CLINICAL PERSPECTIVES ON EXCLUSION AND ECONOMIC ASSIGNMENT: THE SUBJECT’S RESISTANCE
Alexandre AMAND, PhD
Alexandre Amand, PhD, is a Doctor of Psychology and clinical psychologist at Centre Hospitalier Edouard Toulouse, specializing in adult psychiatry, CMP/CATTP interventions, and the psychology of urban exclusion.
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ABSTRACT
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Context and Problematic
Contemporary social exclusion cannot be understood as a simple rupture of social ties or as a position outside society. Individuals living on the street are not disconnected from social discourse; on the contrary, they are deeply embedded in dominant economic logics that assign them to positions of assistance, rehabilitation, and social devaluation. The pervasive intrusion of economism into social policies and clinical practices tends to reify the excluded subject, reducing them to a form of social waste to be reinserted into the market. The central problematic addressed here is how to conceptualize exclusion clinically without submitting the subject to a strict economic determinism, and how to recognize subjective forms of resistance to these socio-economic assignments.
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Objectives
This work pursues two main objectives. First, it aims to demonstrate that exclusion does not imply a systematic breakdown of social bonds but rather constitutes a specific mode of social linkage shaped by economic imperatives. Second, it seeks to identify and analyze the subjective solutions developed by excluded individuals, particularly symptomatic responses that resist normative injunctions. The text also aims to draw clinical implications that preserve an ethics of subjectivity in highly normativized contexts.
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Method
The analysis is based on an interdisciplinary framework combining psychoanalytic theory, social sciences, and philosophy, alongside clinical fieldwork conducted through humanitarian outreach and street-based clinical practices. The methodological approach is qualitative and clinical, emphasizing close attention to subjective expressions, identificatory processes, and the dynamics of the bond to the Other.
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Results
Clinical observations reveal that excluded subjects exhibit complex symptomatic responses, including inhibition, depressive syndromes, paradoxical demands, and specific identificatory positions. Among these responses, urban wandering emerges as a particularly significant subjective solution. Wandering is not merely a pathological displacement but a structured trajectory without direction, capable of producing a relief of psychic suffering. Subjects report a suspension of the experience of being social waste and a temporary transformation of their subjective position.
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Interpretation
Wandering is interpreted as a symptomatic protest against social and economic reification. By reactivating the associative chain through spatial movement, wandering introduces indeterminacy into the subject’s status and opens the possibility for renewed identification. It functions as a resistance to normative fixation imposed by the socio-economic order. The clinical perspective thus reveals that the symptom is not merely pathological but operates as a singular form of resistance, calling for a rethinking of clinical practices beyond purely economic or functional logics.
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RÉSUMÉ
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Contexte et problématique
L’exclusion sociale contemporaine ne peut être comprise comme une simple rupture de liens ou une marginalité extérieure au système social. Loin d’être « hors société », les sujets vivant à la rue sont profondément pris dans les logiques économiques dominantes, qui les assignent à des positions de dévalorisation, d’assistance et de réhabilitation normative. Cette immixtion de l’économisme dans les politiques sociales et les pratiques cliniques produit un effet de réification du sujet, souvent pensé comme déchet social à réintégrer dans le marché. La problématique centrale est alors la suivante : comment penser la clinique de l’exclusion sans réduire le sujet à une détermination économique totale, et comment entendre les formes de résistance subjectives à ces assignations ?
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Objectifs
L’objectif de ce travail est double. Il s’agit, d’une part, de montrer que l’exclusion ne correspond pas à un processus de déliaison systématique, mais à une modalité spécifique de lien social, profondément marquée par l’économie. D’autre part, il s’agit de mettre en lumière les solutions subjectives élaborées par les personnes en situation d’exclusion, en particulier les formes symptomatiques qui résistent aux normes sociales et économiques. Le texte vise enfin à dégager des implications cliniques permettant de maintenir une éthique du sujet dans des contextes fortement normatifs.
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Méthode
L’analyse repose sur une articulation entre références théoriques issues de la psychanalyse, de la sociologie et de la philosophie sociale, et une expérience clinique de terrain acquise dans le cadre de maraudes humanitaires et de dispositifs cliniques hors les murs. L’approche est qualitative, clinique et réflexive, centrée sur l’écoute des manifestations subjectives, des identifications et des modalités de lien à l’Autre.
