Adolescence and Psychoanalysis

The Story and the History

Francois Ladame, Maja Perret-Catipovic, Francois Ladame, Maja Perret-Catipovic

• Publisher: Routledge
• Year: 2018
• ISBN:
  9780429910623
• Edition: 1
• Topic: Psychology
• Subtopic: History & Theory in Psychology
• Index: Psychology

This book deals with specific aspects of psychic functioning and development in adolescence. It offers a conspectus of present-day psychoanalytic understanding of the process of adolescence and its vicissitudes. The book is helpful for those interested in the field of adolescent psychoanalysis.

CHAPTER ONE
Adolescence and psychoanalysis: the story of the history

Maja Perret-Catipovic and François Ladame

Adolescence and psychoanalysis: both of these terms are the victims of their own success. The word "adolescent" was used in a disparaging sense at the end of the nineteenth century, and nowadays everything is readily dismissed as "adolescent". As for "psychoanalysis", the term has emerged from a circle of initiates into everyday—perhaps too everyday—parlance, where it now punctuates all forms of humanistic discourse. In view of their success, might these words not be said to have lost their meaning?

If we venture to treat the two terms as a couple, the story of their union is one whose beginning is never-ending. We shall attempt here to determine their origins in so far as they are known to us. Let us for the moment consider the two terms separately and define them as follows.

Adolescence is the psychic process that allows the changes of puberty to be integrated. It begins as soon as puberty is cathected by the child, sometimes even before it is experienced in the body. In some cases this cathexis—whether positive or negative—arises on the occasion of the first physical manifestations of the generative capacity, whereas in others it may commence before any physical changes are felt. The link between puberty and the process of adolescence is clear, although the two classes of phenomena cannot be equated (even in time).

It is less easy to grasp the point when adolescence ends. This difficulty is probably responsible for the air of vagueness surrounding the term "adolescence". Let us take it that adolescence concludes when the identificatory transformations inherent in the adolescent process culminate in the assumption of a stable and irreversible sexual identity. Furthermore, the new identifications must allow the internalization of the social code and the acquisition by the individual of a status of his own that supersedes parental protection. It must be emphasized that adolescence has an end. That end is normal when the transformations mentioned above succeed, but pathological if the process of adolescence is short-circuited, preventing the subject from developing autonomy of thought and appropriating the sexually mature male or female body. Such faulting may be glaringly evident (as in severe pathology) or more or less subtly masked by adaptive or mutilating defences.

What is psychoanalysis? It is at one and the same time a procedure for the investigation of the unconscious area of psychic life, a therapeutic method based on this investigation, and a theory of the functioning of the human psyche. This is the concise definition adopted by the Swiss Psychoanalytical Society, whose Constitution and Bylaws it heads. Regarding the first aspect, it may be added that what is to be investigated includes the unconscious meaning not only of a subject's words but also of his actions and imaginary activities. As to psychoanalytic treatment, it differs from other forms of psychotherapy by interpretation of the transference (and of the countertransference), wishes, and resistances, as well as by providing a specific and unvarying setting in which all these factors are given maximum scope to unfold.

Links between psychoanalysis and adolescence

Whereas the discovery of infantile sexuality is one of the cornerstones of psychoanalysis, it is sometimes forgotten that in the Freudian view psychosexual development is a biphasic process: one phase comes to an end with the temporary setting aside of the oedipal conflicts of infancy and the onset of the latency period, while a second commences with puberty; the latter is the decisive phase [krisis = decision] that will confer upon infantile sexual life its final, normal form (Freud, 1905d). Let us add that this final form may be normal or abnormal. For all are agreed that, whereas everything is prepared in childhood, everything falls into place in adolescence (Kestemberg, 1980, and Chapter 6 of this book).

Obvious as this is, adolescence has generally been—and to some extent still is—relegated to the background. Why should this be? The first reason is that the at the time scandalous acknowledgement of infantile sexuality probably contributed to the ousting of puberty from its central position. The fascination immediately aroused by this discovery gave rise to important theoretical and clinical advances and to the extension of the method of psychoanalytic treatment to children, through the work of Melanie Klein and of Anna Freud. The controversy between these two great ladies of child psychoanalysis, and subsequently between their followers, has kept this fascination alive to this day.

