Traumatic Experiences and Their Relationship to Self-Destructive Behavior in Adolescence

Many therapists who treat adolescents encounter patients who frequently hurt themselves. Although this generates concern and anger in those around them, these teenagers often appear to be quite indifferent to the consequences of their maladaptive behaviors. This article introduces Noshpitz’s theory of self-destructive behavior and its relationship to trauma. Noshpitz emphasizes the need to define the influence of what he terms the “negative ego ideal” on self-destructive behavior in adolescents. He claims that the negative ego ideal and trauma work together to strengthen self-destructive behavior. He identifies numerous similarities between the torturous thoughts that occur after being exposed to a traumatic event, and the torturous thoughts that derive from the negative ideal. Thus, the traumatic encounter undergoes a new interpretation within the superego when it is interpreted by the negative ideal ego. Noshpitz’s emphasis on the negative ideal ego can shed light on many manifestations of self-destructive behaviors, and can contribute to work with adolescents and young adults who have lived through some type of traumatization. Two vignettes are presented that illustrate these tenets, including the transference-countertransference dynamics involved.