[For a clinical approach to impulsion phobias]

Having first recalled the problems involved in classifying impulsion phobias, (problems which have been experienced in the course of all the work done on this subject), the authors report, from a strictly clinical viewpoint, on a series of studies of patients whose problems are very different but who all show the symptoms of impulsion phobia. They next setout a phenomenological approach to the problem, with emphasis on the products of the patient's imagination, his passive fascination with the image of a terrifying act constituting the object of the phobia, the external world in relation to the subject, and the ambiguity of dependance on others which is mirrored by aggressiveness. Lastly, the subject's entire existence is put symbolically at stake, and the phobia is seen to spring from his narcissistic relationship with the external world at a deeper level than that of any oedipian relationships. The first stage in the treatment is, indeed, to build up this narcissistic relationship, and later treatment will be varied according to the patient's fundamental needs.