{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T07:20:07Z","timestamp":1791012007927,"version":"4.1.0"},"reference-count":34,"publisher":"Consortium Erudit","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["smq"],"abstract":"<jats:p>S\u2019il est g\u00e9n\u00e9ralement admis que le traitement des troubles de la personnalit\u00e9 constitue une entreprise souvent parsem\u00e9e d\u2019emb\u00fbches, les connaissances sur les d\u00e9fis et obstacles de l\u2019intervention associ\u00e9s au traitement des troubles du groupe A du DSM demeurent limit\u00e9es. Le pr\u00e9sent article se propose d\u2019illustrer ces difficult\u00e9s \u00e0 partir de l\u2019\u00e9tude du suivi d\u2019un patient pr\u00e9sentant un trouble de personnalit\u00e9 schizo\u00efde, qui a b\u00e9n\u00e9fici\u00e9 pendant plus d\u2019un an d\u2019un traitement psychodynamique. Les vicissitudes de ce suivi permettront d\u2019explorer les angoisses relationnelles profondes qui peuvent compliquer le traitement de ce trouble, et comment ces angoisses doivent \u00eatre prises en consid\u00e9ration dans les interventions. Les enjeux contre-transf\u00e9rentiels puissants suscit\u00e9s par ces patients seront approfondis, en particulier ceux g\u00e9n\u00e9r\u00e9s par les silences prolong\u00e9s et la gestion constante de la distance th\u00e9rapeutique optimale. L\u2019article propose \u00e9galement une r\u00e9flexion sur les limites de la conceptualisation actuelle du trouble par les mod\u00e8les cat\u00e9goriels comme celui du DSM, et fait ressortir comment une compr\u00e9hension dynamique qui fait appel aux notions d\u2019angoisse et d\u2019ambivalence relationnelle peut enrichir le traitement.<\/jats:p>","DOI":"10.7202\/1012649ar","type":"journal-article","created":{"date-parts":[[2012,10,17]],"date-time":"2012-10-17T12:25:01Z","timestamp":1350476701000},"page":"135-155","source":"Crossref","is-referenced-by-count":2,"title":["Le cin\u00e9phile\u00a0: r\u00e9flexions sur le traitement d\u2019un trouble de personnalit\u00e9 schizo\u00efde"],"prefix":"10.7202","volume":"37","author":[{"given":"Dominick","family":"Gamache","sequence":"first","affiliation":[{"name":"Institut Universitaire en Sant\u00e9 Mentale de Qu\u00e9bec, Service de Psychologie, Centre de traitement le Faubourg Saint-Jean, 175 rue Saint-Jean, Qu\u00e9bec, Qc, G1R 1N4"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louis","family":"Diguer","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Laval, \u00c9cole de psychologie"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"4194","published-online":{"date-parts":[[2012,10,3]]},"reference":[{"key":"rb1","unstructured":"Akhtar, S., 1992, Broken Structures\u00a0: Severe Personality Disorders and Their Treatment, Jason Aronson Inc, Northvale."},{"key":"rb2","unstructured":"American Psychiatric Association, 2000, Diagnostic and Statistical Manual of Mental Disorders (4e \u00e9d., texte r\u00e9vis\u00e9), American Psychiatric Association, Washington DC."},{"key":"rb3","unstructured":"Beck, A. 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