The Body in Adolescence: Psychic Isolation and Physical Symptoms examines the affective experience of psychic isolation as an important and painful element of adolescent development. Mary Brady begins by discussing how psychic isolation, combined with the intensity of adolescent processes, can leave adolescents unable to articulate their experience. She then shows how the therapist can understand and help adolescents whose difficulty with articulation and symbolization can leave them vulnerable to breakdown into physical bodily symptoms.

This book introduces fresh ideas about adolescent development in the first chapter. Subsequent chapters include clinical essays involving adolescent patients presenting with bodily expressions such as anorexia, bulimia, cutting, substance abuse, and suicide attempts. Attention is also paid to adolescents’ use of social media in relation to these bodily symptoms – such as their use of on-line ‘pro-ana’ or cutting sites. Clinicians can feel challenged or even stymied when presented with their adolescent patient’s fresh cut or recent episode of binge drinking. Brady uses Bion’s conceptualization of containment and the balance of psychotic versus integrative parts of the personality to examine the emergence of concrete bodily symptoms in adolescence.

Throughout, Mary Brady offers ways of understanding and empathically engaging with adolescents. This book is essential reading for psychoanalysts and psychotherapists who treat adolescents and other patients with physical symptoms, as well as other readers with an interest in the psychoanalytic understanding of these issues.

chapter |7 pages


chapter |16 pages

“Unjoined Persons”

Psychic Isolation in Adolescence and its Relation to Bodily Symptoms

chapter |15 pages

Invisibility and Insubstantiality in an Anorexic Adolescent

Phenomenology and Dynamics

chapter |18 pages

Cutting the Silence

Initial, Impulsive Self-Cutting in Adolescence

chapter |17 pages

Substance Abuse in an Adolescent Boy

Waking the Object

chapter |18 pages

“High up on Bar Stools”

Manic Defenses and an Oblivious Object in a Late Adolescent