Adolescence and the reorganization of infant development: a neuro-psychoanalytic model.

The psychoanalytic view of adolescence as a phase of turbulence and reorganization occupied a central position in child and adolescent psychiatry until about 1980. The view of adolescence as a silent-transition phase then prevailed and diverged from the psychoanalytic perspective. This article reviews infant and adolescent development using an interdisciplinary, neuro-psychoanalytic model in which psychoanalytic, neurobiological, and developmental perspectives converge and complement each other. Recent empirical research focuses attention on adolescence as a phase in which a far-reaching neurobiological and psychological reorganization takes place. According to the ontogenetic principle of psychoanalysis, the development and organization of the basic psychic functions occur in the first five years of life, while a reorganization takes place in adolescence. Neurobiological research confirms that the basic growth and maturation of the brain occurs in the first five years of life, and that a substantial reorganization in brain development transpires in adolescence. Research also verifies the clinical psychoanalytic concept that neurobiological and psychological maturation in adolescence remain unfinished till approximately age 23. The long-term and late biopsychosocial maturation in adolescence implies that adequate monitoring by parents and school remains necessary. The view that adolescents need to separate, and discover their individuality and independence alone, is unsupported by recent findings. The adolescent must acquire his independence, personal identity, and self-agency ("scaffolding") step by step. It is important that the adolescent knows that his parents are in the background monitoring and intervening as necessary; that he is not entirely alone, adrift and at risk for potential fragmentation. The long-term plasticity of the brain in adolescence implies greater vulnerability for the development of psychopathology, but offers opportunity for psychotherapeutic interventions to have greater impact.