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Résultats
Les observations cliniques montrent que les sujets exclus développent des réponses symptomatiques complexes : inhibition, syndromes dépressifs, demandes paradoxales ou investissements identificatoires spécifiques. Parmi ces solutions, l’errance urbaine apparaît comme une modalité singulière de traitement de la souffrance psychique. L’errance ne correspond pas à une désorientation pathologique, mais à un trajet sans direction, doté d’un effet d’allègement subjectif et de désidentification du statut de déchet social.
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Interprétation
L’errance est interprétée comme une protestation symptomatique contre la réification économique du sujet. En réactivant le fil associatif et une chaîne signifiante spatiale, elle ouvre une indétermination identitaire et permet une résistance à l’assignation normative. La clinique révèle ainsi que le symptôme constitue une forme de résistance singulière aux logiques socio-économiques contemporaines et invite à repenser l’intervention clinique dans une perspective non réductrice du sujet.
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Introduction
The clinical study of exclusion reveals a paradox. Those who live on sidewalks, under bridges, or in abandoned wastelands are not the most disconnected from discourse. On the contrary, there is an over-adaptation (Chevalier, Langlard, Le Maléfan, 2017) to the coordinates of social expectations associated with the figure of the homeless person. In this respect, the economy operates as a constraining discourse. It assigns individuals to the position of welfare recipients, of social waste, to which the subject responds with a set of already well-characterized depressive signs (Douville, 2014). Moreover, the identificatory process with the object rejected by the economic system fixes a subjective position characterized by self-exclusion (Furtos, 2008).
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Indeed, the individual is supported through redistribution mechanisms intended to mitigate the deleterious effects of their position as an excluded person. Yet this palliative does not resolve the problem and may even reinforce it. Through institutional and spontaneous assistance dispositifs, the excluded individual is assigned to a delegitimized position (Fouliard, 2022). Nevertheless, from a clinical standpoint, it is crucial to wager on the subject of the unconscious, as this opens the possibility of hearing subjective solutions to this overwhelming condition. Spatial displacement—what I would call wandering, characterized by its trajectory, direction, and aim—constitutes a remarkable solution, allowing for a renewal of identification.
In order to break down this issue, I will first describe the intrusion of economic logic into the treatment of exclusion in France and its counterproductive effect of assignment. I will then address the clinical dimension of exclusion and the nature of the aforementioned identification. I will outline the preliminaries for a clinical stance that is congruent with the socio-economic and psychic issues of exclusion. Finally, I will examine wandering as an original solution to exclusion. This work is grounded in the practice of humanitarian outreach and clinical outreach, as well as in the completion of a doctoral thesis in psychology.
The economy of exclusion: turning social waste into an employable individual
It is a strange perspective to situate the homeless person (S.D.F.) as caught in the nets of the economy. And yet, the economy is far more than a theory devoted to the management of resources, including their extraction, transformation, and distribution (Parrique, 2023). The so-called homeless person would seem far removed from this material process and from the hyper-rationalist theories that organize it. And yet, today the economy exerts an influence that extends well beyond the sole domain of production systems and market exchange. The capture of politics by the economy (Streeck, 2023) is the submerged face of the hegemonic position of economic thought. Its current ideological matrix is designed to shape human subjectivity so that it unwittingly serves the economy (Foucault, 2004). It has thus largely infiltrated the unconscious layer, to the point of short-circuiting any exercise of reason (Poenaru, 2024). Its networked mode of propagation (Stiegler, 2018) induces a formal renewal that is now so rapid that social organization itself struggles to grasp its consequences and adapt to them. One principle, however, remains stable: the accumulation of value, which has now been elevated to the status of an anthropological imperative.
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The entanglement between the socialized dimension of the economy and its subjective effects is not new within the field of the human and social sciences. Indeed, the categories and concepts of libidinal economy (Lyotard, 1974), capitalist discourse (Lacan, 1972), and psychic economy (Deneault, 2021) each, in their own way, point to the isomorphism between contemporary drive logic and the principle of generalized surplus value. As is well known, capitalism has recently undergone a major inflection. Its expansion has relied, on the one hand, on financialization and, on the other, on the rise of technoscience. Such an evolution has severed the moorings that once tied capitalism to real human activity; as a result, value production is now established within an infinite, immaterial, and impersonal field. In full coherence, the concepts relating to capitalism have therefore changed, indexing a totalizing and autonomous dimension. The categories of cyber-capitalism (Poenaru, 2023) and the market panopticon (Keppler, 2025) underscore its transversality and its effect of generalized surveillance. Given such a panorama, how can one still imagine that anyone might be held outside this economic matrix? Not even those who are supposed to live outside the system itself.
