[Psychosomatic medicine--the future of an illusion].

This paper presents the phenomenology and the development of theories about alexithymia, a "behavioral neurosis" in psychosomatic patients, with background of the american (F. Alexander, R. Grinker and P.

[HIV infection in women. Psychological and somatic obstacle].

We consider the word "impediment" in the meaning of what compels someone, makes someone feel uncomfortable. What are the consequences/implications of seropositivity for the woman in her sexual life, in her motherhood and how does she then cope with it? The following clinical observations account for the suffering induced by seropositivity and the diversity of the processes spontaneously set by HIV-infected women in their sexual life. To answer that suffering, the commonly used psychotherapeutical approach is a palliative one.

[Anaclitism, the abandonment syndrome and essential depression].

Following the recall of certain basic notions such as anaclitic depression, "abandonic syndrome" and "essential depression", the authors concentrate their interest on the clinical case of an adolescent girl both asthmatic and "abandonic"; the deprivation syndrome is discussed as a consequence of abandonment when the substitutive figure is deficient; the relationship between psychosomatic disorder and perturbations of the mother-child relationship is examined. A certain correlation between anaclitic depression in the infant and "essential depression" in adult life is suggested in the light of a re-enactment of the initial psychosomatic unit.

[Alexithymia. A new syndrome?].

The concept of alexithymia introduced by Sifneos is analyzed in relationship to its symptomatology. Its nosographic significance in the framework of character disorders is discussed. The distinction between psychosomatic manifestations and alexithymic behavior must be maintained as their causal relationship put to further questioning.

[The establishing of the therapeutic relationship with the alcoholic (author's transl)].

Due to his relationship to alcohol which has cut off all other relationship, the alcoholic patient is left alone with a double image of himself: the image of what he has become and the one of what he has been or could have been. The therapist is therefore ill - at - ease in front of this splitting, with varied reactions influenced by his own personality, by the patient's personality and by what alcohol means to both of them. Several attitudes may result from this relational difficulty: rejection and possible referral to a "specialist", symptomatic treatment or rigid, ethical, defensive attitudes.

Training and brief psychotherapies.

The authors report their experience on a workshop centered on brief psychotherapy (the STAPP model defined by Sifneos) in a postgraduate training in psychotherapy. STAPP, its extensed frame of reference and its relatively 'easy' access to study of essential paradigms, seems to constitute a priviledged tool in training psychiatrists to-be to the fundamental psychodynamics processes involved in psychotherapy. Provided the transferential and countertransferential issues are adequately met with (in individual and group supervision), it is lived very positively by trainees as such and has, moreover, a positive carry-over in so-called supportive therapies.

Alexithymia, 'pensée opéatoire' and predisposition to coronopathy. Pattern 'A' of Friedman and Rosenman.

The 'behavioral pattern A' and the 'B' pattern in selected groups of male populations in the framework of a prospective and predictive study of a large population of civil service employees is compared. The Personality Inventory of Lazare, Klerman and Armor and the auto-questionnaire of Bortner were used to differentiate the 'A' and 'B' group populations. Selected cards from Murray's TAT seem more appropriate in this respect and demonstrate the lack of efficiency of certain questionnaires in areas of psychosomatic research.

[Psychoanalytical nosography and digestive pathology (author's transl)].

The author states that aside from two major digestive psychosomatic conditions, peptic ulcer and ulcero-hemorragic colitis, one only encounters in the adult a widespread psychosomatic pathology, that is to say: 1 degree phenomena of hysterical conversion (gravidic vomiting for example); 2 degrees digestive phenomena concomitant with emotional reactions (diarrhea and anxiety, hypersecretion and anger, constipation and depression etc.); 3 degrees digestive manifestations accompanying anxiety neurosis; 4 degrees authentic functional diseases, such as the irritable colon corresponding to a well defined personality structure. The author concludes this article by some considerations of psychosomatic symptoms observed by the psychoanalyst; he specifically relates the role of the body barrier, the implication of reality and finally the very particular fantasies found in these psychosomatic patients.