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With reference to the fantasy and its traversal, this article examines the relation between desire and jouissance in the analytic experience, where the object a "can only be deduced to the extent of each individual's psychoanalysis". [ABSTRACT FROM AUTHOR]

This article describes the main elements of the therapy of parents of a 12-year-old boy who was brought in for consultation due to rage episodes and a history of incendiary behaviors. This therapy took place at the Lamerchav Center, a psychodynamic reference clinic serving the ultra-Orthodox community in Jerusalem. The narrative of the final session is particularly detailed. The analysis of these elements draws on the key concepts from the model of Psychanalytic Family Therapy in France, allowing for an examination of the notions of family mythopoiesis, transgenerational transmission, self-parenting, and the psychic foundations of the couple. [ABSTRACT FROM AUTHOR]

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Based on the clinical work with patients who had made a very serious suicide attempt, in the context of separation or loss of a loved one, this article aims to analyse the different ways that psychic work can take when faced with grief and the originals productions of these types of psychic work which take a place aside in the continuum drawn by Freud between grief and melancholy. Three years of clinical observations and work brings us to a hypothesis that the severity of suicide gesture of the patients is not necessarily linked to the recent loss but frequently to a former loss that the patients suffered in the past sometimes without identifying this event as a loss, in some cases even with the transgenerational dimension. Through a network of memory, this former loss gives another sense to the recent loss and opens a new space for elaborative psychic work allowing us to access previously unattainable thoughts, dreams, associations, and identification conflicts. [ABSTRACT FROM AUTHOR]

Freud set forth the following principle of analytic technique: analysis must as far as possible take place in a state of refusal, of abstinence. That is what Lacan translated into « not to respond to demand ». Now, by elaborating the notion of demand and the question of its satisfaction, Lacan finally showed that the analyst must in fact satisfy the demand that deserves to be considered as fundamental. [ABSTRACT FROM AUTHOR]

Using both formal analysis and the framework of critical whiteness studies, this paper studies the role played by lighting in the construction of Ryan Gosling’s persona, focusing on its racial dimension. More specifically, it analyzes the way the star is lit in five films of the 2010s that portray his whiteness as under threat. After a first part dedicated to Drive (2011), which plays a crucial role in shaping the star’s dual persona, the second part of the article examines the different ways in which lighting contributes to building Gosling’s whiteness as “in crisis” in the four following films : The Place Beyond the Pines (2012), Only God Forgives (2013), Blade Runner 2049 (2017) and First Man (2018).

In both A Serious Man and Breaking Bad the concept of repetition is addressed, and reworked following a Freudian and a Lacanian take. The true repetition is what is new, and not what is obsolete, and always the same. Destiny as mere result of classical repetition, as an already there, already written, is thus confronted with the other side of repetition, that of the presence of the subject on "the scene of the world", and not merely among the spectators. Moreover, "the scene in the scene" is in both features a way of showing that the unconscious is the royal path to one's identity, in its singularity. Repetition in all its states is therefore the actual choice for the subject in order to choose its own way of dying. And, without knowing it, this is precisely what the two heroes, Larry and Walt, put forward in these pictures. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Mathematics, Mechanics & Computer Science is the property of Al-Farabi Kazakh National University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Considering that Husserl identifies passivity as the general principle of genetic dynamics and as given prior to any intentional activity, the original condition of possibility of such passivity must be clarified. Phenomenological analysis can successfully attest the presence of a drive-habituality operating prior to the level of the I, an instinct-character, thus, that raises the question about life as auto-affective capability. In the framework of a universal monadology the latter's teleological orientation must be questioned in order to avoid that both the limes constituted by the unconscious as well as affective being remain indeterminate and anonymous, which would not do justice to the transcendental rootedness of drive and instinct through the form of ipseity. [ABSTRACT FROM AUTHOR]

Jules et Jim by François Truffaut or the Unbearable Lightness of the Feminine. Truffaut’s movie Jules et Jim (« Jules and Jim ») is an intimist movie but also a fresco of Europe throughout the first half of the 20th century, as it was torn apart by the two world wars and Nazism. At the same time, the film tells the story of the friendship that began during the “Belle Epoque” between two intellectuals, a French (Jim) and a German (Jules), both madly in love with an English teacher (Catherine). In the insular tradition of the Elizabethan theatre, this is a story about love, treason, jealousy, hate, and finally murder and suicide. In its structure, it is a mix of farce, sentimental drama turned into tragedy, and which in the end reveals itself as a comedy of errors, with, nevertheless, very serious themes: love and war, desire and drives, femininity, maternity and semblance, competition between men for a woman etc. This movie brilliantly represents the “Nouvelle vague” and is a proof that Freud and Lacan were right when they established once and for all that the unconscious is a fundamental and necessary scene. Human “destiny” is set and its mysterious “scripts” are played out - from sexuality to death, from Eros to Thanatos - as the subject’s fantasy, the window through which he or she tackles reality. [ABSTRACT FROM AUTHOR]

The composer Arnold Schoenberg teaches us about what prompted him to renew the laws of musical composition of his time, despite taunts and criticism. From the writings he left us, we have been able to identify an essential void felt by the composer that his music allows him to treat, but not fill. The path that leads him to the invention of his atonal system follows a path similar to that of the drive: a deaf inner force pushes him in that direction, but never results in full satisfaction. The tension comes up again very quickly and leads him to keep composing. If his courage allows him to follow his own inclinations relentlessly, Arnold Schoenberg's position on what drives him to compose also contains a mystical, messianic side. His music is inspired by God and becomes a struggle. It seems necessary that his compositions keep an enigma for the public and critics, allowing Arnold Schoenberg to avoid a feeling of persecution and to continue to create. [ABSTRACT FROM AUTHOR]

The sadomasochistic subculture of “female domination,” namely femdom, has formed a conspicuous mode of digital carnality that prevails among new media interfaces while radicalizing interactivity. The submissive man’s relationship with the dominant woman is never simple here, not just pornographic but symptomatic of complex phenomena regarding power and society, media and life that shape our techno-libidinal age. This paper sheds light on its sexual, psychological, psychoanalytic and socio-ethical implications, drawing on and reframing theories about masochism, abjection, biopolitics, nihilism and so on. Full of paradoxes, femdom embodies a formally structured governance of sensation and determination, an exceptional law beyond normal law by which submission to a sexual sovereign leads to both the slave’s self-deprivation and regain of freedom. His failed desire for the unobtainable object then takes on the Lacanian drive, the instant satisfaction of circulating around the void as if to constantly “edge” without closure, as typified in the digital loop of gif images. More precisely, desire and derive mingle indiscernibly in the disintegration of the Symbolic and the Real, of the private and the public that characterizes the self-destructive addictive culture of capitalist hedonism. In this context the femdom wonderland turns out to be a permeable network of numerous Dom/subs’ life-building communities, a self-modulating interactive heaven of the undead desire-drive without outside, without nirvana.