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Exclusion does not amount to a radical isolation from the world. In truth, those who live on the street are not cut off from all ties, as the etymology of the word exclusion might suggest. They are most often found in our city centers and maintain neighborhood relationships (Mathieu, Charreton, Pitici, 2011). Urban rhythm serves as a reference point, and they organize themselves accordingly. And when one of them disappears, their absence produces, for the passerby, an effect in the mode of après-coup (Velut, 2011). Exclusion therefore does not create strict social hermeticism but rather a de-subjectivizing dialectic. To be excluded from a large part of the social bond is to be excluded from a part of oneself, hence de-subjectivation. But in what way is this dialectic fueled by the economy? Before answering, I will offer an anecdote by way of illustration.
For several years, I participated in humanitarian outreach patrols (maraudes) within a major non-governmental organization (NGO). In the evenings, in a van with several volunteers, we distributed food and directed people toward appropriate services.
However, a change in the organization of these patrols raised an ethical issue serious enough for me to decide to leave the NGO. Before heading out on patrol, late in the afternoon, seated in a van with other volunteers on the way to food distribution points, I heard the team leader describe the new practical arrangements. After each encounter, it was now necessary to record the homeless person’s name and collected information such as age, nationality, location, specific needs, and the assistance services they frequented. I asked what these data were for and was told that they would help better tailor responses to the person’s needs. Somewhat suspicious, I pressed further, and it was finally explained that this information would be transmitted to the police prefecture. Is it necessary to underline here the resemblance between this recent procedure and the apprehension of consumers in terms of data correlated with needs? And, on the other hand, the organization of explicit surveillance of individuals extracted from the fields of consumption and production?
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Outreach patrols, like emergency shelters or day centers, are part of a graduated response by French public authorities intended to address exclusion.
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Exclusion is, as such, approached as a problem for public authorities, insofar as it threatens social cohesion (Castel, 1995). The first level consists in the implementation of assistance, which aims to meet the basic needs of the excluded individual.
Assistance developed in response to the severe degradation of the security once provided by salaried employment. Indeed, wage labor was a vector of social integration (Castel, 1995) through collective protection (social security) against contingent risks (illness, old age, unemployment). The progressive erosion of these protections under the effect of neoliberal policies prompted public authorities to create assistance schemes. Rehabilitation constitutes the second level. A term consecrated by the creation of CHRS (Centers for Housing and Social Rehabilitation) in 1974, rehabilitation involves a gradual reintegration into the labor market and thus into consumption and production. This assigns the beneficiary to a delegitimized position that ratifies social uselessness (Fouliard, 2022). Moreover, procedures verifying the absence of income or housing contribute to a form of humiliation identified in sociology as social disqualification (Paugam, 1991).
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Both assistance and rehabilitation aim at restoring an employable individual capable of contributing to value production. As early as the 1980s, Michel Foucault (2004) noted a redefinition of social policies in favor of the market economy. The objective was no longer to correct socio-economic inequalities but to enable the individual to barely survive and to encourage their full return to the labor market. The treatment of exclusion aligns with this perspective, with an added security dimension illustrated by our anecdote. Today, following a certain post-war tolerance (Geslin, 2013), the homeless person is often considered an idle and refractory figure, to be chased out of city centers. The increase in police interventions against them and the insidious creation of anti-homeless urban furniture bear sad witness to this (Terrolle, 2004).
