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Abstract: Post-partum psychosis occurs in one to two cases out of 1000 deliveries. Studies in prenatal psychiatry have improved our understanding of the symptoms. If the prognosis of the acute state is generally positive, the rate of recidivism remains important due to the risk of becoming chronic. Analysis of the data allows preventative work with mothers-to-be. From a psychodynamic perspective, pregnancy is a time of important psychological conflicts, identity crisis and awakening of infantile conflicts. The understanding of those psycho-emotional mechanisms related to pregnancy and the multidimensional approach appears to be indispensable in taking care of acute psychiatric post-partum states. The case of Mrs. O, hospitalised in adult psychiatrics for a post-partum manic episode shows how those theoretical models become relevant in order to elaborate intra-psychological conflicts. The anamnesis and the history of the patient revealed the existence of several risk factors for triggering the psychosis. The identification of the patient to her maternal lineage in association with revisiting her infantile past grounded the psychosis. We worked the issue of her place within her maternal lineage, with her husband and her place as a mother. The confusion about her own identity added to the patient''s generational confusion was gradually amended and a work of separation/individuation could then be undertaken. [Copyright &y& Elsevier]