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SUMMARYThe history of the last thirty years of North-American psychiatry points up the difficulties encountered in the treatment of psychotic patients in a hospital setting but also in the maintaining of their social integration. In a search for solutions, and taking into account the needs observed at the Robert-Giffard Hospital in Quebec, a group of professionals of GIFRIC decided to open, in the center of town, a Psychoanalytical Center for psychotics. Operating since 1982, the "388" is arming at a social réintégration of the psychotic patients in order to read a more satisfying life according to their possibilities of co-existence with others. It is an outside of the hospital structure which permits the treatment of the crisis as well as providing longterm care. The care and services given are based on a psychoanalytical frame. This paper describes the clientele, the services offered, the treatment, the patients' evolution and the problems that arise from the evaluation of such a new structure.

This article aims to define a basic structure of the complexity in the relationship between cognitive attitude and action by questioning the principle of the excluded middle. Taking as a starting point the human will, we show that, given its weaknesses (Aristotelian akrasia and objectives referred to as essentially secondary effects by Jon Elster), the person implements self-restraint strategies (such as commitment), which are irrational but effective. Their effectiveness arises from the human capacity to self-deceive. The structure of this «mauvaise foi», as Jean-Paul Sartre conceptualized it, is based on the result of the contradictory co-presence of incompatible beliefs and, even more, their mutual strengthening, in spite of the fact that forcing oneself to believe is an example of an essentially secondary effect. We describe the mechanism of this contradiction, thus questioning the law of the excluded middle. The result can be thought of as the «elementary brick» of human complexity.

Keywords: Volonté, irrationalité, mauvaise foi, effet essentiellement secondaire, principe du tiers exclu, Will, Irrationality, Self-Deception, Essentially Secondary Effect, Principle of the Excluded Middle

A previous paper (Culture 11,2) proposed a structural model of masculine supremacy as related to violence, valid for several New-Guinean cultures. This paper explores the problem of the reproduction of these cultural structures. Drawing on Herdt's ethnographic material on the Sambia, the author proposes a double structural and psychoanalytical interpretation of the factors involved in the Sambia youth's acquisition of a social and individual warrior's identity. The complementarist approach allows for a pertinent articulation between the cultural encoding of violence and individual levels of identity and psychic organization. This double analysis enables drawing some important conclusions about the nature of militant violence, and points to further research possibilities.

Le trouble de stress post-traumatique (TSPT) consiste en un ensemble de symptômes d’intrusion, d’évitement, d’altération des cognitions et de l’humeur et de modification de l’état d’éveil et de la réactivité développés à la suite de l’exposition à un événement traumatique. À l’international, ce trouble présente des taux de prévalence à vie de 3,9% dans la population générale et de 5,6% plus spécifiquement chez les individus ayant été exposés à au moins un événement traumatique au cours de leur vie. Le TSPT est généralement associé à une grande complexité clinique, où l’individu se retrouve affecté à plusieurs niveaux au-delà des symptômes propres à ce trouble. Ce dernier est effectivement accompagné de problèmes connexes dans environ 80% des cas, par exemple d’autres troubles psychiatriques du DSM. Il …

This case analysis aims to describe the clinical manifestations of three children with a diagnosis of Reactive Attachment Disorder and interpret them in the light of possible neurocognitive impairments. The emotional and behavioral difficulties, the attachment representations, and the clinical history of the children are first presented. Some common factors are then highlighted. An integration of their difficulties, their neurobiological disorders, and knowledge from the neurosciences concerning attachment disorders is elaborated. Finally, the limits of this case study are discussed and some ideas for future research are exposed.

Keywords: trouble réactionnel de l'attachement, neurosciences, psychopathologie, reactive attachment disorder, neurosciences, psychopathology

A student in psychological distress is above all a student in crisis. Between the rupture full of potentialities, and the organization of rupture at risk, how to use the dynamic slope of the state of crisis? Through the presentation of an innovative device, the Relay Student High School Student Health Foundation of France, we will discuss some of the technical resources specific to the care of students in a perspective of short and multidisciplinary psychodynamic treatment : the immediacy of the time of the object relation compared to the long time of the transference neurosis, the multifocal approach and the reformulation of the initial problem, the necessary alliance and the empathy for an investigation and a dynamic evaluation initiating change.

Keywords: étudiants, thérapie brève, mal-être, jeunesse, crise, multifocal, psychodynamique, students, short therapy, malaise, youth, crisis, multifocal, psychodynamic

The association between alexithymia and eating disorders is now well established. However, the precursors to such an association are not well known. Based on a series of psychoanalytic models, this study attempts to deepen current knowledge by testing the role of two emotion regulation strategies (expressive suppression and cognitive reappraisal) as predictors of this relationship. It is proposed that the constant suppression of emotions, will predict alexithymia personality traits, witch favours emotion dysregulation and thus eating disorder symptoms. Inversely, the use of cognitive reappraisal would negatively predict alexithymic personality traits, which would negatively predict ED symptoms. The hypothetical sequences were confirmed.

Keywords: trouble de la conduite alimentaire, alexithymie, suppression expressive, réévaluation cognitive, dérégulation émotionnelle, eating disorder, alexithymia, expressive suppression, cognitive reappraisal, emotion dysregulation

Dans le contexte de la psychiatrie moderne, les troubles de santé mentale graves et persistants, notamment la schizophrénie, présentent des défis thérapeutiques considérables. La schizophrénie, en particulier, impacte profondément le fonctionnement des individus, notamment à travers des symptômes tels que les hallucinations. Ces manifestations peuvent affecter de manière délétère les interactions interpersonnelles des patients, leur régulation émotionnelle et sont associées à un taux de suicide nettement supérieur à celui de la population générale. Face à la résistance aux traitements psychopharmacologiques de première ligne, des thérapies non-pharmacologiques ont été développées, dont la thérapie par Avatar (TA) en réalité virtuelle (RV), qui permet aux patients souffrant d'hallucinations auditives résistantes aux médicaments d'interagir avec une représentation en 3D de leur voix perturbatrice. Bien que cette thérapie ait montré …