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Despite the criticisms formulated and argued here, I would like to avoid any misunderstanding. I do not claim that the principles of assistance and rehabilitation—though they must be questioned—are purely negative. However, taken alone, they evacuate a fundamental dimension and require critical reflection. Both target the general and the normative, while ignoring the singular dimension. The latter contains the immanent paradoxes of the subject, who may well refuse the help offered (Martin, 2000) and even aggravate their self-exclusion. Excluding the possibility of negative therapeutic reactions (Furtos, 2002) amounts to misconstruing the effectiveness of reintegration. Such paradoxical signs must be heard as costly attempts to detach oneself from a mortifying social Other. For the singular—and particularly the symptom—is not entirely soluble in living together. It thus asserts itself, in part, as a resistance to the social bond (Lacan, 1974). The clinical challenge, then, is to establish a social bond capable of accommodating everything that constitutes the subject’s specificity. The sharp edge of this operation is that it must resist, when there is no proven vital risk, the counter-transference that pushes one to extract—or worse, to save—the excluded person from their condition. Destitution, sometimes experienced as unbearable, can lead the clinician toward an interventionism that evacuates the function of the symptom. Such a high ethical demand makes clinical teamwork and sustained institutional work absolutely necessary (Negrel & Negrel, 2019).
The clinical approach to exclusion
The clinical study of exclusion sheds light on the effects of multiple ruptures of social bonds. The loss of employment is sometimes the triggering event that leads to a fall into homelessness so rapid that any process of mourning is impeded (Douville, 2014). Housing and the partner often constitute collateral losses that seal the rupture of bonds. Moreover, these concrete losses can reactivate traumas that occurred within early relationships due to deficient primary bonds (Mathieu, Charreton, Pitici, 2011). Through exclusion, the subject actualizes a relationship to primary ties devoid of affective investment. This reactivation introduces an enacted repetition that leads the subject toward self-exclusion.
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The economic bond of re-assignment, through assistance and rehabilitation, amplifies and perpetuates the subject’s conviction of being nothing for the Other. Exclusion is a situation in which not only socio-economic protections malfunction, but in which the symbolic register—as defined by society and its norms—is also eroded. This rupture introduces the subject into a very specific position. Between social uselessness (Fouliard, 2022) and humiliation (Paugam, 1991), the position that befalls the person living on the street is that of waste. In psychoanalytic terms, this translates into dephallicization. This term may seem abstract, but it simply designates the subject’s inability to sustain the supposition of being the object of desire for any alterity whatsoever. Such external desire normally acts as a catalyst for narcissistic investment, psychic conflictuality, and drive mobility toward the object. Desire is heteronomous, insofar as it is grounded in alterity (Villetore, 2007). There is indeed a persistence of bonds in exclusion; however, the bond of desire is impeded (Amand, 2024). In the process of exclusion, the subject moves from a symbolic bond that organizes differences of position and sustains a heteronomous dynamic (desire), to a bond of reification that ratifies ontological fixity and de-subjectivation. This upheaval has multiple consequences; I will detail only two of them here: withdrawal from the field of demand, and a particular mode of identification. These two effects, despite offering only a partial view of this clinical field, can nonetheless help to think through clinical intervention.
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Among the paradoxes that clinical practice allows us to observe, I have heard many excluded subjects note that passersby and associations are indeed helpful. They receive food donations, sleeping equipment, cigarettes, and small amounts of money. However, this assistance in no way undermines the conviction of not counting for the Other. Material gifts and concern for needs in fact evacuate the always ambiguous stakes of demand, which has both a conscious and an unconscious face (Lacan, 1998). Assistance targets only the satisfaction of needs, not the underlying demand for recognition (Amand, 2024)—assuming such a demand is even present in the subject. Yet the subject living on the street is waiting for a bond (Douville, 2014), and their demands do not concern material gifts alone, but rather constitute an appeal to a desiring alterity toward them.
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As a clinician, I have observed that the establishment of a transference bond is relatively slow due to identification with social waste. Identification, since Freud, is the psychic process of recognition and consequent transformation. Waste is an object that is used and then discarded. In this case, identification with waste has a double valence: that of an object of jouissance, which translates into the conviction of being abused by any alterity, or that of refuse—abandoned, ejected by an indifferent or even difference-intolerant Other.
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Clinically, there is no contradiction between these two positions; rather, there is an oscillation between these two extremely painful poles. Theoretically, these valences converge in the position of an object of jouissance, characterized by the absence of the desire of the Other.
