Surprisingly little has been written on the impact of the death of a baby on an older sibling. This paper describes how a narcissistically vulnerable latency boy grappled, in the course of his psychotherapy, with the painful loss of his baby brother. Emotional and cognitive aspects of his early confrontation with the reality of death are considered. The patient's six theories about the cot death are described. Attention is drawn to the value of the sibling relationship and to the narcissistic needs which this relationship fulfilled. The termination phase is discussed in the light of the dynamics of sudden loss. The safe therapeutic context provided the space in which this young, rather muddled latency boy could grieve and mourn this traumatic loss.

Authors propose a review of the international literature on infantile anorexia nervosa. They show that a nasographical consensus is far from being reached although this trouble occurs very frequently. They suggest classification axes which should be considered before research criteria that be used in a unified nosology.

Through the case study of the analytic psychotherapy of an adopted child, the authors illustrate the specificity of identification problems, in particular towards the paternal imago within an oedipal context. The transferential-countertransferential conditions that enable to consider the psychosexual development, in relation to trauma and adoption, within the framework of the therapeutic relationship will also be considered.

This article is about the case of a six month old baby whose parents had found more than twenty times in his bed almost agonizing and who had been reanimated each time thanks to the alarm given by a monitor. The psychotherapeutic treatment of the family, in the presence of the child lasted 32 sessions: this put an end to the respiratory and cardiac disorders and enabled a better understanding of the psychodynamics and the psychopathology of infancy.

Study of 133 children and adolescents hospitalized and operated in child and adolescent reconstructive surgery. We will study the fantasy representations of anxiety as it is expressed by this population, as well as the psychological repercussions of surgical interventions: behavior disorders, depression, anxiety. We will show that pre-adolescents and adolescents represent the most vulnerable patients in regard to the anxiety triggered by the surgical act and that some of them experience, at the time of the operation, episodes of psychic disorganization of psychotic appearance. We will look into the impact of this mutilating surgery and the weight of severe orthopedic handicaps, and have noted that the expression of anxiety isn't always in relation to the seriousness of the handicap and/or that of the intervention. The anxiety is linked to the psychological balance of the child which is largely due to the relationship he has with his parents and the feeling of self-esteem that the child has if he is accepted as he is. The surgeon seems to us like an important element in the dynamic of the way anxiety is dealt with since the patient and his parents establish a truly transferential bond to him that is of great intensity. The number of school problems, relational and behavioral difficulties and depressive reactions noted in this population shows that reconstructive surgery is very disorganizing for the personality and acts as a psychological trauma.

Through a clinical case, the authors propose a psychological approach of tagging. The phenomenon that started in Harlem's black ghettos at the end of seventies and appeared in France less than ten years after, does not seem to be a simple sociological one, but seems to take place within the psychic economy of certain adolescents as an attempt to operate the necessary identity work to become an adult. Tagging as well as wandering can be considered adolescents' acting out behaviors and show the externalization of the psychic processes, thus proving a basic insecurity in their psychic space, invaded by anaclitic depression. Graffing, on the other hand, bears a resemblance to strolling in a psychopathologic approach, and already shows an attempt to become a person, and a quest of the Other.

The French and American views of autism have often been seen as irreconcilable, the theoretical and inferential aspects of one conflicting with the empiricism and positivism of the other. Nevertheless, multiple lines of convergence tie together these two traditions, from the commitment to phenomenology embodied in the early work of Jean Itard and his American disciples, to the emphasis on developmental issues represented in French psychoanalytic approach and Kanner's reliance on Gesell's work. Several important differences remain, with an oftentimes sharp contrast between the predominantly psychogenic views in France and the predominantly neurobehavioral views in the United States. This divergence has important implications to research and services affecting individuals with autism. However, recent developments are bringing together these two viewpoints, with mutual benefits. There is a renewed commitment to cross cultural discussions, resulting in constructive reappraisal of concepts and research in both countries, and leading to the attention to important phenomena. The stimulation engendered by this dialogue is leading to new research.

This work tempts to emphasize the relation between the quality of the reception of the young child and the shared observation work done by the team. It also tries to define the psychologist's contribution.

