‘Unjoined persons’: psychic isolation in adolescence and its relation to bodily symptoms

Abstract

This paper examines psychic isolation as an important element of adolescent development. The author conceives of psychic isolation in adolescence as an affective state with important developmental underpinnings. The affective elements are estrangement and loneliness. The developmental underpinnings include shifting (conscious as well as unconscious, internal as well as external) object relations and senses of the self. Psychic isolation combined with the intensity of adolescent experience can leave adolescents unable to articulate their experience. This difficulty with articulation and symbolisation can leave them vulnerable to breakdown into concrete bodily symptoms. The paper uses Bion’s conceptualisation of containment and the balance of psychotic vs. non-psychotic integrative parts of the personality to examine the emergence of concrete bodily symptoms in adolescence. At times, the transitional space of an analysis, where new experiences can be dreamed together with the analyst, allows adolescents to feel they are no longer ‘unjoined persons’ but ‘members of the wedding’.

Keywords:

• adolescence
• puberty
• psychic isolation
• bodily symptoms
• separation
• individuation
• symbolisation
• containment
• cutting
• anorexia

Notes

A version of this article will be included in Brady’s book, The Body in Adolescence: Psychic Isolation and Physical Symptoms, to be published by Routledge in December 2015.

1. For example, Bion describes how the ‘contact barrier’ separating conscious from unconscious gradually develops as alpha elements cohere. ‘The nature of the contact-barrier will depend on the nature of the supply of alpha elements and on the manner of their relationship to each other’ (1962a: 17). Thus, the ‘structure’ of the contact barrier is also a dynamic process that depends on the quality of alpha function or other issues such as whether alpha function is disrupted or has not been well developed in regard to particular contents.

2. Excerpts from The Member of the Wedding by Carson McCullers. © 1946 by Carson McCullers, renewed by 1973 by Floria V. Lasky, Executrix of the Estate of Carson McCullers. Used by permission of Houghton Mifflin Harcourt Publishing Company. All rights reserved.

3. Self-harm is considerably more prevalent in adolescents than adults. A statewide survey of self-harm in Massachusetts (Massachusetts Department of Education, 2011) found that 18% reported self-injury (‘cutting or burning without wanting to die’ [p.2]) in the previous year. One source of comparison with adults is Briere and Gil’s (1998) research, which used a random sample of US adults. 4% reported ‘having self-injured at least occasionally’ (Walsh, 2006: 41). Walsh also notes that there are ‘no large nationwide epidemiological studies’ of self-harm (2006: 32). The Massachusetts Study (2011) finds an even higher number of high school students – 22% – reported binge drinking and 7% reported attempting suicide in the past year (2011: 24). Offer’s work (1971) is sometimes cited to indicate that adolescence is not as tumultuous as early analysts (e.g., Freud, 1958) described. However, Offer’s work shows that, while many adolescents indicate agreement with their parents on larger societal issues, myriad rebellions occur on an everyday basis. Further, self-report research data is very different from the material of analytic sessions that allow a deeper view into unconscious processes. However, we analysts must remember (as Offer points out) that our clinical data is not necessarily representative of the larger population. That is, healthier adolescents don’t generally arrive in analysts’ offices – nor may the most disturbed who may be more represented in juvenile justice systems or may have little access to treatment.

4. Campanile (2012) distinguishes actions ‘on the body’ (my focus here) versus ‘actions in the body’ – hysterical conversion symptoms. His description of these hysterical symptoms is fascinating but I find that actions ‘on the body’ are far more prevalent in adolescence.

5. Other motivations for cutting have been discussed, such as self-soothing or the effort to disrupt feelings of emptiness or numbness, or sado-masochism (Shaw, 2012), as well as cutting becoming addictive (Gardner, 2001). Bodily symptoms often multiply, determined (Waelder, 1936) with various motivations being served in the same act.

6. I have discussed this case at greater length for other purposes (see Brady, 2011).