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The clinical stance is therefore particularly difficult to maintain beyond the simple accompaniment of a different being, exposed at every moment to re-assignment. The subject will seek to question what intimately motivates us in the encounter with them, given their own identification. This dimension must constantly be revisited within the team. It turns out that the Fort-Da is a particularly relevant metaphor (Benhaïm, 2014) for thinking about the construction of rhythm and alterity for the subject living on the street. The Fort-Da is a game observed by Freud in a child who would alternately throw an object away and retrieve it.
As such, it allowed the child to represent the absence of the adult. Transposed to the clinic, the Fort-Da invites attention to the alternation between presence and absence. Indeed, it is sometimes less the isolated encounter than its regularity that proves decisive for initiating a (transferential) bond with the excluded subject. The supposition directed toward the clinician will become possible only when the clinician can be experienced as lacking by the subject. The interval between encounter and absence—while assuring the subject of the clinician’s return—constitutes a fundamental clinical framework. For certain subjects, this framework can foster the emergence of identificatory indetermination. While it is entirely unrealistic to think one can isolate the subject from the effects of the world and its economic primacy, identification with waste can nevertheless, in some cases, be reworked within a dynamic process of renewal through clinical intervention and the compass of transference. This is not, however, the only option available to the subject for undoing or attenuating identification with refuse.
The problem of economic determination and the symptom
Psychoanalytic theory involves wagering on the subject of the unconscious. It therefore draws clinical attention to the subject’s symptomatic inventions as ways of dealing with the unrepresentable dimensions of their being and of the social [or socio-economic] bond. These inventions participate in the formation of the symptom, which, as indicated, partly resists the social bond. A clear illustration of this unconscious resistance of the subject in our time—outside the field of exclusion—is the prevalence of depressive syndromes at the very heart of an exaltation of performance. While preserving each individual’s singularity, inhibition is often a means by which the subject opposes the discourse of the Other.
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The analytic literature already distinguishes several types of solutions adopted by people living on the street. These include paradoxical demands that consist in addressing requests to the wrong interlocutors (Furtos, 2008), as well as the tendency to care for companions whose condition is more severe than one’s own (Douville, 2014). The former allows the object of need to be evacuated from the bond of speech, while the latter makes it possible to maintain an identificatory link with a peer. Both support, via indirect paths, the maintenance of links to alterity. One must therefore refrain from asserting that the excluded subject is engaged in a process of systematic disconnection. Ultimately, our position is to move against a strict determinism in articulating the individual with the social field. Although our era is marked by economism, the category of the subject makes it possible to discern what is elaborated so as to maintain a properly singular umbilicus.
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Let us now turn to a singular solution to social and economic reification—one that dispenses with transference to a clinician and instead relies on urban wandering. A combinatory of places in the form of pedestrian enunciation (De Certeau, 1990) shows that the subject can sometimes free themselves from the reifying social assignments characteristic of our time.
Wandering as a subjective solution
Freud wrested the notion of the symptom away from medicine alone and, by the same gesture, from its purely pathological character. The symptom constitutes a compromise between drives that demand satisfaction and the superego charged with prescriptions tied to the era. In other words, the symptom is an unconscious and singular solution. In this regard, wandering cannot be reduced to a simple pathological displacement. To apprehend it, one must move away from an etymology that has long conveyed the idea of an erroneous itinerary. Clinical practice shows that this is not the case. I have shown (Amand, 2025) that wandering does indeed involve a route. Subjects living on the street who truly wander can name the places they traverse in an apparently random manner. What is annihilated, however, is direction. The route is devoid of subjective meaning and is therefore not vectorized. By contrast, wandering has an alleviating effect on psychic suffering. The wandering subject can say, in effect, that the feeling of being a piece of waste ceases, that they feel different and relieved.
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In other words, through the reactivation of the associative thread, wandering acts as a treatment for the morbid identification with social waste. The route, as a signifying chain, reintroduces indetermination at the level of the subject’s status and opens the possibility of renewed identification. In this sense, wandering can be considered a solution insofar as it produces a route without direction yet endowed with a purpose. The subject’s wandering is thus less a pathological journey than a search for elsewhere. It is a radical symptomatic response to a social bond that claims to frame and fix the subject’s being.
