Interventions involving the skin are attempts to redraw the boundaries between inside and outside; they act as a tool for getting through the delicate passage to manhood or womanhood. Hairstyle, skin (make-up, tattoos, piercings, cosmetic surgery) and clothes – every youngster is over-informed about possible looks and how other people will receive them. Such attempts to control one’s self-image or to alter it (through scarification, for example) express the adolescent’s wish to escape from an intolerable identity.
Adolescence, 2016, 34, 3, 489-498.
The psychosomatic approach is something like the dancer’s split, stretching out to join, on the one hand, the medical approach, whose very foundation is the isolation and objectification of the symptom, and on the other hand, the subject, with his history, his fears and his sometimes complex demands. Using several clinical observations, we will try to show some particularities of this treatment in the adolescent.
Like an image in a dream, the tattoo is above all the graphic expression of the subject’s psychical production. Voluntary tattooing become a language act half-way between a writing that is close to hieroglyphics, with its symbolisms, and spoken discourse. A substituting representation, the image inscribed on the skin acquires value as an ersatz of the subject’s inner world, not necessarily metaphorized. Drive excitation is in search of representations. When these are lacking, the inscription of an image on the skin can have the status of a substitute function. Half-way between psychical representation and the external object, in an in-between neither completely outside nor completely inside. For Nicolas, his tattoo, like the shield of Perseus, reflected back the gaze of an other who could remind him of the difference of the sexes, and thus he felt protected from his fear of remaining petrified by his own projected castration anxiety. This was a meta-psychological function for fencing off the representational void he feared he would be sucked into, and for keeping his bodily ego from falling into it at the same time, reinforcing his shaky system of repression.