Response to Julia Fabricius' Paper

Having struggled with the sheer bulk of material to be dealt with, in reviewing the background, the difficulties and, in most cases, early treatment of these twelve young people, I am conscious of how deft and unlaboured Julia Fabricius has been and of what a valuable résumé she has given us.

Beyond this, however, has been the task of thinking about what we have learned so far - effectively, of finding a way into this wealth of data and of bringing an order to it, so that we can make distinctions and conjectures and perhaps lay down the basis for a fresh understanding of the developmental process and its failure.

In her paper Julia Fabricius has taken up the material which our patients have given us and examined it in the light of criteria which mark the transition into adulthood: the capacity to love and to form a sexual relationship, the capacity to work, and the attainment of a sufficient degree of separation from the primary objects, both external and internal, to allow for a reliable self-sufficiency. She asks why it is that these young people have come for treatment when they have. Finally, having noted the failure of many to pursue or establish sexual relations, she examines this in greater detail and relates it to a continuing involvement with the preoedipal mother.

Of our patients, half were unemployed at the time of referral and another three are still in full-time education. Even for those in whom intellectual activity is not a major defence, it does seem likely, as the author suggests, that the end or final stage of formal education is a point beyond which they have known themselves unable to proceed. A similar predicament may be seen in the young women who withdrew in alarm after a first failed sexual relationship.

I think the author is right, however, to balance, against the notion of a defensive screen which is breaking down, the more hopeful possibility of an ego that has been able to maintain itself, at whatever cost, until help can be found or used. In