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L’évolution psychiatrique 83 (2018) e13–e26

Original Article
Formations de l’idéal, Hikikomori, et réalité virtuelle à
l’adolescence夽
Formations de l’idéal, de l’hikikomori et de la réalité virtuelle pendant
l’adolescence
DR Manuella De Luca (Psychiatrist, Hospital Practioner, Head of the
Department of Adolescent and Young Adult Psychiatry Psychopathology,
Associate Profesor, Director of Research) a,b,c,∗ , Pierre Chenivesse
(Psychiatrist) c
a Institut MGEN, 78320 Le-Mesnil-Saint-Denis, France
b PCPP EA lab, université de Pairs Descartes Sorbonne Paris cité, institut de psychologie Henri-Pieron, 40–56,
boulevard E. Vaillant, 92100 Boulogne-Billancourt, France
c CS 90572, institut Marcel-Rivière, avenue de Montfort, 78322 Le-Mesnil-Saint-Denis cedex, France

Abstract
Goals. – Withdrawal behaviors in adolescents are becoming increasingly prevalent, both in clinical practice
and in the specialist literature. First described in 1980s Japan as hikikomori, these behaviors are now found
across international nosographies and in a variety of structural models. They are not always accompanied by
intensive video gaming. Adolescents’ use of digital technologies is quantitatively and qualitatively varied.
It can be situated in a particular mobilization of ideal-formations at the intersection of the virtual and the
illusory. It can also be a step towards a renewal with social relationships, in that it allows for a less threatening
confrontation with the object.
Method. – Using the clinical example of a 15-year-old secluded in his home for 18 months, we will explore the
interactions between withdrawal behaviors and the use of digital technologies from the perspective of ideal-
formation. We will examine how the formations of the ideal intertwine with the processes of identification
and with the subject’s ability to process loss.
Results. – In Japan, a cultural and sociological explanation of hikikomori is preferred, and the reference
to psychiatry is excluded. Withdrawal behaviors can be understood within a particular form of culture, or

夽 Any reference to this article must mention: De Luca M. Formations of the ideal, hikikomori, and virtual reality during

adolescence. Evol psychiatr 2018: 83 (3): pages (for the paper version) or URL [date of visit] (for the online version).
∗ Corresponding author at: CS 90572, institut Marcel-Rivière, avenue de Montfort, 78322 Le-Mesnil-Saint-Denis cedex,

France.
E-mail address: mdeluca@mgen.fr (M. De Luca).

https://doi.org/10.1016/j.evopsy.2018.04.003
0014-3855/© 2018 Elsevier Masson SAS. All rights reserved.
e14 M. De Luca, P. Chenivesse / L’évolution psychiatrique 83 (2018) e13–e26

rather a counterculture: an idiomatic or singular form of adolescent suffering that uses virtual reality as a
specific mode of relating to others and to the world. The ideal, like adolescence itself, is characterized by its
incompleteness. Paradoxically, this notion also contains both a confrontation with the subject’s inadequacy
and the possibilities for remedying this inadequacy. Virtual reality can thus enable the subject to fight against
the consequences of the losses that define the process of adolescence.
Discussion. – Withdrawal behaviors appear in a variety of psychical constellations, especially since they
tend to begin in adolescence or in early adulthood. The use of digital technologies makes it possible to
stop the passage of time and to limit the impact of pubertal transformations and of the confrontation with
sexuality. Maxime’s investments in the ideal and in the virtual play out on a continuum between toxicity
and creativity. Toxicity can be seen in the stagnation of the adolescent process and the preservation of a
narcissistic omnipotence via an ideal ego.
Conclusion. – Not all housebound adolescents use digital technologies intensively; and the digital can also
contain a restorative dimension at this age. For the most vulnerable teenagers, video games enable narcissistic
reinforcement, less threatening object relationships, and a less painful handling of loss. Together, virtual
reality and the formations of the ideal can help “restart” a stalled adolescent process.
© 2018 Elsevier Masson SAS. All rights reserved.

