Search

Researchers and clinicians live in increasingly separate worlds, precipitating psychotherapy into a crisis of legitimacy. This paper hypothesizes that the therapeutic alliance, as an integrative variable, is an element capable of reducing this gap, considering in particular that the alliance between researcher and clinician is based on the same principles as the working alliance between patient and therapist. A few examples of empirical research allow us to address three conflicting aspects of our current knowledge about the alliance: as a common factor or as a specific agent, as useful to the researcher or useful to the clinician, and finally the distinction between the trait-component and the state-component of the alliance. The time has come to strengthen this vital alliance between research and clinical practice. [ABSTRACT FROM AUTHOR]

The association between play and pleasure may seem natural, even intuitive. Although the hedonism associated with playful activities is generally evident in normally developing children, for children who have experienced early relational trauma (Bonneville-Baruchel, 2015), play can be related to displeasure, suffering and great psychological distress (Romano, 2010). Play, then, does not seem to obey the pleasure principle, nor for that matter the reality principle, in the same way that it is neither entirely in the realm of either reality or fantasy (Winnicott, 1975). This theoretical and clinical paper focuses on the evolution of the nature and role of pleasure in the psychotherapy of children who have experienced early relational trauma and who are able to experience pleasure. It attempts to demonstrate that for these children, pleasure is initially related to sensoriality, but that access to psychotherapy and pretend play allows a transition from a form of pleasure associated with the senses to one which is linked to meaning. The characteristics of play in traumatized children are outlined and clinical vignettes are presented to illustrate different manifestations of pleasure in children with early relational trauma. [ABSTRACT FROM AUTHOR]

This paper text seeks to locate psychoanalysis and psychoanalytic psychotherapy on a continuum, in light of the notion of the "work of transference." These different settings give the conditions for a "transference demand upon the mind" of both the analysand and the analyst, and the conditions for the interpretation "of" the transference and "in" the transference. These three forms of the work of transference are examined. The paper proposes that the demand coming from the transference at work requires from the therapist not only a solid training but also a personal and intimate experience of transference within a personal analysis. Finally, the text puts forward the idea of a radical break between psychoanalytic psychotherapies and "psychoanalytically informed therapies.". [ABSTRACT FROM AUTHOR]

This paper is a contribution to a debate that is currently taking place in the well-defended field of psychotherapy in Quebec, but also wherever interventions of this nature are practiced. Some are claiming "evidence-based practice" as defined by scientific criteria, in accordance with a particular definition of the word science. Others emphasize the relational dimension of the psychotherapeutic act, but without sacrificing its rigour. The reflections that follow will attempt to get to the root of this opposition, or at least to one possible source. As a part of this task, I will resort to thinkers preoccupied with the nature of science and the effect of its practice on the two major object categories: nature and human phenomena. [ABSTRACT FROM AUTHOR]

Résumé Le thème de la santé mentale a considérablement élargi le champ d’intervention de la psychiatrie et de la psychologie, en invitant ces disciplines à considérer non seulement la maladie mais, dans l’accomplissement personnel, l’accès au bien-être. Cette vision de la santé a fortement essaimé au cours des années 1960, notamment dans l’antipsychiatrie. Il n’y est donc pas seulement question d’une perspective thérapeutique mais bien d’une véritable philosophie politique et morale dont on peut tenter de retracer les origines et les fondements. À ce titre, l’article, revenant sur les écrits fondateurs de William James, cherche d’abord à montrer combien la notion de santé mentale est indubitablement liée aux principes d’une psychologie du soi. Partant de ce premier éclairage, il entend ensuite indiquer de quelle manière cette pensée a cherché à mêler un parti épistémologique et méthodologique au projet d’une clinique susceptible d’aiguiller le changement social. Psychology and psychiatry have significantly extended their scope of action by addressing the topic of mental health and by focusing, beyond the study of disabilities, on well-being through personal development. This approach was already widely popular in the 1960's, especially in the field of anti-psychiatry. As a result, mental health, as a therapeutic perspective, went on to become a major concern for moral and political philosophy. This paper aims to trace back the origins of this shift and delineate its foundations. To this end, the pioneering work of William James serves as a basis for showing how the notion of mental health relates to the tenets of the psychology of the self. Then, this paper uses this analysis to demonstrate how this approach combined epistemological and methodological principles to support a new clinical project that was supposed to contribute to social change. [ABSTRACT FROM AUTHOR]

Résumé Les troubles de personnalité limite sont caractérisés par un certain nombre de manifestations éparses telles que des actes autodestructeurs, une angoisse massive, des affects intenses et labiles, des ruptures interpersonnelles et une grande impulsivité. L’objectif de cet article consiste ainsi à reprendre un certain nombre de données de littérature susceptible de dresser une vue d’ensemble des troubles de personnalité limite à la lumière de la théorie de l’attachement, en supposant que celle-ci puisse en expliciter les mécanismes à l’œuvre et rassembler les comportements décrits en une unité cohérente. Ainsi, l’étude étiologique basée sur l’attachement, englobant les modèles biopsychosociaux et plus particulièrement la question des traumatismes, permet d’éclairer la symptomatologie à la fois multiple et spécifique de ces troubles par le biais de mécanismes tels que l’activation du système d’attachement, la dysrégulation émotionnelle et la mise à défaut de la mentalisation. Borderline personality disorders concern clinicians and caregivers because of the violent and impulsive nature of their behavioral and affective reactions, which often confronts them to a feeling of helplessness and incomprehension. Indeed, it may be difficult to deal with self-harm, massive anxiety, intense affects and interpersonal ruptures, which are often present in the life course of the borderline patients. Their distress is particularly difficult to accept as it takes place in the therapeutic link, which reveals the core of the patient's attachment problematic. This paper aims to draw up an overview of borderline personality disorders, in light of attachment theory, which could help to clarify the involved mechanisms and gather the described behaviors in a coherent unit. Many studies relating to borderline personality disorder and attachment theory highlight what constitutes the specificity of these disorders through an integrative approach. Thus, the combination of an insecure attachment style, biological vulnerabilities and environmental stressors like traumatisms may induce the establishment of many defensive mechanisms, such as attachment system hyperactivation, emotional dysregulation or mentalization's failure. People suffering of borderline personality disorder activate these mechanisms as soon as they have to deal with real or imagined abandonments related to one of their attachment figures. However, in view of the massive anxiety and the severe disruption, those inefficient mechanisms cannot enable a good resolution of stressful situations. Consequently, borderline patients are likely to resort to new kind of emotional regulation such as suicidal, destructive and impulsive behaviors. Attachment based theories focus on these defensive mechanisms and inadequate attempts of emotional regulation, in order to propose an appropriate treatment for borderline personality disorder. [ABSTRACT FROM AUTHOR]

