Psychology: “The injunctions to be well have never been so numerous”

The Cross : Prime Minister Michel Barnier has made mental health the great national cause of 2025. Are the French really more unhappy than before?

Sylvie Wieviorka : It’s difficult to say because subjectivity is major in psychiatry and psychology. But there are indeed lots of polls, surveys and studies which affirm that the French are doing badly and that they were happier before, and I myself have the feeling that we were happier there at forty years old.

The paradox that I observe is that we are invaded by information telling us that the world is going badly, that the planet is burning, and that war is upon us. And, at the same time, the injunctions to be well have never been so numerous. Personal development books sell extremely well. They tell us that you have to be motivated, a good student, take care of yourself, succeed socially, have a fulfilling love life, play sports, smile… We expect a lot from individuals, it can be pressurizing. How can we make the link between the outside world, which is very anxiety-provoking, and this pressure to succeed in life? For those who can’t do it, it’s very difficult.

You say you have observed the disappearance of certain diagnoses and, conversely, the appearance of “new” pathologies. You cite as an example the “thousands of hyperactive children”, the “legions of perverted narcissistic husbands” or “cohorts of burned-out employees”…

S. W. : This is firstly explained by a change in outlook. Spasmophilia, very present in diagnoses in the 19th century^e century, means that psychological anguish manifests itself in the body. It was therefore replaced by “anxiety attacks”, or “panic attacks”. Another explanation: for a long time, American psychoanalytic concepts, such as attention disorder with or without hyperactivity for example (ADHD) were frowned upon. They finally found their place in our country. These disorders exist, obviously, but they are, I think, overdiagnosed and, worryingly, often poorly treated.

You rightly point out that the dazzling progress in medicine and science has had little effect on the management of mental health. How to explain it?

S. W. : Our understanding of the nervous system has improved. Today we are able to objectify a certain number of links between psychological disorders and cerebral organizations. In autism, for example, we know that there are genetic elements, which was not the case before. There is overall progress in the understanding and mechanisms of the psyche. What is very disappointing is that unlike other areas such as cancer or diabetes, there is no revolution in drugs.

As for the rest, this is completely beyond science. Care has to do with human relationships. Some patients come, talk to me, and tell me that they are better simply because I am there and attentive, that cannot be explained. The problem is that we have less and less time. When I was a young doctor working in the hospital, I took care of twenty patients. Today, the figure has risen to a hundred.

What has surprised you the most during these forty years of practice?

S. W. : The writing process allowed me to understand that the world has changed and how much we live with the concepts of our times. At work, at school, in all the areas that I deal with, I did not realize to what extent my own outlook had evolved. This journey is disturbing and interesting. Like every human being, I feel like I live in a form of continuity, which is ultimately not the case at all.