Psychoanalytic Psychotherapy with Adolescents

College student development and treatment

Philip Rosenbaum, Richard Webb, Philip J. Rosenbaum, Richard E. Webb

• Publisher: Routledge
• Year: 2022
• Print ISBN: 9781032159782
• eBook ISBN: 9781000573978
• Topic: Psychology
• Subtopic: Mental Health in Psychology
• Index: Psychology

In this book, Philip Rosenbaum and Richard Webb consider the complexities of working as counselors and psychotherapists for college students, and offer a broad and detailed account of the developmental issues essential to understanding adolescent experience.

Drawing on existentialism, cultural psychology and relational and object relations theories in psychoanalysis, this book offers a perspective that is sensitive to both clinical concerns and the broader context of college counseling and working with adolescents. Particular attention is paid to the emergence of adolescent identities through a relationship with "otherness," and several considerations are explored as a result. These include the emergence and reconciliation of destructive feelings, suicidal phenomenology and the effects of trauma.

By taking a fresh look at clinical developmental theories as they affect adolescents and young adults, Rosenbaum and Webb provide a view of college-student development that is theoretically rich and clinically applicable in a way that warrants renewed appreciation and practice among counselors, psychotherapists and psychoanalysts working with college-age clients.

Chapter 1 Important Aspects of Our Existential Nature and Meaning-Making

DOI: 10.4324/9781003246558-2

We feel that our thinking about college and university students has to begin with considering the ontological aspect of our (and their) existential-relational condition. In other words, before moving to discuss periods, phases and phenomena of development specific to young adulthood, we have to reflect on our fundamental nature as beings. Indeed, while consideration of this is relevant throughout all of our lifespans, from our perspective it takes on significant urgency during the college years of late adolescent and young adults. Hence, before we can address the various ways, we progressively and alternately organize the particulars of “what we are,” we must appreciate “who we are.”

In our approach to addressing the question of “being,” we consider two aspects of our existential-relational situation that are common to all of us:

1. The tension between continuity and discontinuity that is intrinsic to our sense of being-ness as we emerge out of symbiotic one-ness with our primary caretaker and face the challenge of how to separate and individuate ourselves from others while also maintaining our connection to them.
2. How we make meaning out of our life experiences through our essential reliance on the acquisition and use of semiotic (sign) systems which are always culturally experienced before being internalized.

Finding continuity/discontinuity in our being in relation to difference

Some problems with the usual state of “separation and individuation”

Our emergence into the world starts with our separation away from our symbiotic one-ness with our primary caregiver. While usually referred to as “mother,” we note that this can be any primary caregiver whose role is central to our well-being and to create “good enough” conditions for us to be safe and to flourish (Winnicott, 1971). As stated in our introduction, in acknowledgment of this caregiver's non-specific gender, we, hereafter, will refer to this person either as a primary caregiver or as “M-other.” In any case, this person is ideally one who is invested in our care and who provides sufficient conditions for us to emerge as an agentic being.

Not surprisingly, much of developmental literature rightfully focuses on the process of “separation/individuation,” with numerous books having been devoted to this natural process (Mahler et al., 1975/2000). Usually, this literature maps out the stages that can be identified as we proceed from infancy to childhood and then on through adolescence to separate or individuate from our family and our assortment of key caregivers. While we think the idea of separation/individuation is important, we find the typical ways of dealing with this process insufficient for two reasons.

First, they often fail to note how this is an ongoing and lifelong process. Indeed, Erik Erikson (1950) is one of the few clinical theorists whose “staging” acknowledges this. However, we propose that the staging, especially past adolescence, is not robust. Second, perhaps even more importantly, we maintain that even when these stages are loosely applied, our existential nature is misrepresented or overlooked. Characteristically, stage theories imply a subjective teleology that there is an endpoint toward which all the stages march. In as much as this is so, most developmental theories do not acknowledge that an essential aspect of our being-ness is our incompletion even as we proceed toward greater differentiation.

