Developmental Disturbances in Adolescence and their Implications for Transference and Technique

Developmental concepts assist our thinking about adolescence in three ways: firstly, they provide a conceptual framework of ongoing development within which to view the normal adolescent phase; secondly, they define the normal tasks of adolescence; thirdly - and this is the issue I wish to discuss in this paper - they help to clarify different sources of interference with the adolescent process, and hence to distinguish which aspects of therapeutic intervention will be appropriate for a particular individual.

Developmental concepts help us to distinguish two main sources of interference in the adolescent process:

1. currently active conflicts which may be specific to the adolescent phase, or may be revived from earlier phases of development;

2. the stunting or distortion of a range of developmental processes earlier in childhood which result in the individual arriving in the adolescent phase lacking some capacities essential for resolving adolescent issues.

Anna Freud distinguished between childhood neuroses and developmental disturbances. She pointed out that interpretation of unconscious conflict, the basic technique of psychoanalytic therapy, is most effective in cases where the different areas of personality development are evenly balanced: that is, where development in all areas has proceeded at a roughly similar pace. She described this in terms of Freud's structural theory (S. Freud, 1923), stressing the importance of the balance between instinctual development, the development of ego functions which serve adaptive and defensive functions, and the development of superego which provides ideals, aims and prohibitions, rewards and punishments: the more these areas are out of balance, the less likely is the patient to be able or willing to make use of interpretation. Children with distortion or delays in ego or superego development or in object relations may, however, make use of other