Peer-Impact Diagnosis and Therapy

A Handbook for Successful Practice with Adolescents

Vivian Center Seltzer

• Publisher: NYU Press
• Year: 2009
• ISBN:
  9780814786871
• Topic: Psychology
• Subtopic: Developmental Psychology
• Index: Psychology

Adolescents are infamous for their rebellious behavior. Indeed,much of the focus of therapy and clinical intervention with troubled adolescents focuses on their presumed need to rebel against their parents as they define their own identities. Yet psychologist Vivian Center Seltzer argues that approaching work with adolescent clients with this presumption in mind is likely to miss the roots of their problem behavior.

Rather than acting out against parental authority, adolescents in need of clinical help are most often dealing with their disappointing comparisons with their peers—the most relevant others to them during this period of their development. Seltzer explains that it is countless interactions with their peers, at school and elsewhere outside of the home, that are the primary mode of psychological and social development for adolescents. Practitioners must recognize this crucial influence, and perhaps forgo traditional approaches, in order to better work with their adolescent clients.

Peer-Impact Diagnosis and Therapy is a practical professional guide for how to approach and aid troubled teens by accessing the wealth of insight to be gained from understanding the influence of peer interactions on development and on behavior. Full of diagnostic categories and protocols for use with all types of adolescents, as well as guidance, tips, case studies, and offering a targeted model for adolescent group therapy, Seltzer provides professionals with all the tools they need to assist teens on their road to adulthood.

PART I

Forces of Adolescent Development

1

Dealing with Development

Four Domains of Adolescent Growth

It is important for professionals to bear in mind that from time to time it may seem as if the adolescent with whom you are working is quite different from the way he or she was just a few days before. This perception may be due to shifting moods but may well be a manifestation of a periodic integration of the gradual change occurring during this stage of growth, when child turns into adult. As noted in the introduction, development occurs in four domains: physical, cognitive, emotional, and social. Each domain proceeds along its individual calendar. Sometimes physical growth is ahead; at other times it is behind one or more of the other three. Relative positions keep changing places. The domains are like cars of a railroad train that change places at junctions. Car A can be behind during one portion of the journey and ahead at others. To put this analogy in human terms, an early adolescent who has been taller than classmates for years may stop growing at age 13 or 14. Conversely, the slow developer may achieve full height at 16 or 17 years of age and turn out to be taller.

Physical growth is immediately visible; cognitive, emotional, and social growth are not. Growth in the latter three becomes evident in words and actions. Behaviorally, some surprises are in store. For example, she who seemed shy overtakes the “talker”; he who struggled with math may before long exceed the algebra star. These changes reflect cognitive growth maturing at different paces. Emotional growth takes place right alongside both cognitive and physical growth. It is the internally felt sensation that responds to physical and cognitive changes. As the latter two become more complex, so do emotions. Social growth can be defined as comprehending which behavior is appropriate in different social settings. It is complete when the three domains of growth are integrated and all four are combined. This type of growth evidences itself in appropriate adult social behavior.

This development process is complex and takes a long time to complete—ten years or more. Each month, each week, sometimes even each day can bring contradictions that need resolution.

Impact on the Adolescent

The adolescent does not remain immune from the impact of frequent changes. It is very confusing. The adolescent looks to peers, since they are changing too. As discussed in the introduction, adolescents seek out similarity to find some comfort that they are not becoming “strange” or “uncool.” But they need to look at difference too. Difference offers new data with which to compare.¹ Adolescents need both similarity and difference, similarity to bring a sense of ease and difference to model possible qualities for the self they are trying to construct.

All adolescents speculate on what happens between themselves and their peer models. Whereas physical interaction is intentional and obvious, most psychological interactions of this stage are subliminal. Assessing the results of psychological interactions requires cognitive direction and emotional reflection. Results are registered emotionally. No adolescent finishes the process quickly. All do a lot of pondering, altering, re-altering, and re-re-altering. When they study outcomes, or when they encounter new models, they may switch to new aspirations and behaviors. The subliminal comparison processes start all over again. Adolescents may be together physically, but growth is an individual task.

A natural question to ask is, if adolescents seek to find their individuality, why do they dress similarly and use codelike phrases and innuendos and why are they eager to be in touch with one another almost constantly? The answer is quite simple: uncertainty. It is a formidable situation no longer to see yourself as you did before but to remain uncertain of who you are right now. It is even more angst-ridden when there is little clue as to what you will eventually be like. Thus, finding others essentially in the same boat who need to resolve similar, albeit not identical, growth issues is welcomed. Looking, talking, and acting alike afford a balance to an internal sense of instability. Yet, as adolescents witness one another’s spurts in development, usually at times different from their own and/or not necessarily in the same direction, relationships can become far less soothing.

