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This article presents theories of play, envisaged as a means of treatment, with reference to the writings of Melanie Klein and D.W. Winnicott. Taking these elements as a starting point, the author discusses the particularities of video gaming, and particularly the possibilities of “fictional immersion” (Picard and Arsenault) at work, mobilized by identifications with the avatar and regressions linked to the sensoriality of the videogame support. The case of Victor, aged 7, will illustrate the use of video gaming in psychotherapy and the transference/countertransference issues mobilized in the sessions. The quality of the patient/clinician relationship, which is woven through the sharing of videogaming, fosters imaginary narratives which make it possible to gain access to the child’s family problems and to his abandonment anxieties. The author argues that video gaming has an important role to play as a support for projection and mediation.