[Psychoanalytic study at a pediatric oncology department].

The place of a psychoanalyst in a Paediatric Oncology Department is described. Unfortunately mutual ignorance, mistrust and fear continue to be obstacles to the integration of psychoanalysts in medical teams. The conditions required for the work of the psychoanalyst to be possible are underlined: he must be fully integrated into the team and should have sufficient time to devote to his work. Parents should have unhindered access to the unit. Pain must be recognized and treated. It is important that the members of the staff are aware of and sensitive to the different aspects of his work (a Balint type of group might help to achieve this objective). The analyst will intervene when he has pinpointed psychic distress in the child; he will sometimes have to search for it in the parents, among siblings, and even among the medical and non medical members of the staff, where it is discrete or even concealed. All staff members should be sensitive to this distress and anguish, because each and every one of them could be chosen by the child to bear witness to the problem or to discuss it with him/her. The members of the staff should be trained to be sensitive to this distress so that they can direct the child towards the psychoanalyst soon enough. The psychoanalyst should adapt his techniques so that they are in keeping with hospital conditions. His work is not conventional psychoanalytical treatment nor wild, haphazard interpretations but rather psychoanalytical meetings which are often intense, brief and rare. Five case reports illustrate these different aspects.