A footnote in Freud's work and the Isakower phenomenon.
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In this paper, I discuss how the specific developmental function of adolescence can result in behaviour and thought which resemble the adult psychoses but which, in most circumstances, are fundamentally different from the adult psychoses. Anybody who treats the seriously disturbed adolescent will be familiar with a simple and obvious characteristic of these adolescents--it is an irreconcilable, unanswerable quest to alter the image of the body. If we try to understand the psychotic manifestations or psychoses of adolescence, we must differentiate between (i) a psychotic episode, (ii) psychotic functioning, and (iii) psychosis. The assessment of psychosis must be reserved only for a very special category of disorder in adolescence and must not be confused with either a psychotic episode or psychotic functioning.
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Detailed clinical material is presented from the analysis of a latency girl whose inner life revolved around a series of beating fantasies. The clinical data support Freud's 1925 formulation that the perception of sexual differences initiates the oedipus complex in the girl. Whether a girl experiences vaginal sensations before puberty has been a controversial issue; in this girl vaginal sensations and contractions appeared prior to puberty.
The health professional can be helpful to the adolescent, the adolescent's family, and the community through participating in and initiating local sex education programs. Religious settings provide a great potential for sexuality education within a value framework. A helpful curriculum will include the meaning of sexuality; developing a positive concept of sexuality, and a healthy sexual identity; present the issues of adolescent sexuality, including the various health issues; and an understanding of quality relationships within the family and among peers. If health professions and the community religious institutions can joint together, they can reach the goals of most programs in human sexuality, namely, "learning to appreciate our sexuality as a positive potential for self-expression, fulfillment and intimacy; respect for the personhood and well-being of others; and responsible decision-making."
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In order to separate hormonal from social effects on adolescent male sexual behavior, serum hormone assays were performed and questionnaire data on sexual motivation and behavior were collected on a representative sample of 102 boys in grades 8, 9, and 10 of a public school system. Free testosterone was a strong predictor of sexual motivation and behavior, with no additional contribution of other hormones. Including measures of pubertal development and age (indexing the effects of social processes) indicated no additional effects. Free testosterone, therefore, appears to affect sexual motivation directly and does not work through the social interpretation of the accompanying pubertal development.
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