Résumé L’évaluation des psychothérapies, pour des raisons ayant trait à la fois au respect de règles de santé publique et à l’amélioration de nos connaissances et de nos pratiques, est devenue une étape incontournable. L’efficacité des psychothérapies, et particulièrement des Thérapies Comportementales et Cognitives (TCC), est aujourd’hui largement documentée dans le traitement des épisodes dépressifs et dans la prévention de leurs rechutes. Les travaux récents portent leurs efforts sur l’amélioration des prises en charge afin d’optimiser encore le gain en termes de prévention de rechutes. C’est dans ce cadre que la démarche MBCT prend toute sa place. Certains auteurs ont montré qu’adjoindre une démarche MBCT améliorait encore le gain en termes de rechute après une TCC auquel le patient avait été répondeur (Vittengl et Jarrett, 2015) lui permettant d’améliorer sa qualité de vie. En revanche, la question du pourquoi elles fonctionnent, dans quelles conditions, pour quels individus particuliers ainsi que l’identification des mécanismes et processus de changement sont encore très d’actualité. Pour ce faire, l’évaluation de l’effet d’une pratique en MBCT a utilisé à la fois des mesures se voulant directes (auto-questionnaires) et des mesures plus indirectes du changement (épreuves neuropsychologiques, mesures psychologiques, techniques d’imagerie cérébrale, etc.). Cette communication se propose de faire le point sur ces mesures, les résultats qu’elles ont apportés et les hypothèses qu’elles ont soulevées respectivement dans la littérature internationale de la dépression unipolaire. The assessment of psychotherapies, for reasons related both to the respect of public health rules and to the improvement of our knowledge and our practices, has become an unavoidable stage. The effectiveness of psychotherapies, and particularly of Cognitive and Behavioral Therapies (CBT), is now widely documented in the treatment of depressive episodes and in the prevention of relapses. Recent work focuses on improving care to further optimize the gain in relapse prevention. It is within this framework that the MBCT approach takes its place. Studies have shown that joining an MBCT approach further improves the gain in relapses after CBT to which the patient had responded (Vittengl et Jarrett, 2015). On the other hand, the question of why they work, under what conditions, for which particular individuals and the identification of the mechanisms and processes of change are still very current. In order to do this, the evaluation of the effect of a practice in MBCT used both direct measures (self-questionnaires) and more indirect measures of change (neuropsychological tests, psychological measures, brain imaging, etc.). The purpose of this paper is to review the results of these measures, the results they have produced and the hypotheses they have raised in the international literature on unipolar disorder. [ABSTRACT FROM AUTHOR]

Résumé Introduction/objectifs La dynamique suicidaire est approchée abondamment chez l’adolescent (Arrfa, 1982 ; Jeammet et Birot, 1994 ; Diwo, 1998 ; Diwo et al., 2004 ; Silberg et Armstrong, 2010 ; de Kernier, 2009, 2012, 2015). Son étude chez l’enfant l’est beaucoup moins (Pfeffer et al., 1979 ; Guillon et al., 1987 ; Petot, 2012). Nous présenterons le cas de Marguerite, 12 ans non pubère, dont le père s’est suicidé 6 ans auparavant et qui a elle-même tenté à plusieurs reprises de mettre fin à ses jours. Méthodologie Nous avons utilisé conjointement l’entretien clinique, le test des contes (Royer, 1978 ; de Tychey, 2010), le test de Rorschach interprété selon le modèle de l’École de Paris (Chabert, 1987 ; de Tychey, 2012), et l’épreuve de dessin des trois arbres (Fromage, 2011) parallèlement au suivi psychothérapique de l’enfant avec une analyse en double insu par deux cliniciens différents de ceux qui ont fait le bilan et le suivi psychothérapique de l’enfant. Résultats Les données cliniques projectives riches issues Rorschach et du test des contes confirment notre hypothèse de départ de la force de l’identification mélancolique de Marguerite aux aspects négatifs de l’objet mort perdu, ce qui suggère chez elle une dynamique suicidaire proche de celle mise en œuvre chez nombre d’adolescents (Chabert, 2003 ; de Kernier, 2015). Conclusion Les épreuves de dessin au cours de la psychothérapie permettent de suivre l’évolution du travail de deuil de Marguerite, de la phase initiale associant déni puis identification au père mort à un progressif travail de détachement de l’objet perdu. Introduction/objectives As far as teenagers are concerned, the suicidal dynamic has been broadly tackled by Researchers (Arrfa, 1982; Jeammet and Birot, 1994; Diwo, 1998; Diwo et al., 2004; Silberg and Armstrong, 2010; de Kernier, 2009, 2012, 2015). Conversely, studies on children are much set aside (Pfeffer et al., 1979; Guillon et al., 1987; Petot, 2012). In this paper, we will develop the case study of 12-year-old Margaret (non-pubescent), who has tried to end her life several times after her father's suicide 6 years before. Method We chose an exploratory single case study related to the psychodynamic two months psychotherapy during the child's hospitalization. Originality of our approach is related to the fact that we combined clinical interview with a multifocal projective approach using several tools to test our theoretical hypothesis of melancholic identification of the child to her death father We used the tales’ Test (Royer, 1978; de Tychey, 2010), the Rorschach Test as interpreted by Parisian School (Chabert, 1987; de Tychey, 2012), and the three trees drawing test (Fromage, 2011). Alongside with that, the psychotherapeutic follow-up has been completed with a double-blinded assessment by two other different clinical psychologists. Results The projective clinical data produced by the fairytales’ Test and the Rorschach Test confirm our hypothesis: Marguerite's melancholic identification stems from the negative aspect of the dead lost object. Repeated dead human and animal contents were projected on Rorschach cardsand showed the traumatic impact of father suicide on the child. On the other side, child's identification to death baby animals was very impressive in the tales’ test. Therefore, her suicidal dynamic is closed to the one implemented by so many teenagers (Chabert, 2003; de Kernier, 2015). Conclusion The drawing tests used while counselling Marguerite enable us to follow the evolution of her grieving process. She moves forward from an association of denial and identification to the lost father, to a progressive work resulting in the detachment of the lost object. Further researches are suggested, both to prove the importance of melancholic identification in children’ suicide attempts and to prevent such an issue. [ABSTRACT FROM AUTHOR]

