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Clinical applications of adolescent female sexual development.

Growth and development during the teenage years encompass two closely related maturational phenomena: 1) puberty, the process of physical growth and development, and 2) adolescence, the process of cognitive and psychosocial growth and development. Puberty and adolescence usually proceed in an orderly, predictable sequence. Knowledge of the usual sequence of adolescent physical and psychosocial development is critical for distinguishing normal developmental processes from pathologic conditions. Providing effective anticipatory guidance to adolescents and their parents requires an understanding of the wide range of normal adolescent behavior and the ability to identify young people who are not developing normally.

Adolescent↗

Fragmentation and narcissism. A revaluation.

The paper focuses on the articulation of two areas of theory: that of development of the self through fragmentation and differentiation and that of narcissism in early psychological development, and its pathology later in life. Jungian ideas concerning the self and individuation (including those developed by Fordham) are linked with psychoanalytic ideas, notably Kohut's, and related to the concepts of narcissism and ego-development. In this the focus is on a revaluation of the negative overtones of 'fragmentation' and 'narcissism' and an indication of their place in the process of individuation. It is pointed out that a varying emphasis in the analyst on what are called the biological and ethological aspects of these theories will have important implications for the treatment of patients. The theoretical position is illustrated by a lengthy clinical example involving a case of early injury to the self which suggests the pathology of narcissistic character disorder. But the case also illustrates the contribution to development of fragmentation and narcissism, which are revalued here as the 'part-for-the-whole' and as one of the 'motors' of individuation. Working within a perspective that prioritizes the importance of the drive towards relationship, it is recommended that the analyst learns to respect and value phenomenologically the contribution of fragmentation and narcissism to normal development, if true healing is to occur.

Adult↗

Fixation and regression in the psychoanalytic theory of homosexuality--a critical evaluation.

This essay evaluates the notions of fixation and regression in the psychoanalytic theoretical conceptualization of homosexuality. Charles Socarides has had a central role in formulating the most prominent and influential psychoanalytic metapsychological understanding of homosexuality in recent years and for that reason this essay focuses principally on him. The concepts of fixation and regression are central to his understanding and I argue that the evolution of these concepts in contemporary usage renders them irrelevant to formulating the current psychoanalytic understanding of homosexuality and that their continued use by analysts reflects a negative attitude toward homosexual behavior on the part of Socarides and many other analysts that stems from an extremely narrow and idealized conception of human development.

Adult↗

Gender identity disorders in children and adolescents.

Gender identity disorders in children and adolescents are uncommon and complex conditions. They are often associated with emotional and behavioural difficulties. Intense distress is often experienced, particularly in adolescence. Treatment and prevention of the emotional and behavioural problems are essential, even if the atypical gender development remains unchanged.

Adolescent↗