Résumé Objectifs Il s’agit dans cet article d’interroger les nouvelles pratiques de chirurgie bariatrique dans la clinique de l’obésité puisque les effets qu’elles produisent peuvent s’avérer mystérieux sur le plan organique, parfois problématiques, jusqu’à mettre en échec la démarche thérapeutique initiale. Chez une majorité de patients opérés, l’apparition de modifications olfactives et gustatives à la suite de l’intervention met en lumière le fait que la transformation du corps réel par la chirurgie provoque des effets de remaniements non seulement organiques mais aussi psychiques. Ce bouleversement de l’organisation pulsionnelle et des investissements libidinaux, soutenu par les modifications corporelles, prendrait sa source dans l’actualisation du mécanisme du refoulement « organique » chez le patient opéré. Convoqué par la clinique, ce concept freudien oublié permettrait de tirer des pistes de réflexion pour la compréhension théorique et l’amélioration de la prise en charge psychique des sujets en situation d’obésité et opérés d’une chirurgie bariatrique. Méthode Les patients rencontrés ont été opérés d’une chirurgie bariatrique de type Sleeve gastrectomie ou de type Bypass gastrique . Il a été proposé aux patients de parler de leur expérience de la chirurgie bariatrique et du retentissement des modifications corporelles sur leur comportement alimentaire, sur leur rapport au corps et sur leur rapport à l’autre. Résultats Les modifications psychosensorielles post-chirurgicales attesteraient de l’actualisation du processus de refoulement « organique » et du remaniement de l’organisation pulsionnelle qui lui est connexe. La coupure du corps réel provoquée par ce type d’intervention va avoir des incidences sur le refoulement « organique » qui va s’actualiser et se renforcer chez le sujet opéré. Les représentations qui, avant l’intervention, amenaient le sujet vers un plaisir organique et psychique auto-érotique vont être ainsi réprimées du champ de la conscience car les conditions d’accès à ce plaisir érogène ont été modifiées. Les objets, notamment alimentaires, qui se liaient par association à ces représentations refoulées, seront perçus consciemment par le sujet comme vecteurs de déplaisir. Ces objets, auparavant source d’un certain plaisir érogène pour le sujet, vont ainsi devenir objets de dégoût et de répulsion après la survenue des changements corporels. Discussion Les changements olfactifs et gustatifs dans la perception des aliments représenteraient non seulement l’impact de la chirurgie sur la vie psychique du sujet opéré, mais signaleraient paradoxalement que derrière les aliments qui « refoulent » et qui sont maintenant mis à distance par le sujet se cacherait en réalité ce qui a été refoulé psychiquement lors de l’actualisation du refoulement « organique ». Ces modifications psychosensorielles sélectives et les relations alimentaires particulières qui sont visées par ces changements semblent être régulièrement mises en lien par les patients eux-mêmes avec certains aspects de leur histoire personnelle et intime, avec des souvenirs ou des représentations d’évènements dans lesquels la sexualité infantile s’est retrouvée dans l’écueil, parfois traumatique, du rapport à l’autre. La verbalisation de ces souvenirs-écrans, convoqués depuis ces changements perceptifs sélectifs issus de l’actualisation du refoulement « organique », ouvrirait ainsi une nouvelle voie d’accès vers l’élaboration d’une vérité subjective inconsciente pouvant, par ailleurs, être en lien avec l’édification de la construction symptomatique de l’obésité. Conclusion Cette étude souligne l’importance du refoulement « organique » pour penser ces modifications psychosensorielles sélectives après la chirurgie bariatrique et pour comprendre le réaménagement psychique conduisant à ces changements du comportement alimentaire. Il conviendrait de prendre en considération l’impact des éléments spécifiques présents dans la construction symptomatique de l’obésité (oralité, image du corps, structuration familiale), en fonction de leurs différentes modalités d’expression pour chaque sujet, sur le refoulement « organique » après la modification chirurgicale du corps. Mais il s’agirait également de cerner, dans la construction symptomatique propre à chaque sujet, les formes prises originairement par le refoulement « organique » avant même son actualisation par les effets de la chirurgie bariatrique. Ces deux étapes (pré et post-opératoire) sont essentielles pour la compréhension des éléments psychiques conduisant à un échec thérapeutique dans le traitement chirurgical de l’obésité, afin d’améliorer les soins et de limiter une rechute de la maladie. Objectives This study aimed to investigate the new practices of bariatric surgery in the clinical treatment of obesity, since the effects produced by these procedures are organically enigmatic, sometimes problematic, and may cause treatment failure. Thus, in many operated patients, the psycho-sensory changes following surgery, such as olfactory and taste mutations (from “pleasure” to “displeasure”), show that these technical transformations of the body cause organic, and also psychic reorganizations. These disturbances in instinctual organization and in libidinal investments, underpinned by profound bodily changes, seem to originate from the updating of the mechanism of “organic” repression in the patient. Derived from clinical practice, this forgotten Freudian concept raises points of interest for the theoretical understanding and improvement of the psychic management of patients with obesity undergoing bariatric surgery. Method The patients investigated were treated with bariatric surgery, including Sleeve gastrectomy or Roux-en-Y Bypass . They were asked to comment on their experience of bariatric surgery and on the impact of the body changes on their eating behaviours, their relationship with the body and with the others. Results In most of the patients, bariatric surgery brought about olfactory and taste changes. These psycho-sensory changes seem to attest to an updating of the process of “organic” repression and to a restructuring of the associated instinctual organization. In these patients, cutting into the reality of the body appears to have an impact on “organic” repression, which is reshaped, updated and reinforced for most of the operated subjects. Consequently, the representations that, before surgery, brought the subject organic, psychic, self-erotic pleasure appear to be repressed from the field of consciousness because the conditions underpinning access to this erotic pleasure have been altered. Therefore objects, in particular food items, which are bound by association to these repressed representations, could be consciously perceived by the operated subject as vectors of displeasure. These objects, previously providing erogenous pleasure, will thus become sources of disgust and repulsion following the bodily changes. Discussion The olfactory and gustatory modifications in the perceptions of food observed after bariatric surgery underline the impact of this procedure on the psychic life of these patients. Behind the “disgusting” foods now pushed away could lie what was repressed when the “organic” repression was updated. These selective psycho-sensory changes and the dietary relationships affected by these changes seem to be regularly linked by the patients themselves to certain aspects of their personal and intimate history, including memories or representations of events in which infantile sexuality was confronted with the pitfalls of relationships with the others. The verbalization of these screen-memories, appearing after these selective perceptive changes and resulting from the updating of “organic” repression, could thus open a new way of access to the elaboration of an unconscious subjective truth, which may be linked to the elaboration of the symptomatic construction of obesity. Conclusion This study underlines the importance of the notion of “organic” repression to approach these psycho-sensory changes after bariatric surgery and to understand the psychic reorganization leading to these changes in eating behaviour. It is important to consider the impact on the process of “organic” repression of the specific elements present in the symptomatic construction of obesity (orality, body image, family structure), according to their different modes of expression for each subject, following surgical modification of the body. In addition, it is important to understand the forms originally taken on by “organic” repression, before its reshaping or updating by the effects of bariatric surgery, in the light of the specificity of the symptomatic construction of each subject. These two pre- and post-operative steps are essential in the understanding of the psychic elements leading to therapeutic failure in the surgical treatment of obesity, in order to improve quality of care and to limit relapses. [ABSTRACT FROM AUTHOR]