Résumé Objectifs Cet article propose une étude des rapports entre l’histoire et la psychiatrie, en abordant la psychiatrie dans son histoire et en analysant les enjeux épistémologiques, cliniques et méthodologiques qui les traversent. Méthode Trois points sont envisagés : les rapports entre l’évolution des idées et des pratiques psychiatriques et le contexte historique depuis le début du 19 e siècle à nos jours ; les relations entre l’épistémologie de la psychiatrie et celle de l’histoire ; enfin l’utilisation du récit dans le soin psychiatrique notamment institutionnel. Résultats L’étude de son histoire montre qu’à l’opposé du reste de la médecine, la psychiatrie n’évolue pas selon une logique d’accroissement des connaissances. Elle accompagne les transformations sociales et l’histoire des idées, et est subordonnée à ses avancées libérales et à ses reflux autoritaires. Discussion Pour le moment, la psychiatrie a plus à gagner d’un rapprochement avec les sciences humaines qu’avec la médecine et la neurobiologie. En suivant l’épistémologie de Paul Veyne, plusieurs points communs peuvent être identifiés : la psychiatrie et l’histoire sont l’une et l’autre basées sur l’événement singulier et non sur l’établissement de lois. La causalité en psychiatrie comme en histoire est « rétrodictive ». Les diagnostics sont des abstractions, des catégories, des hypothèses provisoires, qui ne peuvent prétendre à la valeur de fait comparable à la lésion en médecine. Conclusions La psychiatrie comme l’histoire se fondent sur les principes de la narratologie, tels qu’ils ont été établis par Paul Ricœur. La narratologie forme le point commun de toute intervention de type psychothérapeutique et elle constitue notamment les fondements de la psychothérapie institutionnelle. La clinique est inséparable de cette mise en récit partagée entre soignant et soigné, support à la fois du plaisir de penser et véhicule de la consolation des pertes. Objective This paper aimed to study the relationships between history and psychiatry, approaching psychiatry within its history and analysing the epistemological, clinical and methodological challenges involved. Method History and psychiatry have strong relationships. Three points are considered: the relationships between the evolution of psychiatric ideas and practice and the historical context from the beginning of the 19th century to the present day, the relationships between historical epistemology and the epistemology of psychiatry, both based on single events and not on the founding of laws, and the use of narrative in psychiatric and especially institutional care. Results The study of this history shows that, unlike the rest of medicine, psychiatry does not evolve according to a logic of increasing knowledge. Psychiatry accompanies social change and the history of ideas, and is subject to liberal advances and authoritarian withdrawals. Discussion At present, psychiatry has more to gain from a rapprochement with the social sciences than with medicine and neurobiology. According to Paul Veyne's epistemology, several points in common can be identified: psychiatry and history are both based on singular events and not on the edification of laws. Causality in psychiatry as in history is “retrodictive”. Diagnoses are mere abstractions, categories, provisional hypotheses, which cannot claim to possess the value of scientific fact held by a lesion in medicine. Conclusion Psychiatry, like history, is based on narrative principles, as expounded by Paul Ricoeur. Narrative is what all psychotherapeutic interventions have in common and in particular it underpins institutional psychotherapy. Clinical practice is inseparable from the narrative shared by caregivers and receivers, which carries with it both the pleasure of thought and consolation for loss. [ABSTRACT FROM AUTHOR]

Contemporary works on empowerment focuses on promoting the freedom of the subject as an core component of recovery process. We propose in this paper to review the psychological difficulties associated with the exercise of freedom, as analyzed by existential and humanist psychology. Freedom, a source of fulfillment for the subject, is also a difficult exercise for each of us. In fact, it involves the confrontation of the subject with his own death, with solitude and with the quest of meaning. Therefore, the exercise of freedom requires the caregiver's attention and may in some case constitute the target of a psychotherapeutic work. [ABSTRACT FROM AUTHOR]

Résumé Objectif Les médiations thérapeutiques sont fréquemment utilisées dans les services de soin psychiques. Pour autant, elles sont l’objet d’un nombre relativement restreint de travaux visant à évaluer leur efficacité et à modéliser leurs effets. Nous proposons dans ce travail une reprise synthétique des recherches en ce domaine afin de développer une théorie générale des médiations thérapeutiques selon une perspective psychanalytique. Cette thématique est également abordée du point de vue de l’évaluation qualitative des processus et de la modélisation des psychothérapies. Méthode Nous nous sommes appuyés en particulier sur les perspectives ouvertes par les travaux de l’École Lyonnaise. Celle-ci se distingue notamment des pratiques de l’art-thérapie sur le plan théorique par la prise en compte des effets de l’associativité et des formes multiples du transfert. Une réflexion sur le cadre thérapeutique et la dynamique groupale est également proposée pour penser les processus de la médiation. Résultats Nous avons dégagé quatre hypothèses princeps concernant les processus sous-jacents à l’usage des médiations thérapeutiques. Outre (1) la tendance spontanée de la psyché à imprimer son empreinte dans les objets qui l’entourent, nous avons souligné comment celle-ci tendait à auto-représenter ses processus de manière extériorisée dans le but de les élaborer. Ce sont alors essentiellement (2) les éléments non symbolisés qui feront retour dans l’actualité des séances et qui seront « projetés » dans la médiation. Ces éléments non symbolisés s’exprimeront notamment (3) selon les caractéristiques sensorielles et actuelles de la médiation ce qui ne pourra avoir lieu qu’à condition que (4) les propriétés de la médiation fassent écho aux caractéristiques de la réalité psychique selon une forme de « résonance » suffisante entre la psyché du sujet et la médiation. Discussion L’analyse des processus de la médiation peut être associée à une évaluation quantitative et qualitative de ses effets et de ses modes d’action. Ce travail d’évaluation nécessite néanmoins de tenir compte des spécificités de la réalité psychique, au risque de mutiler le réel clinique et de produire une évaluation de surface qui dénature les pratiques et se coupe de l’écologie institutionnelle. Le passage de l’expérience sensible à la modélisation des processus peut notamment se faire par des méta-modèles – sous forme de grilles – aux propriétés épistémologiques spécifiques. Conclusions Le développement actuel d’une théorisation et d’une évaluation des processus de la médiation permet dans un même mouvement une meilleure compréhension de la nature de l’efficacité de ces dispositifs et une relance du travail de symbolisation des cliniciens en accroissant la réflexivité inhérente à ces pratiques. Aim Therapeutic mediations are frequently used in mental health services. However, only a small number of studies are designed to assess their effectiveness and try to analyze their effects. In this paper we propose a summary of the research in this area in order to develop a general theory of therapeutic mediation from a psychoanalytic point of view. This topic is also discussed from the viewpoint of the qualitative analysis of the processes involved and the modeling of psychotherapies. Method Our analyses are underpinned by the theoretical framework of the School of Lyon, which differs from art therapy by the fact that it takes into account the effects of associativity and the different modes of transference. A reflection on the therapeutic framework and group dynamics is also proposed to cast light on mediation processes. Results Four assumptions concerning the processes underpinning therapeutic mediation are proposed. First (1) there is a spontaneous tendency of the psychic reality to “print” its mark in its environment in order to self-represent it own processes in an externalized manner. These processes concern essentially (2) non-symbolized psychic elements that will return during the therapeutic sessions and will be “projected” into the mediation. These non-symbolized elements will be expressed (3) according to the ongoing, sensory aspects of the mediation, which can take place only if (4) the properties of the mediation echo the characteristics of the psychic reality in the form of a “resonance” between the psyche and the subject of the mediation. Discussion Theories on mediation processes also need quantitative and qualitative assessments of the effects of the mediation and its mode of action. Nevertheless, these evaluations also need to consider the particularity of the psychic reality. The risk is otherwise that of distorting clinical reality and producing a surface analysis giving a false image of clinical practice far removed from “ecological” institutional aspects. Thus, to move from experience to modeling of these processes, what is needed is meta-models – taking the form of grids – corresponding to specific epistemological properties. Conclusion Current developments of theories and evaluations in the domain of therapeutic mediation are improving our understanding of reasons for the effectiveness of these settings, and also help clinicians to improve the reflexivity inherent in this practice. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: The objectives of this study are to offer some clinical and semiological considerations for a psychopathological conception of psychopathy. In the first part, the author provides a history of this diagnosis (see Introduction of this paper) and a description of the current trends in the international literature: the contributions of R.D. Hare and the PCL-R, D.J. Cooke and the Comprehensive Assessment of Psychopathic Personality (CAPP) and T.H. Pham for French-speaking validations (subtitle 2 of this paper). After that, the author proposes a definition of psychopathology in the sense of Minkowski and Jaspers proposals (i.e. these latter come from the principles of the continental phenomenology) (subtitle 3 of this paper). Patients and methods: This theoretical essay is improved by clinical situations. The psychopaths were interviewed in prison or in forensic centers. The method used was a psychopathological analysis from the clinical material, as well as references to the phenomenological psychopathology (continental phenomenology) and the philosophy of J.-P. Sartre, M. Foucault and P. Ricœur. Results: This study shows that it is useful to consider a psychopathological reflection on psychopathy and this approach gives a framework for the clinical investigations. Regarding that, the author proposes a first comparison between the binswangerian conception of mania and the psychopathic functioning (subtitle 4 of this paper). By this way, we can understand why many studies show a positive correlation between the scoring in the PCL-R and the scale of the MMPI mania. The behavior is similar but the difference is about the dialectic between the “ego” and the “alter ego”. The maniac has a fundamental crisis of the “ego”, which the psychopath does not have. A second finding of our investigations concerns emotions and the dimension of the adaptive psychopathic disorder (subtitle 5 of this paper). An epistemological discussion of the concept of emotions allows us to say that the psychopath is competent in the management of emotional stimuli, which confers a psychological advantage to him. In addition, fundamental research on the management of the emotional stimuli in the psychopath seems to confirm our hypothesis of an adaptive dimension for the psychopathic disorder. The last point we discuss is about “morality” and “ethics” for the psychopath (these notions are from the concepts of empathy and sympathy). On the basis of Foucault''s distinction between these two concepts, it becomes possible to study these dimensions and integrate them in the practice of psychopathology. This proposal enables to introduce the concept of narrativity. This observation prompts the clinician to listen to the patient and to pay attention to how he has to tell himself. Conclusions: Our contribution shows that it is possible to conduct a study about the psychopathology of psychopathy. Our study is not intended to be complete and irrefutable. Our goal is rather to give some evidence for a psychopathological consideration on psychopathy (as indicated by the title of this paper). Finally, we offered some thoughts on the practice of psychotherapy by integrating the adaptive dimension of this disorder which, when it is missed, can lead to a psychotherapeutic stalemate. [Copyright &y& Elsevier]

