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Using ludic video materials in psychotherapy is an innovative practice. Today, we are more familiar with the virtual world’s possibilities to shed light on the patient’s inner universe and his psychic conflicts. However, few writings are based on concrete cases or on clinical experiences based on the mediation of video games. Based on clinical examples, this paper shows how much psychotherapy could gain from using the video game as a mediation. However, it also points out the need for reflection about a video game that would be a clinical material conceived by and for practitioners.