Psychoanalytic Psychotherapy with Adolescents

Psychotherapy with Adolescents


Psychotherapy with adolescents could help this young man.Psychotherapy with adolescents provides a unique opportunity to impact identity at a key time in development.  Understanding the roles of “self” and “identity” is helpful in this process.

Self and identity have been variously defined and, at times, viewed as synonymous.  It is clinically helpful to distinguish between the two in psychoanalytic psychotherapy with adolescents.  Compensatory identities are sometimes formed during this period, in response to profound psychic conflict.  Exploring the function of these identities as objectified processes to cope with psychic trauma must be balanced with respect for the “subjectivity of self as a vehicle for psychological truth.”  

In a recent article, Dr. Michael Gerson discussed such distinctions and their clinical implications, as they applied to his psychodynamic treatment of two adolescent patients.  The article is “Clinical Implications for the Expressions of Self and Identity in Adolescent Psychotherapy: Case Studies of a Vampiress and a Gangster,” published in volume 24, issue 6 (pp. 718-732) of Psychoanalytic Dialogues: The International Journal of Relational Perspectives.  

Struggles with self and identity impact the adolescent mind.  The adolescent’s experiences of self–as derived from bodily experiences and emotional confusions–can create an ineffable sense of alienation from others.  In adolescents, self-conflicts can also present with transient dissociative states.  Experiences of identity, by contrast, can provide a compensatory, reflective function.  

The article describes Dr. Gerson’s work with two troubled adolescents.  One had taken on the identity of a vampiress and the other of a gangster.  The psychodynamic treatment focused on exposing, understanding, and working through the internal conflict, thus helping the patients negotiate between the perspectives of self and identity.  By examining the contrast between identity and self, these patients were able find ways of living that, ultimately, felt more truthful, authentic, and integrated.

Please contact Dr. Gerson at to receive a free personal copy of the article.

For more background on self and identity, also see the courses Classical Psychoanalytic Theory or Ego Psychology.

“Self” and “Identity”

Neuroscience, Self, and Identity

Neuroscience, Self, and IdentityWhat do we mean when we refer to self?  Is self distinct from identity?  The constructs of self and identity have been understood and discussed historically in diverse ways.  Neuroscience research is now supporting that they are indeed distinct constructs.

Neuro-imaging research is consistent with self as reflecting right hemisphere, reflexive, nonlinguistic experience.  In contrast, identity involves left hemisphere, reflective, linguistically-mediated experience.  

Self and identity have distinct functions as well as developmental significance.  Self refers to how we experience the moment, from the perspective of “I”.  Feeling the exhilaration of reaching a mountain top, for example, would be engaging the self.  Identity reflects our experiences from the observer, or “me”, perspective.  Thinking of oneself as an adventurer would be an example of identity.  

Very young children are more likely than adults to be in touch with the self.  Clashes between self and identity are often particularly evident during adolescence–a stage of enormous neurological growth and changes.  As noted by Erikson and many other theorists, adolescence may be a time of turmoil as a life-long identity is forged.

Understanding the differences between self and identity can be helpful clinically.  To read more, view the fascinating article, “Reconsidering Self and Identity Through a Dialogue Between Neuroscience and Psychoanalytic Theory,” published in Psychoanalytic Dialogues, 24(2), 247-251, as well as the commentary with discussion, Gerson, M. J. (2014). “A meta-commentary: Response to the commentaries of Marks-Tarlow and Solow Glennon.”  Dr. Gerson discusses the empirical study of consciousness in terms of contemporary psychoanalytic concepts and argues for interdisciplinary research in which neuroscience and psychoanalysis may engage in a mutually informing dialogue.  Please contact him at to receive a free personal copy of the article.

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