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During adolescence there are normally alternating phases of chaos and consolidation. Underlying these alternating phases are interacting processes consisting of the adolescent's struggles to achieve genitality, a firm sense of self, a nonincestuous object, and, finally, a steady relation between the three psychic systems. In the course of these processes, the phallic organization of the libido disintegrates and is succeeded by a fluctuating constellation of oral, anal, and genital impulses: the well-anchored sense of self is disturbed; the kinds of instinctual satisfaction which are permitted or forbidden fluctuate.
In evaluating an adolescent for analysis, it is essential to ascertain whether he has really been exposed to the adolescent process, is submerged by it, or is emerging from it. This cannot be determined from his apparent life pattern because its order or disorder does not always reflect accurately his internal mental organization. Often the adolescent will not complain of inner disorder because his ego and superego are able to tolerate considerable mental flux and contradiction. However, when dealing with emotionally loaded topics, his language will often become unintelligible.
The author illustrates the usefulness of the above considerations with examples of two nineteen-year-old patients: one was untouched by the adolescent process; the ego of the other was thoroughly fragmented by it.