Developmental Breakdown and Psychoanalytic Treatment in Adolescence: Clinical Studies: Edited by Moses Laufer and M. Eglé Laufer. New Haven and London: Yale University Press. 1989. Pp. 217.

This book comprises a description of nine severely disturbed adolescents in five times per week psychoanalysis undertaken by analysts at the Centre for Research into Adolescent Breakdown. The clinical work was part of a research project. This research project sought to understand the nature and severity of breakdown in adolescence by distinguishing three types of adolescents according to the way they used their body to express their disturbance. They included the adolescent whose relationships were of a perverse nature, the adolescent who had attempted suicide and the adolescent whose behaviour showed signs of severe disturbance in functioning such that his relationship to external reality was clearly distorted (e.g. as in anorexia nervosa).

The Laufers consider these different uses of the body as the outcome of defences which are mobilized by the adolescent whose relationship to his sexual body breaks down at puberty. As the adolescent develops, he finds that these defences are unable to cope with the anxieties he experiences about his maturing sexual body. Usually, it is at this point when self destructive attacks against the body take place that professional help is sought. In summary, the Laufers maintain that the key to understanding adolescent breakdown is the uncovering of the adolescent's relationship to his sexual body at the time of puberty which they claim is subsequently repeated and lived out in the transference.

In order to understand these formulations, which perhaps may be unfamiliar to many analysts not acquainted with patients who break down in adolescence, I think it is helpful to state some ideas from the Laufers' first book Adolescence and Developmental Breakdown1 since these ideas clearly influence the thinking behind the research project. In this book they state that;

During adolescence oedipal wishes are tested within the context of the person's having physically mature genitals, and a compromise solution is found between what is wished f