In the societies of control, when old Foucaultian confinement institutions are in crisis, the movement of the computer-digital flow deterritorializes the biological body of the anatomy, which is doomed to obsolescence. In this context, with the concept of “body without organs”, Deleuze and Guattari recover the corporality of Lacanian drive, but beyond intrasubjective dispositions of the human body.

Résumé Objectifs L’objectif de cet article est d’interroger la fonction de la trace inconsciente dans son articulation au désir et aux effets de création. En partant du champ psychanalytique, l’article explore les domaines de l’histoire de l’art et de l’esthétique car l’art et la création (littéraire ou autre) sont dépositaires de ce qui ne peut être pensé. En revenant sur l’idée que l’artiste devance le psychanalyste, l’article se propose de dégager la fonction de l’émotion esthétique et de la création dans le traitement du réel, notamment l’émergence de l’écriture pour deux sujets : l’un analysant, l’autre écrivain. Méthode Cet article met en perspective trois éléments : (a) un questionnement issu de l’expérience analytique de l’auteur, où l’émotion esthétique dans le traitement du réel s’est avérée cruciale ; (b) un travail théorique sur les concepts de « trace » et de « détail », mené dans le champ de la psychanalyse, de l’esthétique et de l’histoire de l’art ; (c) un retour sur un fragment d’analyse issu de la pratique clinique de l’auteur et sur l’œuvre d’un écrivain. La méthode de cet article s’inscrit dans la tripartition même de la psychanalyse : traitement, recherche, conceptualisation ; et s’ouvre vers d’autres domaines susceptibles d’éclairer les enjeux de l’inconscient : l’esthétique, l’histoire de l’art, la littérature. Résultats Cet article montre l’importance de la trace dans le travail psychanalytique et dans la reconnaissance de l’inconscient. Il met en évidence la conception de l’histoire et du temps propres à la subjectivité et réaffirme que la cure, loin de chercher à combler les lacunes de la mémoire, s’attèle à une certaine déconstruction qui vise le fantasme. Parcourir ce chemin qui mène du souvenir au fantasme ne se fait pas sans un travail sur la trace et sur la pulsion qu’elle recèle. La trace, de même que le symptôme, convoque un réel pour le sujet et son interprétation concerne la vérité subjective. L’expérience analytique et l’expérience esthétique sont présentées ici dans ce qui leur est commun : elles s’orientent d’un réel. L’exploration de la trace avec l’artiste et l’historien de l’art a montré le paradoxe propre à tout traitement du réel : tantôt approchée comme histoire sédimentée, tantôt comme frappe d’une vérité, comme coupure. Il en ressort qu’il n’y a pas de traitement possible du réel sans un accueil de l’imprévu, de l’inattendu et que dans ce parcours, l’émotion esthétique est à même de tenir une fonction de nouage. Discussion L’article propose un travail sur la trace aux origines de la psychanalyse : les liens entre trace, inscription et vérité subjective y sont abordés. La fonction du fantasme dans le remaniement de la trace et du réel est développée. Les travaux de Carlo Ginzburg, Jacques Rancière et Daniel Arasse ouvrent le questionnement sur la trace vers le domaine de l’esthétique et de l’histoire de l’art et mettent en évidence le paradoxe propre à tout traitement du réel. La dimension esthétique de l’inconscient est développée et discutée à partir de la trace et du détail. La fonction du beau dans le rapport du sujet au réel et dans l’émergence des effets de création est interrogée à travers le témoignage d’un sujet et de l’œuvre d’Imre Kertész. L’article met l’accent sur l’idée que dans le mouvement qui va de l’esthétique à la vérité subjective se situe un enjeu éthique. Conclusion Cet article propose une conclusion générale qui reprend la conception de l’histoire et du temps propres à la subjectivité. Dans la question de la trace, se situe un enjeu majeur pour la reconnaissance du désir inconscient et de l’humain lui-même : la fonction de la trace renvoie à la question de la causalité et à la réponse subjective devant la rencontre du réel. L’esthétique et l’histoire de l’art ouvrent ce travail vers d’autres domaines d’efficacité de l’inconscient, la question de l’émotion esthétique se dégageant dans sa fonction spécifique de nouage. Objectives The aim of this article is to explore the function of the unconscious trace in its articulations with desire and with the effects of creation. Starting from the psychoanalytic field, the article explores the areas of art history and aesthetics, since art and creation (literary or other) are the receptacles of the unthinkable. Returning to the idea that the artist is in advance of the psychoanalyst, this article proposes to distinguish the function of aesthetic emotion and creation in the way the real is processed, in particular the emergence of writing for two subjects, one the analysand and the other the writer. Method This article sets three elements in perspective: (a) questioning derived from the author's analytical practice, where aesthetic emotion in the processing of the real has proved crucial; (b) theoretical considerations on the notions of trace and detail set in the area of psychoanalysis, aesthetics and art history; (c) consideration of a fragment of analysis derived from the author's clinical practice, and of the works of a writer. This method is in tune with the tripartite nature of psychoanalysis itself – treatment, research, conceptualisation – and it opens up towards other domains liable to cast light on the issues of the unconscious: aesthetics, art history, literature. Results This article shows the importance of the trace in the psychoanalytic process and the recognition of the unconscious. It evidences the conceptions of history and time that are specific to subjectivity, and restates that the psychoanalytic cure, far from seeking to fill the gaps in memory, focuses on a form of deconstruction aimed at the subject's fantasy. Following the path from remembrance to fantasy is not possible without working on the trace and the drive that it entails. The trace , like the symptom, calls up the real for the subject, and its interpretation relates to subjective truth. The analytic experience and the aesthetic experience are presented here for what they have in common–they find their orientation from the real. The exploration of the trace with the artist or the art historian shows the paradox of any processing of “a real”: sometimes approached as a sedimented narrative, sometimes as the blow of a truth, as a break. This shows that there is no possible processing of the real without accepting the unexpected and the unforeseen, and that in this journey aesthetic emotion can have a knotting function. Discussion This article proposes consideration of the trace underpinning the origins of psychoanalysis. The links between the trace , its registration, and subjective truth are examined. The function of fantasy in the reshaping of the trace and the real is also explored. The work by Carlo Ginzburg, Jacques Rancière and Daniel Arasse open up the exploration of the trace towards the domains of aesthetics and art history, and evidence the paradox that is specific to any processing of the real. The aesthetic dimension of the unconscious is broached and discussed on the basis of the trace and detail. The function of beauty in the relationship of the subject with the real and the emergence of creation is explored by way of the narrative of a subject and the work by Imre Kertesz. The article focuses on the idea that in the move from aesthetics to subjective truth there is an ethical challenge. Conclusion The article sets out a general conclusion returning to a conception of history and time that is specific to subjectivity. In the issue of the trace , there is a major challenge for the recognition of unconscious desire and humanness itself: the function of the trace is linked to the question of causality, and subjective response in the encounter with the real. Aesthetics and art history open up these considerations towards other areas of efficacy of the unconscious, and the question of aesthetic emotion can be seen in its specific knot function. [ABSTRACT FROM AUTHOR]

