Enjeux et perspectives psychopathologiques de la phobie scolaire

Abstract

BackgroundIn our modern society, the number of teenagers and adolescents refusing to go to school is regularly increasing. These difficulties are a common reason for medical consultation. Indeed, school requirements which often interfere with puberty and with adolescent processes can be a source of important psychological conflicts. Despite the intellectual abilities of these young people, these situations of anxious refusal are often incomprehensible for professors and parents alike. MethodsBuilding on an extensive review of historical and clinical literature, the authors recall the interest enjoyed by the generic term “school phobia”. Object of a considerable number of reports and studies in psychiatry and psychopathology, distinguished from other forms of phobias or educational problems (truancy, learning refusal), school phobia was defended by the psychodynamic orientation of European psychiatry. This notion knows nowadays some disaffection. More recently, the promotion of school refusal is currently the peak of the psychologizing of youth and adolescent experiences in school. With undeniable political and economic issues, “school refusal” is expected as an ideological attractor in the field of health. ResultsThe article shows the importance of school phobia at the crossroads of mental pathology. When school refusal includes the most diverse school issues (defection, addiction, avoidance, self-sabotage) and mask the clinical characteristics of these behaviors, school phobia has historically allowed for essential clinical discussions on anxiety, depression and secondly to distinguish phobic symptoms of classic style and those belonging to very diverse defensive formulas (borderline, psychosis). DiscussionsFor many children and adolescents, school phobia is part of a very emergency symptomatology. This subjective solution is certainly very precarious. It may however be the support of a major “work on oneself.” beyond contemporary syndromic categories, the authors point the importance of active listening. The multidisciplinary care of the adolescent must pay significant attention to the dynamics of the family psychic economy.