This chapter will move beyond the dynamics of personality development to consider some essential aspects of the therapeutic relationship.  In particular, the transference relationships between patient and therapist and how they are critical to clinical work in all fields of medicine and form the core of psychotherapeutic activities will be discussed.

The entrance into school is symbolic of the crucial issues of the period. Children now move into the world beyond the home and must begin to find their places in it, and in so doing their self-concepts, value systems, and cognitive capacities change.

We cannot understand human functioning without a clear appreciation of how emotions and physiology are inextricably interrelated, and how individuals’ personality development influences their body structure and can even determine what constitutes stress for them and creates strains on their physiological apparatus.

The adolescent lives with a vibrant sensitivity that carries to ecstatic heights and lowers to almost untenable depths. For some, the emotional stability achieved in childhood and the security of the family attachments contain the amplitude of the oscillations and permit a fairly steady direction; whereas others must struggle to retain a sense of unity and a modicum of ego control.

The lengthy developmental process as a dependent apprentice in living draws to a close as individuals attain an identity and the ability to live intimately with a member of the opposite sex, and contemplate forming families of their own. They have attained adult status with the completion of physical maturation, and, it is hoped, they have become sufficiently well integrated and emotionally mature to utilize the opportunities and accept the responsibilities that accompany it.

Occupation and personality traits are intimately related.

Along with the hazards and the need for realignment of personality functioning, the marriage brings with it new opportunities for self-fulfillment and completion.

The topic of marital adjustment involves the requisite shifts within each person—within the personality of each—that make possible the necessary interrelationship that proximates a coalition; it concerns the finding of reciprocally interrelating roles that permit the meshing of activities with minimal friction; it includes the reorganization of the family patterns which each spouse learned at home, and which may involve differing ethnic and social class patterns, into a workable social system; it concerns how the childhood family romance of each partner can find consummation.

The birth of a child, perhaps actually the awareness of conception, changes the marital partnership by the need to make room—emotional room—for a third person. The product of their unity can be a strong bond, a source of common interest and shared identification, but children are also a divisive influence—in varying proportions in each marriage, a unifying and separating force. In becoming parents, the marital partners enter into a new developmental phase.