Keywords: Ideal; Hikikomori; Virtual reality; Video game; Adolescence

Résumé
Objectif. – Les conduites de retrait chez les adolescents ont pris une place croissante dans la clinique et la
littérature spécialisée. Décrites au Japon dans les années 80 sous le nom de Hikikomori, elles traversent la
nosographie internationale en sollicitant plusieurs modèles. Ces conduites de retrait ne s’accompagnent pas
nécessairement d’une pratique intensive des jeux vidéo. L’usage du numérique par ces adolescents est pluriel
quantitativement et qualitativement. Il peut s’inscrire dans une mobilisation toute particulière des formations
de l’idéal aux frontières du virtuel et de l’illusion, il peut être une étape vers la reprise de relations sociales
en ce qu’il permet une confrontation objectale moins menaçante.
Méthode. – À partir d’un cas clinique, d’un adolescent de 15 ans reclus au domicile pendant 18 mois, nous
explorerons les interactions entre conduites de retrait et pratique numérique à travers les enjeux de formation
d’idéal dans leurs intrications aux processus identificatoires et au traitement de la perte.
Résultat. – Au Japon, une approche culturelle ou sociologique du Hikikomori est privilégiée, excluant toute
référence à la psychiatrie. Le retrait peut s’inscrire dans une forme de culture, ou plutôt de contre-culture
spécifiquement adolescente, un idiome c’est-à-dire une forme particulière de la souffrance adolescente qui
utilise le virtuel comme modalité particulière de relations aux autres et au monde. L’Idéal est une notion
caractérisée comme l’est l’adolescence par son inachèvement. Elle est aussi paradoxale dans un double
mouvement de confrontation à l’insuffisance et aux potentialités pour y remédier. La réalité virtuelle peut
ainsi permettre de lutter contre les effets des pertes inscrites dans le processus adolescent.
Discussion. – Les conduites de retrait se déploient dans des constellations psychiques variées ce d’autant
plus qu’elles débutent à l’adolescence ou à l’entrée dans l’âge adulte. Le recours au numérique permet de
figer l’écoulement du temps et de limiter l’impact des transformations pubertaires et la confrontation à la
sexualité. L’investissement de l’idéal et du virtuel se déploie chez Maxime dans un continuum entre toxicité
et créativité. Toxicité d’abord dans l’arrêt du processus adolescent qu’ils soutiennent et le maintien d’une
toute puissance narcissique portée par le moi idéal.
Conclusion. – Les adolescents reclus au domicile n’ont pas tous une pratique intensive du numérique qui
peut revêtir une dimension trophique à cet âge. Les jeux vidéo permettent un renforcement narcissique, des
relations objectales moins menaçantes et une confrontation à la perte moins douloureuse pour les adolescents
les plus fragiles. Le virtuel et les formations de l’idéal peuvent s’unir au service d’une reprise du processus
adolescent.
 M. De Luca, P. Chenivesse / L’évolution psychiatrique 83 (2018) e13–e26 e15

© 2018 Elsevier Masson SAS. Tous droits réservés.

Mots clés : Idéal ; Hikikomori ; Virtualité ; Jeu video ; Adolescence

Withdrawal behaviors in adolescents are becoming increasingly prevalent, both in clinical

practice and in the specialist literature. First described in 1980s Japan as hikikomori [1], these
behaviors have since crossed over international nosographical boundaries and call upon multiple
structural models: neurosis, for the Anglo-Saxons and their “housebound syndrome” [2], and
psychosis for the French and their “seclusion syndrome” [3]. Because of the variety and instability
of psychopathological expression during adolescence, any attempt to make use of overly static
and overly defined nosographical categories is bound to come up short. Instead, the wide range of
adolescent clinical expressivity encourages us to consider these behaviors as symptomatic, that
is, as the expression of a conflict in search of a resolution. The stakes involving both narcissistic
and object investments, as well as the instinctual reshuffling that takes place during adolescence,
infiltrate the adolescent subject’s capacities to construct an identity, to process loss, and to take
on the formations of the ideal1 . When all goes well, the passage through adolescence and the
process of becoming an adult lead to the installation of a mature superego and to a more measured
reckoning with the demands of reality. However, the narcissistic fragility of some adolescents
complicates this transformational process, leading to a standoff with their own internal conflicts as
well as with parental and societal expectations. Eschewing the depressive or delirious solution, the
subject “chooses” to withdraw, thus limiting both external and internal stimuli. These withdrawal
behaviors are not necessarily accompanied by an intensive use of video games. Adolescents’ use
of digital technologies is quantitatively and qualitatively varied. It can be situated in a particular
mobilization of ideal-formations at the intersection of the virtual and the illusory. It can also
be a step towards a renewal with social relationships, in that it allows for a less threatening
confrontation with the object. Using a clinical example, this paper will explore the interactions
between withdrawal behaviors and the use of digital technologies through the lens of the stakes
of ideal-formation in their imbrications with the processes of identification and with the subject’s
ability to process loss.

1. Withdrawal behaviors and video games: borders at stake

Withdrawal behaviors can appear in a variety of psychical constellations, especially since they
tend to begin in adolescence or in early adulthood [4]. They are especially prevalent in boys,
giving their adolescence a “negative” color, and this rather paradoxically, in comparison with the
classic vision of adolescence as a tempestuous time punctuated by acting out, drug use, running
away, violence, and other dramatic manifestations. Here, acting out expresses itself implicitly,
in the adolescent’s refusal to interact with others and with the outside world, and in a voluntary
seclusion in his bedroom. In an article from 1954, Gayral [3] gives a detailed description of the
forms of what he calls “seclusion syndrome,” favoring a nosographical approach. This syndrome
is situated at the borders of the major nosographical entities: of psychosis, as can be expected,

1 Freud introduces this expression in “On Narcissism.” It underscores the ways in which the ego ideal is less an agency

than an unfinished process, as well as the ways in which this ego-ideal-in-formation is mobilized during adolescence.
e16 M. De Luca, P. Chenivesse / L’évolution psychiatrique 83 (2018) e13–e26

