Le jeu comme « leurre » et le démenti

In the cure, according to our hypothesis, the games played by children obey different unconscious logics, which reveals the importance of envisioning the reception of different types of play in the cure. We propose a Freudian-inflected “structural classification of play,” drawing upon similar attempts made by Piaget for developmental psychology, and Caillois for sociology. We will consider that certain play follows a logic of negation (Verneinung) – play that we call “trompe-l’oeil” games; or a logic of disavowal (Verleugnung) – “decoy” games; or a logic of foreclusion (Verwerfung) – “suppléance” games. This article develops the type of play associated with the mechanism of disavowal: the game as decoy. We draw upon and analyse an example from the literature – that of Arpad, the “little chanticleer” received by S. Ferenczi in 1913. The examination of this case allows us to clarify the reasons for which such games can be an obstacle to the cure, as well as to the establishment and development of the transference. We will be led to cast doubt upon the possibility of considering such play to be “therapeutic” in the sense of winnicottian playing. Following the hypothesis that such play does not favour subjective change, we will propose a comparison with “trompe-l’oeil” and “suppléance” games.     

L’« hyperdatation » et sa fonction défensive dans la psychose

The question of time in psychoses has been studied more often as lived time (perceived) than as discursive time (abstract). The specificity of lived time in psychosis can disturb the modes of “intrigue setting” (‘mise en intrigue’ according to Ricœur seems to translate lived time into a narrative process), particularly as concerns lack of dating or excess of dating. In this paper, the authors study the phenomenon they have named “hyperdating” and its defensive function in psychosis. “Hyperdating” would be a function of overdating, illustrating the distance between the patient who “hyperdates” and the affective charge he feels. “Hyperdating” would then consist in a radical lack of the dating function. The purpose of dating would not be to tag events temporally in order to organize the narrative chronologically, but to proceed to evacuate the meaning out of the event by designating only its date. In fact, we suppose that the affect would be shifted onto this date, and thus disconnected with the representation of the event for which there are representational deficiencies and probably a very intensive original affective load. Dating is a vehicle of chronology, and is the manifestation of a faculty for the narrative of self to become an autobiography as temporal experience. We suppose that in psychosis, this process is inefficient. In fact, there is either a lack of dating of narrative events, or a “hyperdating” which overloads narrative with temporal pseudo-indicators, in particular through quasi-sacred dates. “Hyperdating” would therefore be a defensive psychic process against the traumatic load connected to the remembrance of the event, transferring the central characteristics to the date itself, which would then be exterior to any meaningful chronology. The authors propose to define this “hyperdating” phenomenon, and to investigate its psychic function. The methodology is qualitative, and based on two clinical cases, one of schizophrenia, the other of mania.

A single case of schizophrenia

We think that in schizophrenia the “hyperdating” phenomenon could be underlain by a schism between affect and representation. This is an isolating process which fits into a psychotic dissociation, recalling the break characterising schizophrenic temporality. The speech is centred on a time-based accuracy to the detriment of experience narration and its affective expression. It then seems that “hyperdating” enables the person to avoid the huge traumatic load related to the factual content in order to shift the affective load on the dating itself.

A single case of mania

Here “hyderdating” would be the expression of a game with dates in an omnipotent process. This game appears as a mosaic, a disjointed and blurred control attempt lacking a linear temporal trajectory. In mania, a cumulated series of dates does not ensure either temporal links or any necessary “temporalisation” for “intrigue setting”. Time is one of the forms of “discontinuity and hopping” frozen in instantaneity. “Hyperdating” reveals a need to control the temporal flux which can only fail and it is, under a chronological appearance, an expression of a temporality frozen on the return of the same. The lack of temporal succession and of alternatives to “temporalisation” of events by means of a date which freezes them and removes their affective dimension can only render the reflexive capture of an identity through a biographic narrative problematic.