A review of the original paper on motive by Blum and McHugh (1971) is used as an occasion to make transparent an approach to social theory as it has developed over the years in their work. This method, in treating motive as an illustration, engages it as an example of the status of the signifier as a symptom of interpretive conflict endemic to any situation of action, always inviting an analysis of the symbolic order and imaginative structure that sustains the distinction as a force in social life. In this paper, motive in particular is unpacked to show how it serves as an indication of fundamental ambiguity with respect to a problem-solving situation, revealing in this case constant perplexity in relation to the enigmatic character of what comes to view on any occasion and the recurrent contestation that is released.

Résumé Objectifs En venant compléter deux publications relatives à l’enquête Hepaig-quali, l’une consacrée à la sexualité et l’autre à l’usage de drogues, cet article s’intéresse à la dimension psychodynamique des récits recueillis auprès d’homosexuels masculins séropositifs pour le VIH. L’enquête Hepaig-quali constitue l’un des volets de l’étude épidémiologique Hepaig, portant sur les « hépatites aiguës C chez des homosexuels atteints par le VIH », coordonnée par l’Institut de veille sanitaire (France). En complément de résultats recueillis par questionnaire, et à partir du point focal de « l’événement hépatite C », l’objectif de ce volet qualitatif visait à recueillir des récits de pratiques relatifs à la sexualité et à l’usage de drogues, à connaître les motivations de tels choix et à les replacer dans la trame biographique des sujets, à détailler les événements survenus dans leurs parcours de soins et à explorer les représentations relatives à leur santé physique et psychique. Méthode L’enquête repose sur la réalisation de deux entretiens successifs réalisés auprès de 31 hommes, initialement inclus dans l’étude Hepaig. Ces entretiens, intégralement retranscrits, ont fait l’objet d’une double lecture, psychodynamique et sociologique, selon une posture épistémologique se référant à une approche compréhensive des comportements. Résultats Cet article s’intéresse spécifiquement à la santé psychique des enquêtés et à la dimension psychodynamique de leurs récits. Bien que les entretiens, réalisés par le sociologue, ne soient pas l’équivalent de « cas cliniques », les enjeux psychiques y sont très présents. Les répondants évoquent, avec leurs mots, leurs expériences du stress, de la « déprime » et évoquent pour certains leurs idées suicidaires. Ils abordent en majorité leurs pratiques, et les motivent selon un discours de recherche de jouissance et de maîtrise rationnelle des risques. Discussion À bien des égards, les enquêtés apparaissent comme des « hommes ordinaires », notamment du point de vue de leur socialisation sexuée et de leur représentation du risque. Leur spécificité du point de vue de la santé psychique tiendrait à leur expérience des discriminations et à leur vécu d’une maladie chronique. En exprimant une tension permanente entre pulsion et raison, entre recherche de jouissance et besoin de maîtrise de leur vie, ils présentent les caractéristiques de l’individu hypermoderne dont les contradictions se révèlent dans le rapport à l’autre. Conclusion Les enquêtés, bien informés, adhèrent au discours médical positif des soignants, qui les soutient psychiquement face au poids de morbidité des infections par le VIH et le VHC. L’évolution des cultures sexuelles se traduit, pour ces hommes, par un rejet de la norme du préservatif et par l’adoption de pratiques décrites comme plus satisfaisantes, mais pouvant comporter des risques accrus. Leurs comportements sont toutefois régis par d’autres dimensions que la connaissance et la rationalité. La recherche de jouissance ne s’embarrasse pas toujours des freins et des empêchements que la raison imposerait. Cela devrait conduire les soignants à mieux entendre et accompagner les efforts de réduction des risques de leurs patients. Objectives This paper focuses on the psychodynamic dimension of narratives collected in interviews carried out with HIV-positive gay men, and completes two previous publications concerning the Hepaig-quali study, one centred on sexuality and the other on drug use. The Hepaig-quali study was part of the Hepaig epidemiological survey on acute hepatitis C among HIV-infected gay men, coordinated by the Institut de Veille Sanitaire (InVS, France). In addition to the results gathered from questionnaires, and with a focus on the “hepatitis C event”, the present study aimed to describe sexual practices and drug use among HCV-infected gay men, to assess the motivations of these choices, to position them in relation to their life histories and healthcare experiences, and to explore how they viewed their physical and mental health. Methodology Our study was based on two successive in-depth interviews with 31 men previously included in the Hepaig survey. These interviews, conducted by a sociologist, were fully transcribed, and analysed from a dual psychodynamic and sociological viewpoint, an epistemological stance related to the comprehensive approach to behaviours. Results Thirty-one men were included in this qualitative study. We focused specifically on the mental health of the respondents and the psychodynamic dimension of their narratives. Despite the fact that these interviews were not equivalent to “clinical cases”, psychic issues were very much present. In their own words, the respondents talked of their experiences of stress and depression, and some mentioned suicidal ideations. Most talked readily about their practices and explained them via discourse on achieving pleasure, alongside the rational control of risks. Discussion In many respects, the respondents appeared as “ordinary men”, in particular with respect to their gendered socialisation and their representations of the risks. From a mental health perspective, some specificities were linked to the experiences of discrimination and chronic illness. With the permanent tension between impulse and reason, between the search for pleasure and the need to control their lives, they present the characteristics of the hypermodern individual whose contradictions are revealed in their relationship with the other. Conclusion Accurately informed, the respondents also embraced the positivist medical discourse of their caregivers, which provides them with support and helps them to face the burden of HIV and HCV infections. The evolution of gay sexual culture leads these men, via the rejection of the “condom norm”, to choose practices described as more satisfying, but entailing greater risks. Nevertheless, as with any topic, their behaviours are regulated by other dimensions than knowledge and rationality. The search for pleasure is not always restrained by the hindrance and impediments of reason. This should lead caregivers to better understand and support the efforts that their patients make to reduce risks. [ABSTRACT FROM AUTHOR]

