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
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.
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.
Mark Schechter, MD is the Chair of Psychiatry at North Shore Medical Center, and a part-time Instructor in Psychiatry at Harvard Medical School. He is a member of the Boston Psychoanalytic Society and Institute, and a member of the Boston Suicide Study Group. He teaches about suicide in the Massachusetts General Hospital/McLean residency program, and has published papers and book chapters about various aspects of psychotherapy with suicidal patients.
Benjamin Herbstman, MD, MHS is a psychiatrist in private practice in Cambridge, Massachusetts, and a psychoanalytic candidate at the Boston Psychoanalytic Society and Institute. He is an Assistant Psychiatrist at McLean Hospital, a part-time Lecturer in Psychiatry at Harvard Medical School, and a member of the Boston Suicide Study Group.
Elsa Ronningstam, PhD is an Associate Professor of Psychology at Harvard Medical School and a Clinical Psychologist at McLean Hospital in Belmont, Massachusetts. She is a member of the faculty at the Boston Psychoanalytic Society and Institute and a member of the Boston Suicide Study Group. She has published and presented extensively nationally and internationally on topics related to studies and treatment of suicide and personality disorders.
Mark J. Goldblatt, MD is a psychiatrist and psychoanalyst in Cambridge, Massachusetts. He is Associate Clinical Professor of Psychiatry at Harvard Medical School, Clinical Associate at McLean Hospital, Faculty Member at the Boston Psychoanalytic Society and Institute, and Founding Member of the Boston Suicide Study Group. His long-standing interest in suicide and psychoanalysis is reflected in his publications and teaching commitments.
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