Page - 202 - in Psychoanalytic Perspectives on Puberty and Adolescence - The Inner Worlds of Teenagers and their Parents

202 Lost by the wayside – overstepping limits (retreat into a private world). These phenomena signify psychic crises that can appear either gradually or suddenly. Laufer speaks of a “disruption in develop- ment” (Laufer 1995a) – disturbances in child development become visible that previously went unnoticed. The challenge of psychic crisis in puberty constitutes the last chance for help before a lifelong distortion of character sets in (Ibid). When evaluating an adolescent undergoing psychic breakdown, the following three areas should be investigated: A: development that is dominated by defensive functioning (italics original) B: deadlock in development that precipitates an acute crisis in functioning (italics original) C: foreclosure in development, where there is a premature end to the developmen- tal process (italics original) (Laufer 1995a, 179) Regarding A: Is only one specific area affected by the crisis, or is the patient’s ability to work and form relationships affected? If several areas are affected, the danger of a total breakdown is imminent if the patient’s psychic defenses collapse in the face of increasing fear. To what extent does the adolescent see his body as only an object to attack or neglect? Or does his actual body still possess the capac- ity for libidinous or narcissistic satisfaction? Regarding B: Deadlock is the point where the patient’s defenses, which until now could contain his fears, can no longer do so. Further development is stymied, with no possibility of reverting to an earlier stage of development. For instance, when an 18 -year -old views the end of his first sexual relationship as confirming his latent conviction that his sexual body is meant to be rejected, he can no longer withdraw to a pre -pubescent attitude where he could obtain support from his par- ents. In such a deadlock, there is the serious risk of an acute psychotic episode, i.e., a temporary break with reality – in a manic, depressive or suicidal form. Regarding C: Foreclosure means a developmental process that was prematurely ended and leads to the adolescent’s acquiring a distorted body image where sexual satisfaction is reduced to a limited form without enabling new experiences (i.e., perverse forms of sexuality or satisfaction through addictive experiences). Before this period of inner transformation, swift physical and psychic develop- ment and reorganization, the patient’s defensive structures were still equal to her inner impulses, fears and challenges. Now, due to new challenges, they collapse. An interview can determine whether the crisis lies within the range of normal ado- lescent development or tends in the direction of a borderline or psychotic distur- bance. Kernberg (1984) asks: “Do all adolescents present some degree of identity diffusion and hence are their symptoms and behavior indistinguishable from later borderline personality organization?” (quoted in Flynn 2004, 215). The difficulty in evaluating such a crisis is that each of the possible symptoms also occurs in milder form during the normal transformations of adolescence: (only) one depressive or psychotic episode is experienced by approximately 30% of all