Conclusion

Thus, other than the discrepancies related to the specificity of the “hyperdating” process in the psychic economy of psychotic patients, there would be some similarities concerning “hyperdatation” in psychoses such as abortive attempts of intrigue restoration, deadlock of the chronological function of dating, but also freezing of temporalisation on a number. These illustrate the schism or the instantaneity, devoid of any temporal flux and therefore of any link with “withholding” (apprehension of what has just occurred) and with “protention” (intuition of the immediate future), which characterise time experience according to Husserl. The limits of our study are rooted in the difficulty of identifying this phenomenon as it seems to occur less often than those concerning forgetting or lack of dating. Furthermore the links between “hyperdating” and the affect management process as well as the differences of those links within the different types of psychosis will need to be investigated more thoroughly. That is why the prospects of this study could be the following ones: interrogating the links between “hyperdating” and memory in psychoses. (Is the “hyperdating” phenomenon a failed attempt to recover memories, and/or an attempt to shape raw mnesic traces?); further investigations of the psychotic temporality issue; therapeutic contributions in the management of time and affects could be based on these previous points as far as it seems that it is only through the flexibility of such a defence that the patient will reach the affects and integrate them in an intersubjective relationship with the therapist.     

Les enjeux d’une « consultation rémission »

The temporality of the subject cannot be superimposed to the medical one: Remission time certainly tells it enough. What can be at stake in a remission support unit such as the one recently created at the Centre de Lutte Contre le Cancer in Reims, as it is organized on a pair-team basis with a cancer care experienced general practitioner and a psychologist-psychoanalyst? From the moment when the illusion of identity is broken by the diagnosis shock to the time of remission when the substitutive surface identity produced by the “framing-effect” of long-terms treatments collapses, landmarks are emerging for a clinical renewal in cancer care: Problematics of identity, prosthetic effect of the care institution, loss of dropping, maternal bereavement elaboration… For we approximately know what it is to be ill or not, but what do we know of the person who “has had a cancer”? The extension of Support Care to the phase of remission is probably necessary…     

Subversion et humour dans le traitement analytique d'un patient schizophrène

The psychoanalytical therapy of schizophrenic patients is traditionally based on the development of a positive transference and on an interpreting, holding analytic work. In this paper, we present the case-study of a patient for whom all “making-sense” work became persecuting. We will name this very ambivalent person an “alterno-valent” patient. Within this conflicting transference, only a humoristic approach allowed us to develop a trustful relationship with the patient. We describe the subversive nature of this relationship-humour, which is to take a completely opposite position to the analytical position, but to remain nevertheless attentive and empathic. We show further how this humoristic play serves us to interpret the transference. The humour-concept is assimilated to the Freud's “Witz”. We refer further to the literature in order to describe the psychotic transference as an oscillating movement between “transference-erotomania” and the “let-down-position”, both also deleterious. We propose the idea that the therapist's effort to make sense could induce in psychotic patient a psychic disorder who acts first as a defence (against the confusing pointing of the Big Other), second as a guarantee for the permanency of the relationship (the subject's disorder engage the Big Other in an organizing work). We also use “the concept of “projective identification””-concept, which is considered not only as the projection against bad objects, and also as a mechanism that allows the projection of the working-out abilities.     

Psychiatrie en institution : par delà la classification nosographique,une clinique de la singularité en réunion (Lola ou le cas des « jambes cigarettes »)

Introduction

The daily psychiatric practice combines two parallel “clinics”. The first, which is called “general”, uses the diagnostic categories or the psychopathological mechanisms usually adopted for the patients. The second, called “singular”, notes that which is specific to the patient him/herself, and irreducible of any entry in a classification. The issue concerns the function of this second “singular” clinic in the therapeutic process in institution.

Objective

The objective of this work is to illustrate the “function – meeting” and show its therapeutic usefulness, specifically regarding the singular specificities of the clinic.

Methodology

The remarks exchanged at the meetings are retranscribed, put into perspective and combined to form an “interpretation” of the institution. The case of this 49-year-old woman, diagnosed schizophrenic, has the advantage of a fairly clear readability in stimulating remarks exchanged within the team regarding the problem of the patient. This case is supported by several bibliographical references.

Results

The elements converge on the problematic of mourning with an intracorporeal identification of the deceased mother of the patient. A clinical meeting of the constellation of nursing staff made the interpretation in several phases possible, allowing the observation of a significant clinical improvement of the patient.

Discussion

In multiple references, psychotic transference is “dissociated” and dispersed in the institution. The function of the meeting of the nursing staff is to collect the transference fragments that have specific qualities. This clinical case illustrates the deployment of this dissociated transference in the institution and the role of the meeting in the collective “elaboration-interpretation” and then the return of this “elaborated-interpreted” material to the patient with positive therapeutic effects.

