There are differences today amongst psychoanalysts regarding if psychoanalysis should limit itself to being exclusively a hermeneutic discipline or if psychoanalysis should find points of contact with neurobiology. The purpose of this essay is to touch upon the larger issue that creates the different points of view: Can psychoanalysis become enriched by finding points of contact with neurobiology, and should psychoanalysis be regarded as belonging to a broader scientific field than being exclusively a human science? The question at issue is: Can modern neurobiology contribute to a development of the psychoanalytic concepts; compulsion to repeat, transference/countertransference and talking cure? The method used is a literature study. The result shows that: Freud’s theories regarding traumatic compulsion to repeat can be linked with LeDoux’s theory of "emotional memory". Freud’s theory of the death instinct as an explanation to the compulsion to repeat can be replaced by a modern neurobiological theory of "emotional memory". The part of the countertransference that is an emotion transferred from the patient to the analyst can happen with the assistance of mirror neurons through "embodied simulation". This suggests that the phenomenon of the analyst being able to experience the patients emotion in himself does not have to imply that projection or intersubjective pressure have played a part in it. To be able to include this phenomenon in the concepts of transference and countertransference these need to be broadened or revised. It is possible to link and develop Freud’s theory of the talking cure with Deacon’s theory about symbolic communication. The results clinical implications are: Understanding of the traumatic compulsion to repeat as an expression of "emotional memory" demands work with this as an expression of memory processes. Understanding of the transference of emotion in transference/countertransference as possible through reflexive simulation processes, implies that projection or interpersonal pressure should not be preconceived in an emotion transference situation. It also implies that the emotional activation in the analyst should not by necessity be seen as an activation of the analyst’s internal objects together with emotions towards these. Deacon’s theory of symbolic communication implies that the talking cure should be used with awareness of its negative tendencies, visual thinking should not necessarily be considered non-symbolic and focus should be put on multiple ways of communication in the clinical situation.

La prescription médicamenteuse est l’un des principaux outils thérapeutiques utilisé par le médecin. Si la médecine somatique décline sa clinique selon l’enchaînement symptômes- diagnostic-traitement, la psychiatrie se démarque d’une telle linéarité. En effet, bien qu’elle se soit calquée sur le modèle médical depuis la découverte des psychotropes en 1952, elle relève d’une clinique spécifique : en psychiatrie, d’une part le symptôme constitue une adresse à l’Autre, il contient donc une dimension relationnelle essentielle, d’autre part, le soin psychique implique une participation active du sujet, toute thérapie étant aussi auto-thérapie. La neuropharmacologie, en plein essor depuis 1952, propose un schéma thérapeutique se voulant plus scientifique car de plus en plus éloigné de la psychopathologie clinique. Le psychiatre est alors convoqué en tant que technicien de la prescription de psychotropes, le médicament se suffisant à lui-même d’un point de vue thérapeutique. Face à une telle évolution de la psychiatrie, comment préserver un abord clinique ?Notre pratique esquisse la possibilité de dégager l’acte de prescrire d’une technicité exclusive. En effet, sous certaines conditions, la prescription de psychotropes constitue un acte psychothérapeutique à part entière. Pour cheminer dans notre réflexion, nous sommes passés par le paradigme du pharmakon afin de complexifier la question du prescrire. La clinique suggère une possible alliance entre parole et médicament. Prescrire dans la parole, au-delà de la molécule, consiste à qualifier la substance par la parole, de façon à ce qu’elle devienne un médicament spécifique de la rencontre clinique. La molécule, guidée par la magie des mots, sera plus efficace. L’acte de prescrire se conçoit donc comme une création à deux, à réinventer à chaque nouvelle rencontre, le moment de la prescription relevant d’un cheminement intime du côté du clinicien. Ainsi, loin de s’exclure mutuellement, psychothérapie analytique et pharmacothérapie ont tout intérêt à croiser leurs regards sur la question du prescrire. Penser conjointement effet pharmacologique et relation clinique permet au clinicien de s’engager dans une authentique rencontre humaine avec le patient. La psychopathologie s’ouvrira, peut-être, sur de nouvelles perspectives thérapeutiques. / Prescribing medication is one of the main therapeutic tools used by physicians. If somatic medicine clinically acts according to a 'symptom-diagnosis-treatment' model, psychiatry does not follow this linear pathway. Although it has copied the medical model since the discoveryof psychoactive drugs in 1952, it possesses a specific clinical approach. First of all, in psychiatric care, the symptom is an address to the Other, it contains an essential social dimension. Moreover, it implies the subject's active participation, each therapy also being a self-therapy. Neuropharmacology, in full expansion since 1952, has taken a therapeutic scheme aiming at more scientificity by moving away from clinical psychopathology. Hence psychiatrists are seen as technicians of psychoactive drugs prescription, drugs being considered as self sufficient therapeuticaly. With regard to this evolution in psychiatric care, how can a clinical approach be maintained ? In practice, the act of prescribing can free itself from being exclusively technical. Prescribing psychoactive drugs can indeed, under certain conditions, be a true psychotherapeutic act. To guide us through this reflection, we used the pharmakon paradigm to make the issue of prescribing more complex. Clinical practice suggests a possible alliance between patients'words and medication. Beyond molecular action, prescribing through talking qualifies the substance by words, so it becomes a clinical-interaction-specific drug. The molecule, guided by the magic of words, will be more efficient. The act of prescribing is thus conceived as a creation made possible by two people, that must be reinvented at each encounter. The moment for prescribing is rather the fruit of the clinician intimate decision process. Thus, far from excluding each other, analytical therapy and pharmacotherapy would gain much from sharing their views on the issue of prescribing. Integrating both the pharmacological effect and the clinical interaction would allow clinicians to engage in an authentic human encounter with patients. Psychopathology may then open up to new therapeutic perspectives.