where the passive withdrawal of the negative forms of schizophrenia is contrasted with the active
and virulent withdrawal of the paranoid psychoses–but also of neurosis, whether in its hysterical,
obsessive, anxious, or phobic forms. The English-language literature favors the phobic form of
withdrawal or seclusion behaviors, in its description of “housebound syndrome” whose specificity
is that it solely concerns girls caught up in the throes of a painful resolution of the Oedipus complex
[5].
For these authors, the psychopathological approach is highlighted, because of the variable
places occupied by withdrawal behaviors in these subjects’ psychical functioning. While mak-
ing reference to the Freudian proposition of a continuum between normal and pathological, this
approach also promotes the idea of process, as G. Lantéri-Laura points out [6]. This process-
centered approach seems to fit with the contemporary understanding of adolescence and with
the current ways in which suffering expresses itself at this age, particularly through housebound
behaviors. However, an exclusively nosographical approach to withdrawal behaviors is not unan-
imously accepted, notably in Japan, where the majority of studies that identified these behaviors
(under the name of hikikomori) in the 80s favored a cultural or sociological approach, excluding
any reference to psychiatry. In France, as well, the cultural stakes of these behaviors are high-
lighted, with withdrawal understood as belonging to a form of specifically adolescent culture, or
counter-culture. J.-P. Benoît questions the nature of withdrawal behaviors by proposing a con-
tinuum between symptom and posture, between manifest and latent, mapping out the obstacles
of the passage through adolescence: “between a psychiatric diagnosis and a social posture, with-
drawal behaviors could be considered an extreme developmental manifestation of the transition
to adulthood, an acute crisis in the adolescent process, within diverse psychopathological struc-
tures” [7]. Certain hikikomori specialists, such as A. Téo [8], suggested the creation of a culturally
specific syndrome for the fifth edition of the DSM; but this proposition was refused in light of the
presence of similar cases outside of Japan: first in the sultanate of Oman or in Spain, and then in
a multitude of countries. The hikikomori was integrated into another “cultural” category, that of
a specific idiom of adolescent suffering [9].
Several axes can help us understand the psychical stakes mobilized by the entry into adulthood.
Instead of engaging with the object, the subject goes into a kind of libidinal hibernation, which
manifests itself in his or her seclusion. Apparently, the equilibrium between narcissistic and
object investments shifts in favor of preserving the former. The subject’s ability to harness the large
quantities of excitation mobilized by puberty, as well as the ability to organize this excitation under
the stage of genital primacy, hit a snag: inhibition and passivity become the preferred solutions.
This mobilization of a negative or implicit register is underscored by certain authors who describe
these behaviors as “a negative preference” [10], in reference to H. Melville’s character Bartleby and
his enigmatic formulation “I would prefer not to” [11]. During adolescence, withdrawal behaviors
could be seen as a particular step towards adulthood, an attempt to create new rites of passage, or
a way out of childhood’s temporality: “withdrawal would be a practice ‘of open negativity’ that
opens onto a nameless future” ([10], p. 600). One could also articulate this proposition with A.
Green’s reflections on the work of the negative [12] mobilized in the subject’s confrontation with
the excess of the drives: a particular form of psychical work that transforms the primary process
or banishes it from the psyche–and one that is especially made use of during adolescence.
Inhibition is at the heart of the hikikomori process: inhibition of social relationships, of motor
functions, of investment in the world of school or in the future. In the clinical descriptions,
sexuality is absent or glossed over, as are romantic relationships, which are either barely invested
in or simply absent from the descriptions in the literature and from the patients’ stories. The
reliving of the Oedipus complex has only a minimal place in their fantasy lives, which are more
 M. De Luca, P. Chenivesse / L’évolution psychiatrique 83 (2018) e13–e26 e17

rooted in the originary register, suggesting a petrification of the adolescent process, in which
fantasies of self-conception [13] or a return to the maternal womb are the most present. This
second fantasy can function as a protective shield, in the subject’s attempt to master, rather than
submit to, the passage of time–or it can take on a more deleterious or melancholic aspect in
the subject’s attempt to stop the passage of time during the traumatic experience of the bodily
transformations of puberty [14].
Current studies attempt to specify the stakes of withdrawal behaviors in the transition from
adolescence to adulthood. M. Fansten and C. Figueiredo [15] suggest a definition of the archetypes
that undergird a categorization of these behaviors. In order to do so, they take into account
the interconnections between withdrawal behaviors, digital practices, the functional modalities
of the family constellation, and access to healthcare. This leads them to define three forms of
withdrawal: a “reactional withdrawal,” a sort of symptom in response to an outside conflict
usually related to the family; a “chrysalis withdrawal,” a sort of self-cocooning that interrupts
the process of becoming an adult; and an “alternative withdrawal,” a particular expression of
the passage through adolescence. This third category recalls the hikikomori proposition as an
idiomatic form of adolescent suffering.
The use of digital technology and especially video games in withdrawal behaviors is neither
unequivocal nor systematic. Studies on housebound or secluded adolescents and young adults
show variations in their use of digital technologies. In Japan, hikikomori belong neither to the
category of professionally unstable young adults–who accumulate short-term contracts or part-
time jobs that they change often, which goes against the Japanese tradition of fidelity to one’s
employer–, nor to the category of NEETs (Not in Education, Employment, or Training) [16].
However, these three sociologically constituted subgroups are integrated into a larger category
of youth whose behavior transgresses Japanese cultural norms. The computer- and video game-
obsessed geeks are not included in this transgressive category but instead are grouped with the “no
lifes” [17], adolescents who are absorbed by a massive and single-minded use of video games.
Any other quotidian or relational activity is put aside in favor of these subjects’ investment in a
new, virtual reality. In this way, withdrawal behaviors and the use of digital technology do not
necessarily overlap, even if withdrawal can be paired with a certain use of the digital.
An exploratory study [18] of housebound French youth underscores the diverse modalities
of their use of digital technology. Digital technology can be used as a source of entertainment;
or as an educational support, allowing subjects to continue or take up studies; or as a means
of socialization, allowing for mediated, less threatening encounters with others. Only one youth
in the study had withdrawn because of his intensive use of video games; the other housebound
adolescents use digital technologies to access information and to stay “connected” with the outside
world. As the author of the study points out, digital interfaces allow for a reversal of the movement
between interior and exterior, since the outside world can be accessed without leaving one’s home
or one’s bedroom. The consequences of withdrawal behaviors, of the disconnection with the
outside world and with others, are thus moderated by the use of the Internet, which becomes a
place to meet others–even to meet romantic partners, as the case studies show. The intermediary
and mediating dimensions appear to be particularly mobilized in these subjects’ use of digital
technology, whose virtual, potential aspect also seems to be at work. The author also advances
the hypothesis of a specific adolescent digital counterculture, which she distinguishes from the
relational uses of these technologies favored by adults.
S. Tisseron’s studies of the virtual as a tendency-to-an-activity focus on its links with different
modes of representation: the virtual, the imaginary, and the perceptive. He puts forwards the
hypothesis of an obstacle, in hikikomori behaviors, to the psychical treatment of the gap between
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the representation created in the anticipation of action and the representation obtained by the
confrontation with the experience. As if it were necessary, in the words of S. Tisseron and V.
Tordo, “to break the chain between anticipatory representations and the sensory perception of the
real” [19]. The adolescent subject experiences the overwhelming physical changes of puberty,
which modify the relationship to one’s body and to one’s surroundings, in a position of extreme
passivity. The gap between adolescent, parental, and societal ideals on the one hand, and, on
the other hand, the adolescent subject’s ability to attain them, only increases the anxiety about
loss and powerlessness. For S. Tisseron, following upon his conception of the virtual, hikikomori
behavior represents “a psychical, followed by a social, coming-undone” [20].