Conclusion

Singular, combined with general, clinics are of undeniable interest. The “function – meeting”, the open “transversality” of the exchanges among the teams regarding particular details of the behavior of the patients can have an enlightening, and secondarily a favorable interpretative effect with regards to “institutional psychotherapy”. This concept is well known but often abstract, and this case is a concrete illustration.     

L’« originalité » perceptive d’un sujet pervers au test de Rorschach

The author starts with a discussion about two notions appearing into the Rorschach test: the perception and the apperception. By this way, it is suggest ways for a phenomenological study of the Rorschach test. These proposals are consistent with those of the Comprehensive System (Proposed by John E. Exner). Then the author proposes a protocol analyzing of a patient with a perverse psychological functioning. In one hand, the result obtained by the Form Quality (FQ) is detailed in particular regarding to the status of unusual perceptions. According to the Comprehensive System proposed by J.E. Exner, a significant proportion of responses “u” (46 % for this protocol) indicates that the person is not influenced by any social request or any expectation and some of his behaviors could ignore or avoid any question about social convention. From an other point of view, when analyzing these data, an adaptive dimension for these unusual perceptions is identified. The pervert perceives the stimuli that “really exists” according to him not everyone can perceive it. This advantage allows a better adaptation to the environment and the ability to change this environment. The manipulation (a particular skill that is most of the time attributed to the perverse person) is probably a consequence of having an original perception of reality. It is also discussed the interpretation of the “anatomical content” in connection with this adaptive hypothesis. In addition, the author also discusses a particular answer of the protocol: the answer “shoes” that presents a specific perceptual characteristic.     

La contingence cybernétique : un « surgissement » au service de l’inconscient ?

Cybernetics is a “science of government” whose necessity follows from our difficulty to understand and to be understood by a binary machine. Science has evolved, and so have machines, confronting us more and more with their contingency. Today, cybernetics is the instrument of an “Appearance/Emergence” sufficiently operational to bring us to attribute some powers to it that it actually does not possess. With this monograph on Simon's case, we will try to show that the cybernetic appearing is meant to mobilize the refrained desire of the subject. This paper has the aim to analyse how “virtual acts” can be constituted as some multiform expressions of a fantasy. Cybernetic contingency suggests then a “shivering” which would testify that it would be possible for the subject to be able to magically reinvent across it his relationship to the object. As a consequence, this lure seems to promote cybernetics to the rank of a support, susceptible of favouring the psychical elaboration. The case of Simon would therefore testify that cybernetics can be considered a clinical operator, whose function would define a transfer relation hardly obtained through classical therapy.     

« Drapeaux rouges » : quand s’alarmer, quel examens demander ?

The diagnosis of Parkinson's disease (PD) requires ruling out other causes of parkinsonism. Among various “other” causes of parkinsonism, neurodegenerative causes or “atypical parkinsonism” are the most difficult to diagnose. Most common diseases are “synucleinopathies”: multiple system atrophy and dementia with Lewy bodies and “tauopathies”: progressive supranuclear palsy and corticobasal degeneration. Unexpected or atypical signs and symptoms for PD, also called “red flags” along with absent or poor or short-lived levodopa response may be a clue for the diagnosis. Some tests may also support the diagnosis, among them, structural (MRI) and functional brain imaging, autonomic function tests and urodynamics, oculographic recordings and neuropsychological work-up, are the most useful.     

Les « pousseurs de métro » : à propos de huit cas de patients hospitalisés en unité pour malades difficiles

“Subway pushers” have been newspapers' highlights but also a forensic subject. Through eight case reports of offenders sent to high secure unit (unité pour malades difficiles Henri Colin), a profile of homeless psychotic man without any outpatient treatment has been found. Crimes seem unmotivated, where as delusions or hallucinations exist. Meta-analysis confirms this profile, though some alcoholic pushers have been described. Prevention of these tragic accidents rests on psychiatrists' awareness of homeless mentally ill people risk and safety subway programs.     

Phénomènes d’allure télépathique dans la relation thérapeutique avec des patients schizophrènes : hypothèse d’une potentielle nocivité de la pensée soignante

Telepathic phenomena within the transference relationship with psychotic patients are regularly described by many authors, well-known serious psychoanalysts; many examples will be proposed. Telepathy was a noted subject of scientific studies between the end of the 19 and the beginning of the 20-century. Many examples got from the author's clinical experience will show that in the frame of a long-term therapy with psychotic patients, some telepathic-like phenomena can occur. We propose to name “telepathic identification” such moments when the therapist stops to pay attention to his patient's speech, monopolized by a sudden concern, and when the patient begin to talk about this very concern as if it was one of his own. Many explanatory hypotheses will be developed. The author emphasizes also the possible iatrogenical influence of the therapist's mental objects, as well his concerns as his theoretical models. At last, the hypothesis of a “telepathic identification” is considered as a manner to avoid being abandoned by the therapist, a mechanism, which originates in the early mother-infant interactions.     

