This article proposes a synthesis on the current practice of psychoanalytical psychodrama in France and as it may be proposed in many public care institutions. Considered in its historic trajectory (and based on the references to the works of J.L. Moreno), this method of mediation is presented in its different forms (the individual psychodrama, the individual psychodrama in group and the individual psychodrama on group), their common denominator being the important part given to the improvised play which is itself based on a group dynamics which is initiated in concert by both the therapists and the patients. In this paper, particular attention will be given to the indications for this type of care, to its therapeutic effects and therefore to the psychical processes that it mobilises (notably in terms of the interconnections between the various ranges of symbolisation). Two clinical vignettes from the personal clinical practice by the authors will illustrate our purpose.