Traumatisme fantasme et mémoire dans la pathogenèse des problématiques sexuelles

The aim of this article is to highlight a change in the way in which sexual disorders and their etiology are treated, seen by the author as a step backwards. In the past few decades, directly traumatic pathogeneses are increasingly often suspected and diagnosed, flying in the face of the findings of psychoanalysis, where Freud abandoned his first seduction theory. The article is based on 10 years of clinical experience in an urban practice, with 48 patients, mainly women, suffering from sexual disorders. It is based on findings in the field of neurosciences concerning the reliability of memory, already understood by Freud as capricious, and the analysis of certain intersubjective reactions within the therapeutic relationship. Taking a few simple clinical cases, the author aims to draw attention to potential pitfalls: neglecting the importance of subconscious fantasy, fostering the creation of fake memories, stopping on a screen-memory, underestimating the role of the subconscious, not only the patient's subconscious, but also the therapist's. Although, with Ferenczi, the seriousness of real sexual abuse cannot be denied, there is still room for much more complex aetiologies. Some methods that are very fashionable today with the public, such as hypnosis or more recently EMDR, can be popular with patients, seeing them as therapies to reveal forgotten or repressed trauma, whilst sitting back and waiting for a spontaneous recovery as if by magic. These fake solutions, although appealing because they look so easy, are dangerous, since they run the major risk of locking the patient into a never-ending quest for an omnipotent therapist or therapy.