Adolescence is a stage of development marked by sexual energy arousal and the transition from an “infantile psychological ground” to an adult one[1]. It is a vulnerable phase by nature, full of intensity and idealization, in which the most relevant aspect regarding cultural influence on personality is the need of socially belonging (to the group of peers). Teenagers’ typical inhibitions, hesitations and insecurities continue to happen in the internet and virtual relationship context, added by the speed of (dis)information. From a psychiatric perspective- syndrome diagnosis-, panic attacks are intensified anxiety crises, classified by the level of associated and concomitant signs[2]. For PA[3], from a psychodynamic perspective, panic attacks refer to the sudden loss of reference (the feeling of losing identity) and must be understood within a broader picture of patients’ structural psychopathology. For instance, Marcos[4], a 17 year-old boy, searches for psychotherapy after an episode of aggressiveness, followed by a panic attack. The situation is worked out in sessions, and some strategies are put into practice. However, after a few months, he has new panic attacks, mainly in sexual meetings with some partners. As we dig into common aspects of those situations, conflicts concerning intimate contact emerge. Once Marcos becomes aware of the main conflict at the root of his anguish, it turns into a psychological one, which leads to an impasse he must confront. Most importantly, as the hidden conflict come to the surface and is worked out in psychological sphere, it stops being somatically discharged. From that time on, situations that reactivate memories linked to that conflict don’t trigger consciousness “warning signs” anymore. In other words, they don’t trigger the defense mechanism associated with that conflict (anxiety). This is an example of how Marco’s panic attacks worked as a somatic discharge for conflicts linked to his sexuality (sexual identity[5]), which, in the end, are always linked to infantile identity models blocks. In another example, Juliana, 18 year-old girl, searches for psychotherapy in the middle of a panic attack. Her symptoms matched with panic disorder: asphyxia, tachycardia, dizziness, in short, a picture mainly described by the feeling of “literally lacking the ground”. From a psychodynamic perspective, panic disorder stands for the “lack of psychological ground”. It commonly happens between the ages of 17 and 24, a stage that symbolically marks the beginning of adulthood. During this time, young adults usually bring to psychotherapy sexuality issues, neurotic anguishes (internal impediments) and existential anguishes that may appear in the obstacles to find a direction in life. It is a period of huge emotional weight that will be overcome as long as resolutions for those anguishes are worked out. The direction for Juliana’s psychotherapy occurs on two axes: on the one hand, decoding her dreams helps working on old memories linked to conflicts from childhood feminine models. Once neurotic anguishes (feminine model blocks), existential anguishes (related to her adult identity) and circumstantial ones (linked to her professional identity) are worked out, she gradually starts to develop a healthier Ego. She now faces new challenges, linked to uncertainty (future), but panic crisis are gone. A panic disorder may reoccur later in the future if her new psychological ground happens to suddenly disappear. Circumstantial anguishes, in turn, continue to happen all lifelong. Symptoms (panic attacks) will cease as a result of resolved conflicts/atmospheres in the source of identity models blocks. Strengthening Ego is not only a construction process, unless it is taken into its more truistic sense, i.e, of being a continuous process over the time. Above all, the success of psychotherapy lies in a process of integration, which means digging into inner conflicts in order to make the necessary confrontation, conciliation with the past and reparation. This is the path towards a healthier Ego. An integrated Ego assumes who they really are, are in touch with their needs and desires (feminine drive) and have combativeness (masculine drive) to find a way to make them happen in a genuine way.
In addition, contemporary society is exposed to a multitude of references from early years[6]. Despite not being decisive, it has an impact on some children’s development who are permanently in contact with ambivalent atmospheres which require them to “choose a side” , for example, in fights between parents. This is an example of how these atmospheres may have an impact, at a basic level, on intimate insecurity and on later hesitant personalities. To conclude, puberty is a period of deep cenesthetic and psychological change and, hence, a hesitant period by nature. Giving appropriate psychological attention to anxiety episodes ate this stage, may avoid panic outbreaks by the time they will be exposed to performances and demands of adult lives.
To be continued in the next Post
[1] For more details see Essay 3- Sexual identity development and Post 5-Existential Anguish, in Essay 5- Anguishes. In: www.ceciliapsicologa.org. See also Chapter IV-Episode 2- Anguishes in adolescence. Part 1 and Episode 3- Anguishes in adolescence. Part 2. In: Talking about psychology with Cecilia Leite. In: YouTube Para maiores detalhes ver Ensaio 3- Desenvolvimento da identidade sexual e Post 5 Angústia Existencial, In: Ensaio 5- Angústias. In: www.ceciliapsicologa.com. Ver também Bloco IV- Episódio 2- Angústias na adolescência. Parte 1 e Episodio 3- Angústias na adolescência. Parte 2. In: Falando de psicologia com Cecilia Leite. In: YouTube [2] DSM-Diagnostic and Statistical manual of mental disorders.300.01 (F41.0) [3] PA stands for Psychodramatic Analysis and it is my main methodological reference. [4]These are examples inspired by clinical cases. Patients’ names are not real. This is general information and it doesn’t reveal any case in details. They aim at illustrating similarities and differences between psychodynamic and syndromic diagnoses. [5] For more details see Essay 4- Sexual Identity blocks, in: www.ceciliapsicologa.org. See also- Chapter VI- Sexual Identities retentions and blocks . Video 2-Sexual Identity retentions and blocks.. Part 1-Puberty. Video 3- Sexual Identity retentions and blocks. Part 2—Adolescence in: Talking about Psychology with Cecilia Leite. In: YouTube [6] For more details see Essay 7- Cultural influences on Identity. In: www.ceciliapsicologa.org
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