The conflict cycle in the case of an adolescent in crisis

This is an extension of a previous paper describing a conflict cycle in families and therapy consisting of four steps: (1) the dispute; (2) blaming; (3) shame, guilt, or denial; and (4) reparation, reconciliation, or retaliation. The focus is on a single case of a 15-year-old male with a gender identity disorder in addition to a conduct disorder. He is an adopted child living in a small community in the southern United States. Conflict is illustrated from several perspectives in a single interview with the family and over the length of contact over a nine-month period: (1) between the adolescent and parents, (2) between the adolescent and community, (3) between the parents, and (4) between the Good Self and the Bad Self of the adolescent. The thesis is that the conflict cycle is an organizing principle helpful to therapists working with families to make assessments and plan interventions.This paper is an expanded and edited version of a presentation by the senior author in San Diego, California, on November 12, 1988, at the Western States Conference of the American Society of Adolescent Psychiatry.