Résumé Objectifs (1) Cet article vise à articuler une définition du concept Lacanien de la jouissance de façon à ce qu’il puisse faire sens au niveau physiologique et à étayer une proposition d’une instanciation de la jouissance au niveau physiologique. Méthode (1) Par la lecture de l’œuvre Freudienne et Lacanienne, la distinction de quatre aspects du concept est effectuée : au niveau du corps (a) de la pulsion, (b) de l’événement de satisfaction et (c) de l’excès de tension corporelle, et, au niveau de l’histoire, (d) l’empreinte historique. (2) Cette grille d’analyse est appliquée dans le domaine des neurosciences. Résultats (1) La jouissance se présente tant comme (a) la tension motrice sous-tendant l’action satisfaisant la pulsion, (b) le vécu qui accompagne l’évènement de satisfaction inaugurale, (c) l’accumulation de tension corporelle à la rencontre du Das Ding ou à la reviviscence de l’état de vœux que comme (d) ce qui marque le corps avec l’histoire de sa commémoration et ce qui, à partir de cette inscription, pousse à agir et à répéter. (2) Le circuit mésolimbique dopaminergique qui relie les parties les plus archaïques dans le tronc cérébral avec les cortex moteurs les plus évolués en passant par l’interface névralgique du noyau accumbens dans le système limbique, sous-tend à chaque fois ces quatre aspects distincts : (a) il a été caractérisé précédemment comme l’instanciation de la pulsion freudienne ; (b) la satisfaction non-anticipée est scellée par une libération de dopamine jubilatoire ; (c) à partir de là, chaque nouvelle rencontre annonçant le renouvellement de la satisfaction induit une libération de dopamine qui met le corps sous tension d’agir ; (d) précisément ce système peut inscrire par des adaptations neuronales à long terme une hypersensibilité pour l’agir précédemment scellée par une libération de dopamine. Qui plus est, ce système, qui dissocie l’agir du résultat de cet agir, implique structurellement son dérapage, le dit autoshaping , tout comme la jouissance implique un dérapage au niveau clinique. Discussion Si notre réflexion porte sur « une physiologie de la jouissance », l’idée n’est pas de présenter ce corrélat physiologique comme la jouissance chez Lacan, puisque cette jouissance relève de la clinique et que, dans l’approche épistémologique proposée, la clinique permet une interprétation du physiologique, mais non l’inverse – la physiologie ne permet pas l’interprétation de ce qui se joue au niveau psychique. Conclusion Le système mésolimbique dopaminergique semble un bon candidat pour une instanciation au niveau physiologique du concept de jouissance ; en contrecoup, cette instanciation physiologique corrobore la cohérence théorique du concept établi cliniquement. Objectives (1) This article aims to articulate the Lacanian concept of jouissance in view of applying this definition to the physiological sphere. (2) It aims to develop a proposal for an instantiation of jouissance in the physiological sphere. Methods (1) Distinction is made, with reference to Freudian and Lacanian texts, of four different aspects of the concept: for the body (a) drive, (b) the experience of satisfaction, and (c) excess body tension, and for the history, (d) the historical imprint. (2) This interpretative framework is applied to the domain of the neurosciences. Results (1) Jouissance at once entails the following: (a) the bodily tension underlying the action that satisfies the drive, (b) the experience accompanying the inaugural satisfaction event, (c) the accumulation of body tension due to the encounter with das Ding or to the revival of the wishful state, and (d) the inscription in the body of the history of its commemoration, which drives it to re-enact. (2) The mesolimbic dopaminergic system, linking the most archaic parts of the brainstem with the most developed motor cortices, via the nucleus accumbens in the limbic system, underpins each of these four distinct aspects of jouissance : (a) it was previously characterized as the instantiation of the Freudian drive; (b) dopamine release rewards each unanticipated satisfaction; (c) subsequently, each new encounter announcing the renewal of the satisfaction leads to dopamine release which puts the body under tension to act; (d) more specifically, this system can generate long-term neuronal adaptations leading to hypersensitivity towards actions that were previously mediated by dopamine release. In addition, this system, dissociating the action from its result, structurally implies its own derailment, the so-called autoshaping , just as jouissance implies a derailment in clinical terms. Discussion While we propose here a “physiology of jouissance ”, the idea is not to present this physiological correlate as actually being the Lacanian jouissance . Indeed, this jouissance is a clinical concept and, in the proposed epistemological approach, while the clinical approach enables an interpretation of the physiology, the reverse is not true – physiology does not enable an interpretation of what is played out at mental level. Conclusion The mesolimbic dopaminergic system appears as a good candidate for an instantiation of the concept of jouissance on a physiological level. Consequently, this physiological instantiation corroborates the coherence of this clinically-derived theoretical concept. [ABSTRACT FROM AUTHOR]