Abstract: Objectives: The objectives of this study are to offer some clinical and semiological considerations for a psychopathological conception of psychopathy. In the first part, the author provides a history of this diagnosis (see Introduction of this paper) and a description of the current trends in the international literature: the contributions of R.D. Hare and the PCL-R, D.J. Cooke and the Comprehensive Assessment of Psychopathic Personality (CAPP) and T.H. Pham for French-speaking validations (subtitle 2 of this paper). After that, the author proposes a definition of psychopathology in the sense of Minkowski and Jaspers proposals (i.e. these latter come from the principles of the continental phenomenology) (subtitle 3 of this paper). Patients and methods: This theoretical essay is improved by clinical situations. The psychopaths were interviewed in prison or in forensic centers. The method used was a psychopathological analysis from the clinical material, as well as references to the phenomenological psychopathology (continental phenomenology) and the philosophy of J.-P. Sartre, M. Foucault and P. Ricœur. Results: This study shows that it is useful to consider a psychopathological reflection on psychopathy and this approach gives a framework for the clinical investigations. Regarding that, the author proposes a first comparison between the binswangerian conception of mania and the psychopathic functioning (subtitle 4 of this paper). By this way, we can understand why many studies show a positive correlation between the scoring in the PCL-R and the scale of the MMPI mania. The behavior is similar but the difference is about the dialectic between the “ego” and the “alter ego”. The maniac has a fundamental crisis of the “ego”, which the psychopath does not have. A second finding of our investigations concerns emotions and the dimension of the adaptive psychopathic disorder (subtitle 5 of this paper). An epistemological discussion of the concept of emotions allows us to say that the psychopath is competent in the management of emotional stimuli, which confers a psychological advantage to him. In addition, fundamental research on the management of the emotional stimuli in the psychopath seems to confirm our hypothesis of an adaptive dimension for the psychopathic disorder. The last point we discuss is about “morality” and “ethics” for the psychopath (these notions are from the concepts of empathy and sympathy). On the basis of Foucault''s distinction between these two concepts, it becomes possible to study these dimensions and integrate them in the practice of psychopathology. This proposal enables to introduce the concept of narrativity. This observation prompts the clinician to listen to the patient and to pay attention to how he has to tell himself. Conclusions: Our contribution shows that it is possible to conduct a study about the psychopathology of psychopathy. Our study is not intended to be complete and irrefutable. Our goal is rather to give some evidence for a psychopathological consideration on psychopathy (as indicated by the title of this paper). Finally, we offered some thoughts on the practice of psychotherapy by integrating the adaptive dimension of this disorder which, when it is missed, can lead to a psychotherapeutic stalemate. [Copyright &y& Elsevier]

Abstract: Professionals working in a service for young people with gender identity disorder (GID) often experience a particular type of pressure in the course of the work, which makes thinking and decision-making very difficult. The paper suggests that an examination of the position of the professional and of its service within the system may bring some relief and be a starting point to direct thinking and possibly action. The perceived position of the professional and of the Gender Identity Development Service within the wider organisation of a psychotherapy and mental health trust is discussed. The paper makes reference to the model developed by Lagenhove and Harré as described by Campbell and Groenbaek in their book Taking positions in the organisation. The position taken by the professional or the service is also explored as a possible re-enactment of the psychological dynamics of the young people with GID and their families. This view is based on Britton''s paper on the mirroring and re-enactment of individual and family dynamics in the professional network. A view is put forward that this dynamic leads the professional or the service to the risky position of “working at the edge”. The paper discusses processes that could facilitate the move from a position of being psychologically at an edge to the more secure position of being in the mainland. These involve exploration of the model of care and the relationship of the professional to the wider organisation in which the service is located and to self help organisations. [Copyright &y& Elsevier]