Le surgissement de l'originaire et le « retrait hallucinatoire » dans les formes délirantes de l'éveil de coma

The clinical investigation of delirious and hallucinatory states during the awakening from a coma reveals hallucinated representations of a polymorphic nature. The diversity of their contents suggests the implication of differentiated etio-pathogenic processes. The assumption followed here, based on the conceptualizations of P. Aulagnier, is that the emergency care awakening traumatism causes a prevailing reinvestment of various operating modes, from the recovery of a “pictographic production” due to the abolition of conscience, to the fantastical scenario characterising primary education that remobilises and upsets the identity bearing layers in which the essential moments of the instinctual history were elaborated. These symptomatic constructions thus express this “in-more” generated by the psychotic processes which combine the double movement of a regression and of a “redeployment” of the traces of the Primal. This second period fulfils the paramount requirement of a primitive development of the coma awakening experience following the “postulate” of the dominance of the Primal according to which any psychic object is seen initially metabolized in a pictographic representation. The stratification noted within these dreamlike formations reveals: on the one hand modes of composition of images similar to those of the night dream; and on the other a deployment of various imagos of archaic states of the parcelled out body; and finally “psychic residues” that re-appear in the form of “parasitic” reminiscences, analysable as resurgences of psychic activities resulting from the coma phase. Thus a representation of the data of the Primal is then generated and although these data are psychic they remain forever heterogeneous and external to the Unconscious and to the I. The common clinical term which supports this analysis is “hallucinated feeling” which, according to Aulagnier, emerges sometimes within a schizophrenic patient which could be understood as equivalent to an autistic withdrawal which we suppose to be here at the heart of the deliriousness of the awakening from the coma. Thus the proposal that two etio-pathogenic logics are at work in these acute episodes: 1/ one that is initiated in a movement of decomposition of the I, due to the multiple traumatic effects of the primary affection and of the emergency care awakening process, balanced by the variations of the state of consciousness of the patient. At the time of this regression the projective mechanism, combined with other defences such as rejection or cleavage, reveals scenarios in the psychic space which mobilize images of the body and perceptive or mnemonic fragments. 2/ the other trajectory is comparable to this dynamics of the “withdrawal in the hallucination”. The re-establishment of the specific processes of the primary and secondary agencies imposes a requirement of specific psychic work consisting in metabolizing this resurgence of the pictographic representations that originate in the (quasi) nothing of the coma.     

« Une danseuse est dressée (sur la pointe des pieds) ». Approche de la question du masochisme dans la danse classique

Practising ballet at a professional level implies an almost permanent physical pain. We suppose that such a pain, to be borne, requires to be found pleasant, to be satisfactory in some way. As a result, we assume that ballet dancers present masochistic features. These masochistic features could belong to two different types of masochism: either a “narcissistic” or an “object” masochism, or, using the words of Michel Fain, either a “completed” or an “uncompleted”. By referring to the notions of Ego-skin (Didier Anzieu), suffering covering membrane (Micheline Enriquez), self-calming processes (Gérard Szwec) and self-sadism (Jean Gillibert), we first demonstrate that in the narcissistic/uncompleted type of masochism, pain would be wanted because of its holding function: hurting the body would paradoxically enable the subject to define its outlines by experiencing them. In a second time, referring to the works of S. Freud, we demonstrate that in the objectal/completed type, pain would be wanted because of the fact the subject has an unconscious need for punishment from a parental authority; pain would enable the subject to satisfy his incestuous desires in a regressive way and at the same time to expiate the crime that this satisfaction constitutes.     

L’analyste, « terre d’accueil » pour sortir du fantasme totalitaire ?

