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Today, psychiatric therapy is divided between pharmacological and psychotherapeutic approaches. This paper examines psychiatric therapy from the psychoanalytic perspective. Psychopharmacology is linked to the notion of drive and to economic concepts (free and bound energy, displacement, secondary process, narcissistic and object investment) used in Freudian metapsychology. Psychotherapies are linked to the notion of object relations and its vicissitudes (repetition and renewal) and are approached via a theorization of all interhuman encounters with a therapeutic aim. The quality of somato-psychic states is thereby designated in terms of object relations under the auspices of the pleasure principle.