2. Ideal-formation and withdrawal behaviors

The formations of the ideal are the subject of debates about the necessary distinction between
the ideal ego–a product of primary narcissism–and the ego ideal–the measurement and the project
of perfection–, as well as debates about the link between ideal and superego, ideal and idealization,
ideal and sublimation. In his study of Freud’s writings on the ideal, P.-L. Assoun [21] suggests
that the installation of ideal-formations is a process that cannot be reduced to a developmentalist
passing-through of different steps (beginning with the baby and its ideal ego, the product of
primary narcissism, and leading to the adult superego and ego ideal), but rather is engaged, in the
heart of the unconscious, as a motor of repression. As Freud writes, “for the ego the formation of
an ideal would be the conditioning factor of repression” [22]. Most authors agree that adolescence
is the moment in which the process that allows for the transformation of the ego ideal and the
arrival of the mature superego is resumed. Adolescence–notably because of the reactivation of
the Oedipus complex and the subject’s efforts to repress it, and because of the stress placed on his
or her narcissism by the transformations of puberty–requires a redistribution of the formations of
the ideal. The mobilization of ideal-formations at stake in withdrawal behaviors–ideal-formations
that play the role of mediator between narcissism and object love, between the internal and the
external, and between restorative and toxic, in addition to their interactions with the different
modalities of identification and the treatment of loss–seem more strongly at work here than they
do in the case of “ordinary” adolescents. As D. Scarfone points out, “the appearance of the ideal-
formation marks out the installation [. . .] of a narcissistic circuit, regime, or field [. . .], stretched
between two poles, one of which represents openness to the outside world. [. . .] The ego ideal is
the pole of narcissistic withdrawal that responds immediately and magically to the commands of
the all-powerful ideal-formations (the ideal ego)”[23]. In this way, the narcissism that infiltrates
the ideal would have either a protective, revitalizing function, or a more negative valence of object
avoidance. These two aspects can also manifest themselves in withdrawal behaviors.
The transition to adulthood includes a confrontation–often difficult, sometimes painful–with
loss: the loss of childhood omnipotence, the loss of all-powerful parental figures, the loss of a
bisexuality which allowed the subject to put off his or her painful reckoning with castration, and
the loss of a “someday,” the promise of consolation held out to the subject’s narcissism wounded
by the disparity between its current capacities and the demands of the reality of the outside world.
The formations of the ideal and the processes of identification are both called upon to process
loss: for the former, through idealization, and, for the latter, through the introjection of the object’s
idealized characteristics–which introjection grants the subject the impression that the object is
not irrevocably lost. Idealization is enlisted to serve denial, notably the denial of the sexual, in
its libidinal and aggressive components. For D. Bourdin, “idealization has a tendency to mask
and to prevent loss at any price” [24], even if this means turning the object, in the subject’s
 M. De Luca, P. Chenivesse / L’évolution psychiatrique 83 (2018) e13–e26 e19

