ABSTRACT
We can assume that the adolescent who is sufficiently concerned about himself to acknowledge that he needs therapeutic help is unconsciously aware of being out of touch with part of his internal life; he feels he does not have the choice to do what he wants with his life. The reality of a physically mature body confronts him with the fact, albeit also unconsciously, that his fantasies now contain a new dimension—namely, that he is a sexual being and that his past solutions to conflict now hinder his development. In the past he may have been able to explain away his behavior, feelings, and fantasies, but after puberty he is for the first time in his life faced with the realization that past solutions to present conflicts may mean abnormal development, especially in relation to sexual life and object relationships. When he talks of his internal life, he is telling us that he feels as if he now has a passive relationship to his body and to a part of his fantasy life that forces itself upon him and, perhaps more importantly, forces him to feel and behave in ways that are out of his control. An adolescent patient who says, for example, that she hates herself because she feels compelled to eat or feels like ripping out her insides so that she can stop masturbating may be describing the content of her central masturbation fantasy, but emotionally she feels that there is nothing inside her to help her deal with the repetitive onslaught from her body. For her, her sexual body is not only an enemy but the representative of her abnormality.