From their clinical experience with infants of psychotic mothers who present serious parental disorders, the authors wonder about the effects of early exposure of the child to maternal psychosis. The dynamic of development, within the frame of a major disturbance of mother-infant interactions is illustrated by the therapeutic follow-through treatment of a child and his family, from birth to the age of eight. This enables to formulate several hypotheses that aim to establish connections between interactive disfunctioning and characteristics of psychic life and the child's organisation mode on short and longer term.

An evolutionary diagram that takes into account the development of personality and its structuring or restructuring was developed thanks to a better understanding of autistic disorders from a psychodynamic point of view through long term psychoanalytic treatment of autistic children. This grid is organised around the major stages of the formation of the bodily ego which autistic children helped us understand better. The construction of space and the capacities of cognitive instrumentation are logically within this line of structuring. These major stages are defined: the first is the "successful" autistic state; the second is the stage where the primary skin is recovered (feeling of a circular envelope); the third is the symbiotic phase which includes vertical splitting then horizontal splitting of the image of the body; finally, the fourth is the phase of individuation/separation into a whole body. At each stage the following are assessed: state of the image of the body, of the gaze, of language, of writing, the autistic symptoms, emotional-relational manifestations, exploration of space and objects, recognition in time, the aggressive behaviours, reactivity to pain and to immune states (somatic and psychosomatic manifestations).

This text presents, from the case study of the analytical treatment of a young girl after a very serious suicide attempt, a theoretical reflection on the question of death during adolescence and its place and function in the psyche. The hypothesis suggested is that resorting to the "idea of death" constitutes an attempt to neutralise the excitement created by the excess of representational activities. A parallel is suggested between the way death and pain are used as a protective shield.

Because of the scarcity of the research on the interruptions of treatment with adolescents and the clinical importance of suicide attempts in this population, the author studies the relation between these two variables. Using a group of nearly 300 adolescents, he statistically compares a certain number of socio-demographic and clinical factors in adolescents who have committed suicide and those who haven't. If the global frequency of treatment interruption is comparable in both groups, a further analysis of the data shows the importance of a very intensive initial treatment program for the first group. Among the other results, like previous researches, this study points out a statistically significant relation between sexual violence and suicide attempts, as well as the frequency, also statistically higher in patients who have tried to commit suicide than in others, of a psychopathological diagnostic, in particular depression.

It is suggested that there is a special correlation between the frequency of sessions in psychoanalytical treatment and the nature of the transferences which evolve and, at the same time, of the countertransference responses elicited in the therapist. This in turn has a crucial bearing on the characteristics of the psychoanalytical process which develops in the course of treatment. These interrelationships are explored with special reference to the treatment of children and adolescents. The author draws upon his experiences with high and low frequency treatments to make comparative assessments. On the basis of clinical examples from both analyses and psychotherapies, the effects of these various settings on the development and intensification of the transference are explored. Similarly, the repercussions on the countertransference are discussed. It is suggested that the density, i.e. the temporal proximity of sessions, provides the optimal conditions for the unfolding of the analytical material, the proliferation of fantasies and the emergence of transference derivatives. As for the therapist this setting provides the space that is necessary to gain the most thorough understanding of the patient's inner world, in particular his or her unconscious. Finally, the nature of the psychoanalytical process is discussed as well as the effects which different settings have on the development and quality of this process. It is suggested that different processes evolve in high frequency as against low frequency settings.

Merycism has always intrigued clinicians. A review of the recent literature reminds us of its characteristics. The auto-stimulation dimension appears important, whatever the underlying psychopathology of mericysm. The frequence of mericysm during early childhood seems to have considerably diminished, even almost disappeared. We will discuss the reasons why mericysm continues to exist in the anorexic and boulmic young adult. We will analyze the relationship of mericysm in early childhood to depression and to growth delay. The dimension of ascendency seems to help us understand this problem.