fantasy, into an idol to be worshipped and to whom the subject must remain faithful. The fact
that ideal-formation is a process creates a tension between idealization and de-idealization, and
explains the oscillations between these two polarities. For those adolescents confronted with the
greatest difficulties, the fixation on parental imagoes, in light of the reactivation of the Oedipal
fantasy, limits their possibilities of de-idealization. The idealized parental imagoes of childhood
are kept in place, to the detriment of a readjustment of the parental figures in light of the subject’s
confrontation with reality. “The process of de-idealization, and the ability to renounce and rework
omnipotence and the absolutization of ideals, are just as important as idealization itself.” ([24],
p. 44). For the subject confronted with the loss of his or her omnipotent parental figures, this
disappointment can be neither repressed nor integrated. This disappointment, then, is transformed
into destructiveness. Only by desperately hanging on to their portion of the ideal–which comes
at the cost of the desexualization of the child/parent bond–can the subject avoid his or her own
destructivity.
Both sexuality and aggressiveness are kept at a distance in withdrawal behaviors, even if several
Japanese hikikomori have made headlines thanks to violent acting-outs (assault, the hijacking of
a bus). Beyond the mobilization of inhibition and ideal-formation, other defensive modes such as
sublimation can also be called upon. As one of the vicissitudes of the drives, sublimation offers
a solution that allows the subject to avoid a direct confrontation with the sexual by diverting it.
Sublimation is part of a larger movement of desexualization that can also be seen in idealization,
such as in the case of a subject’s withdrawal into digital technologies, which are endowed with the
qualities of constant availability, reactivity, and narcissistic validation. The withdrawn adolescent
abandons the “lowly” material activities of daily life and of overly stimulating object relations
in favor of sublimated activities of which technology use makes up the lion’s share, in large part
because it allows the subject to disconnect from in-person exchanges.
Just like adolescence, the ideal is a notion that is characterized by its incompleteness. Para-
doxically, this notion also contains both a confrontation with the subject’s inadequacy and the
possibilities for remedying this inadequacy. For A. Beetschen, “the formation of ideals during
adolescence [. . .] allows us to clarify an essential strength: if the ideals are satisfactorily achieved,
they also give a glimpse of what is lacking; and this lack shows what the subject can move towards,
what he or she can aspire to” [25]. The transformations of puberty demonstrate this painful para-
dox of the ideal: the sexualized body has the potential to achieve orgasm and jouissance, but it is
also the proof of the threat of castration and of the renunciation of Oedipal wishes. The ideal also
infiltrates the subject’s thought processes. Because adolescents are capable of abstraction, their
thinking has considerable potential–but there is also the danger of falling into an abyss of existen-
tial and ontological rumination. The overwhelming physical changes and the newfound mental
capacity for complex formal operations reveal a sometimes traumatic reality: “someday” can no
longer be put off, because it has arrived; and the confrontation with formations of the ideal can
generate intense suffering. Virtual reality can be called upon to limit this painful confrontation: for
example, in the creation of a physically and psychically perfect avatar. The virtual–which, as X.
Vlachopoulo and S. Missonnier point out, derives etymologically from “potential” [26]–reveals
its full meaning: that is, the virtual is that which has the potential to germinate, but also that which
is a source of strength and power. The virtual participates in the transformations of adolescence
and in the passage to adulthood, and, in the case of more fragile subjects, it can act as a kind of
support to and as a reactivator of the process of growth. F. Marty and S. Missonnier suggest that
“virtual technologies help the subject reconfigure adolescence as a sensual experience of the cons-
truction of a self and of the explorations of one’s limits” [14]. Clinical experience with secluded
adolescents reinforces this notion of virtual reality’s ability to help restart a stalled adolescent
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process in that it allows these subjects to accept that their future and their ideals are a work-in-
progress–represented by the different levels to master in a video game, or by the evolutions of
one’s avatar–, thus protecting these ideals from the demands of the superego.

