auteurs concluent leur article, à lire dans le N°67 de la revue Psy Cause, sur la pertinence d’une approche multidimensionnelle de la prise en charge « conciliant la conception du patient, sa réalité culturelle et la vision du thérapeute. » Au total, ce travail transfrontalier centré sur une même aire culturelle nous propose une approche originale de la psychiatrie africaine.

 

Jean Paul Bossuat

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