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[A focus on self-directiveness in the training and support approach of caregivers].

The aim of this paper is to quickly define the notion of "self-nomativity", a central element of my thinking and the impact this notion of the patient's link to his disease and the norm has on the health care relation. Its active and paradoxical aspect is highligthed as well as the difficutly for the caregiver to detect it as a normative process, even in the framework of apparently pathological behaviours. I therefore invite the caregivers to open their mind to the listening of the chronically ill patient during clinical examination.