3. Clinical illustration

Maxime is hospitalized not long before his 15th birthday after a violent episode in the family
home: while his sister was watching a reality TV show in her room, Maxime, who considers
these shows to be stupid and irritating, destroyed the television set. Maxime lives with his mother
and ten-year-old sister. His father, a golf instructor, left his mother when Maxime was seven.
The mother describes Maxime’s father as a good-for-nothing womanizer. By the time he was
hospitalized, Maxime hadn’t left his house for over 18 months. He has been living in his bedroom,
even taking his meals there (meals that his mother delivers). All of his time is dedicated to playing
video games, indeed, to one game in particular that he refuses to name. This game has a link with
his imagined future career, which he also refuses to discuss. Maxime stopped attending school
in the 7th grade, having discovered his future career and deciding that he didn’t need any more
classroom education. His career path being fixed, he said, he knew what he needed to do to achieve
his goal. Maxime will add later that he was the scapegoat for two boys in his grade, because of
his small stature and his childish appearance. After having dropped out of school, Maxime was
able to enroll in distance-learning classes because of his school phobia, but he never followed a
single lesson, nor completed a single assignment. Maxime’s mother describes him as a sweet and
calm boy, a homebody who prefers to avoid superficial relationships with other teens. At the same
time, she describes him as tyrannical: Maxime chooses the family’s meals, dictates his sister’s
activities, and decides whether or not she can watch TV. Since Maxime’s father hasn’t paid child
support since Maxime was 10, neither Maxime nor his sister have seen him since then. However,
Maxime speaks warmly about his father, recounting how he would follow him around on the golf
course, how he was doted on by his father’s adult clients, “wealthy pupils” people who would buy
him a drink or a snack at the end of their lessons or would drive him back to his mother’s house
after the lessons in expensive cars, inspiring his mother’s anger and the use of crude language
when the “pupils” in question were female. Maxime felt torn between his parents, and in order to
avoid this conflict, he would ask to be dropped off a block from his mother’s home.
Maxime is thus hospitalized after his mother calls the police during his violent outburst. She
tells the police that she fears for her safety and that she didn’t recognize her son. When Maxime
arrives at the hospital, he is mute. He has a ghostly appearance: excessively pale skin, flaxen hair
hanging down to his waist. He is very thin and small for his age. His body seems untouched by
puberty: unchanged voice, no sign of facial hair, a very androgynous appearance. His mother,
who has accompanied him, expresses her incomprehension about his outpouring of violence;
instead, she describes a gentle child, unlike other boys, who spend their time getting into trouble,
drinking alcohol, and chasing girls. Regarding Maxime’s dropping out of school, she says that
she followed his lead: his future career only requires being 18 years old and knowing how to
drive. However, she can’t supply any further details about this mysterious project. More than a
month will go by before Maxime can broach the topic–with, however, many hesitations, since he
fears for our safety and the potential backlash that his announcement could provoke. Reassured
by our promise of confidentiality, he announces that he wants to be a “go-faster”–that is, a driver
of ultra-powerful cars used by drug traffickers to move their wares throughout Europe. Hence the
inutility of school; but Maxime will need to be an exceptional driver, which is why he spends so
much time “practicing” on a car-racing video game. Above all, he will need to wait to turn 18
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and to be recruited. He spends over 18 hours a day playing video games; and on several occasions
experienced suicidal ideation (without a precise scenario) when he felt that he wasn’t progressing
quickly enough through the game’s different levels. In these moments, he says, it was as if his
life was meaningless. Encouraged to elaborate on his professional aspiration, the project quickly
appears as poorly defined and situated at the crossroads of ideal, idealization, and delirium: it came
to him like a revelation. The concrete elements of his project are not taken into consideration.
Maxime can’t explain how he will connect with a network of drug dealers (he doesn’t use drugs),
nor why it will be necessary for him to have a driver’s license, seeing as he will be partaking in
an illegal activity. However, over the course of this discussion Maxime seems deeply interested,
almost exalted–a far cry from his usual withdrawn, self-effacing presence. This project has become
his reason to live; it’s the only thing he thinks about; he’s counting the days until his 18th birthday.
What emerges first and foremost is his passion for speed and for expensive cars, as well as the
possibility of earning lots of money and being to ignore the speed limit, to avoid tolls. Maxime
dreams of living free of constraints by performing a dangerous and secret job, one that is reserved
for the best and brightest, for those who have exceptional qualities.
After the revelation of his professional aspirations, Maxime’s behavior changes: he is more
often seen in the hospital’s collective spaces; he takes pleasure in participating in group activities;
he agrees to think about resuming his studies before he turns 18. Over the course of his four months
in the hospital, he will undergo a physical transformation, growing almost eight inches taller. In
addition, he will need to consult a dermatologist for the stretch marks on his back that cause him
intense pain. On a supervised leave at his mother’s house, Maxime decides to cut his hair–against
the wishes of his mother, who thinks he is so attractive with his long hair. Maxime will reunite with
his father despite a certain opposition from his mother, who continues to denigrate him during
interviews, going so far as to give detailed accounts of their sexual life and his inability to satisfy
her. Maxime’s father is reluctant to have Maxime stay with him, citing his financial problems,
his lack of a car, and the difficulty of using public transport. Because of this, Maxime will stay
at his father’s home only rarely. Maxime will begin a romantic relationship with a young woman
hospitalized for an eating disorder and who excels in school. Maxime is especially impressed
by this particular detail; he describes her as an exceptional being, the first girl he could fall in
love with, thanks to her physical and intellectual perfection. His passion for cars appears in a
skills appraisal, and he agrees to enroll in a part-time professional training course to become a
mechanic, since understanding how cars work can only help him be a better driver, he says. He
hasn’t completely renounced his dream of becoming a go-faster, but he has relegated it to plan B
status. His current objective is to become a mechanic on the auto racing circuit.