Then and Now in the Academic Literature

It is important to note before we proceed to explore child and adolescent development that controversy regarding how to categorize adolescence in psychology is age-old and continues today. The perception of “adolescence” as a distinct period of development grew more prominent in contemporary times during the dramatic decade of the ‘60s. The perception of adolescence as a stage of life to have some unease about also grew during this period of U.S. history, which saw rebellious youth acting out in unpredictable and antiestablishment behaviors. The appeal to young people of dramatic and even dangerous contrariness worried parents and elders. However, this was not the first instance in history in which youth were singled out for special attention and, in some cases, concern.

Long ago, adolescence was considered a distinct period of development. Yet for quite a lengthy period it was not acknowledged to be a stage separate from childhood. According to Rolf Muuss, an educational psychologist and author of books with discriminating synopses of major theories of adolescence, the word adolescence first appeared in the 15th century and was at that time “subordinated to theoretical considerations about the general nature of human development.”²

Aristotle

Aristotle, who lived in the fourth century B.C.E., conceived of human development within three stages. Each stage lasted seven years: infancy to age 7, age 7 to the onset of puberty, and puberty to young adulthood. Translated into modern usage, the third period is what we now call adolescence, the period identified as commencing with the changes of puberty and ending in maturity. Aristotle described the nature of adolescent sexuality as “young men possessed of strong passions and a tendency to gratify them indiscriminately.”³ Today, we include both genders in our “worry sack” about adolescents and how, when, and with whom their libidinous drives are expressed. Aristotle thought of adolescence as a period of “instability,” and we too worry about adolescent uncertainty, tendencies to abrupt and possibly unwise decision-making, and lightning-fast changes in attitudes and even behaviors.

Aristotle wrote about adolescents’ sensitivities and their concern about fair treatment. Today, these same stressors may be expressed in adolescents’ demands for “respect.” Aristotle also wrote about adolescents’ desire for success and concern for the future rather than the past. We call these “goal setting” and abdication of values revered by older generations. The “symptoms” may appear different, but youth transitioning to adulthood seem to express by their behaviors the same drives and ambitions seen hundreds of years in the past.

Instantaneous Creation

The theological view of instantaneous creation was espoused centuries after Aristotle and Plato. It was a philosophy of preformation, or what is on occasion referred to as a view of “homuncular man”—a child born as a little adult, in whom all systems are complete at birth. The difference between a child and an adult was considered to be quantitative, not qualitative. Children were small adults. Paintings of that period feature children in adult attire. In other words, after birth no development was expected other than the internal and physical height and breadth that was preordained. Children were expected to behave as the adults they were. Hence, there was no childhood, let alone any concept of adolescence.⁴

Rousseau and Locke

The position of the preformationists was challenged at the very start of modern science. The writings of the French author and philosopher of the 18th century Jean-Jacques Rousseau promoted his position that a child is very different from an adult and is entitled to grow freely rather than being restricted as an adult would be.⁵ Perhaps the most serious actual and forthright challenger to the doctrine of homunculism was another philosopher, John Locke (1632–1704). Locke took the position that at birth one arrives as an empty slate—a tabula rasa. He regarded experience as the source of development—of what we know, what we think about, and what we have to offer.⁶ How the child becomes adult and what kind of adult he or she becomes depends on what his or her experiences have been. Here, we see antecedent thinking of 20th-century behaviorism⁷ and operant conditioning.⁸ Although the positions taken by Rousseau and Locke were radically different from each other, since Rousseau followed a stage view of development rather than the Lockean philosophy of tabula rasa, neither believed that a child was merely a small adult. Rousseau accorded adolescence a unique stage, as had Aristotle.

Modern Time in Adolescence

G. Stanley Hall is widely acknowledged as the father of modern adolescence. He bridged the gap between the philosophies of his predecessors by connecting them to modern science. Hall concurred that physiological factors are genetically determined (but do not arrive complete with birth) and emphasized that they come to fruition in a gradual unfolding growth (and are not a product of experience alone). The latter view left him open to a later challenge by disciples of tabula rasa.

Hall presented his model in a series of groundbreaking lectures at Clark University in 1908. The lectures, based on a book published in 1904, marked the first formal psychology of adolescence. At last, there was a formula to follow in understanding behavior clearly demarcated as uniquely adolescent.⁹ Hall’s model perceived of adolescence as the fourth stage of growth, as opposed to Aristotle’s view of it as being the third stage and Sigmund Freud’s identification of adolescence as the fifth stage.¹⁰ Hall’s fourth stage was preceded by infancy, childhood, and youth. All these theories were similar in setting the onset of adolescence at puberty and establishing that it continued until psychological maturity is achieved. Each identified adolescence to be different from both childhood and adulthood.

Today, little argument exists in contemporary thought that adolescence is a quite separate stage of development. And yet it is puzzling to see so many scholarly books—and for that matter popular books—that discuss children and adolescents in one relatively small volume. Children and adolescents are not the same and should be regarded and handled quite differently.

