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Human sexuality is the product of cultural forces as well as genetic and biologic factors.12 Kernberg was concerned with intrapsychic life as it relates to developmental lags in young adults, but he also cautioned us to be aware of cultural changes which have particular effects on young adults because of their susceptibility to rapid impulse discharge.3 To young adults, moral and ethical choices are issues of the keenest importance.
As analysts, we are interested in both the early pathologic development of our patients and their response to cultural trends.4,5 Treatment of the young adult offers us a unique opportunity to see familial interactions. Our genetic reconstructions can be based on closer scrutiny and thus more accurate; we see and hear the patient's experiences as he relates to his parents and siblings.
Although young adulthood is frequently a chaotic period of heightened states, with swings from elation to depression, from asceticism to hypersexuality, it is also one of flexibility and lack of psychological rigidity.6,7 Therefore, contrary to much traditional opinion, the young adult patient has great ability to work analytically and to synthesize interpretive work. The young adult's fragility, weakness, and vulnerability may be assets to the analytic process if handled with commitment and concern. In the development of the transference neurosis, we note that the young adult is frequently searching for an ego ideal.8 What better period in which to conduct treatment could offer itself? The psychoanalyst can, potentially, be a model of identification and a source of support during a period of relative storm, difficulty, and sexual aberration. Eventually the negative aspect of the transference must be reviewed with the patient, and, of course, one must also realize that the ego ideal has a defensive posture in binding anxiety.9
The young adult is probably more amenable to treatment than the adult with similar problems. As in any therapeutic situation, however,