Conclusion
The intrusion of the economy seems to know no limits. From politics to the clinic, no field can fully protect itself from its effects. Thus, exclusion—despite the disaffiliation it entails—exposes subjects even more to the effects of the prevailing economism. Georg Simmel (2018) observed in his time that individuals in situations of poverty were in no way detached from society but, on the contrary, caught within a specific mode of interaction. Like poverty, exclusion indeed implies a precise link to the rest of society—an alienating link laden with contemporary imperatives. The excluded person must be rehabilitated in order to return to the market as a contributor and consumer. This normative demand has the consequence of evacuating any subjective dimension.
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These coordinates, identified by the human and social sciences, prepare the clinician for heightened tact in approaching the subject living on the street. The clinician encounters them in a street, a square, a vacant lot—through signs of somatic suffering and isolation—and slowly weaves a bond of speech. Through this bond, the person living on the street can experience another response to their demands, other than the mere satisfaction of needs. At its core, a demand questions what the subject is for the Other. Far from being resistant to all bonds, the person living on the street awaits recognition by an alterity. Nor are they entirely helpless in the face of the assignments imposed upon them. Indeed, the symptom opposes norms, and through it the subject resists what the economy reduces them to. It is through this symptomatic protest that the subject may choose the radical path of wandering. In this way, the clinic reveals the singular resistance to the socio-economic assignments characteristic of our time.
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REFERENCES
Amand A. (2025). L’errance en ville : d’un mouvement à l’Autre, Actes du Congrès de Valvort.
Chevalier J., Langlard G., Le Maléfan P., Bouteyre E. (2017). Stratégies de défense et exclusion sociale : la suradaptation paradoxale des sans domicile fixe (SDF), Bulletin de psychologie, 1(547), p.33-44
Furtos J. (2002), Le syndrome d’auto-exclusion, Rhizome, 9, p.15
Furtos J. (2008). Les cliniques de la précarité. Contexte social, psychopathologie et dispositifs, Masson.
Gueslin A. (2013). D’ailleurs et de nulle part. Mendiants vagabonds, clochards, SDF en France depuis le Moyen Âge, Fayard.
Douville O. (2014). Clinique psychanalytique de l’exclusion, Dunod.
Mathieu F., Charreton G., Pitici C. (2011). La pratique du squiggle urbain. Réflexion sur l’accompagnement des personnes sans domicile fixe, Perspectives Psy,2(50), p.146-154.
Martin J.-P. (2000). La récusation de l’aide comme symptôme. Rhizome (2), p.4-5 Negrel R. , Negrel M.-F. (2019). Résistance et travail en rue, D’une.
Parrique T. (2023). Ralentir ou périr. Économie de la décroissance, Seuil.
Paugam S. (1991). La disqualification sociale. Essai sur la nouvelle pauvreté, PUF.
Poenaru L. (2023). Inconscient économique, L’Harmattan.
Poenaru L. (2024). Impossible régulation de l’inconscient ? À propos de l’article « Inconscient économique et influences non conscientes de la publicité » de D. Courbet, In analysis, 8(3), p. 1-8
Keppler J. H. (2024). Économie de marché et inconscient. La pulsion à l’origine de la valeur économique, Classiques Garnier.
Lacan J. (1972) « Jacques Lacan à l’école Belge de Psychanalyse », inédit, https://www.ecolelacanienne.net/wp-content/uploads/2016/04/1972-10-14b.pdf
Lacan J. (1998). Séminaire V Les formations de l’inconscient, Seuil.
Lyotard F. (1974). L’économie libidinale, Éditions de Minuits.
Stiegler B. (2018). Dans la disruption. Comment ne pas devenir fou ?, Babel.
Sauret M.J. (2015). Peut-on penser une science clinique qui serait construite autour de la singularité du cas ? Pour une théorie du singulier, Dans Guillen A. : Essai d’épistémologie de la psychiatrie de demain, Eres.
Simmel G. (2018). Les pauvres, PUF.
Terrole D. (2004). La ville dissuasive : l’envers de la solidarité avec les SDF, Espaces et société, 7, 116-117. p. 143-157
Velut N. (2011). Mourir à la rue : ne pas laisser de trace ?, dans: J.-R. Freymann, Clinique de la déshumanisation, Eres, p.201- 207
Villetorte F. (2007). L’hétéronomie, une porte d’accès au désir et à l’autonomie, Journal des psychologues, 4(247), p.51-53
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