In this article we proposes an « overview » of the major specificities of therapeutic mediation through video games with reference to psychoanalytic metapsychology and the work of the Lyons school. The authors analyze the clinical implications of this setting and its various components such as interface, avatar and Gameplay. These characteristics make the video game a special attractor of psychic life, because of the possibility for the player to be director, author, spectator and actor of the evolution of the processes that unfold before him. These elements lead us to consider the relation that immersion, as a feeling and a process of subjective adhesion to the internal reality of the video game, maintains with the perceptive-hallucinatory activity. The description of the different components and specificities of the video game set-up highlights the therapeutic potentialities implied by this type of medium, in particular thanks to the forms of transfer that it mobilizes and the modalities of transformation of the subjective experience that it makes possible.