[Mental Health and relationships]

After acknowledging that the diversity of cultural, historical and theoretical perspectives has given place to multiple definitions of mental health, the author circumscribes the goal of this article to reflecting on mental health from the viewpoint of human relationships in intersubjective milieux. The basic assumption that guides this paper is that the subject's psychic structure is constituted and developed in a relational matrix. Conceptualized in a relational context, the individual's mental health needs to take into account each member's developmental stage and asymmetrical position in a relationship. In the theoretical and therapeutic approach proposed here, drive renunciation, negative pacts, and intersubjective work are described as basic concepts in the analysis of relational links. Drive renunciation is defined as the operation that excludes certain drives derivatives from explicit relational interchange in order to maintain the structure and stability of the relationship. Negative pacts are defined as the configurations of reciprocal libidinal investments that give form to drive renunciation. The concept of intersubjective work places the emphasis on the interaction of the poles of the relationship, on how what one does influences the other's response. Thus, in the therapeutic context, intersubjective work accounts for each member's processes of symbolization and working through in the interchange and reciprocal impact of each member on the transformation of the relationship. Finally, the complexities around the formulation of therapeutic goals are emphasized and the occasional need of an interdisciplinary therapeutic plan is highlighted.