Another reason might be connected with the nature of the disorders classically deemed to be the province of psychoanalytic treatment, namely neurotic disorders. A so-called neurotic subject suffers primarily from unconscious conflicts between the world of his wishes, which naturally demand satisfaction, and the judging agency that is quick to condemn such aspirations. Moreover, in the universe of unconscious wishes, infantile sexuality reigns supreme.

However, the importance assigned to infantile sexuality may perhaps also have served as a "screen-concern" to distract attention from adolescent sexuality. The integration of sexuality, in its function as a foundation of the human psyche, was perhaps more acceptable when mediated by infantile sexuality—which was ultimately "innocent", whatever one might think about its "perverse polymorphism"—than a sexuality enshrined in the reality of the adult body, a sexuality now freely exercisable because no longer held in check by the prepubertal child's physical and psychosexual limitations. This disconcerting truth did not escape Aristotle, who wrote in his Rhetoric: "Young men have strong passions and tend to gratify them indiscriminately. Of the bodily desires, it is the sexual by which they are most swayed and in which they show absence of self-control."

The last twenty years have witnessed a rekindling of interest in adolescence and in the modifications of psychic functioning that must take place during this period of development. On the one hand, the thirst for knowledge inseparable from any genuine psychoanalytic thought is a natural encouragement to exploration on the boundaries of our known world; and, on the other, psychoanalysts have in the last quarter-century proved willing to treat an increasing number of subjects whose pathology is inconsistent with the classical definition of neurosis. Whereas these new visitors to our psychoanalytic couches or armchairs do still suffer from conflicts originating in the sphere of wishes, these conflicts spread their tentacles more widely, encroaching upon these patients' narcissism and their capacity to establish a positive self-representation and a continuous sense of being. This capacity is often unstable if not positively chaotic. Paradoxically, the fact of experiencing a desire for someone other than oneself—which is indispensable to adult human sexuality and affords prospects of libidinal satisfaction and narcissistic enrichment (as well as, admittedly, an inevitable risk of frustration)—becomes a threat to the integrity of the subject's own sense of existence if his ego foundations are too fragile. The area of conflict thus shifts from simply having (in the sense of possessing the object of desire) towards being: for how is the individual to preserve his sense of being, a coherent self-image, while at the same time acknowledging himself to be the subject of desire, the bearer of his own desires, and the object of the desired object's desires?

This takes us to the very heart of adolescence, and more precisely to certain miscarriages of the adolescent phase of development that are of interest to contemporary psychoanalysis because it deems them to lie at the root of the characteristic disorders of many of its patients.

The role of individual psychoanalysts in the evolution of adolescent psychoanalytic practice and theory

The Minutes of the Vienna Psychoanalytic Society give a good impression of the concerns of Freud [1856-1939] and his colleagues during the period 1906 to 1918 (Nunberg & Federn, 1962, 1967, 1974, 1975). The major issues of adolescence—masturbation, sex education, suicide attempts—recur frequently in the discussions, even if these concerns do not ultimately lead to precise theories (Marty, 1996; Ouvry, 1996). The references to adolescent sexuality (with its potential for consummation) are always allusive or peripheral, and Freud's text on puberty and the associated psychic transformations (Freud, 1905d, and Chapter 2 of this book) was at the time the only clear contribution on the subject.