The author tries, in is own, name to translate the French position on early child autism. This position can be expressed through a few acceptable points for the majority of French professionals, obviously without any idea of a consensus. The concept of a plurifactorial determinism and the psychopathological view of the disorder which is not thought of in France as susceptible to be reduced to a handicap of a primarily cognitive nature are therefore underlined. Thus the importance of a unified multidimensional therapeutic approach that considers the different consequences of the illness without forgetting its fundamentally interactive nature ("autistic-making process"). Today, the psychoanalytic approach tends to concentrate on the analysis of secondary factors of upholding and on the significance given in the after-thought by the autistic disorders within the family group. This opens the way to a collaboration between specialists of the different disciplines that are involved, including those who work in the field of neuroscience.

The way NGO's intervene can offend "shrinks", who are attached to a slow temporality and suspicious of practices that are for the most part interventionist and that indicate the primacy of act over thought. Yet a certain number of people from our profession engage in "humanitarian activities", taken in, like others, by the effects of an illusional salvation and omnipotence. Yet when "shrinks" are aware of the context in which they intervene they can help establish alliances, create frameworks referred to a third party and seek for meaning. It is these three last points that seem to make their intervention most pertinent.

The destinies of the 11 children first reported in 1943 as suffering from autistic disturbances of affective contact are brought up to date. Their life histories are summarized succinctly in terms of developmental data, family constellations, clinical observations in the course of the years, the varieties of professional planning, and present status. Attention is called to the subsequent scientific studies of early infantile autism with ever-increasing facilities for research in nosology, biochemical and general systemic implication, and therapeutic amelioration. The need for continued follow-up studies of autistic children is emphasized.

Starting from The Freud-Klein Controversies, the author explores the historical reality of these controversies and their transformations into myth which give them the appearance of titanic fights. The verification of the different periods, the description of the variations in themes and style of intervention of the principal actors of these debates show aspects of the way a psychoanalytic institute works and of the theoretical elaboration in psychoanalysis: these appear very different from what the myth suggests. The major function of myth is, as Freud noted and Strachey reminds us, to hide very trite, even shameful realities. History and myth, theoritical effort and institutional life are all organized from and around transference, a major axis of psychoanalytic thought. When we organize our psychoanalytic lives in societies, we have the pride or the vanity of participating in a great historical movement. This goes back to the work of transference in institutional life that involves primal objects in the crudeness of their sexuality. Such is the constraining strength of transference. Being fully conscious of it, like Stratchey or Balint show us, enables to alleviate its violence and stimulate creativity.

The account of the medical and psychological treatment of Pascal over a period of three years shows the complexity and the stakes of the problem that families and the medical core are faced with when confronted to a child infected by the HIV: to talk of his infection or his illness. How do you approach the problem with an 8 year old child? What do you answer to his questions without the risk of triggering an unbearable death anxiety for him and his family? Starting with a lie, Pascal's mother will progressively realise the intrication of her own internal conflicts (that go back to her childhood) with her present suffering. She thus becomes able to look at her son's illness properly and discuss it with him in a healthy and natural manner. The question of whether to disclose his diagnosis to a child is discussed; some recommendations are suggested.

Clinicians and parents are familiar with the fact that adolescents have a special vocabulary, but very few studies have examined this. Linguists describe it as deeply metaphoric, creative and lively, thus showing that young people have a deep knowledge of language and truly experience pleasure using words. This contrasts with teachers' complaints about the little taste adolescents show for oral school activities and how poorly they express themselves. Some of them link this to the use of this polysemic and all purpose vocabulary. The context of locution is probably the explanation for these diverging opinions. Using this hypothesis, we have realised a quantitative study of the lexical variations depending on the person the adolescent is talking to in two groups (20 and 19 subjects), from very different social and educational backgrounds. Each teen-ager had to perform the same linguistic task: the description of a photograph on two occasions, once with an adult examiner and once with a friend. We studied the lexical differences between the two narratives. When adolescents are together they use their particular vocabulary four times more than when with an adult. But this qualitative difference is not a quantitative one, such as the length of the narrative or the number and repetition of whole words, and isn't correlated with the lexical stock. The use of this vocabulary runs across gender and social class categories. It can equally be found in high performance and upper class students as well as in underprivileged youngsters of technical schooling. It is the only variable that does not change between the two high schools. Thus this special vocabulary would not be connected to the subject's lexical competence, nor to gender or social background. It is the psychological function of this language that seems to be prominent.