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Moses Laufer, the director of the Centre for Research into Adolescent Breakdown and M. Eglé Laufer, a staff member at the London based research center are coauthors of this original and provocative interpretation of psychological illness in adolescence. According to the Laufers the central pathology of the severe behavioral disturbances of adolescence—attempted suicide, homicidal violence, anorexia, profound depression, sudden academic failure, sexual abnormality—is an inability to leave infantile sexuality behind and come to terms with one's final sexual identity. Whereas the same sorts of behaviors in adults could be considered signs of psychoses, with these regressed adolescents the extreme acting-out represents a temporary break with reality which, if properly appreciated and judiciously treated, is reversible. Many clinicians are hesitant to treat acting-out adolescents, especially by the psychoanalytic method. The Laufers contend that not only is treatment indicated, it is urgent. Furthermore, psychoanalysis is the treatment of choice. Basically, the method delineated by the Laufers entails a four or five times weekly process that fosters, not the familiar transference neurosis, but rather a reexperiencing in the analysis and in the relationship to the analyst the developmental breakdown that precipitated the severe acting out disturbance—a process the Laufers have termed “transference breakdown.”
The authors are to be commended for elaborating a diagnostic rationale that makes these acting-out adolescents more accessible to our emotional and intellectual comprehension and thus less awesomely confusing. However, it is not likely that the average clinician, even one with many years of psychoanalytic training and expertness with adolescent patients, will be able or willing to undertake the heroic therapeutic measures recommended by the Laufers who, after all, conducted their therapeutic activities within the safety of a supportive research setting. So, while the