The history of psychoanalysis is equivocal as to the position assigned by Freud to adolescence. However, when doubts are still expressed today about the analysability of adolescents, it is well to remember that, according to the available clinical information (with which we are all familiar), many of Freud's female patients belonged in that age group; Dora, for example, was 18 years old. This historical point has often been stressed. But another important factor might be partly responsible for the uncertainty. In the early years of the twentieth century, in contrast to the present situation, the words Adoleszenz and adoleszent were very uncommon in German. These two terms do appear in the Gesammelte Werke (Freud's complete works in their original language), but much less frequently than Pubertät [puberty]. Apart from the fact that the word Adoleszenz was not in common use at the time, Freud's training was of course medical, and his early background was in neurology and paediatrics. The detour through these two specialities inevitably led him to respect terminological custom by preferring the words Pubertiit, Jugend, and Jugendliche [puberty, youth, and the young] to Adoleszenz when referring to the phenomena of adolescence. The Standard Edition of Freud's works has perhaps compounded the problem because at the time of its publication the English words "puberty" and "adolescence" were not used in exactly the same senses as the equivalent German words. Yet one thing is certain: an attentive reading of Freud's works reveals the importance he assigned to this period and, in particular, to the psychic transformations of puberty, in regard to adult sexual life as a whole.

Following Freud's inaugural work on the transformations of puberty (1905d) and the discussions of the early Viennese psychoanalysts on the subject of adolescence, a number of investigative trails were blazed in the second generation, which was that of Freud's "first" pupils. One of those pupils was SIEGFRIED BERNFELD [1892-1953], who was particularly interested in the links between psychoanalysis and education. He worked hard to secure the integration of psychoanalytic theories in the pedagogics of his time. In 1912-13, Bernfeld had founded his own young people's movement, which was distinguished from others of its kind by, in particular, the integration of psychoanalytic ideas from Freud's Three Essays in the understanding of adolescence. From 1915 on, Bernfeld attended meetings of the Vienna Psychoanalytic Society on an unofficial basis, where he continued to develop his theses on "young people" and "youth" (see the above linguistic comments). An outstanding psychoanalytic contribution of his was the paper "Concerning a typical form of male puberty", which he read to the Society on 15 February 1922 (Bernfeld, 1923). Meanwhile, HELENE DEUTSCH [1884-1982] was concentrating on the development of girls (Deutsch, 1925).

Another member of this generation, AUGUST AICHHORN [1879-1949], made a prominent contribution to adolescent psychoanalysis. He was surely one of the first to emphasize the crucial function of a capacity for empathy with young people in distress. As early as in 1925, he published Wayward Youth, which earned him an international reputation. In this book he gives an account of his experience as an educator in two boarding-schools for young delinquents and orphans in Austria, illuminated by the psychoanalytic training upon which he had just embarked. His role remains central in the ongoing relations between the psychoanalytic movement and educational circles.

Several groups of psychoanalysts were thus working on the theme of adolescence during the inter-war years, but always within a theoretical perspective limited to educational applications, whether normal or therapeutic. Psychoanalysis gained acceptance as a form of treatment first for adults and later for children, but nothing was heard for many years about its applicability to adolescents. Perhaps the shock of the tragic death of HERMINE VON HUG-HELLMUTH [1882-1924], who was murdered by the 16-year-old nephew she had tried to "psychoanalyse", caused more emphasis to be placed on the perils than on the benefits of psychoanalysis during this period of life.

MELANIE KLEIN [1882-1960], who—together with Anna Freud and von Hug-Hellmuth—first cultivated the still virgin soil of childhood for psychoanalysis, hardly ever ventured into the field of adolescence. Apart from one short paper on puberty (Klein, 1922) and the chapter setting out her views on "The technique of analysis in puberty" (Klein, 1932), she made no further incursions into it. This position is ultimately in line with her understanding of psychic functioning and the way it should be approached and, indeed, treated. The fundamental importance assigned by Klein to the death drive from the moment of birth distracted attention from the fate of the libido during the process of sexual maturation, in which puberty is pivotal. For example, she describes the onset of menstruation in the girl as "the outward and visible sign that the interior of her body and the children contained there have been totally destroyed" (Klein, 1932). Kleinian thought is thus resolutely directed towards the most archaic levels of the psyche, which are deemed decisive for the future psychic organization. In her view, everything depends on the capacity of the infant to negotiate his— constitutional—aggression in his early object relations. Adolescence is systematically approached by comparison with childhood, and its problems are seen as a repetition of those of the infantile oedipal stage. Understandably, the Kleinian school does not regard the transformations of puberty as fundamentally mutative where psychic functioning is concerned. Psychic disorders of adolescent onset are understood as repetitions of the infantile, and no specificity is assigned to the different age categories except as regards therapeutic technique (word association or play). This is one of the roots of the controversy between Melanie Klein and Anna Freud.