Abstract: This paper is a commentary on two letters from Pierre Janet to William James found at the Harvard Medical Library in the Francis A. Countway Library of Medicine and at the Houghton Rare Books and Manuscripts Library of Harvard College. One of these letters was unrecorded and turned up recently. It discusses Pierre Janet''s influence on the so-called “Boston School of Psychotherapy” and his critical attitude toward “Parapsychical Research,” a field of investigation in which William James was involved in the late nineteenth century and the beginning of the twentieth century. This paper''s aim is to show the relationship between these two leading figures of early experimental psychology. It concludes the topic from another point of view: A letter to William James from Théodore Flournoy, a psychologist from the University of Geneva, describing Janet''s attitude toward parapsychological studies during the 1900 International Congress of Psychology in Paris. [Copyright &y& Elsevier]

Abstract: This paper proposes that psychoanalytic psychotherapy can be a helpful form of treatment for certain autistic children. Some of the misconceptions surrounding this kind of treatment are discussed. The literature identifying a particular sub-group of autistic children is then reviewed and the characteristics of this group, and the relationship of their difficulties to early trauma, are described. Using clinical material from work with a child who probably fell within this sub-group, and who had very marked autistic features, the paper illustrates the importance of the therapist taking an active role in the therapy and how this helped the child to emerge from his withdrawn state. Particular emphasis is placed on the importance of introducing themes of aggression, and of this being done in a playful way. The impact of trauma on children’s development, with particular reference to the acquisition of language, is considered. The role of sibling rivalry as a factor is emphasised. [Copyright &y& Elsevier]

Abstract: When the psychological, psychiatric and psychoanalytical literatures abound in developing the theme of the children''s aggressive desires towards his father, few mentions is made of the father''s aggressivity towards his child. This is much unfortunate for the theory as well as for the clinic. This paper, after having shown how this theme is though recurrent through mythology, considers the deep psychic shake-up as well as the possible uneasiness generated by the irruption of a child, from his conception, into the life of a man becoming a father. The paper reports this uneasiness by evoking various psychic processes called upon when the child comes up: appearance of a “forclos” signifier, various identifications leading to a re-update of infantile desires, namely oedipal ones, maturation in the generational axis. The paper ends up with an evocation, through short clinical illustrations, of the psychotherapeutic approaches when such difficulties occur. [Copyright &y& Elsevier]

Résumé Objectifs Les techniques d’imagerie cérébrale permettent aujourd’hui l’observation de la connectivité fonctionnelle entre différentes régions du cerveau. Cela rend possible l’abord de l’intimité psychique de la personne. L’objectif de cet article est de confronter la notion classique d’esprit à l’approche des processus psychiques réalisée avec l’imagerie cérébrale. Méthodes Sont passées en revue les techniques d’étude de la connectivité fonctionnelle cérébrale, les anomalies de connectivité dans les maladies psychiatriques, et l’utilité potentielle de ces techniques dans les processus de guérison. Est aussi abordée la question de l’apport de l’imagerie dans la compréhension de ce que sont le soi et l’élaboration des pensées. Résultats L’imagerie cérébrale permet de déconstruire les processus psychiques, ouvrant sur la possibilité de les reconceptualiser sur des bases connectomiques. Et il est aujourd’hui évident que l’essentiel du soin en psychiatrie consiste à rendre fonctionnels des réseaux qui fonctionnent de façon pathologique au cours des maladies. Discussion L’étude de la connectivité fonctionnelle cérébrale conduit à la construction d’un nouvel et immense espace imaginaire, que l’on peut qualifier d’imagerie de l’esprit. Conclusion Libre de toute référence métaphysique, l’esprit ne peut être conçu que comme un produit de l’activité du cerveau. Ce qui ne signifie pas pour autant que les techniques actuelles d’imagerie cérébrale permettent de l’aborder dans toute sa complexité. Objectives Brain imaging techniques today enable the study of functional connectivity between different brain regions, thereby providing insight into an individual's unique psychic world. The objective of this paper is to confront the classic notion of mind with the model of psychic processes developed and facilitated by brain imaging techniques. Methods Techniques enabling the study of functional connectivity and connectivity abnormalities in mental disorders, and the potential usefulness of imaging techniques in recovery processes are reviewed. The questions of the contributions of brain imaging to understanding self and the elaboration of thoughts are also addressed. Results Brain imaging techniques enable a deconstruction of psychic processes, and a reconceptualization of these processes in terms of connectomics. We also show how most recovery processes in psychiatric illnesses primarily consist in improvements in dysfunctional connections. Discussion The study of brain functional connectivity leads to the construct of a vast, new imaginary space which could be called the “mind imagery space”. Conclusion Mind, freed from any metaphysical reference, is considered to be a product of brain activity. However, this should not imply that brain imaging can apprehend all the mind's complexity. [ABSTRACT FROM AUTHOR]

Résumé Les dispositions françaises de l’obligation de soin sont présentées au travers de l’exposé du travail psychothérapique mené dans le cadre d’entretiens réguliers d’un « agresseur sexuel » auprès d’un thérapeute. Les conditions du passage à l’acte de nature sexuelle d’un père sur sa fille seront abordées à partir d’une manifestation hallucinatoire. La situation d’inceste agi permet aux auteurs de revisiter la question de l’inceste dans sa version du passage à l’acte au regard d’une clinique orientée par la référence à la psychanalyse. Le dispositif orienté par l’obligation de soin pris dans la conception d’une « enveloppe psychique » a pu permettre la relance de la position subjective du patient. The point of compulsory care and its effects are presented here through the description of psychotherapeutic work undertaken in the form of regular discussions, lead by a therapist, with a “sexual attacker” who committed acts of incest on his daughter. The authors provide a wide-angle analysis of therapeutic attitudes (in and out of prison) related to sexual behaviour: legal and ethical questions raised and the cornerstone of the psychopathology of such disorders is criticized. It allows the authors to revisit the situations of incest with regard to the clinic care oriented toward psychoanalysis. We must move towards the through-making process itself the place of de-subjectivation. This means that the therapist's role is fundamental in a relationship from subject to subject. This paper presents the various devices utilized for the compulsory care. The recounting of the occurrence of incest shows a method of committing the act, which is borderline to psychosis. The analysis of resorting to sexual acts has more to do with a theorical mapping of the perverse act (for a psychopathological clinic of the transgressive act); the underlying personality structures, being varied, can be revealed by the positioning of the subject faced with his act in the after-event. The plan implemented through compulsory care allowed the re-evaluation of the subjective position of the person on trial. [ABSTRACT FROM AUTHOR]

