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Depuis quelques années, le contexte économique et social dans lequel évoluent les psychologues cliniciens amène certains auteurs à se demander si la psychothérapie est en perte d’humanité. En effet, les thérapeutes se retrouvent confrontés à la pression d’offrir des traitements brefs, rentables et validés par des données probantes, ce qui peut avoir pour effet de négliger l’aspect humain. Par ailleurs, bien que la recherche démontre le caractère fondamental de la relation thérapeutique, la dimension humaine de la psychothérapie demeure peu étudiée. En lien avec ces concepts, ceux de relation réelle, d’authenticité, de présence thérapeutique, de profondeur relationnelle et de compassion ont fait l’objet d’études et suggèrent la pertinence de s’y intéresser. Toutefois, plusieurs recoupements sont observés entre ces concepts et aucune recherche n’appréhende la dimension …

Many children with Fetal Alcohol Spectrum Disorder (FASD) show signs of developmental trauma. While psychotherapy with children with developmental trauma has been documented, this is not the case for the use of psychotherapy with children with FASD. Dyadic developmental psychotherapy (DDP), originally developed for children with developmental trauma and attachment issues, can also be used for children with FASD, but requires some adaptation to accommodate the neurodevelopmental challenges of this clientele. This article presents the most recent scientific knowledge on FASD and developmental trauma. Subsequently, the fundamentals of DDP will be presented. Finally, a case study will illustrate the use and adaptation of DDP with a child with FASD and developmental trauma.

Keywords: Trouble du spectre de l'alcoolisation foetale, trauma complexe, psychothérapie, attachement, Fetal Alcohol Spectrum Disorder, developmental trauma, psychotherapy, attachment

Psychodynamic approaches are said to be less inclusive in the face of sexual and gender diversity. Developmental theory, suggesting that a problem arisen during development would explain the etiology of different identities, as well as the minimization of socio-cultural influence in these approaches are the main criticisms raised. Yet, psychodynamic approaches can be a good choice for psychotherapy since several elements specific to these approaches are favorable to working with people of diversity. Examples of approaches and clinical considerations for a more inclusive practice within psychodynamic approaches are presented.

Keywords: approches psychodynamiques, psychothérapie, diversité sexuelle, diversité de genre, inclusion, psychodynamic approaches, psychotherapy, sexual diversity, gender diversity, inclusion

Focussing on the first interview and reflecting the two major themes underlying all the papers—the constant analysis of counter-transference and the need for quite real external third party in the treatment of the most serious pathologies—the author shows that it is not enough to cling to the representations we have of patients, but that it is important to inquire into their conceptions of their problems and how they foresee the psychoanalyst's help. If the patients' “therapeutic theory” differs from what we are thinking about proposing to them, it is advisable to explain it to them briefly and to allow them to reflect upon it when we are not present. The goal is to show them that we are not placing ourselves in a relationship in which a therapist prescribes a treatment to a sick person, but that we are offering them a collaborative relationship. This usually makes it possible to avoid too frequent premature interruptions, which are admittedly disappointing for the therapist, but above all harmful for the patients.

Keywords: contre-transfert, tiers externe, théorie thérapeutique du patient, counter-transference, external third party, the patient's therapeutic theory

Les réactions spontanées de 30 thérapeutes à des vignettes cliniques, codifiées à l'aide de la Grille d'analyse du contre-transfert (GAC: Normandin, 1991), servent à examiner l'influence de la psychothérapie personnelle sur le travail des réactions contre-transférentielles. Les résultats montrent une relation positive entre la psychothérapie personnelle et la capacité des thérapeutes à laisser émerger librement à leur conscience des réactions internes encore diffuses et peu spécifiées, à bloquer ces dernières et à élaborer celles qui étaient auparavant inconscientes. Par ailleurs, les droites/courbes de régression procurant la meilleure qualité d'ajustement indiquent qu'avec l'augmentation de la durée de la psychothérapie personnelle, l'activité mentale rationnelle-objective tend à diminuer alors que l'activité mentale réactive tend à augmenter. L'activité mentale réflexive tend pour sa part à augmenter au cours des …

AbstractThere are at least six psychotherapeutic treatments of personality disorders having received empirical and clinical validation in terms of their efficacy. These treatments are based on different theoretical models, namely the cognitive-behavioural, psychodynamic and interpersonal models. This article briefly presents these treatments, focusing on the process of therapeutic change. It is assumed that the process of emotional activation is one of the most interesting theoretical psychotherapy ingredient in treatments of these patients. The treatments are discussed regarding this hypothesis and its clinical implications.