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Psychoanalytic Psychotherapy with Adolescents
By: Marylie W. Gerson, PhD

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.

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