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Doctors, S.R. (1998). Adolescence and Character Disturbance. By James B. McCarthy. Lanham, MD: University Press of America, 1995, 206 pp., 52.50 (hardcover), 28.00 (paperback).. J. Amer. Psychoanal. Assn., 46(1):331-334.

(1998). Journal of the American Psychoanalytic Association, 46(1):331-334

Adolescence and Character Disturbance. By James B. McCarthy. Lanham, MD: University Press of America, 1995, 206 pp., 52.50 (hardcover), 28.00 (paperback).

Review by:
Shelley R. Doctors

Almost thirty years ago, Peter Blos (1968) noted that the topic of character formation, while virtually synonymous with adolescence, is itself so multidimensional that virtually every aspect of psychoanalytic theory is related to it. In Adolescence and Character Disturbance, James McCarthy undertakes to review the concept of character formation and to survey theories of adolescent development. He sets himself the further task of conducting both reviews from varying psychoanalytic vantage points—Freudian theory, object relations, and interpersonal theory. In addition, he seeks to clinically illuminate a variety of specific character disturbances in adolescence. His central thesis is that primitive anxiety states interfere with individuation from internal objects, thereby derailing the developmental process. In his view, the resulting personality disorders exemplify pathological character formation. In addition, the author seeks to “explore adolescents' orchestration of primitive anxiety during both character consolidation and the psychoanalytic process” (p. 5). McCarthy sees anxiety associated with individuation from internal objects as analogous to anxiety associated with resistance. Several chapters devoted to resistance in the therapeutic process are meant (1) to illuminate the specific anxiety underlying character disturbances via extrapolation from clinical instances of severe, disabling disintegration anxiety, and (2) to extend his conceptualization to the broader arena of clinical work with adults, complete with resistive elements of transference and associated countertransferences. While this ambitious agenda may be, as Blos suggested, a function of the natural relation of the topic of character formation to a panoply of psychoanalytic topics, I wish that McCarthy had focused more singularly on his special interest—primitive anxieties and their potentially disabling effects on processes of differentiation. McCarthy attempts to cover so much psychoanalytic territory that his central contribution is diffused in the welter of data in which it is embedded.

If McCarthy is correct, and vulnerability to primitive anxiety states is a central factor interfering with the processes of differentiation and integration that are the hallmark of the adolescent transformation, his thesis requires illustrations exemplifying the spectrum of possible disorders of the adolescent transformational process.

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