Striked by the recurrence at a clinical level of fantasies in connection with totalitarism, we are searching to explore the reasons of these fantasies, with the aid of Perec's works, particularly W ou le souvenir d’enfance. If the reality of his mother's destiny, died in a concentration's camp, is indisputable, these fantasies are also revealing a psychic functionning, as the work of Gabel and also Perec's book Un homme qui dort can attest it. But a third example, that of a young girl, questions us also about the links between these fantasies and, not only a reality lived by a third person (as Perec's mother), not only an internal reality (a psychic functionning), but the reality of a link with madness: madness of History, madness of a psychotic parent, or madness of a maltreatant parent indeed. The therapeutic perspectives within analysis follow the way showed by Pontalis: to extricate oneself of a mechanical counter-transference (of interpretation), to find a place for the patient's pain and to permit the patient to give birth to himself. But we also propose that the cure finds itself the fantasm of a “land of welcome” where the perverse link could be denounced, in a link with the other which is not in a narcissistic mirror anymore.     

Critique de l’utilisation de l’enseignement de Jacques Lacan dans l’abord psychanalytique des troubles psychotiques ou d’une question postliminaire à tout traitement possible de la psychose

Lacan has left a teaching, mainly in his “seminars”, which is often synthesized, simplified and reduced to a simple explanatory theory, principally regarding psychotic process. Such a simplifying view can become a discriminatory, iatrogenic conception of the psychotic person and of the psychotherapeutic (or psychoanalytical) treatment. In the first part of this paper, the author tries to show that Lacan’s teaching was principally a transmission of the psychoanalysis itself, in different ways, as half-sayings, ambiguity, poetry and style, topology, mathems… Lacan passed himself on as a possibility of analytical opening, like in a cure. He does not generate a rational discourse, but he proposed several different theories as simple “vectors”. In the second part, the author puts some concepts as “Name of Father foreclosure”, “borromean knot” and “object a” into a political (within the psychoanalytical community) and historical context. If those items of Lacan’s teaching are diverted from their primal function of “vectors” and are considered as explanatory theories, then they lose their pertinence and can lead to a stigmatizing conception and to possibly iatrogenic attitudes in the treatment. That will be examined further.     

L' « Ouverture émotionnelle » dans les Troubles de la dépendance et les Troubles de la personnalité

Emotion processing is supposed to play an important role in psychological dysfunctions in alcohol and drug dependency disorders (DD), as well as in personality disorders (PD). The model of “Emotional Openness” (“Ouverture émotionnelle”) provides a multidimensional framework to analyze problematic patterns of emotion processing. Within this framework, it is suggested that drug- and alcohol-dependent patients as well as borderline and antisocial patients show reduced a) “cognitive/conceptual representation” of affective states; b) “emotion regulation”; and c) “expression and communication of emotion”; but d) increased “awareness of body internal indicators” of affectivity; and e) appropriate psychological treatment is supposed to improve these patterns. Drug-dependent patients with PD comorbidity (in particular borderline or antisocial) are supposed to present even stronger deficits in (a) and (b). The hypotheses are tested with the 36-item DOE questionnaire (“Dimensions of Openness to Emotional experiences”, trait version; [19]), assessing six main dimensions of emotion processing as represented by the subject (French and Italian version). The instrument presents satisfying reliability coefficients (mean alphas of the scales in two recent studies (N = 251; N = 435) vary between 0.74 and 0.82) and good factorial validity (6-factor PCA solutions with varimax rotation solutions in the two samples are highly coherent; the mean of Tucker's congruence coefficients is 0.93). Results of two clinical studies are presented, comparing N = 71 patients (21 drug-dependent without personality disorder; 30 drug-dependent with borderline or antisocial personality; 20 dependent in-patients receiving psychological therapy) with normal control subjects (N = 51 matched; N = 50 reference group), including one pre-post treatment comparison. Results confirm marked deficits of DD patients concerning “conceptual representation” and “emotion regulation”, as well as a reduction of “communication/expression of emotion” but an increased “awareness of body internal indicators” of affectivity. Differences of patients with a double diagnosis correspond to effect sizes of d = -1.33 for cognitive/conceptual representation of emotions and d = -1.25 for emotion regulation; differences in emotion communication and expression are also significant but less important d = -0.44. Awareness of body internal emotion indicators is increased (d = +0.27) but does not differ significantly from the control group. As supposed, patients with a double diagnosis (DD and PD) described significantly stronger deficits in conceptual representation and emotion regulation than the patients with dependency disorder only. In the second study, a group of DD patients receiving multi-component treatment, including individual and group therapeutic intervention, according to the client-centered approach, and working on emotion processing, showed marked differences from the reference group at the beginning of the treatment (d = -0.91 for cognitive/conceptual representation, d = -0.82 for emotion regulation and d = +0.46 for awareness of bodily internal indicators). As supposed, pre-post comparisons indicate improvement with change effect sizes of d = 0.99 for conceptual representation, d = 0.97 for emotion regulation, as well as d = 0.88 for emotion communication and expression. Furthermore, the changes following treatment are highly significant and substantial, except for the awareness of internal bodily indicators, which only slightly decreased. Patients “normalize” their emotion processing following treatment, describing increased conceptual representation and emotion regulation, as well as emotion communication and expression. Results underline the importance of dysfunctional modes of emotion processing in both pathologies, and underline the validity of applying the model and the DOE instrument. They are discussed with reference to the model of alexithymia.     

