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DISCUSSION: Dr. Maurice Friend wondered how one can dissociate fantasy from behavior in adolescence: masturbation should not be distinguished as an activity from any other activity of adolescence. He questioned the meaning of narcissistically cathected fantasies in adolescence since all adolescents have such fantasies and use them in an attempt to reduce tension due to increased drive energy.
Dr. Cecilia Karol agreed that masturbatory fantasies are used as a bridge which enables libido in the mental representation of the body-self to flow first to part objects, then to whole fantasy objects, and ultimately to objects in real life. At times the adolescent may treat the fantasy as if it were real, while the actual masturbatory act is denied or made devoid of its sexual meaning.
Dr. Melvin Scharfman felt there should be more clarification of what is normal in adolescent development and what is pathological. He agrees that we should further our understanding of the vicissitudes of narcissism along developmental lines but felt that Dr. Sarnoff's presentation of case material did not serve this purpose. Rather than a simple projection of narcissistic masturbatory fantasies, the many shifts and reorganizations that take place during adolescence modify the nature of those fantasies. Changes in fantasy levels of organization do not always correlate with changes in the real level of object relationships.
Dr. Alan Eisnitz made the point that masturbatory fantasies play a role in ego development, but not in isolation. Changes in the masturbatory fantasy itself reflect changes in ego organization, and therefore are an aspect of maturation. The adolescent does not overcome narcissism; heightened narcissism in adolescence is a normal occurrence in response to increased instinctual drive pressure and exacerbated castration anxiety.