Emerging Adults, Identity Development, and Suicidality: Implications for Psychoanalytic Psychotherapy

 

by Mark Schechter, MD; Benjamin Herbstman, MD; Elsa Ronningstam, PhD; Mark Goldblatt, MD, – members of the Boston Suicide Study Group

 

Abstract

Emerging adulthood (approximately ages eighteen to twenty-nine) has been identified as the transitional age between adolescence and young adulthood. People in this phase of life face specific issues and pressures in developing and consolidating various aspects of identity. The process of coming to experience oneself as a coherent, whole person, and learning about one’s own attributes, capacities, and potential for growth can be fraught and vulnerable to developmental disruption. Difficulties with identity development and consolidation can lead to experiences of disconnection, aloneness, despair, and harsh self-attack that heighten vulnerability to suicide. The psychotherapeutic relationship can help the patient achieve a degree of self-recognition that might not otherwise have been possible, decreasing vulnerability to suicidal despair and opening up the potential for ongoing development and growth. Together, patient and therapist have the opportunity to more fully recognize aspects of the emerging adult’s identity that are present but have not been fully realized, and also to renegotiate other aspects of identity that are based on old, maladaptive “scripts.” We present clinical material to illustrate how struggles with identity relate to suicidality, and to highlight the challenges and opportunities of psychodynamic work.

Psychoanalytic Study of the Child, 71:20-39, 2018.

Link to Online Publication [fulltext can be downloaded in, or can be requested from, the library].

 

The Boston Suicide Study Group has also recently published John Terry Maltsberger, American Psychoanalyst: Contributions to the Development of Studies of Suicide and Self-attack (Journal of the American Psychoanalytic Association, 66(5), 861–882, November 2018). John Terry Maltsberger (1933–2016) was an American psychoanalyst and a BPSI member who greatly influenced studies of the suicidal patient, and a suicidologist whose contributions significantly impacted psychoanalysis. Through his devotion to the understanding and treatment of suicidal people he exerted a major influence in both areas. Throughout a long and productive career, Maltsberger focused on an uncomfortable area of the psyche, that sphere that impels the attack on the self. His position in psychoanalysis stands out for his early emphasis on the patient’s internal subjective experience and the dynamics of the therapeutic engagement. He had a broad range of knowledge and interests beyond psychoanalysis and was able to integrate perspectives from empirical studies with his empathic understanding of clinical material and a striking ability to make complex and impenetrable intrapsychic processes lucidly understandable.