ANNA FREUD [1895-1982] held that child psychoanalysis could not be equated with that of adults and developed theses in support of the specificity of the former. Similarly, when she turned her attention to adolescent psychoanalysis, she refused to amalgamate this group of patients with children and adults. The same is true of all analysts who accept the dualism of the drives arid assign an essentially organizing (or sometimes disorganizing) function to sexuality. Following her father, Anna Freud maintained that the upsurge of drive energy at the time of puberty introduced an imbalance between the id and the ego and weakened the latter. This meant that adolescents had little tolerance of frustration and were impelled to seek immediate pleasure rather than substitutive, sublimatory satisfactions. Again, the anxiety connected with the weakening of the ego must cause the defences to become more rigid. In view of these particular features, classical analysis was contraindicated. By this position, Anna Freud was assigning a quite specific place to adolescent pathology, and, although this did not mean that she sought to treat adolescents by psychoanalysis, her work is a continuation of that of the friends of her youth who continued to take an interest in this period of life. She remained open to all the ideas and experiments emerging in adolescent psychoanalysis.

This position differs radically from that of DONALD WINNICOTT [1896-1971], which is clear if not defensible. He wrote:

There exists one real cure for adolescence, and only one,... [It] belongs to the passage of time and to the gradual maturational processes; these together do in the end result in the emergence of the adult person. This process cannot be hurried or slowed up, though indeed it can be broken into and destroyed, or it can wither up from within, in psychiatric illness. [Winnicott, 1961]

Yet Winnicott refers in the same paper to the problems of the identity crisis, which may be manifested in suicide attempts or severe depression, while at the same time maintaining that "we meet the challenge rather than set out to cure what is essentially healthy". The harm done by such statements can readily be imagined. The fact that a renowned paediatrician and psychoanalyst classified suicide attempts and severe depression among tokens of health cannot but have made for the trivialization of adolescent psychic disorders and deprived many young patients of the appropriate care they urgently needed.

A change of perspective becomes evident at the end of the 1950s. JEANNE LAMPL-DE GROOT [1895-1987], a Dutch psychoanalyst who was a pupil of both Sigmund and Anna Freud and the latter's friend, maintained that it was not only possible but also necessary to analyse adolescents. She also pointed out that the resistances to embarking on such treatments might be due to the fact that the period of adolescence was not systematically analysed in adult treatments (including those of psychoanalysts-to-be). The paper reproduced in Chapter 4 (Lampl-de Groot, 1960) demonstrates the new trend then emerging and also undertakes a noteworthy discussion of the fate of narcissistic cathexes by way of considerations on the ego ideal, the ego, and the superego.

The paper published by ANNA FREUD in 1958 (cf. Chapter 3 of this book) offers an initial summary review of the ever-increasing number of psychoanalytic contributions on adolescence. It bears witness to this pivotal moment in the history of psychoanalysis and adolescence when psychoanalytic theory, applied psychoanalysis, and psychoanalytic therapy come together—especially as, at the time of its publication, Moses Laufer had become one of the most brilliant satellites in the firmament of Anna Freud's universe. The whole question of the analysability of adolescents was coming to be seen in an entirely new light through the early work of Laufer, conducted before the very eyes of Sigmund's daughter. From the very beginning of her psychoanalytic training, Anna Freud had sha...

Table of contents

• Cover
• Half Title
• Title
• Copyright
• Contents
• ABOUT THE EDITORS
• PREFACE
• 1 Adolescence and psychoanalysis: the story of the history
• 2 The transformations of puberty
• 3 Adolescence
• 4 On adolescence
• 5 The second individuation process of adolescence
• 6 A note on the crisis of adolescence: from disappointment to conquest
• 7 The central masturbation fantasy, the final sexual organization, and adolescence
• 8 The pubertal, its sources and fate
• 9 The process of becoming-a-subject in adolescence
• 10 Normality and pathology in adolescence
• REFERENCES
• INDEX