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The canoe is made from the tree. Melanesian proverb. Based on their experience at various missions of “Doctors of the World” (Médecins du Monde), the authors offer a reflection on the psychological suffering of migrants in comparison with the conditions at the “departure” of their migration. For those whose departure is part of a project, a psychic continuity and an adaptation seem possible in spite of depressive demonstrations. But for those whose departure was a break, an uprooting, loss of landmarks and cultural and historical disagreement, this seems to be at the origin of their “difficulty (malêtre)”, going as far as the loss of their identity. Some “reconstructed subjectivities” or certain alienations to beliefs or ideologies correspond to (their) attempts to survive. The authors discuss the possible therapeutic remedies. The group appears to be the place of cultural interbreeding which allows a possible resumption of individual psychic processes.