Continuity/discontinuity and completion/incompletion

We suggest that a worthy alternative approach is one that captures the dynamic interplay in our being-ness between seeking completion/continuity and incompletion/discontinuity. A theory is needed that appreciates our ontological condition and that thereby is able to highlight the tension between our search for a coherence in and evolution of who we are to ourselves and others. The psychoanalyst, Jacques Lacan, is pertinent in this regard. He (1977) considers how our march into and through iterations of being-ness is an intrinsically challenging one, which starts with the physical rupture of the symbiotic relationship the mother and child share while the child is in the womb and then proceeds immediately into the psychological realm where it is played out in our connection and individuation from important others in our life. Lacan sees this original separation as alienating to the child since the child only is able to construct an image (identity) of themselves through the fragmented perspectives of their caretakers. Only being able to glimpse ourselves through these fragmented reflections of our caregivers’ perceptions means that our experience of ourselves, especially during our early years, is known to us fundamentally in the refracted way that characterizes our socially constructed identity.

This process engenders an elusiveness of identity in any essential sense. We come to experience and so know, who we are through the gaze of important others in our lives, as well as our broader society and culture. Hence, our sense of “being” and of who we are, is always plural, multiple and reflective of our numerous relationships. Within this complex plurality of images and refractions, we search continually to find a coherence within which we can distinguish boundaries between ourselves and others and therein articulate identities, which feel specific and authentic to our own being.

Lacan further notes that it is not adequate to speak of “an identity” only in relation to others. Our identity also speaks to who we are in relation to ourselves. In other words, our sense of ourselves emerges not only out of our relationship to others but also out of our experience and understanding of who we are to our own self. Assuming we do not contravene the nature of our ontology by deluding ourselves into thinking that this journey can end prior to our death, we must embrace the idea that our identity is always something that is in pursuit of itself. We are always “becoming.” As Mikkel Borch-Jacobsen says,

For Lacan, it would no longer be a question of recognizing one's self in the mirror; on the contrary, the issue would be not to recognize oneself in the mirror, to shatter it and move on, bloodied, into the void of its absence. (1991, p. 81)

Our incompletion, then, is what constitutes our existential condition. It is both our lifelong challenge and our potential for the pleasure of ongoing newness. “[W]here the real journey begins” is beyond “the ecstatic limit of ‘Thou are that’” (Lacan, 1977, p. 7, original emphasis).¹ We and others can only frame our sense of our being within the realm of words and cultural understandings, but the fact is that this is so means that our reference point for being “named” is always one that can claim no relationship with an unfiltered reality. In short, our identity is something that can never be fully captured by any construction of meaning available to us within the ever-changing relativity of culture and words. Therefore, it is something, as we noted earlier, which we can ever view as complete. As Jacques Lacan says, “There is nowhere any last word unless in the sense in which word is not a word … Meaning indicates the direction in which it fails” (1982, p. 150, original emphasis). Gary Whitehead says in his poem, A Glossary of Chickens, we should not assume, “that by naming we can understand,/as if the tongue were more than muscle” (2010, p. 39). The “should” in this is something we will shortly discuss when we focus on the completion/incompletion nuance within continuity/discontinuity.

As such, our identity is not something which should not be considered a stable “achievement” but rather as something which is always in the process of developing and becoming. Keys to navigating this shifting world of identities are the ways that we come to experience ourselves as individuals who have and bear responsibility for our own desires and the capacities to pursue these desires. The attachment theorists (Beebe, 2005; Beebe & Lachmann, 1998, 2003, 2014; Beebe et al., 2012; Stern, 1983; Schore & Schore, 2008) highlight how the bi-directional and mutually regulating relationships between babies and their caregivers set the stage for our emergent multiplicities and agency. In this regard, they extend beyond Lacan's understanding of rupture and alienation toward articulation of the challenging and complicated relational factors that are at play. As the burgeoning child, we experience not only positive attachment with our caregivers but ambivalence. Always present is the potential for an attachment that reflects avoidance or disorganization. Our caregivers attach to us in a corresponding way, and the complex mix of factors mentioned above is especially in play when our caregivers have experienced trauma. However, as we will discuss later, the potential for dysregulation in the attachment is present when, for whatever reason, conditions are not “good enough.”