4. Discussion

Maxime has been housebound for more than 18 months; however, he doesn’t show signs of
any particular suffering when this period is brought up. He gives the impression of having created
an internal equilibrium: he can hone his driving skills through playing video games; he is free
from the obligation to frequent boys his age who are more physically developed; he doesn’t show
any special interest in romantic relationships. His decision to no longer leave his bedroom also
contributes to the family’s equilibrium. Indeed, with the exception of the violent episode that
resulted in his hospitalization, his mother never attempted to get him to leave the house. On the
contrary, she was reassured by the fact that he preferred his room to the company of other boys
his age and the mischief they could get up to.
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Maxime’s intensive use of virtual reality stops the flow of time: nothing new will come to
pass before his 18th birthday, the moment that will allow him to obtain his driver’s license and
thus become a go-faster. Likewise, the process of adolescence is suspended for Maxime, both
physically–his height and weight are those of a pre-pubescent child–and psychically–no signs of
conflict with his parents, no identification to a (non-familial) group, a lack of interest in sexuality.
His seclusion is coupled with a limitation of his motor skills. Maxime barely leaves the chair
installed in front of the screen where he plays. His body is motionless, as if petrified, protected
from the assaults of puberty and the desires that come with it. The renunciation of the childhood
illusion of omnipotence is avoided through an imbrication of the ideal ego and the ego ideal that
gives Maxime the certainty that he will succeed in his project upon turning 18. The childhood
“someday” is circumscribed in a limited temporality, of which the fated date of his 18th birthday
simultaneously marks the limit and allows for a preservation of the narcissistic grandeur of the ideal
ego. The confrontation with the school milieu that had dealt such a blow to his narcissism–notably
through the mockery of his male classmates but although through his average-at-best grades–is
circumvented by the use of virtual reality’s educational aspect: video games allow him to practice
and thus to become a world-class driver. The virtual comports a double defensive solution: in
the reversal of a passive experience into an active one, and as a rampart against a depressive
breakdown. As M. Jeannerod suggests, “the representation of an action is an integral part of that
action; it is in functional continuity with the accomplishment of the action” [27]. In this sense,
pretending to be a go-faster while playing a video game allows Maxime to skirt the disappointment
of failure and reinforces the feeling of power. Through its constant availability, the virtual object
also participates in this defensive logic, allowing the subject to avoid dealing with loss.
The immersive powers of the virtual, as well as its defensive and creative efficiency, were
demolished for Maxime during the episode of violence and of the mobilization of a figuration
through his acting-out. The destruction of his sister’s TV can be understood as an attempt to
shield her–and himself–from an eruption of sexualized content. Indeed, the reality TV show
in question follows contestants as they pair up and break up; and the stakes of seduction and
sexual rivalry are omnipresent. The strategy employed by Maxime up until this point has become
ineffective: sexuality bursts into his life, shattering the illusions of a temporality free from the
impact of puberty and of the omnipotent narcissism that conditioned his relationship to reality.
In one fell swoop, Maxime becomes an adolescent, freeing himself from the massiveness of
excitation through the shortcut of a violent acting-out. The violence that had, until this moment,
been inhibited or repressed reveals Maxime’s adolescent side–a side whose only prior place of
expression was in the cocoon of his bedroom, in front of the screen on which he saw himself as a
superior driver. This revelation also disrupts the stability within the family. Maxime’s mother, who
had been delighted to have an ideal son at home–the opposite of her ex-husband, the unfaithful
seducer–finds herself face-to-face with a young man she no longer recognizes. Her feeling of
anxiety and uncanniness is so intense that she calls the police for help, while Maxime, having
destroyed the TV, returns to his bedroom and stays there until a group of police officers bursts
in. A docile Maxime, a far cry from the brutal monster described by his mother, will follow the
police without a word, terrified by this intrusion of the forces of law and order. The arrival of the
police is a trauma for Maxime, an explosive interruption of reality that puts a serious dent in his
scenario of grandeur and invincibility.
The eruption of sexuality by way of reality TV–we could also underscore the traumatic effect
of reality contained in these shows–brings the Oedipal stakes and the incestuous proximity with
the mother to light. The act of violence allows Maxime to break free from this and also to shatter
his mother’s idealized image of him as a docile and readily available child. For M. de M’Uzan,
 M. De Luca, P. Chenivesse / L’évolution psychiatrique 83 (2018) e13–e26 e23