A Short Step Back in Time

Before turning to the stage directly leading up to adolescence, it is well to take into consideration mid-20th-century theorists whose work brought very important but less popularly known perspectives on development. Psychoanalyst Otto Rank, a disciple of Freud who later broke from him, formulated a theory stemming from the “birth trauma.” Rank’s work introduces us to the most primitive and intimate relationship between mother and child. The mother’s body responds to the infant’s signal of readiness to separate. Psychological growth of the child begins with resolving separation, which Rank designated as the first emotional task of the individual. Union and separation, one of Rank’s most prominent themes, depicts the reality of “living”; each occurrence of union and separation reawakens emotions of the primary experience.¹¹ Thus, adolescents are inevitably in an extremely sensitive life-stage. An early social psychologist, Harry Stack Sullivan, contributed the concept of “interpersonal psychology.” Sullivan concentrated on the influence of depth and process in interpersonal relating on development and behavior. Erik Erikson is widely known for his seminal contribution of establishing identity achievement as the adolescent developmental task. All three of these theorists devoted a lifetime of study to issues of growth and psychological development—separation from the familiar, union with new others, and integration of these experiences.

Each of these historically prominent theorists provides insights that professionals will find valuable in their therapeutic work today with adolescents. A very brief look at the essential position in Sullivan’s theory is followed by a discussion of Erikson on adolescence. Sullivan’s position on emotional development in adolescence is also discussed later in the chapter.

HARRY STACK SULLIVAN

At a time when cognitive theory was not yet prominent in adolescent literature, Harry Sullivan advanced the theory that interpersonal relationships are the essential ingredients for normal human development. If experiences are negative and arouse anxiety, social problems of immaturity, deviance, and serious emotional disorders arise. Feelings of sorrow, despair, anger, even depression may also be stimulated by inadequate responses to interpersonal needs. One’s feeling happy means one has positive interpersonal contact.¹²

ERIK ERIKSON

Erik Erikson was a follower of psychoanalytic theory who departed from traditional theory to stress social impacts and not libidinous outlets as Freud’s followers did. Erikson’s focus on social forces in everyday life and the impact of those forces on development and behavior necessitated adding three stages beyond Freud’s five. All eight stages involve the resolution of a psychological conflict; lack of resolution at one stage means that movement to the next stage will be emotionally handicapped and thus harder to resolve successfully. The preadolescent (school age) task is industry versus inferiority, and the adolescent developmental task is identity versus identity diffusion.

Achievement of identity entails certainty about one’s gender and direction in life. The opposite, identity diffusion, portends the trying out of many personalities and roles; it indicates that maturity is yet distant. Satisfactory resolution of identity and the three additional stages brings intimacy in relationships, pleasure of rearing the next generation, and ending life emotionally satisfied—the perception of a life well lived. Erikson sounds two notes to which it is important that the professional be ever alert. The first is an optimistic one. In each crisis, under favorable conditions, the positives toward resolution will probably outweigh the negatives. The second, that each stage resolution builds strength for entering the following stage defines an implicit professional responsibility: helping adolescents find their unique path.¹³ Special attention is well spent on the identity-diffused adolescent. Although trying out a number of alternatives for what might work in the future is a good thing to do, identity diffusion—inability to discard identities deemed inappropriate and/or continuing to look for “the perfect answer”—seriously threatens reaching identity. This type of adolescent remains “in process,” avoiding maturity.¹⁴ Erikson too warns of less-than-satisfying times in the future if adolescence is not resolved well.

Late-Middle Childhood

Development moves back and forth. It does not occur abruptly. In order to understand adolescent development and behavior better, it is advisable to be informed about the years immediately prior to adolescence. Such knowledge assists in allaying concerns when there need not be any and in raising a flag if particular age-inappropriate behavior persists over a long period.

Late-middle childhood, ages 8 to 10 or 11, is generally a pleasant time for both children and parents. For the child, it is a period when new skills are being acquired. Parents enjoy teaching children and entering into activities with them. The child is less dependent, has more information, can join into conversation, and appears interested in being a real part of the family. Children enjoy going places with their parents. Home is still the center of their life. Parents retain their reputations as “experts.” Friendships are generally smooth. Youth venture out further and further by themselves, yet not too far. Children of this age delight in hobbies, Internet entertainments, stories, and movies. If there are no serious internal or external problems, life is generally pretty good for all concerned.

Physical Development

The late-middle-childhood youth does not take much note of height and weight differences, although during the latter part of this period of life bodies begin to change. All sizes are seen as natural. Children are not yet tuned in to emotional aspects of physicality in themselves and others. Males are particularly alert to those who are good at sports and those whom not to choose to join one’s team. Those selected are not regarded as “early developers”; rather, they are “good at sports.” Nor are there names for those who grow very tall or show beginning sexual characteristics. As females near adolescence, they become aware of beginning breast buds, but they are not self-conscious. It is not yet important. Playing with friends and going places with the family is what matters—usually for both early and late developers.

The growing distance between the genders goes relatively unnoticed. Same-sex friendships are so important that little attentio...