Interne en psychiatrie, Centre hospitalier Le Vinatier, 95, boulevard Pinel, 69500 Bron. Université Claude-Bernard Lyon 1, 43, boulevard du 11-novembre-1918, 69622 Villeurbanne, France
P.-H. Castel's La Fin des coupables is an epistemological and a historical study of the transformation of obsessional neurosis into obsessive-compulsive disorder in the 20th century. The author develops a minute analysis of the anthropological context in which this disease and its treatment was conceptualized. The transition from psychoanalysis to cognitive-behavioral therapies (CBT) would thus be linked to a change in the moral and social order, mainly concerning the nature of individual autonomy. This paper raises the question of the role of psychoanalysis in a world not only where it has lost its predominance, but it also underlines the paradoxical junction between the scientific claims of CBT and their unavoidable moral rooting. It then shows how the anthropological approach to psychotherapy allows for a rational alternative to the naturalistic conception of mental diseases.