Objective. - The metapsychology of musical creation elaborated from the direct clinical approach of the musician-artist is rarely explored within the psychoanalytical literature. The aim of this article is to explain how clinical listening to musicians allows us to posit some specificities related to musical creation and to suggest the need to elaborate a particular practice of listening. In doing so, clinicians can respond in an adapted way to the requests for psychic care that are addressed to them. This subject calls for interdiscipli-narity: identity and practice of musical art, theories and practices of the analytical clinical practice. In view of this complexity and amplitude, this essay also aims to be synthetic and circumscribed.Method. - The article is based on a selection of works by Freud and D. Anzieu dedicated to artistic creation. From our intra-textual cri-tical reading, correspondences are established. Other theoretical contributions are inserted in filigree in our proposal as a com-plement. All of this is articulated with our clinical observations resulting from psychotherapeutic work with conservatory-trained professional musicians.Results. - Freud expressed his distance and reservations concer-ning the understanding of musical art and this position is generally thought of in terms of a-musicality. However, the weaving of his research associated with that of D. Anzieu, as well as the meta-psychology of music and the collection of our clinical data, allow us to identify the particularities of the psychic reality involved in musical creation. It is a question of almost constant and neuralgic anxieties. These last ones relate, on the one hand, to the mecha-nisms of regression constituting one of the psychic properties of music, which stems from the status of sound as an extension of the intra-uterine environment, and on the other hand, to the mecha-nisms of psychic dissociation strongly mobilized in performance situations. The musical training frequently committed to in child-hood, even early childhood, and the repression, denial, or revelation of its socio-affective context by the musician-patients received in my consultation complete this clinical picture. These particularities shed analytical light on the nature of the complaint and symp-toms at work in certain musicians. They also inform the encounter between the clinician and the musician, precisely the transferen-tial dimension, when this is loaded with resistance. Moreover, it appears that the treatment of psychological suffering is most often oriented in the first instance towards supportive psychotherapy, within the framework of adapted devices, without ruling out the possibilities of analytical psychotherapy and a typical cure. One of the therapeutic stakes would consist essentially in regulating the anxieties of loss relating to the movements of constant coming and going between the mechanisms of dissociation of the self and the processes of reunification of this authority.Discussion. - Our proposal is situated in the register of the meta-psychology of musical creation. It has therefore circumscribed our approach to the musician-subject in her/his links to this cultural object. However, the reading of the requests for psychotherapy emanating from professional musicians can be completed by exis-ting research that explores the register of the suffering at work. Conclusion. - The requests for care addressed to the clinician coming from musician-subjects reveal the need to pursue existing research on the metapsychology of musical creation. Further research could explore the sense of the clinical implications - both on an individual and a group level - for vocal or instrumental ensembles as well as for cultural institutions.(c) 2023 Elsevier Masson SAS. All rights reserved.
