[Emotional deprivation and narcissistic regulation--development and treatment of depressive crises in children and adolescents].
This paper outlines developmental and treatment issues of depression in childhood and adolescence. Impairment of parental empathy based on emotional disturbances of a parent leads to adaptive reactions as the child is confronted with threats of loss and separation. Hereditary vulnerability as well as insecure attachment patterns and the effects of explicit trauma must be viewed as further facilitating factors. Anxiety in children and--with the advent of adolescence--suicidal behaviour are described as important tools for narcissistic regulation and reconciliation and for mobilising help. Accordingly the last section of the paper is dedicated to therapeutic approaches to adolescent despair, depression, risk taking and suicidal behaviour. Guiding suicidal adolescents out of their crises can be a tightrope walk between attempts to limit life threatening acting-out behaviours, leniency toward the patients' grandiosity along with sensitivity for narcissistic injuries and the building of a viable narcissistic transference.
du Bois
Reinmar
R
Klinik für Kinder- und Jugendpsychiatrie und Psychotherapie am Olgahospital Stuttgart.
D000293:Adolescent; D002648:Child; D016241:Child of Impaired Parents; D003419:Crisis Intervention; D003866:Depressive Disorder / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy; D004644:Emotions; D005260:Female; D006801:Humans; D007389:Internal-External Control; D008297:Male; D009289:Narcissism; D009769:Object Attachment; D010287:Parent-Child Relations; D011575:Psychoanalytic Therapy; D011610:Psychosocial Deprivation; D012307:Risk Factors; D013405:Suicide / Q000523:psychology; D000092864:Suicide Prevention