TIFT #21 Adolescent Development

Continuing on the theme of how important development is to the clinician, let’s review some developmental issues in adolescence, which can now be considered to go on until around age 25, when, as a parent wryly observed, "parental IQ begins to move back up to normal." First, let’s go through a clinically oriented look of what goes on in adolescent development.

Pre Adolescence

The first years of adolescence are a time to form bonds with peers to help transition away from total parental dependance. The goal is conformity, not individualism, which is sometimes hard for parents to appreciate. In general, girls have been practicing relationship skills for some time, while boys are often far behind in that domain. Massive changes in friend groups are frequent and often traumatic. This is a time when some young people cover up their neediness and vulnerability by using power over peers, manifested as cliques and bullying.

Early Adolescence

In early adolescence, young people begin to explore their strengths and weaknesses by attempting difficult challenges. In family dynamics, 15 year-olds will take and use as much power (without commensurate judgment) as they are allowed. School provides a setting for practicing impulse control. Some will use the discipline they acquire to learn advanced skills. Growth in areas not approved of by parents can lead to entrenched conflict. Failure to meet internal and/or external expectations can contribute to an overall sense of shame and low self-esteem which compound the difficulty of growing. Marijuana is particularly potent at this age in relieving anxiety, in part by encouraging avoidance of challenges. Since growth is the result of engagement with various challenges, when it is avoided, development will be arrested or slowed in those areas.

Middle Adolescence

As college looms in the latter years of high school (15-17, in the US), fearful anticipation of adulthood begins to loom. Young people begin to see themselves in an unforgiving world that rewards results, not effort. Here is where clinicians need to appreciate the underlying structure of revolt against parents. What often looks like a struggle between the young person and parents is really one of ambivalence about losing the comfort of childhood innocence and anticipating the weight of adult responsibility. All of us carry an internalized value that maturity is good and immaturity is shameful. This makes it hard for adolescents to admit to being afraid. But they are intensely afraid. The problem is that containing the internal conflict between fear and desire is extremely uncomfortable. How is this hidden conflict manifested?

Chaos in the bedroom is one manifestation. But a more important one is almost inevitable, the externalization of the conflict by projecting one side onto the parents. They become holders of the side that the adolescent can’t own, the fear of growing and responsibility. Paradoxically, this means accusing the parents of standing in the way of growth. In all sincerity, the young person believes that the parents are misguided and are failing in their duty to support his or her path forward. “Why don’t you trust me? I know what is best for me.”

In a classic interaction I call “the adolescent dance,” young people induce parents to take the role of holding them back. For example, the young person makes a reasonable case for more responsibility. Parents agree in the hope of supporting greater maturity. “Ok you can come home at 1 a.m. on weekends.” Next, the adolescent rewards their faith by returning intoxicated at 3 am. In acting irresponsibly, the adolescent forces the parents to tighten the reins. As they do so, they step into a regressive stance of authoritarianism. They feel obligated to lower their expectations and treat their son or daughter more like a younger child. The adolescent hotly denies any irresponsibility, blaming some outside cause, and takes on the role of victim of parents’ excessive need for control. In this way, the projection of one side of the ambivalence is established and maintained. The young person is not aware of any fear, only of the desire to break out of the parent’s controlling overprotectiveness.

Wise parents, aware of this trap and the anxiety behind it, will make every effort to be judicious and measured in their responses. They will avoid another trap by speaking with one voice, and they will emphasize their support for actual, demonstrated readiness for responsibility. While correct, this has the effect of pushing stress back onto the young person.

Later Adolescence

While younger adolescents seek conformity, late adolescence is a time for individuality. Experience increasingly fills out a nuanced picture of personal strengths and weaknesses, likes, and dislikes. In addition to owning their own personal qualities, older adolescents may become ready to fully own their values. This is in contrast to the earlier period when values are borrowed from the family. This ownership is real and serious enough that they may become ready to sacrifice their lives for what they believe. The social hierarchy is no longer linear, where all were previously judged on the same few measures. Instead, self-esteem is now built more on individual qualities the young person feels proud of.

