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A literature review about transference in the treatment of dissociative identity disorder (DID) is presented. Common transference reactions resulting from serious traumas are explored, considering that those kind of trauma are higly present in the pathways of DID patients. Post traumatic transference aspects specific to DID are also presented. In addition, common transference patterns and dissociative aspects of transference in the treatment of DID are explained. Transference is also discussed in relationship to the possible impact of disorganized attachment, which is a main component in the development of DID. The clinical implications of this proposition will be discussed and supported by a case example.

Keywords: transfert, trouble dissociatif de l'identité, attachement désorganisé, transference, dissociative identity disorder, disorganized attachment

SUMMARYAfter giving a brief historical outline of relaxation methods, from Freud to Ajuriaguerra, the author attempts to define relaxation. Then he describes the principal methods of relaxation according to three approaches: the neurophysiological which includes Jacob-son's progressive relaxation; the hypnotic in which can be classed Schultz's autogenous training; and the psychodynamic with the psycho-tonic reeducation of Ajuriaguerra and Cohen. This completed, he focusses on the different therapeutic indicators somatic, psychiatric and prophylatic. In conclusion the author underlines the common points of these methods such as detente, the regressive phase, the use of suggestion; mentions that all of the methods lead to a similar state, whatever name may be given to it, and that these methods can be placed on a progressive continuum.

AbstractAt the Personality Disorders Institute we have been investigating the efficacy of Transference-Focused Psychotherapy (TFP), a twice weekly manualized psychodynamic psychotherapy for borderline personality disorder compared to Dialectical Behavior Therapy (DBT) and Supportive Psychotherapy (SP) in a randomized clinical trial of 90 borderline patients. We will first present some developmental foundations of BPD, followed by a discussion of the theoretical foundations of TFP. We will then discuss patient characteristics that have an impact on outcome. We will present both clinical and empirical data in a discussion of individual cases that were representative of a sample of borderline patients treated in Transference-Focused Psychotherapy (TFP).

Objectives Anxiety and depression are the most prevalent disorders observed in health care services and are frequently comorbid with other disorders. Although Cognitive-Behavioral Therapy (CBT) has widely been shown efficacious to treat anxiety and mood disorders, studies that have focused on its effectiveness in the presence of comorbidity have been few and show conflicting results. Thus, the implications of the presence of comorbid disorders for treatment are still unknown. In an attempt to answer these questions, this study explores the impact of comorbidity on CBT for anxiety and mood disorders in a university-based clinic.Methods A total of 293 clients consulting for anxiety and/or mood disorders at the Service de Consultation de l'École de Psychologie de l'Université Laval (SCEP) between 2007 and 2018 took part in the study. Clients were excluded if they presented uncontrolled psychotic, manic or substance abuse symptoms as their principal complaint. Clients without comorbid disorders where compared to clients who had comorbid disorders on different measures before and after receiving therapy to examine if comorbidity had an impact on CBT effectiveness to treat the principal disorder. The impact of treatment on comorbid disorders was also investigated. Effectiveness was assessed on several measures before and after treatment including the severity of diagnoses (measured with a structured interview), anxiety and mood symptoms as well as quality of life. Repeated measures ANOVAs and t-tests were used.Results Before initiating therapy, clients with comorbid disorders had significantly more severe symptoms than clients without comorbid disorders. However, following therapy, both groups had significantly less severe principal disorders and reached a clinically significant change in equivalent proportions. Furthermore, the number and severity of comorbid disorders significantly decreased following therapy.Conclusion These findings suggest that although the presence of comorbid disorders leads to more severe symptoms, it does not affect the effectiveness of CBT for the principal disorder. Furthermore, comorbid disorders improved even though they were not specifically targeted by treatment. In concordance with the literature, it is thus suggested to keep focusing treatment on the principal disorder, whether comorbid disorders are present or not.

Keywords: comorbidité, thérapie cognitive-comportementale, troubles anxieux, troubles de l'humeur, étude d'efficience, comorbidity, cognitive-behavioral therapy, anxiety disorders, mood disorders, effectiveness study

In recent years, Quebec universities have undergone significant changes; reshaping both academic work and institutional dynamics. These transformations, intensified by the COVID-19 pandemic, have particularly highlighted the psychological health challenges faced by students. Alongside these concerns, issues of equity, diversity, and inclusion have gained prominence within Quebec’s higher education institutions. In response, universities have expanded student services, most notably by increasing access to psychotherapy, to address the rising needs during the pandemic. While these initiatives represent steps toward better student support, disparities remain in level of access to these services, especially for marginalized student populations. Such inequalities raise important questions about the effectiveness and fairness of the support systems in place. In this context, our research focuses on the lived experiences of students within Quebec’s university system, examining the factors that facilitate or hinder their use of support services. We explore how students perceive and navigate these services. This study contributes to a deeper understanding of the challenges students face in managing their psychological well-being and informs ongoing discussions on how to improve student service delivery in Quebec universities.