This paper addresses the problem of filiation and affiliation in the psychotherapy of a Jung pubescent exhibiting behaviour problems. Elyah is the only child of a mixed couple Judeo- Christian (father Ashkenazi and mother Catholic). The working hypothesis involves that individual identity cannot be built outside the registration of a person in a filiation, and any filiation is unthinkable outside affiliation (belonging to a cultural group, a collective identity). The universal meaning of the categories mother, father, child is understandable, in practice, only if taken in the discourse of a particular cultural group. The chaos of puberty (organic, psychological and social) imposes an approach through the multiples links. [ABSTRACT FROM AUTHOR]

In this paper, the author proposes an illustration of the psychoanalytic theories on transitionality - from D. W. Winnicott to Didier Anzieu and René Roussillon, and especially on the importance of arranging the analytic frame when working with difficult patients (non-neurotic), according to "the principles of transitional analysis". Transitionality first implies a form of psychic functioning and inner reorganization - external to the world of the subject by interiorizing/internalizing the subjective experience and the drive movements that determine it. The existence of transitional phenolmena and processes, as well as the creation of a transitional space entail the acceptance of psychic paradoxes, the capacity to perform separation, mourning and melancholy work, they entail adequate relations to the object and the external reality, the development of the symbolization function, the readjustment of psychic representations [ABSTRACT FROM AUTHOR]

The role and meaning of narratives in psychoanalytically oriented psychotherapy has begun to be explored over the past few years. Little, if any, of this material has been related to adolescent psychotherapy and it is the purpose of this paper to make sorne preliminary inquiries into how narratives might operate in this sphere. To explore this hypothesis, Peter Blos' ideas on adolescent acting out are related to a the ory of narrative developed by the French philosopher Paul Ricoeur. Blos' conceives of adolescent acting out as a part of attempts by adolescents to develop a coherant identity in what Blos refers to as a second individuation process. A link is proposed between adolescent acting out and Ricoeur s notion of narrative as the structure which undergirds the process of identity formation. [ABSTRACT FROM AUTHOR]

This paper explored the case study method in its capacity to tackle the clinical case complexity and yield scientific data on the process of change in psychotherapy. While reviewing the history of the research in psychotherapy the author pointed out the failure of Evidence Based Medicine studies to capture the richness of the relationship between patient and therapist, and provide clinicians with appropriate knowledge on treatment decision for individual cases. Stressing the need for alternative methods, he proposed to gather a sufficient number of case studies using a standardised peer-group approach and provides guidelines for conducting such research in psychotherapy. [ABSTRACT FROM AUTHOR]

This papers aims at clarify the confusion between psychotherapies and psychoanalysis. Psychoanalysis is distinct from psychotherapies because when he is a psychoanalyst, psychiatrist does not present himself as knowing what is good for the patient, and does not try to influence him. Few patients are able to use psychoanalysis proper. When it is so, psychiatrist has to modify the therapeutic setting in order to make a psychoanalytic process to occur. In doing so, he practices a psychoanalytic psychotherapy. It is a psychotherapy because the psychiatrist has to act, but it remains a psychoanalysis, because he does not try to influence the patient. Every time psychoanalysis is feasible, it remains the best psychotherapy. [ABSTRACT FROM AUTHOR]

Abstract: A large number of psychotherapies were proposed to depressed patients. The behavioural and cognitive therapies showed their efficacity. This short-term therapy improves quickly the symptoms and prevent around 30% of relapse. Many patients having suffered from depression undergo unipolar depression relapses during the 5years following the treatment. Therefore international guidelines, including pharmacological and psychological interventions, were published to prevent these relapses. Nowadays a combined treatment is most often prescribed. This paper presents the behaviour and cognitive models of depression. This brief psychotherapy works on the depressed symptoms (engaging the patients in a large number of pleasant activities), on hopelessness cognitions and on the own psychological vulnerability (named cognitive schemata). The activation of depressed schemata is correlated with relapse. The indication of TCC in depressed patient is discussed after two ou three sessions (“case conceptualisation”) performed by a cognitive and behaviour therapist. This professional has preliminary learnt the theory and practice during a specific training. This article reviews main studies including the cognitive and behavioral therapy in depressed uni- and bipolar patients. Results are discussed in terms of acceptability, feasibility, and efficacy. A case study confirms the relevance of this approach. New cognitive and behaviour programmes were developed during 20years with recurrently depressed patients, these included additional booster sessions sometimes combined with well-being therapy and even with mindfulness-based cognitive therapy. The new approaches were assessed in pilot studies and their results will have to be confirmed. [Copyright &y& Elsevier]

Abstract: Based on material from psychotherapy with sensory deficient patients (blind or deaf children and adults) this paper analyses subjects’ use of physical space in transference as well as in the elaboration of psychical spaces. Through the psychotherapy of Tom, a blind child, drawing upon Winnicott''s work, we will show how this space, which is at first unapproachable, is progressively assimilated into a shared reality. This space is first experienced as suffering, before being ultimately used creatively and playfully as transitional space. This transformation occurs through the integration of aggressiveness induced by the occupation of this space. Any discontinuity is experienced by the patient as a rupture of the relationship. Furthermore, discontinuity is associated with the elaboration of separations and an increase in the patient''s capacity to distinguish the self from the object. We thus hypothesize that differentiation from the object may pose a particular challenge for sensory deficient patients. The absence of the visual or vocal bond accentuates adhesive identifications (Bick, 1986 ). These pathological identifications can be repeated in transference, where they take the form of the patient''s excessive need for continuous vocal tactile or visual contact. Supported by the therapist, these adhesive identifications can be overcome, and the patient''s access to a three-dimensional world can be facilitated. [Copyright &y& Elsevier]

In this paper, Dr. Ferro situates his work within the history of psychoanalysis and also in relation to more recent developments since Bion, notably the Barangers' concept of the "analytic field." The central focus of this approach is on dreaming, understood in terms of Bion's concepts of transformation, beta elements, and alpha function. The analytic session is conceived as a dream process that converges and clashes in the dynamic field of the analytic relationship. Various possibilities of this model are explored with detailed clinical examples, giving special emphasis to narrative and film metaphors such as plot, characters, and casting. The implications of this approach for technique are also explored. [ABSTRACT FROM AUTHOR]

Abstract: The purpose of this paper was to make a brief review of the main problematics raised by depression in oncology in terms of prevalence, semiology, screening, risk, prognosis factors and treatment. This reflection was based on recent literature data obtained through a PubMed search. Depressive disorders have frequently been encountered in cancer patients. During routine oncology daily care, depression screening, assessment and treatment are of paramount importance regarding psychosocial management. Depressive elements have a tremendous impact on the quality of life, tolerance and compliance with anticancer treatment. Moreover, depression morbidity and its possible influence on prognosis represent an important challenge in terms of prevention. A specific semiology for depressive disorders in the oncologic field might be more relevant with practical clinical implications. Optimal care of these mood disorders have to be implemented as soon as possible and be supported by the association of pharmacological treatment and psychotherapy. [ABSTRACT FROM AUTHOR]

