The therapeutic management of a teenage girl, in whose case history body attacks, either in the form of somatization or acting out/auto aggression, made it possible to understand better the morbid practices of auto-mutilation beyond the classical forms of attacking (at the moment of puberty) the body baring the genital sexuality. Attacking the body (either internally or on the surface) shows the dysfunction of the psychical movement, which goes hand in hand with a pathological Ego-skin in two ways : the first, multi pores showing the defect of pare excitation; the second, the protective shell trying to « keep everything in » when faced with the anxiety of emptiness, leading to self-poisoning. Using a topographical model, the skin wounds are to be considered in their explosive dimension to change the self, like true « psychical air vents » for the psyche threatened with asphyxiation. Paradoxically, these wounds open up a detoxifying movement of projection taking phobic or persecutory forms necessary to build up a « withholding » front, able to welcome the pubertal Eros detoxified of its « impulsion madness ».

Adolescence, 2008, T. 26, n°3, pp. 681-695.