Operating from this perspective which acknowledges our ontological state means that there is no “endpoint” to our efforts to distinguish ourselves with identities. Our nature is not a march toward some ultimate state of organized identity but rather a journey, within the embrace of our continuity with others, always to express our discontinuity, “the cipher of [our] mortal destiny” (Lacan, 1977, p. 7). The choice of the terms continuity/discontinuity and completion/incompletion, then, is our effort to undermine any notion that we are proceeding to some ultimate existential state of definition. Notably, as we will discuss more in the next chapter, this process can be thwarted in numerous ways and, indeed, much of our work as clinicians involve navigating these situations.

An alternative metaphor: Articulation and collapse

In considering the processes related to continuity and discontinuity, we have found ourselves drawn away from the confines of psychology toward borrowing a concept from quantum physics which we think serves well as a metaphor, as a way of thinking of how we, as beings, are disposed to exist within our worlds (Rosenbaum & Webb, 2021). In doing this, we are in some ways appreciating the efforts behind apophatic or negative theology, a speaking toward what is always beyond words by “speaking away” (Webb & Sells, 1995).

In quantum physics, the subatomic matter is viewed as having a duality in its nature. Such matter is simultaneously a wave and a particle. A “gaggle” of matter travels as wave which is everywhere and nowhere at the same time. It has, however, a potentiality to manifest when it “collapses” into a particle, into matter with a particularized location. This happens when the gaggle of matter is observed or measured. Although collapsed in a given instance of observation, the matter that constitutes the particle continues to bring its duality into next events with the potential for new collapses into different particularizations.²

The dialectic between measurement and collapse is useful for meeting the challenges in describing how a person emerges into an interpersonally distinguishable being. From our perspective, we, as people, come into the world also as a gaggle of matter: we start our lives with a broad wave of potential self-states and identities. Over time, our potential delimits itself as we are measured or positioned in language by ourselves and others within our shared cultures. The process of being measured or named by others and ourselves within the fold of our culture's description of reality and the process of being freed from that measuring through recognition of culture's relativity is the movement back and forth between wave and particle. It is the movement which provides a complex backdrop for our emergent identities. It is a back and forth which entails the serial collapse of our being into articulation by naming and then our return to status as a “wave” of not-yet-named potential.

Of course, the use of metaphor to describe the dialectic of our being-ness is something others have also used. While we think quantum physics offers an especially useful means for capturing the process of articulation and then immersion in a one-ness, we wish to note, by contrast, how Friedrich Nietzsche has approached this same issue. To do this we rely particularly on Steven Mitchell's (1986) commentary on Nietzsche.

Nietzsche addresses the dialectic through the anchor of early Greek gods: Apollo, the god of dreams and illusion, and Dionysus, the god, who in an early version represents undoing and the death of the individual. In his theory of tragedy (1910/1872), Nietzsche heralds the “tragic man” who lives with and between both dimensions of being that are represented by these gods: (a) an Apollonian one wherein we emerge temporarily in some form of identity or articulation and (b) a Dionysian one wherein we dissolve into the undifferentiated oneness of “a larger unity, a universal pool of energy” (Mitchell, 1986, p. 195).

To explain Nietzsche's ideas about this, Steven Mitchell (1986) pictures the beach at low tide. He says that the Apol...

Table of contents

• Cover
• Half Title
• Series Page
• Title Page
• Copyright Page
• Contents
• Acknowledgments
• Introduction
• 1 Important Aspects of Our Existential Nature and Meaning-Making
• 2 Introduction to Four Existential-Relational Positions
• 3 Clinical Implications and Posture
• 4 Appreciating “Destructive” Processes in Adolescence
• 5 Developmental Considerations Associated with Suicide
• 6 Treating Trauma in the Fishbowl of University and College Counseling Centers
• 7 The Complexities of Otherness
• 8 A Macro-perspective on Groups and Group Identification
• Concluding Thoughts: What about the Rest of Adolescence?
• Index