Résumé Objectifs Les auteurs proposent d’examiner la valeur et la fonction qu’occupe l’objet de médiation dans la clinique de l’enfant psychotique. Méthode Nous proposerons notre développement théorique à partir d’une étude de cas d’une enfant prise en charge dans un groupe thérapeutique utilisant des outils de médiation. Résultats Un premier travail théorique nous permet de mettre en tension l’objet de médiation avec l’objet autistique et l’objet transitionnel. Dans la psychose, l’objet utilisé dans une fonction autistique prend une valeur de réel et une fonction d’obturateur de l’expression pulsionnelle refermant le sujet sur lui. Dans la névrose, l’objet transitionnel est un objet symbolique organisateur du rapport à l’Autre. L’objet de médiation n’est ni l’un ni l’autre et doit en être précisément distingué afin de comprendre en quoi son utilisation peut se révéler thérapeutique. Notre travail montre comment le dispositif de médiation permet de passer d’un objet transi , c’est-à-dire possédant une fixité, à un objet de transit , c’est-à-dire impliquant une possible circulation. Discussion Contrairement aux développements les plus courants, nous soutenons dans cet article que l’objet de médiation n’offre pas aux enfants psychotiques la possibilité d’accéder à une transitionnalité mais permet de réinstaurer une circulation pulsionnelle par capture d’une part de jouissance. Cette opération s’effectue par l’action du thérapeute : l’objet de médiation est un intermédiaire, un truchement , permettant aux thérapeutes de se faire les partenaires de l’enfant. Pour cela, ils s’effacent derrière l’objet en se faisant manquant, effectuant ainsi un tour d’ escamotage . Conclusion Les effets thérapeutiques d’un tel travail peuvent se révéler dans l’apaisement des troubles du comportement de l’enfant jusque-là à l’œuvre. Objectives The authors propose to examine the value and the function of the object of mediation in clinical practice with psychotic children. Method Our theoretical development is based on a case study of a child included in a therapeutic group using mediation tools. Results A first theoretical approach allows us to set the object of mediation against the autistic object and the transitional object. In psychosis, the object used in an autistic function takes on the value of the real, and a “shutter” function, closing down the drive circuit so that the subject withdraws into himself. In neurosis, the transitional object is a symbolic object organizing the relationship with the Other. The object of mediation is neither of these, and must be clearly distinguished from them in order to understand in what manner it can be therapeutic. Our work shows how the mediation device enables the transition from of a numb object , which possesses fixity, to an object of transit , that is to say implying possible circulation. Discussion In contrast to the most frequent stances, in this article we argue that the object of mediation does not enable psychotic children to reach a transitional state, but allows them to restore a drive circuit by capturing a share of pleasure. This operation is brought about by the therapist: the object of mediation is an intermediary, an expedient, allowing the therapist to enter into a partnership with the child. To do this, the therapist withdraws behind the object, going missing, performing a vanishing trick. Conclusion The therapeutic effects of work of this sort may reveal themselves in the alleviation of the child's behavioral disorders. [ABSTRACT FROM AUTHOR]

Résumé Objectifs L’objectif de cet article est d’analyser les limites de la représentation et les caractéristiques des fictions dans leurs relations à la métapsychologie freudienne. Cette approche comporte ainsi une dimension épistémologique qui interroge les sources et les modèles de la fiction, notamment dans l’élaboration du concept de pulsion. Méthode Cet article correspond à une recherche théorique sur les fictions et les fondements des concepts psychanalytiques, à travers l’analyse épistémologique et historique de la métapsychologie freudienne. La théorie des pulsions est située dans le processus historique de sa construction. Résultats Cette étude démontre que les fictions correspondent à une approche heuristique pour penser « quelque chose d’inconnu ». Cet article suggère aussi que les fictions métapsychologiques ont différents modes d’existence : « fictions théoriques », « concepts fondamentaux », mythes… Ainsi, d’importants arguments en faveur des fictions mythologiques sont exposés : dans le cas de la pulsion de mort, les mythes peuvent fournir une représentation des pulsions et ainsi donner une place à ce qui échappe au savoir scientifique. Discussion L’article propose une approche synthétique du positionnement fictionaliste à l’œuvre dans L’interprétation du rêve . La caractérisation des « fictions théoriques » est reliée à un champ philosophique et aux principaux précurseurs du fictionalisme freudien : Kant et Hans Vaihinger. Un aspect important consiste à montrer comment la métapsychologie intègre un questionnement philosophique concernant la possibilité de la représentation. La question des « concepts fondamentaux » est abordée : la réflexion se concentre alors sur la notion de « convention » et la signification du « concept-limite ». Si le modèle freudien de 1915 est clairement scientifique et conceptuel, l’approche métapsychologique de 1920 devient fondamentalement mythologique et narrative. Ce tournant épistémologique est examiné et sa signification est discutée. Conclusion Cet article propose une conclusion générale : l’épistémologie freudienne de la fiction repose sur une aporie qui est au cœur de la possibilité même de la représentation métapsychologique. D’un point de vue épistémologique, la métapsychologie formule et maintient une position critique sur la question des « concepts fondamentaux » et des constructions théoriques : cette conclusion propose de faire des liens entre le problème des fictions et la question de la croyance. Aims The purpose of this study is to analyse the limits of representation and the characteristics of fictions in Freudian metapsychology. As such, this paper has an epistemological angle, which looks at the sources and models of fiction in the elaboration of the drive concept. Method This article is a theoretical research on fictions and foundations of psychoanalytical concepts, through an epistemological and historical analysis of Freudian metapsychology. The drive theory is located in the process of its construction. Results This study shows that fictions correspond to an heuristic approach to thinking “something unknown”. This article suggests that metapsychological fictions have different modes of existence: “theoretical fictions”, “fundamental concepts”, myths… In this paper, important arguments for mythological fictions are exposed: in the case of death drive, myths may provide a representation of drives and a place for that which escapes the realms of scientific knowledge. Discussion The article contains a brief overview of the fictional position in The Interpretation of Dreams . The characterization of “theoretical fictions” is connected with a philosophical field and the principal precursors of Freudian fictionalism: Kant and Hans Vaihinger. An important aspect is to show how metapsychology integrates a philosophical investigation of the possibility for representation. The question of “fundamental concepts” is examined: the focus concerns the notion of “convention” and the significance of “limit-concept”. If the 1915 drive model is clearly scientific and conceptual, Freud's 1920 approach is fundamentally mythological and narrative. This epistemological shift is examined and its significance is discussed. Conclusion This paper proposes a general conclusion: the Freudian epistemology of fiction is based on an aporia which is present at the core of the possibility of metapsychological representation. From an epistemological point of view, metapsychology formulates and maintains a critical position on the question of “fundamental concepts” and theoretical constructions: this conclusion connects the problem of fictions with the question of belief. [ABSTRACT FROM AUTHOR]

