Psychothérapie intégrative et prise en charge des personnes Agés atteints d’Alzheimer au Maroc. Programme MBT–NEXA Alzheimer Léger

Abstract

Aging is shaped by social and personal representations that seek to control its effects, giving rise to the imperative of “aging well.” This idea is often linked to the illusion of not aging and to the denial of human finitude. Alzheimer’s disease is presented as a major risk of aging, posing both a demographic and clinical challenge, particularly in the Moroccan context where the elderly population is increasing. From a psychoanalytic perspective, aging involves narcissistic issues and is connected to the ego ideal, leading to a manic logic of “doing” rather than “being.” Traditional psychiatric classifications, such as the DSM-5, have historically marginalized geriatric psychiatry, making a multidisciplinary approach necessary—one that integrates psychoanalysis into modern psychotherapeutic practices. The MBT–NEXA Mild Alzheimer program is a mentalization-based protocol adapted for older adults with mild Alzheimer’s disease. It was implemented over a three-month period at the Day Hospital “Psychological Support and Cognitive Stimulation” in Taza. This protocol offers an integrative approach combining psychotherapy, cognitive rehabilitation, and sensory, bodily, spiritual, and socio-cultural stimulation. Despite constraints related to an illiterate population and limited resources, the program was successfully implemented with the collaboration of Ms. Azdade, a local psychologist, creating a supportive environment for clinical practice. The final evaluation showed improvement rather than deterioration among patients, suggesting the development of a form of positive resilience through the program. This article highlights the importance of adapting clinical interventions to the cultural and cognitive context of participants in order to better address aging-related disorders.