Download Author: Sarnoff, Charles M.D.

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Epilogue: Late Adolescence into Adulthood

This chapter is devoted to a description of such tasks and troubles from the point of view of a younger person gazing ageward. It is meant to round out the developmental presentation of this book and to give background within the context of the book for the therapist who needs to know what is on the patient’s mind, though not necessarily in focus and perhaps rejected as unimportant by the unwary child.

Derivatives of Latency in the Psychopathology of Anorexia Nervosa

The occurrence of anorectic symptoms during the period of emergence from latency is a common event. Anorexia most often makes its appearance at this time. The more pathological the cognitive impairments, the more likely is the child to become involved in an intransigent form of anorexia. The longer anorexia lasts as a defensive configuration during emergence from latency, the more entrenched and necessary does the reaction become. For this reason, early psychotherapeutic intervention is indicated.

Masturbation

Adolescent masturbation serves as a bridge from evocation and fantasy to communicative relationships with the world of reality.

Bridges to the Object World

For those who work with adolescents it is important to know that there is a natural maturational and developmental stage during which the capacity to fall in love emerges.  Failure to develop the capacity to fall in love has very serious diagnostic and prognostic clinical implications. Impairments in the capacity to fall in love reflect defects in component ego skills. Diagnostic assessments in adolescence should mark these skills for evaluation in the case of selfish and narcissistic patients.

The Object World Responds

The response of the object world has a strong influence on the final shape of the personality. It is the source of the socialization and reality influences that put their stamp on the ultimate form. From the standpoint of late latency-early adolescence, the interactions of drives, talents, and needs, which make up the adolescent thrust, and the responses of the object world follow a predictable pattern, which results in a predictable and acceptable product.

Assessment

The diagnostic assessment of emotionally disturbed children in late latency-early adolescence (9 to 15 years old) requires that the clinician acquire special techniques and background knowledge.

Psychotherapeutic Strategies

For the most part, it is required that the psychotherapeutic strategy applied to early adolescents be adjusted to take into account certain characteristics of the early-adolescent life-stage. These include, in part, developmentally mandated requirements (e.g., immature thinking processes—thought disorders) and socially defined immaturities (e.g., lack of comprehension of the role of educated professionals in providing expert help in areas of need). Therefore, this chapter is devoted to those psychotherapeutic strategies and techniques derived from information about the psychology of psychotherapy, which set the psychotherapeutic treatment of the early adolescent apart from the treatment protocols used for children of latency age and adults.

Adolescent Masochism

To understand the nature of the manifestations of masochism in adolescence, it is necessary that one understand their origins in the previous phases from which they have emerged. The manifestations are masochistic braggadocio, masochistic perversions, adolescent shyness, aspects of prepubescent schizophrenia, incipient masochistic character traits, and the misuse of free association during psychoanalytically oriented psychotherapy sessions. The genetic complexes of origin that give structure to the forms of adolescent masochism may be studied through a review of the life phases of masochism.

Psychotherapeutic Strategies in Late Latency Through Early Adolescence

Charles A. Sarnoff, the authority on the treatment of the latency-age child and young adolescents, offers sound strategies and new approaches for therapists who treat early adolescents. This volume explores the normal development of this transitional period and therapeutic strategies useful in confronting pathological wanderings from the normal evolution of adolescence out of late latency. Chapters are devoted to the assessment of normalcy and the therapeutic approach to digressions The relationship between this time of transition and future life functioning is amply explored.

The details of the cognitive changes that underlie the maturation giving rise to early adolescent development is coupled with extended descriptions of concurrent metamorphoses of thought and fantasy content.

In any given child—for mankind in general—late latency and its psychology are harbingers of adolescent adjustment. Indeed adolescence does not arise de novo from the head of the child. Adolescence has roots in latency ego and mechanisms of defense as well as the shaping influences of the world in which the late latency child lives. In this book one will find a carefully marshaled set of facts, observations, and theories that set at rest the idea that the relationship between latency and adolescence is one of accidental succession.

This demise of play symbols (ludic demise) as a tool of drive discharge, the ascent of organs that seek partners, the conversion of daydreams into future planning, the end of inward turning of interests, and the move from narcissism to object seeking are sought out and their stepwise development displayed in these pages. The influence of latency on adolescent adjustment and pathology are described and its assessment and ensuing psychotherapeutic strategies are presented in extended chapters with clinical case illustrations accompanied by supervisory comments.

Some of the topics of interest are: precursors of adolescence, the adolescent brink, the fourth cognitive organizing period of latency, the shifting symbolic forms of late latency-early adolescence, evocative symbols and communicative symbols in normality and pathology with keys to the treatment of pathological turning in the ways of the symbol. Also covered are narcissism and omnipotence, sexuality, masturbation, free association in late latency—early adolescent psychotherapy, and the cognitive underpinnings of the capacity to fall in love.

Dr. Sarnoff draws on his years of experience as a child therapist and supervisor in a way that makes this volume a rich source of illustrative clinical vignettes accompanied by supervisory comments. He has carefully demonstrated that the developmental features of the transition from latency to early adolescence have marked implications for adolescent and adult functioning and hence for dynamic theory and clinical practice.

Reviews

“In this volume, and its companion work, Dr. Sarnoff has presented a developmental psychology of the period of transition between latency and adolescence. This psychology offers background information for psychotherapists who devote their attention to the late latency-early adolescent years. This is developed in material on assessment and on the technique for developing psychotherapeutic strategies utilizing the background material in the book.

In the process, Sarnoff has broken new ground in the understanding of the relationship between latency and adolescence. The orientation that has seen little more relationship between the two periods than that of consecutive occupants of the same hotel room has been replaced with the idea that there is a transitional developmental phase between latency and adolescence with its own cognitive transition, pathology, and impact on future adjustment. The metamorphosis that takes the child from his status as a home bound caterpillar in latency to the brightly colored butterfly of adolescence who is testing his wings and is ready to fly is presented in detail. What results is the delineation of a newly defined and richly detailed developmental period, where before there had only been some traces in the void and those buy dimly seen.

Among the topics covered are the maturational growth of symbols, adolescent masochism, narcissism, and omnipotentiality, the development of object relations and the capacity to fall in love, extensive case summaries, some with supervisory glosses, and a reflections on his developmental phase of transition that places within it many of the wellsprings of adult character.”

Donald I Meyers, M.D.
Director Child Psychoanalytic Program
Columbia University

Phobias

The phobias of latency-age children satisfy the requirements of a true phobia, but they have their own peculiarities that set them apart from true phobias found in adults. These differences are useful to know in working with phobic children.