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Résumé Introduction La prise en charge psychique des jeunes patients atteints de maladies osseuses constitutionnelles et de leurs familles nous conduit à nous interroger sur la fonction et la portée du suivi psychologique pour ces enfants. Au-delà de l’accompagnement nécessaire à la prise en charge, le travail d’orientation analytique permet d’obtenir un effet sur la capacité du sujet et de ses parents à gérer certaines manifestations de la douleur sur le corps. Objectifs La mise en perspective freudienne de la douleur et de la pulsion éclaire selon notre hypothèse la direction du traitement. Des entretiens familiaux viennent dans ce contexte questionner une séparation des corps — d’avec le corps souffrant de l’enfant. Méthode Le travail clinique que feront Mathilde, 5 ans, atteinte d’une hypocondroplasie avec retard de croissance, et ses parents permettra de revenir sur le vécu de l’annonce diagnostique. Blaise, jeune adolescent atteint d’une maladie des exostoses interroge quant-à-lui l’ inconnu d’une douleur particulièrement aiguë, associée à une impossibilité à marcher et des manifestations anxio-dépressives, que d’un point de vue somatique la présence des exostoses n’expliquerait pas seule. Résultats Le cheminement de Mathilde et de ses parents conduira à circonscrire l’angoisse de chacun comme angoisse de perte (de mort, d’abandon…) et d’aborder la prise en charge de la douleur tant d’un point de vue somatique que psychique. Le cadre des entretiens individuels avec Blaise conduira à une formulation de ses questions, tant sur son avenir, la transmission héréditaire de la maladie, que sur sa contre-identification à un père, seul de la famille à ne pas être atteint. Discussion Dans les cas d’affections chroniques, l’interrogation clinique de la douleur se porte au carrefour de la maladie, de la déficience et du handicap. Certaines situations de surhandicap peuvent peut-être être prévenues. Introduction The psychological treatment of young patients affected by constitutional bone diseases and of their families has prompted us to look into the function and scope of psychological supervision of these children. Reaching further than the accompaniment needed for their treatment, analytical orientation work has a bearing on the capability of the subject and his or her parents to cope with some manifestations of pain in the body. Objective According to our hypothesis, Freud's placing in perspective pain and impulse sheds light on the direction treatment should take. In this context, family discussions raise questions about the separation of the body — from the suffering body of the child. Method The clinical work that Mathilde, aged 5, suffering from hypochondroplasia with retarded growth, and her parents, will be undertaking will provide an opportunity to go over the process of the announced diagnostic. Blaise, an adolescent suffering from exostosis, wonders about the unknown aspects of particularly acute pain, combined with the inability to walk and the associated anxiety-depressive disorder signs, which the presence of the exostoses alone does not explain from the somatic point of view. Results This path will lead to the circumscribing of the anguish felt by Mathilde and her parents, like the anguish triggered by loss (death or abandonment…), and tackle the process of getting to grips with the pain both from the somatic and mental standpoints. The individual conversations with Blaise will lead to questions being raised, about his future, the hereditary transmission of the disease, as well as the counter-indication of his father, the only family member to be untouched by it. Discussion In the case of chronic affections, if the clinical interrogation with regard to pain is axed around the crossroad of the disease, the deficiency and the handicap, certain situations of excessive handicap could possibly be avoided. [ABSTRACT FROM AUTHOR]

In this article, the author leans on her experience with psychodynamic analysis of work in a geriatric institution. She shows that the sexual, in the Freudian sense of the term, occupies a central place in geriatric care, constituting what Cora Diamond indicates as a "difficulty in the reality." This difficulty can, under certain organizational conditions, be assumed, elaborated and even sublimated in the care teams. But this dimension of the reality of bodies, fantasies and unconscious desire is evaded in most of conventional ethics. As a result, questions of sexual morality are posed within an inadequate theoretical frame. The vitality of the drive is denied for the benefit of a valuation of cognitive activities as the definitional characteristics of beinghuman . The ethic of the auxiliary nurses is the ethic of care. It turns out to be much more adapted to face this difficulty but exposes us to an awareness of our own vulnerability.

ResumenMomentos de Freud. 1913: la educación mejoraría si conociera el desarrollo infantil; dirigir las pulsiones hacia metas valiosas salvaguarda la creatividad y el disfrute. 1925: la educación tiene sus funciones, aunque no conduzca a la madurez; lo cual no puede subsanar el psicoanálisis, pues no es instalable la transferencia con niños. La provechosa instrucción psicoanalítica calaría hondo en pedagogos psicoanalizados. 1932: igual procedimiento pedagógico no beneficia homogéneamente; imposible hacer profilaxis psíquica. El niño, incapaz de alcanzar el dominio de las pulsiones, es psicoanalizable. Además de un educador con información y terapia psicoanalíticas, conviene tener padres que hayan experimentado un análisis.AbstractFreud’s moments. 1913: Education would be better if children it were aware of children development. Directing drive toward s worthy goals enhances both creativity and joy. 1925: Education has its functions, though it does not lead to maturity; this cannot be resolved by psychoanalysis, because transference does not work within children. The advantageous psychoanalytic instruction would go deep into psychoanalyzed teachers. 1932: the same pedagogic procedure does not homogeneously benefit, it is not possible to make a psychic prophylaxis. Children, unable to govern drives, can be psychoanalyzed. It is convenient having parents who have been psychoanalyzed, besides having a teacher who knows psychoanalytic information and therapy.ResumoMomentos de Freud. 1913: a educação melhoraria se conhecesse o desenvolvimento; dirigir as pulsões para metas valiosas salvaguarda a criatividade e o gozo. 1925: a educação tem suas funções, ainda que não conduza à maturidade; o que não pode corrigir a psicanálise, pois não é instaurável a transferência com crianças. A proveitosa instrução psicanalítica marcaria os pedagogos psicanalisados. 1932: igual procedimento pedagógico não beneficia homogeneamente; impossível fazer profilaxia psíquica. A criança, incapaz de atingir o domínio das pulsões, responde a psicanálise. Além de um educador com informação e terapia psicanalíticas, convêm ter pais que haja feito uma análise.