Libéré, Hamlet : Nouvelles approches du « Sphinx de la littérature moderne »

In this paper, the different psychoanalytic lectures of “Hamlet” are confronted to new findings claiming Hamlet to be guilty of his father's murder (Bayard, Enquête sur Hamlet, 2002). Then, Shakespeare's masterpiece is discussed as a paradigm of paradoxality and ambiguity from which stems its unbroken fascination. Instead of determining arbitrarily if Hamlet or Claudius are the villains, a new interpretation uncloses a third possibility of who might be responsable for the king's death: what if Hamlet's mother Gertrude has conceived the King's murder? Finally, the author points out the heuristic value that “Hamlet” contains both as a paradigm and an enigm, for the theory and the practice of nowadays psychoanalysis.     

Pour une théorie du sujet : commentaires sur les « Variantes de la cure type » de Jacques Lacan

This text, written by Lacan, was for the benefit of physicians whereas the speech given in Rome (which dealt with the same subject) was aimed at trainee analysts. The theories of the Ego were called into question to the benefit of a theory of the Subject. Resistance was to be looked for in the discourse and not in the Ego. For Freud, the Ego, an Ego that is based on the aggressive narcissic relationship, is built like a symptom and not like an objectivized Subject. Nevertheless, the Ego is not to be rejected, as is done by some phenomenologist-psychoanalysts who also reject the subconscious. The role of didactic analysis is to allow the analyst “to recognize symptoms of his ignorance in his own knowledge”. Ignorance not being here a “non-knowledge”. Listening is not directed by knowledge but by practice freed from speech. Hence the expression of “cure phenomena” in the shape of equations and axioms; Lacan was building up the theory of transference, not the theory of the subconscious. He transcribed what he listened to and not what he knew. Lacan's genius was to have introduced the logic of the signifier in the therapy phenomena at a time when symbolic logic was almost becoming independent from the objects existing in the world, and at the time when syntax and semantics appeared to be independent from the subject, because, at this time, psychoanalysis, which by definition develops from the ordinary language of the patient in a transference situation, was coming close to analytical logic which itself was now concentrating on ordinary language and not on scholarly language. Lacan came close to the Anglo-Saxon analytical philosophy of Bertrand Russell, Frege, Whitehead or Wittgenstein. This is a psychoanalysis which does not go beyond language and logic but where the sense of reality remains vital during the session. Therefore Lacan's approach to the transmission of psychoanalysis confronts us with the attitude of semioticians who encourage us to leave aside what tempts us most in the practice we are talking about: the “factual experience”. It is of course impossible to set aside painful factual experience in psychiatry and psychotherapy, but we should combine empathy and semiotics in order to tackle the issue efficiently. We have to give life to the mind by the letter and not to the letter by the mind.     

Les psychanalystes et le transfert de pensée : enjeux historiques et actuels

The concept of “thought transference” has a special position within the psychoanalytic field. It is first an object on the sidelines because it originated in the psychical sciences of the late nineteenth century. It is also an object extracted by psychoanalysis to the darkness of the occultism, Freud considering the thought transference as being its true nucleus. But it is also a foreign body because even if it was apprehended by different authors, it remains poorly integrated into the psychoanalytic corpus. In this review of the literature, we try to show how this concept had first played a heuristic role vis-à-vis the theorizing of transference and countertransference. We then see how it was taken over by successive generations of analysts as well as heated debate it engendered, participating to the division of the field of psychotherapy. Finally, we will bring out the relevance of this concept in terms of clinical and current theoretical issues.