Fétichisme et phobie dans le rapport de l'adolescent à  son corps : endroit et envers d'une même symptomatologie

This study, set in the field of the psychopathology of the adolescent, deals with the relation of continuity that exists between the phobic relationship and the fetishistic relationship that the adolescent experiences in regard to his or her body. It appears that these two different ways of relating to the body often share many of the same symptoms, such as dysmorphophobia, mutism, erythrophobia, eating disorders and so on. The first part of the text is concerned with the phenomenon of the “fetichization” of phobic symptoms. This process is described, showing its three subsequent clinical signs: the disappearance of complaints, the exclusion of the phobia-provoking object from the associative chain and the presence of the phobia-provoking object in the object relation. The second part attempts to extract the value of this particular clinical experience with regard to the continuity of the structural relationship that exists between the phobia-provoking object and the fetish in general psychopathology. We make, in line with the topographical, economic and dynamic points of view, the meta-psychological hypothesis according to which the structure of the phobic symptom would be the reverse side of the structure of the fetishistic syndrome. From the topographical point of view, this specular relationship can be explained in the following way: the perverse ego is to a large extent split, except in the region of the fetish, whereas the neurotic ego, on the contrary, is largely integrated, except in the region of the phobia-provoking object. Finally we study the phenomenon of the “phobogenization” of the fetishistic syndrome. We describe, amongst other things, some of the therapeutic difficulties that can be correlated to this phenomenon. The aim of this study is to bring to the fore those theoretical and clinical elements that facilitate a differential and above all progressive diagnosis of the phobic and fetishistic manifestations which appear in the adolescent's relationship to his or her body. Beyond the diagnostic aspect, the goal is to fine-tune treatment of this patient group.