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Laufer, M. (1986). Adolescence and Psychosis. Int. J. Psycho-Anal., 67:367-372.

(1986). International Journal of Psycho-Analysis, 67:367-372

Adolescence and Psychosis

Moses Laufer

The psychoanalytic understanding of psychosis and of the period of adolescence, when combined, may enable us to view the severe psychopathologies during adolescence in such a way as to create serious doubt about the usefulness of the diagnosis 'psychotic' during adolescence. Hopefully, instead, we may be able to differentiate more minutely between behaviour and thought which contain psychotic manifestations and functioning, and that behaviour and thought which might, in some special circumstances, be considered to be structurally and dynamically similar to the adult psychoses.

But I begin with a comment borrowed from William Gillespie that 'psychosis in adolescence is a prognosis and not a diagnosis', a comment which is central to what I want to discuss, and one which summarizes the many serious doubts I have had during my clinical work with seriously ill adolescents about the suitability or the usefulness of the description 'psychotic'. I do not intend, in this presentation, to try to prove that there is no such thing as psychosis during adolescence; instead, I will try to show how the specific developmental function of adolescence, or, as Freud (1905) stated in the 'Three essays on the theory of sexuality', how the 'changes [which] set in [following puberty] which give infantile sexual life its final, normal shape' (p. 207) can, among a certain group of adolescents, result in behaviour and thought which resemble the adult psychoses but which, in most circumstances (at least in my experience and in the experience we have had at the Centre for Research into Adolescent Breakdown, London) is fundamentally different from the adolescent psychoses.

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