Abstract: Sensory-motor integration approach of severe pervasive developmental disorders has become more popular during the recent years thank to André Bullinger''s research in the field of infant development. In this second paper, we aim to report a clinical illustration starting at the sensory-motor assessment as a key for therapeutic proposal in psychomotor therapy. The treatment included two sessions per week in classical room and in pool, alternatively. Technical interventions during sessions are presented and articulated with the sensory-motor assessment. Course of general functioning during the two years of treatment as well as comparison of yearly sensory-motor assessment are summarized. [Copyright &y& Elsevier]

Abstract: Sensory motor integration approach of severe pervasive developmental disorders has become more popular during the recent years thank to research and findings in the field of developmental psychology. In the current paper, we aim: to summarized André Bullinger''s research on infant development, in particular the relation between tonic regulation and representation of the organism, the course and the integration of the so called “corporal axis”, and early sensory skills; to show how these theoretical and developmental tools may shed new light on the clinical manifestations of autism in particular at the level of their sensory or motor understanding, and how they can be investigated in a novel specific manner with the sensory motor assessment helping clinicians to formulate therapeutic proposals for remediation. [Copyright &y& Elsevier]

Abstract: Introduction: The spatial experience in phobic disorders needs to be better understood in order to account for the pathogenic effect of a local phobogenic situation on the whole subjective world. Such an understanding could be useful for the treatment of resistant phobias which are hampered by therapeutic blocks that require a global restructuration of the subjective world. Objectives: Three objectives are addressed in this paper: (1) a clarification of the experience of space in phobic disorders; (2) an account of the impact power of the phobogenic situation; (3) an analysis of levers in cognitive psychotherapy that may help to overcome therapeutic blocks in resistant phobias. To tackle these objectives, we bring in the conceptual framework of representational spaces that proposes some tools to describe a subjective world as grounded in the spatial experience. According to the model of phobic disorders that we build up in this framework, the phobogenic situation behaves like a probe that reveals some strains disturbing in depth the subjective representational space. These strains depend on past traumatic situations that have resulted in the development of phobic cores. Thus, the phobogenic situation materializes some dimensions of the representational space that makes it vulnerable to a traumatic agent. In this framework, a therapeutic lever can be defined as a key-situation that favors a global reorganization of the representational space from a local work on it. Three conditions appear to be necessary to the works of such a lever: (1) the key-situation needs to resonate through the representational space with a central phobic core; (2) the patient should actively grasp the processes of the symbolic structuration of his/her space; (3) the therapeutic lever should only be operated at the suitable time of the therapeutic course by taking account of the subjective defences. Patient and method: Our model is exemplified with a case study that describes the behavioral and cognitive therapy of a patient that suffers from a phobic disorder since his adolescence. The technical method notably uses a work on the cognitive schemas that starts from the patient story. Results: The method used to overcome therapeutic blocks reveals some phobic cores that are related to traumatic situations in childhood and adolescence. Therapeutic levers are operated when key-situations relative to the familial story can be addressed and elaborated by an active work of the patient, with a feeling of global restructuration of his psychic space. Conclusions: The conceptual framework of the representational spaces is interesting to clarify the spatial experience in phobic disorders and to explain the impact of the phobogenic situation. Moreover, in complex phobias, this framework offers some useful tools to conceptualize the therapeutic levers that could be efficient to move the whole subjective world. Such levels can only be used during a long-term therapy. [Copyright &y& Elsevier]

Abstract: First time we remind some questions about different definitions of psychotherapies. The second part of the paper reminds some general principles of psychotherapies’ work with children, teenagers and their family. Then it''s possible to relieve specific position of psychologist for psychotherapies work in infantile psychiatric institutions. [Copyright &y& Elsevier]

Abstract: Lacan has left a teaching, mainly in his “seminars”, which is often synthesized, simplified and reduced to a simple explanatory theory, principally regarding psychotic process. Such a simplifying view can become a discriminatory, iatrogenic conception of the psychotic person and of the psychotherapeutic (or psychoanalytical) treatment. In the first part of this paper, the author tries to show that Lacan’s teaching was principally a transmission of the psychoanalysis itself, in different ways, as half-sayings, ambiguity, poetry and style, topology, mathems… Lacan passed himself on as a possibility of analytical opening, like in a cure. He does not generate a rational discourse, but he proposed several different theories as simple “vectors”. In the second part, the author puts some concepts as “Name of Father foreclosure”, “borromean knot” and “object a” into a political (within the psychoanalytical community) and historical context. If those items of Lacan’s teaching are diverted from their primal function of “vectors” and are considered as explanatory theories, then they lose their pertinence and can lead to a stigmatizing conception and to possibly iatrogenic attitudes in the treatment. That will be examined further. [Copyright &y& Elsevier]

Abstract: The paper focuses on psychic plurality, particularly on its transformations and evolution. From a theoretical point of view, psychic plurality evolves from Janet, Federn and Kaës''s works. In psychotherapy, this notion gave rise to treatments that differently mobilise representational processes, and alter the internal groupality when such becomes pathogenic. This point concerns the hypnotic model called “ego states” therapy, which is an ideal application of the psyche''s groupal model because of the central role played by the dissociative process. The authors emphasize the importance of the “ego states” therapy in the treatment of dissociative pathologies and remind that, according to constructivism, many factors should be taken into account when interpreting hypnotic phenomena. [Copyright &y& Elsevier]

Abstract: This paper reviews the cognitive-behavioural strategies of psychotherapy applied to hypochondria. Cognitive mechanisms of hypochondria are the tendency to amplify body manifestations (pain, fatigue…) and to interpret them in a catastrophic manner. The persistence of anxiety is due to a confirmatory bias, which increases the importance given to information congruent with anxiety. The exposure–response prevention model is an important technique in the treatment of hypochondria. This model has been validated in patients presenting obsessive compulsive disorders. Patients are invited to confront ideas or thoughts that induce fear. This confrontation is repeated or prolonged in order to induce the extinction of anxiety. Another cognitive approach is the step-by-step cognitive “modelling”. During the first step the patient assesses his stress-inducing thoughts concerning his health, he also has to assess the frequency of inadequate medical treatments. During the next step, the therapist helps the patient correct automatic thoughts and false beliefs concerning his illness. The last step is a phase of consolidation. The therapist identifies factors triggering anxiety and excessive medical care. All these behavioural cognitive therapies can be performed in individual or in-group processes. Therapies proposed to patients presenting generalized anxiety disorders can be adapted to hypochondriacs. Lastly, hypochondria can be understood and treated as a form of addiction to medicine characterised by a craving for medical care, for biological exams and for different forms of medication. According to this conception, the treatment can be conducted as a form of detoxification: patients identify the frequency of their pathological behaviour and find strategies to reduce and/or control them. [Copyright &y& Elsevier]