As the older adolescent comes to know him or herself in more depth, choosing a partner becomes more nuanced and mature. Deep and lasting relationships become possible for those who have matured in this way.

Power tools of avoidance

Other than projecting the fear side of ambivalence onto parents, adolescents, especially in developed societies, have access to a number of powerful tools that enable the mind to avoid progress without having to admit to shameful fear or neediness. We can imagine the nonconscious problem solver working hard on both sides of the ambivalence, to seek out growth and to avoid it. Here are some frequent compromise formations that embody both sides:

• Embrace a lifestyle significantly outside the mainstream.
• Seek a goal so lofty that it will not be accomplished.
• Adopt substance use and the associated lifestyle as a way of expressing individual identity, while opting out of competitive life.
• Develop a symptom (such as anxiety, depression, OCD, anorexia, cutting, other compulsive behaviors, and suicidality) which takes on a life of its own and, as a socially acceptable and often genuine diagnosis, requires a degree of withdrawal from full engagement in life, against the individual’s expressed wish otherwise.
• Blame outside circumstances as responsible for failure to progress, while acknowledging only a desire to engage and grow.

Diagnosing trouble

When adolescents and young adults have trouble keeping up with peers on developmental measures, a thoughtful balance is required between concern about specific “causes” while maintaining awareness of the underlying tug of war between motivation and fear. Often parents and helpers support the young person in blaming some specific factor for the problem. Addressing such a problem may be essential to progress, but we should be ready for developmental arrest to persist. Perhaps there will be a new “cause.” Or it may be a more obvious fear and reluctance. The final remedy is for the young person to take measured steps to engage with life and, in doing so, to travel along the path of development. Once there has been arrest, restarting development is harder. Not only is there a deficit to overcome, but shame is a deterrent and habits of avoidance may remain. This is why the need for support is absolutely real. The “kick in the pants” approach to maturation only works when the young person is actually aware that it is time and that he or she really needed a push.

The need for sponsorship

A fundamental principle of development is that any move forward comes with an increase in the need for outside support or “sponsorship.” Where sponsorship has been less than optimal, a trap for clinicians is to overestimate parents’ ability to change. Of course parents will express their willingness to provide support, but they may not be as able to fulfill their promises. One pattern that can sometimes be overcome is the classic split between the soft parent and the tough one. The soft one is extra soft to compensate for the harsh one and the harsh parent feels the need to be even tougher to compensate for the soft one. If this split is allowed to continue, no firm decisions will be made and the adolescent is left to navigate alone. The outcome will be further compromised. Parents may be able to recognize the necessity of speaking with one voice.

Support is a two-edged sword

The problem with giving support or encouraging parents to do so is that success now deprives the young person of an excuse for avoiding growth. Now they must either take scary risks or develop some new reason for being stuck. I see this as a matter of degree. Here are three levels of ability to accept the sponsorship that is so dearly needed. The young person may never admit to being afraid. What is essential is taking further steps to engage with life.

1. The young person just needs a modest increase in sponsorship, which can come from outside in the form of a relative, a professional, a teacher, or some other older, supportive other. When this works, a cycle develops of trying new behaviors, feeling pride in success, and trying more.
2. One or more external “causes” are serious enough that they have to be addressed first before progress can be made. Even if their function of avoiding engagement with adult life is clear, sponsorship may consist in taking the time and resources to work with these factors, one at a time, at whatever level of care is necessary, until the young person is ready to make a step forward.
3. Pre-existing or new long-term disabilities such as biologically-based mental problems or early trauma can amount to long term or even lifetime handicaps that will require realistic goal setting and support to keep development moving. Whatever the underlying limitations, essentially all people are capable of taking steps towards incremental growth.

Jeffery Smith MD

Photo by: Kendra Kamp, Unsplash.