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This text examines the theoretical and clinical reasons that lead practitioners to set up mediation groups to meet the social demand and intrapsychic suffering of difficult patients. Drawing on her clinical experience with a group of adults using photographic images as a form of mediation, the author seeks to show the specificity and efficacy of this setting in response to psychic suffering. Although it is necessary to refer to the psychoanalytic model, and in particular to group psychoanalytic theory, the group leaders know that their practice is neither an extension nor a turning away from or deviation from psychoanalytic theory. Group settings exist in their own right, and they are adapted to contemporary pathologies. As such, they deserve to be defended and supported by practitioners themselves, in particular psychologists who have done group training, and also at a political level in response to the growing success of cognitive models on the pretext that they are easier to evaluate. The paradigm of psychoanalysis deserves to be extended to group settings with mediations.