Abstract: Many patients having suffered from depression undergo unipolar depression relapses during the five years following the treatment. Therefore international guidelines, including pharmacological and psychological interventions, were published to prevent these relapses. Nowadays a combined treatment is most often prescribed. This paper presents the results of cognitive and behaviour therapies in the prevention of relapses in uni-polar depressed patients. A psychotherapy associated with pharmacotherapy resulted in a better prevention than pharmacotherapy alone (with a gain of over than 35%). New cognitive and behaviour programmes were developed during ten years with recurrently depressed patients, these included additional booster sessions sometimes combined with well-being therapy and even with mindfulness-based cognitive therapy. The new approaches were assessed in pilot studies and their results will have to be confirmed. [Copyright &y& Elsevier]

Abstract: This paper was initially presented during the scientific workshop of the French society for child and adolescent psychiatry and allied professions (SFPEADA), devoted to psychomotricity and its current bonds with child and adolescent psychiatry (Paris, September 29, 2005). The authors are a child and adolescent psychiatrist, using daily psychoanalytical psychotherapies in a universitary public hospital and two psychomotricians, who work in a child and adolescent public department, in a private activity and in a specialized institute (therapeutic, educational and teaching institute or ITEP). They present here the results of their clinical practices, exchanges and thoughts about a complex and discussed subject, which touches in more than one way with the bases of our clinical and therapeutic practices with children and adolescents: how do we choose the differential indications between psychotherapies and psychomotor therapies? [Copyright &y& Elsevier]

Abstract: The possibility of a psychoanalytic treatment or cure in the case of a psychotic patient is the controversial subject of many discussions. We are reminding in this paper Freud''s different positions about this subject, in order to show his ambivalence. We examine further the hypotheses and techniques that are proposed by several schools of psychoanalysis and we show how the technical rules of the treatment are resulting mainly of theses hypotheses concerning the etiology and the pathology. The technical rules are inducing a particular position of the analyst, which is different for each school. We assume that these postures are not excluding each other, but they are reflecting particular “moments” of the treatment, or specific “techniques” which are more or less appropriated for each category, we explicit different postures and we match they with these proposed by Freudian, Lacanian or Kleinian authors. The imaginary transference is the one described by Freud in “An Outline of Psychoanalysis”. It represents the transfer on the analyst''s person of an early significant figure (imago). We argue the idea that the initial transference of a psychotic person is a transfer of “functions”, as in the R-scheme described by Lacan. The symbolic transference involves the language, i.e. the working out of a delusion. The real transference is the contrary of the neurotic process of “uncovering” the object: it is the one, which grasp the object into the discourse. We argue the idea that there is a possibility of structural mutations between psychosis and neurosis. The structure is conceived as a preferential pattern of relationship (transference) at a “m” moment. [Copyright &y& Elsevier]

Abstract: This paper discusses the specificity of psychotherapy of dysphasic children. Starting from the distinction between language, speech, speech act and ‘enunciation event’ we discuss the properties of speech therapy reeducation which focuses mainly on communication tools. Next, we proceed to analyse the characteristics of psychotherapy procedures that include the patient historical particularity and subjective position in transferential relationship. [Copyright &y& Elsevier]

Abstract: Who was Frantz Fanon? A political activist, a writer. But Fanon was also an important clinician. The article concerns the accent this aspect of its work and gives as objective to highlight the clinical part of the work of Fanon. His links to the institutional psychotherapy and also its papers on the war traumatism will be analyzed. And also will be envisaged the contradictory connectionsof Fanon to the psychoanalysis. [Copyright &y& Elsevier]

Abstract: Since the first description of hyperactivity, or psychomotor instability at the end of the 19th century, its designation and conception have evolved. Current classifications (namely DSM IV and ICD 10) emphasize the notion of attention deficit. This paper raises questions about the nosological status of this disorder, its unicity –– considering the comorbidities with various other mental disorders, reported in most cases –– and also about the etiopathogenic role of genetic and neurobiological factors. A “polyfactorial model”, which integrates these factors with psycho-environmental factors, is proposed. A multimodal therapeutic approach is suggested in accordance with this theoretical model. [Copyright &y& Elsevier]

Abstract: The psychoanalytical therapy of schizophrenic patients is traditionally based on the development of a positive transference and on an interpreting, holding analytic work. In this paper, we present the case-study of a patient for whom all “making-sense” work became persecuting. We will name this very ambivalent person an “alterno-valent” patient. Within this conflicting transference, only a humoristic approach allowed us to develop a trustful relationship with the patient. We describe the subversive nature of this relationship-humour, which is to take a completely opposite position to the analytical position, but to remain nevertheless attentive and empathic. We show further how this humoristic play serves us to interpret the transference. The humour-concept is assimilated to the Freud''s “Witz”. We refer further to the literature in order to describe the psychotic transference as an oscillating movement between “transference-erotomania” and the “let-down-position”, both also deleterious. We propose the idea that the therapist''s effort to make sense could induce in psychotic patient a psychic disorder who acts first as a defence (against the confusing pointing of the Big Other), second as a guarantee for the permanency of the relationship (the subject''s disorder engage the Big Other in an organizing work). We also use “the concept of “projective identification””-concept, which is considered not only as the projection against bad objects, and also as a mechanism that allows the projection of the working-out abilities. [Copyright &y& Elsevier]

In the field of psychology, very few studies deal with anticipation, the latter being defined as a paradoxical conduct. This paper describes a specific instrument elaborated by Mr Berta. The examined person is asked to imagine what he would wish to become in other life. Thus, he describes this imagery life that is located between two poles; one is rejected, the other ardently desired. Usually, this double attitude is illustrated by imagery. The negative pole (i.e. what the person is fighting) is actually what he does not want to become but as he struggles he actually develops in himself this unwanted, negative pole. The writers provide a clinical vignette, a woman called Mrs B. hospitalized for a depressive state consecutive to her husband’s death. Her protocole shows that she still is strong enough to integrate the bereavement. This way of organizing the psyche between the two poles thus having recourse to deep ethic values provides with innovating psychotherapeutic strategies. [Copyright &y& Elsevier]

The official way of taking care of the mentally disabled is by its principles, procedures and techniques a two-fold treatment. It will appear in this paper that our preference goes to the most traditional of the two options, the combined-therapies, in other words the “multisided therapies”, also called the “focus-shifting” strategies. The issue concerning combined therapies with two or three focuses being applied to severely disabeled patients is raised. This involves simultaneously an analytic investigation as well as behavioral psychotherapy, together with medication and support. Concerning the other more popular technique – the “integrating psychotherapies” – also known as the “psychotherapeutic movement for integration”, it will be critically examined. Our aim is to show that this integrative approach in psychotherapy is an offshoot from the eclectic and pragmatic american school of thought.It is not compatible with a psychoanlytical approach even when it tries to use its clinical and theoretical contribution. [Copyright &y& Elsevier]