The diagnosis : a fatality ?
“An IQ is neither a fate nor a destiny” (Voyazopoulos et al. 2005).
The whole of this text deals with a situation that I had the opportunity to observe during my training. It allowed me to question the possible consequences of a diagnosis from a personal, identity and, professional point of view, based on the situation of Marie. This young teenager, aged 13 years and 11 months at the time of the assessment, was seen at the request of a general practitioner to carry out her cognitive profile following her frontal epilepsies. She had wanted to be a veterinarian for a long time, but the diagnosis of frontal epilepsy would have put this project into question. Now in her third year of school, Marie admits to having difficulties at school for the first time, particularly in terms of commitment and motivation. Concerned about Marie's declining academic performance, her mother wanted this assessment to shed light on and explain this decline in performance. During the assessment, she participated well in the discussion, elaborating her answers and addressing the various topics raised without difficulty. However, I had the distinct feeling that this adolescent was particularly anxious during the test. This feeling was confirmed when the neuropsychologist asked her during the assessment if the questioning of her professional project by a general practitioner was due to her epilepsy diagnosis, which she confirmed. The neuropsychologist then told her that her diagnosis did not affect her intellectual skills and that she had the necessary faculties to succeed in school. She seemed genuinely relieved and less anxious until the end of the assessment. From then on, Marie passed all the subtests. In the end, her cognitive weaknesses alone could not explain this decrease in performance. The hypothesis of general disinvestment linked to the questioning of her professional project was becoming increasingly likely. Indeed, this announcement may have been experienced as the shattering of a dream she had had since childhood and which she dearly cherished. Moreover, can the health professional have a precise vision of the future of a child/adolescent who is currently in a developmental period? In other words, does the diagnosis establish the destiny of the person to whom it is addressed? These ethical notions may question the limits of a cognitive examination and the role of a psychologist. Indeed, should we privilege the protection of an individual by trying to avoid possible failures linked to his or her disability or should we consider the person's evolutionary processes, without drawing hasty conclusions ? In my opinion, it is essential to consider the disability in this dynamic, not as a hindrance but as a particularity of the individual. As psychologists, we must help the adolescent to discover his resources and possibilities, without locking him into his difficulties. It is up to them to build their projects and we must encourage them to achieve their dreams and goals, even if these appear unrealistic at times. Despite scientific knowledge that allows us to have insight into the general future of individuals with certain types of disabilities, each person is to be considered in his or her own right, without judgment. Failure to succeed in a course of study should not be seen as a failure but as a learning experience that will allow the young person to discover his or her strengths and weaknesses as well as his or her real motivations. It is also important that they learn to cope with failure and to get up again, something which will prepare them all the more for their future adult life. Of course, the psychologist must be present at his side to help him overcome his fears and anxieties while involving the family in this support work. Nevertheless, a professional does not have the power to decide for the patient, it is up to the patient to take initiative and to build his or her own life.
By Mathilde Lemarié