the ego ideal “is, in its essence, maternal. The mother imposes her phallic ambitions and their
fulfillment becomes a way for the subject to express his incestuous wishes. The superego is not
fooled by this and imposes its own norms and an unattainable perfection” [28]. The attempt to
distance himself from these Oedipal fantasies through virtual reality is partially thwarted by the
idealization inherent in the project of becoming a go-faster. This dream condenses the incestuous
maternal wishes of a smooth-talking, fast-moving husband under house arrest and of a son entirely
at her disposal, the ideal fantasmatical expression of an active and passive bisexuality, neither
phallic nor castrated, at once girl and boy but neither woman nor man. Maxime’s masculine
identification with his father is rendered difficult in reality by his mother’s repeated attacks on
this paternal figure. He is stripped of his masculine attributes; and the displacement of these
onto the figure of the go-faster creates a condensation of phallic and sexual power. The father’s
departure from the family home when Maxime was seven years old surely compromised the
son’s identification with him and weakened the decline of the Oedipus complex–complicating
Maxime’s entry into the negative phase of the complex–as well as compromising the construction
of a superego that, while forbidding, can also be benevolent. Instead of repression, the mechanism
of suppression is favored, weakening the subject’s defensive resources at the time of puberty’s
instinctual conflagration. The stoppage of Maxime’s bodily transformations–maintained by his
long seclusion in his bedroom–will be undone by his hospitalization. The framework provided by
the institution, as well as the multiple interdictions that compose the ward’s rules allow Maxime
to prop up his failing superego. The containing aspect of the framework–the counterpart to its
forbidding aspect–offers the solicitation of a third-party function, reinforced by Maxime’s physical
separation from his parents. While in the hospital, Maxime is able to open up to his peers and
even invest in a romantic relationship (even if the latter is highly idealized). Here, one can observe
the restorative function of the formations of the ideal, which–if they are utilized to preserve the
subject’s narcissism–can open onto a more measured form of investment in the object: “thus,
sexual overestimation appears as a fallback solution, between narcissistic investment and wasting
one’s resources on the object. In this case, the ideal no longer serves the ego, but the object. [. . .]
This means that the subject becomes smitten with an object over which the ideal holds power”
([21], p. 92).
Maxime’s investments in the ideal and in the virtual play out on a continuum between toxicity
and creativity. Toxicity, here, in the stagnation of the adolescent process made possible by these
investments. The arrival of “someday” that should have been announced with the appearance of
the secondary sexual characteristics is displaced onto the social through Maxime’s secret dreams
of professional success. If his body lacks the attributes of an adult man, Maxime will be one in the
eyes of the world in becoming a top-notch driver that no law, no highway code, no police officer
can stop. The figure of the adult is permeated by an archaic version of idealization, free from the
snare of the sexual and the castration that comes with it. The form adopted by the superego is
neither the benevolent one, undergirded by an ego ideal that pushes the subject to outdo himself,
nor the forbidding form, the interiorization of the parents’ superegos. The denigrated paternal
image lacks the richness and depth necessary for a successful identification to take root; and the
mother’s image is likewise unavailable for identification in light of its incestuous proximity and
its expression of a perverted ideal that, as J. Chasseguet-Smirgel [29] suggests, sings the praises
of a perverse omnipotence and of its idealization of childhood sexuality and part-objects.
Taking into consideration the formations of the ideal in Maxime’s functioning allows us to
avoid too rapidly diagnosing his structure as belonging to the psychotic register. The withdrawal
behavior, the massive use of video games, the desocialization, and the enigmatic or even hermetic
aspect of his “professional” ambitions could have led us in this direction. For P.-L. Assoun, the
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ideal sets itself up in opposition to the real, as a category related to the fictive and the illusory: “the
ideal is, on the one hand, that in which the subject believes above all else, and that which gives
him his “conviction”; and, on the other hand, that which constantly threatens to reveal itself as
an “illusion” behind the smokescreen of idealization” ([21], p. 87). Maxime’s professional goal,
its secret so carefully guarded and nurtured during his hours of practice playing video games,
anchors itself in the formations of the ideal. Any momentary failure to advance in the game could
make him lose his footing and think about death: “it’s like my life was over.” Becoming a go-
faster after having turned 18 and having earned his driver’s license oscillates between illusion
and conviction. A conviction only loosely connected to the contingencies of reality: why wait
until his 18th birthday? Why obtain his license only in order to engage in an illegal activity and
casually transgress the rules of the road? Why would revealing his project to people put them
in harm’s way? The temptation to identify a delirious construction and a psychotic process is
strong, especially in light of the negativity induced by Maxime’s withdrawal and by his hyper-
investment of virtual reality, which could push us in this direction. But doing so would be a denial
of the power of the process of idealization as a means of restarting a stalled adolescent process:
the illusion of grandeur and of success supports Maxime’s wavering narcissism; this illusion
spares him an overly painful confrontation with loss and allows him to maintain an identification
with his father, as we can see in his evocation of pleasant memories of being driven back to
his mother’s home in his father’s pupils’ fancy cars. Very early, Maxime integrated the image
of an all-powerful mother figure. It was necessary to create and maintain a sufficient distance,
both physically and psychically–he would ask his father to drop him off one block before his
mother’s house–in order to avoid her wrath. For Maxime, this omnipotent and threatening figure
is incarnated in the persistent presence of an ideal ego that has remained faithful to his mother’s
narcissistic dreams of perfection and immutability. The use of virtual reality introduces a third
dimension, as well as a temporality based on the present/future dyad, represented by the date of
his 18th birthday, which Maxime considers to be the key to his future success. The formations
of the ideal, as we have already pointed out, are not only called upon to help safeguard the
subject’s narcissism; they also allow for the possibility of investing in object relations–even if this
possibility remains modest. The romantic relationship into which Maxime threw himself at the
beginning of his hospitalization seems to be an illustration of this. The young woman that he chose
fit into his system of ideal-formations. The fact that she is so idealized by Maxime allows us to
perceive all the complexity inherent in the confrontation with the sexual for these two adolescents.
Investments in object relations are not limited to this romantic relationship, but are also deployed
during Maxime’s hospitalization in therapeutic activities, whether articulated around a particular
medium or around the relationship with a group. These group relationships are also maintained
during moments in which Maxime is on leave from the hospital, during which he meets up with
other teenagers to go to the movies or to McDonald’s.

5. Conclusion

Not all housebound adolescents use digital technologies intensively. The presence of these two
aspects, even if it contains a toxic dimension–because of the disconnection with the social and
educational worlds that it brings about–that cannot be underestimated, also contains a restora-
tive dimension, notably in the dynamic sustained by the formations of the ideal. Video games
and Internet usage are both strongly idealized due to the freedom and pleasure–not to mention
transgression–that they offer. The virtual is conscripted by the ideal as a step towards an encounter
with the object that is more direct and less mediated. This step brings with it a reinforcement of the
 M. De Luca, P. Chenivesse / L’évolution psychiatrique 83 (2018) e13–e26 e25

subject’s narcissism sustained by the formations of the ideal and by a less threatening handling of
loss. However, this step brings about others, as illustrated by the dynamic put in place for Maxime
when he was able to leave his bedroom–paradoxically, to be taken to the hospital, but where
he was strongly encouraged not to stay in his room, as we have observed for other hospitalized
withdrawn adolescents [13]–, meet other young people, and even fall in love. The literature on
adolescent hikikomori demonstrates how the Internet can mediate and facilitate online encoun-
ters that can lead to meetings “IRL.” The process-centric dimension of adolescence guarantees a
favorable outcome. The formations of the ideal, as well as virtual reality, can be put to work by
this transformative process, but they can also take root in a self-destructive logic, in the service
of a negative narcissism and of unattainable demands far removed from reality, demands fueled
by a particularly severe superego. Instead of a logic based on things to do, the subject finds him-
or herself in a deleterious logic dominated by the idea of being unable to do anything; instead of
the register of the ideal, the subject finds him- or herself in the register of the superego. As M.
de M’Uzan points out, the ego ideal pushes the subject to act, whereas the forbidding superego
incites the subject not to act. For the most narcissistically fragile adolescents, doing in the virtual
world is a source of satisfaction, especially because this doing involves grappling with an ideal
that carries with it the promise of a “someday” full of success. These promises can then become
certainties because, by the time “someday” arrives, the subject will have been able to do, to undo,
and to redo without the fear of potential reprisals or of insurmountable disappointments.

Disclosure of interest

The authors declare that they have no competing interest.

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