[Psychological management in critical care units. History of a long way]

Some concepts of the General Systems Theory issued from the Social Sciences are used by Liaison psychiatrist and psychologist in the Intensive Care Unit. Human system, interaction process and circular causality, all concepts from the Systemic approach, are useful in order to describe and analyse both vital and existential crisis situation of the patient. As an expansion of the therapeutic context, the relationship among the patient, the family and the medical team are defined in terms of a partnership instead of a power conflict. Then, attention is focused on the distress resulting from these stressful situations, influenced by the "pangs of death". Emphasizing the importance and the role of anxiety allows to recognize a place for it and to offer to everybody an opportunity to talk about it. Finally, the psychotherapeutic function can be defined as the creation of a place given to the person as a Subject, based on the recognition of the fundamental misunderstanding of human illness.