This paper presents a psychodynamic evaluation of a case of fetishism, whose main features are the homosexual or autoerotic choice of the fetish (hair), social and occupational maladjustment and occurrence of epysodes of psychotic depression. After a survey of the literature, with particular emphasis on psychoanalitic and psychodynamic approach, the authors discuss the diagnostic problems presented by this case and decide for a diagnosis works as a largely unsuccessful attempt to escape psychotic regression. In contrast with the situation which prevails in most cases of fetishism, there is no satisfactory adjustment to social and occupational life; the mecanism of ego-splitting is found to be impaired. The authors stress the importance of Kohut's recent contributions to the study of the early phases of narcissism for a better understanding of the differential diagnosis between psychosis, character disorders and perversions, Kohut's narcissistic personality disorders and "borderline syndrome".