Keywords: cservices étudiants, student services, expérience étudiante, student experience, université québécoise, Quebec universities, equity and inclusion in higher education, équité et inclusion universitaire, disparités d’accès aux services, service access disparities

The text analyzes the foundations, development, and current state of psychoanalysis, and formulates a critical response to its current proponents. The first section of the text stresses the importance of two elements: the analysis of 31 cases documented by Freud, underlining the inefficacy of his approach, and Freud's own acknowledgment of his literary vocation. The second section demonstrates that the dogmatic character of early psychoanalysis continues to prevail in certain milieus today. After describing how dogmatism ended Piaget's career as a psychoanalyst, this section argues that submission to authority (a central characteristic of dogmatism) permeates the field of psychoanalysis and that its founding case – that of Anna O. – rests on dogma and fabrication. Drawing on examples from the works of Lacan, Dolto, and Bettelheim, as well as from current practice, the third section formulates a response to arguments that psychoanalysis has evolved, raising doubts about whether such is really the case. Based on the analysis, the fourth and final section concludes that attempts by psychoanalysts to bring the central current of neuropsychology back under their sway are ill-founded.

Keywords: histoire de la psychanalyse, dogmatisme, critique, neuropsychanalyse, history of psychoanalysis, dogmatism, critique, neuro-psychoanalysis

The current review is an analysis of 36 evaluative studies on group treatment for six to twelve years-old children victims of sexual abuse. Treatments are described and results regarding the efficacy of interventions are summarized. Evaluative studies have been identified through various databases and selected with specific inclusion/exclusion criteria. Results indicate that more methodologically sound research is needed. However, existing evaluation studies suggest that group treatments are effective in reducing children's internalizing and externalizing symptoms. When reported, treatment gains seem to be maintained. Important methodological limitations are noted for the majority of studies and few studies have explored clinical effects and revictimization rates.

Keywords: Agression sexuelle, enfants, traitement, groupe, recension, Sexual abuse, children, group intervention, literature review

Patients with serious illnesses like advanced cancer often experience existential and psychospiritual distress. Alleviating this form of pain and suffering has proven to be very challenging using conventional treatments. Psilocybin-assisted therapy (PAT) employs the psychoactive effects of psilocybin as a catalyst for a psychotherapeutic process grounded in indigenous traditions and within the context of a therapeutic mindset and environment (“set and setting”). This carefully curated experience of an altered state of consciousness can promote healing and psychospiritual growth independently of the disease trajectory. Current research supports the use of this form of therapy as a safe and effective therapeutic tool for such patients. This narrative case report, based upon and written from the perspective of the treating physician, describes the therapeutic journey of a patient with the fictitious name Martin, as he receives his diagnosis of a terminal illness, engages in PAT, and on to his deathbed. Martin was the first patient in Quebec to receive psilocybin treatment through Canada’s Special Access Program (SAP) and chose to end his life with medical assistance in dying (MAID), both done in the context of homecare and paid for in its entirety by the public healthcare system of Quebec.

Keywords: Existential distress, Soins palliatifs, Détresse existentielle, Psilocybin, Psilocybine, Psychedelic therapy, Thérapie psychédélique, Palliative care, Aide médicale à mourir, Medical assistance in dying, Soins à domicile, Home care

The specificities of mental health care combined with the contemporary context of health care make ethical issues particularly salient in psychiatry. Thus, residents in training in this medical discipline may be particularly exposed to difficult situations involving an ethical dilemma, which can be a cause of distress and moral suffering. Future physicians are equipped with knowledge and skills that should enable them to address the ethical issues inherent to clinical practice, as teaching of this discipline is now a requirement for accreditation of residency training programs in Canada. However, many questions remain about the design of a valid and effective clinical ethics education for these young practitioners. In this essay, we attempt to sketch out possible answers to this wide range of questions, based on our experience as residents. After having examined some of the specificities of the ethics curriculum which we benefited from the psychiatry residency program at the University of Sherbrooke, we analyze how its structure can be a good example for ethics training of other young professionals, that is, residents. More specifically, we highlight how creating a space to acknowledge the suffering of the care giver in-training can have an impact on their own sensitivity to the suffering of the patient who they are treating.

Keywords: éducation médicale, bioéthique, souffrance du soignant, résidence en psychiatrie, santé mentale, medical education, bioethics, clinician suffering, psychiatry training, mental health