Emotional turbulence during the ending of psychotherapy with an anorexic adolescent

In this paper I reflect on the phase of the analytic process which precedes the termination of a psychoanalysis and describe my work with an adolescent girl. Adolescents with serious eating disorders relive in a particularly violent way, in the final phase of their analysis, the catastrophic anxiety of separation and the fear of annihilation connected with this. The perception of the final date, felt to be irrevocable, reactivates in these patients the psychotic part of their personality, which tries through a phantasy of omnipotent possession (expressed through pathological projective identification) to obscure the reality of separateness and loss. It is useful with these patients to set a date for ending at least a year in advance to enable the working through of these psychotic anxieties. Clinical material illustrates how in the final year of treatment all phases of the analytic process are relived in a violent way, and how this emotional turbulence manifests id as a battle between omnipotent phantasy and an increasing insight into psychic reality.     

Friendship Context Matters: Examining the Domain Specificity of Alcohol and Depression Socialization Among Adolescents

Driven by existing socialization theories, this study describes specific friendship contexts in which peer influence of alcohol misuse and depressive symptoms occurs. In the fall and spring of the school year, surveys were administered to 704 Italian adolescents (53?% male, M (age)?=?15.53) enrolled in Grades 9, 10 and 11. Different friendship contexts were distinguished based on two dimensions referring to the level (i.e., best friendships and friendship networks) and reciprocity (i.e., unilateral and reciprocal) of the relationships. Social network and dyadic analyses were applied in a complementary manner to estimate peer socialization effects across the different friendship contexts. Results showed that within friendship networks both male and female adolescents' alcohol misuse was affected by friends' alcohol misuse, regardless of whether the relationship was reciprocated or not. Conversely, peer socialization of depressive symptoms only emerged within very best friendship dyads of female adolescents. Findings suggest that the effects of peer socialization depend on the friendship context and specific types of behaviors. The theoretical and methodological implications of the findings are discussed.