High up on bar stools: manic defences and an oblivious object in a late adolescent

Abstract

The author discusses four inter-related themes of late adolescence: birth/death throes, oblivious objects, manic defences and the potential for physical symptoms, sometimes in emergency form. These issues will be elucidated through the psychoanalysis of a late adolescent who was bulimic and binge drinking. Though her symptoms were severe, elements of her dynamics are seen as characteristic of late adolescence. The definitive separation–individuation processes of late adolescence are seen as a final death throe of childhood and a birth throe of adulthood. In these death throes, the adolescent can see objects as oblivious. The late adolescent can resort to manic leaps to negotiate passages she feels unready for. Such leaps sometimes take the form of physical symptoms, sometimes in crisis form, as late adolescents separate more definitively than in earlier developmental periods.

Keywords:

• adolescence
• separation
• individuation
• eating disorder
• alcohol abuse
• bulimia

Notes

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

1. Natalia’s self-destructiveness could be theorised in relation to Joseph’s (1989) discussion of patients addicted to near death: ‘in their external lives these patients get more and more absorbed into hopelessness and involved in activities that seem destined to destroy them physically as well as mentally; for example, considerably over-working, almost no sleep, avoiding eating properly or secretly over-eating if the need is to lose weight, drinking more and more … ’ (1989: 127). Natalia started treatment absorbed in activities that could destroy her. Further, as with Joseph’s patients, she seemed ‘in thrall to a part of the self that dominates and imprisons them and will not let them escape’ (ibid.: 131). However, Joseph’s emphasis is on the underlying transferential meaning – in her patients ‘calculated to communicate or create despair and a sense of hopelessness in themselves and in the analyst’ (ibid.: 127). She sees this as motivated by the satisfaction at seeing oneself destroyed. Natalia did take some pleasure in proving the obliviousness of her object. However, her shocking me resulted in her taking a more sober assessment of her problems and of how she was relating to me. Thus, she did not ultimately seem wedded to a perverse use of these symptoms but to have a developmental need to have an adult register and respond to them.