Pluralism in psychoanalysis is a given fact, undoubtfully related to various factors among which cultural and theoretical diversity. This diversity is connected partially to the psychic complexity while also raising the issue of adaptations, reformulations, adjustements that approach the matter of its identity and threaten its definition 8 even if thus the diversity enriches psychoanalysis. I propose to reflect upon what can be termed as a fundamental nucleus of psychoanalysis that observes the complexity of the psychic life and the diversity of the clinical landscape with which the psychonalytic practice is confronted. [ABSTRACT FROM AUTHOR]

Even if, as a follower of the Freudian path, Jacques Lacan takes over initial concepts -isolated by this one - and transforms them into foundations of psychoanalysis, even if he recognizes the genius of his master, his models, theoretical and cultural references, the methodology of the psychoanalytic practice differs significantly from those employed by Freud and his students. Can we therefore speak about pluralism in psychoanalysis or are there several psychoanalysis fields ? We question here the mutations that appeared between Freud and Lacan, especially with respect to various domains that influenced their work. Medicine, biology, painting in S.Freud's case, modern mathematics, theology, philosophy, poetry, literature, anthropology for J.Lacan allowed each to advance and enrich psychoanalysis. [ABSTRACT FROM AUTHOR]

Abstract: The article inquires the system of aphonia and its unconscious cales, at the light of advances in medicine, cultural remainders, psychoanalytic concepts and interviews with patients having vocal difficulties. Beyond an absence of the body, an alteration of the bond with the other, an absence of the voice as a “tool of communication”, how does the “absence of being” make the lost voice? It is suggested that between the aphonia of the body and the a-phonia that creates a “sonorous emptiness” in the social bond, exists an “a”-phonia as the “loudest” incarnation of the invoking drive in an original and structural silence. [Copyright &y& Elsevier]

Abstract: Jean Giono chose chronicle style after the Second World War. His novel Deux cavaliers de l’orage is a turning point in his literary work. Since then, Giono confirmes this literary style. He writes about murderous drive in the novel Deux cavaliers de l’orage, murderous and perverse drives in the novel Un roi sans divertissement, about death-carrying drive in Le Déserteur. For Giono, storyteller chronicler style is the condition that allows him to keep writing, as if, always at grips with death-carrying drive, having it told by the other allowed him to take outdistance from it. In fact, the pulsional act borns there where the words are missing, and relating it allows to write about it. Giono conciliates his happiness in writing with the drive which composes with words and sustains his creation. Then he can fictionalize the act of killing, forever a trauma for him since the Second World War. [Copyright &y& Elsevier]

The setting can be seen as the keeper of the psychoanalyst's ethics. A very banal « agieren », a session displacement covers and then clarifies what was, until that time, a rather obscure aspect of the transference/countertransference relationship. For this purpose, a wellarranged divan and a safe setting enable the "reading" of the touch that the patient and the analyst leave on them. A sequence clearly shows that this setting agreed upon together with the patient must be protected against external and internal attacks. The setting safeguards the analyst and the analysand against any unappropriate, ambiguous, in other words sexual character that may be associated with the action involved in any treatment. Therefore, the partners of the psychoanalytical process are protected against any redoubtable sexualization during the psychoanalytical process. [ABSTRACT FROM AUTHOR]

The drive, demarcation concept between body and psyche is what the mind builds with instinct; it is at the very beginning of mind. It is possible to assume that the drive may be dissociated in two libidinal cathecting streams, one in mastery using the mastery apparatus and the other, in satisfaction, cathecting erotogenic zones and the satisfactory experience itself. It is during the satisfactory experience that the representation is built, by a combination of traces coming from the cathexis through mastery stream and satisfaction cathexis. [ABSTRACT FROM AUTHOR]

A subject's difficulty to read - or even write - is a current-day symptom of our civilization. Several clinical examples question here the relationship between learning and unconscious knowledge for a subject. The origin of the will to learn, related to the drives, was taken up by Freud. This has also been discussed in relation to the loss of object a (especially in terms of the gaze and the voice). In the sphere of the real, the function of letters that are lost is also examined. The direction of the treatment and the importance of its temporality are thus approached in order to provide a reading of the unconscious as an interplay of words and letters. [ABSTRACT FROM AUTHOR]

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Abstract: The links, liaison, or more precisely the liaison work is a challenge princeps of subjectivation the little man, princeps vector symbolization processes and deployment of the psychic life unique to humans. The liaison work is played out both on the side of the link and to the pulsionnalized environment objects (humans and nonhumans) that populate and animate, as in the link body/psychic via along the path mentalisation and thickening psychic. Pulsionnalization that accompagnies the deployment of transitionnality, creation and symbolizations but potentiates that the various functions (cognitive, psychomotor, and socioemotionnal) in the first development. Functions that potentiate impulse comes first in the development, bud also help to gradually invest in their own operation and through the pleasure of operate. The clinical hyperactive children with attention deficits is unfortunately an exemplary illustration of the bankruptcy of this liaison work, the fragility of relationships both within and between body and outside psyche in relation to other objects and the world. Reading a complex psychopathological polyfactorial and appear in this field of unstable conditions of the child and particulary essential heuristic in terms of links and routes. The multidimensional therapeutic work on it can then be reconsidered in terms of reroutes and reliance work symbolization and links. [Copyright &y& Elsevier]

Abstract: The evolution of society has changes our perspective in regards to certain aspects of psychopathology. Our focus has changed from the pathology of conflicts, which was nourished by a repressive society to the pathologies of relationships, limits and dependence, which are facilitated by a liberal society. We can no longer consider problems of impulse related to aggressiveness or sexuality without dialectically considering those of the identity of limits, the fear of drowning or of being abandoned by loved ones. The failures of narcissism and the importance of insecure early relationships in these subjects are essential to the understanding of these pathologies. Adolescence is a privileged moment of expression of this problem. The weight of biological and/or social constraints restores the self to a central place into their management.) The self''s capacity to face such constraints, or on the contrary, its vulnerability to overflowing trauma, are essential in regard to the prognostic. This evolution makes us question classic models of psychotherapy and in general, the most effective means to facilitate change in these subjects. [Copyright &y& Elsevier]

Abstract: The thesis of Esquirol devoted to «Passions Considered as Causes, Symptoms and Curative Means of Mental Derangement», (1805), is often regarded as the apogee of Pinel''s conception of «moral treatment» of mental derangement. The integration of passions (or of the affective faculty) in «clinical medicine» was an outline of the psychosomatic conception which led later to the concept of monomania itself destined to disappear at the end of the xixth century. Passions gave way to impulses with Freud (Trieb or Drive), to affective and mood disorders, to addictions with psychobiology and incidentally to disorders in the control of impulses. [Copyright &y& Elsevier]

The American Journal of Psychiatry has received a number of letters in response to my earlier “Framework” article (1). Some of these are reprinted elsewhere in this issue, and I have answered them briefly there. However, one issue raised by some letters deserves a more detailed answer, and that relates to whether biology is at all relevant to psychoanalysis. To my mind, this issue is so central to the future of psychoanalysis that it cannot be addressed with a brief comment. I therefore have written this article in an attempt to outline the importance of biology for the future of psychoanalysis. [Copyright &y& Elsevier]