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October 15, 1973. NARCISSISM, ADOLESCENT MASTURBATION FANTASIES, AND THE SEARCH FOR REALITY. Charles A. Sarnoff, M.D.
As the upsurge of instinctual drives during adolescence normally forces shifts in objects sought for gratification, Dr. Sarnoff postulates that during adolescence a series of developmental steps must be negotiated before successful adult object relationships can be achieved. These steps involve the changing relationships between drives, fantasy, masturbation, and reality. After reviewing the literature on the developmental relationship between masturbatory activity and fantasy, Dr. Sarnoff drew attention to the degree of concordance between masturbatory fantasies and behavior patterns as being an indicator of the ability to respond to reality and healthy object choice.
Two clinical cases were presented. The first, a sixteen-year-old boy, had developed a masochistic masturbatory fantasy of self-cutting at age eleven, which he was able to replace with a realistic object after maturational achievement of orgastic potential. However, a tendency toward self-demeaning object choices remained. The second case involved treatment of severe homosexual conflicts in a twelve-year-old boy. Here the emphasis was on his adolescent narcissism and efforts to resolve his omnipotent masturbatory fantasies. Dr. Sarnoff suggests that fantasies which are familiar and have been mastered in the past are used by some adolescents to establish a bridge to new objects