Book. Reviews 563

NORMAL ADOLESCENCE. By the Committee on Adolescence, Group for the Advancement of Psychiatry. New York: Charles Scribner’s Sons, 1968, 127 pp., $3.95 cloth, $1.45 paper.

Reviewed by Virginia Lawson Clower, M.D.

Adolescents have always provoked anger, pity, and alarm in adults, and every society has its own forms of acknowledging and deal- ing with the stormy passage from childhood to maturity. In our society there is mounting concern over this age group, and a tendency for both observant adults and rebellious youth to be- lieve their plight is worse than in any previous era of history. At this time sheer weight of numbers enhances the conflict between the adolescent and society; almost 20 percent of the population of the United States is between the ages of ten and twenty. In the past decade this age group has become a chief preoccupation of advertising and entertainment media, radio and television, cos- metic and clothing manufacturers, as well as a heavy responsibility for parents, educators, and mental health experts.

Even if we could ignore the dramatic, often sensational, accounts of adolescent stirrings that fill the daily press, we still have in- numerable books and papers ranging from clinical studies of adolescent psychopathology to “Teen Tips” in the ladies’ maga- zines attesting to the fact that adolescence is the most popular sub- ject for writers since sex became respectable in print. Sometimes it is hard to imagine what new can be said about the unique vicis- situdes of the transition from child to adult.

It would be a mistake, however, for the most jaded reader to overlook Normal Adolescence by the Committee on Adolescence of the Group for the Advancement of Psychiatry. Under this simple title the Committee, chaired by Calvin Settlage and including psy- chiatrists, psychoanalysts, and social scientists, has produced a suc- cinct, smoothly readable description of this crucial period of de- velopment in what might be called “an average expectable” adoles- cent. The preface states the modest hope that the report may in- crease understanding and rapport between the adolescent and adult generations. As embattled adults working with volatile teen- agers are often inclined to agree with Anna Freud that this stage is “an intermediary point on the line between mental health and

Dr. Clower is a supervising and training analyst for adult and child psychoanalysis zcith the Washington Psychaanalytic Institute.

564 Book Reviews

mental illness,” the thesis that adolescence is both normal and sus- ceptible to understanding is heartening. The approach is compre- hensive, including a consideration of biology, cultural factors and psychology.

The chapter on biology reviews the physical and physiologic changes in puberty, defined as primarily a maturational, hormonal, and growth process, and distinguished from adolescence, viewed as a psychological, social maturational process initiated by puberty. The initial description of the biological processes is supplemented by an appendix giving more details of the endocrinology and se- quence of pubertal phenomena.

Pointing out that puberty is a stage of development characteris- tically and universally human, the authors go on to an evaluation of the cultural forces brought to bear on the adolescent and the impact of the adolescent on his society. This study is focused on the American middle-class culture for several reasons: the middle class embraces the greatest proportion of our population; middle- class attitudes are more widespread than those of other groups; more reliable information is available about middle-class adoles- cence. Of major importance is the fact that in this country adoles- cents form a special, self-conscious status group, not common to every culture. Comparisons with other cultures and with subcul- tural groups in our society bear out the conclusion that cultural forms are shaped to deal with contrasting biological tasks of child- hood and adulthood, i.e., being nurtured and providing nurture. The authors find that socioeconomic responsibility for children, rather than capacity for sexual reproduction per se, is the criterion of adult status in most of the world. This highlights one of the failures of our affluent society which does not consider the adoles- cent a child, but which does not expect him to take adult respon- sibility and leads to a condition called “hiatus status.” Observa- tions of this sort and adequate elucidation of major cultural in- fluences are informative and stimulating, although there is no attempt to relate these in depth to specific problems of American youth today.

The section called “The Psychology of Adolescence” is written with the greatest authority and clarity. Beginning with the role of childhood experience, through pre-, early, and late adolescence, the shifts in intrapsychic functioning and object relationships are set forth, using concepts of psychoanalytic psychology in lucid prose with scarcely a word of jargon. Major psychological tasks, char- acteristic reactions and behavior are described, with middle-class boys, girls, and their parents in typical situations taken as exam- ples. A chapter on “Dynamics of Adult Responses to Adolescence” is equally clear and is, so far as this reviewer knows, unique in

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current literature on the topic in its explication of both the stress and the opportunity for further growth afforded parents by chil- dren evolving into adults. Noting that parenthood is a stage in human development, the authors remind us that much conflict be- tween the generations is stirred up as children reach developmental levels which rewaken unresolved conflicts in their elders.

In hewing to an attempt to be “comprehensive but not exhaus- tive,’’ the Committee responsible for this study accepted some li- abilities from two standpoints. On the one hand, the report will provide neither fresh theoretical material nor additions to the clini- cal skills of the psychoanalysts and dynamically oriented psycho- therapists who work with adolescents. On the other hand, the a p proach assumes a degree of psychological sophistication in the read- er which makes it no book to put in the hands of every parent, teacher, and youth worker. It is most useful with the latter as an adjunct to consultation in which some of the concepts involving infantile sexuality, unconscious hostility, and various mechanisms of defense can be discussed and clarified. Students and teachers in psychiatric training programs and those in allied fields will appreci- ate the excellent organization of the contents and the good index as well as the vigor and ease of the writing. The bibliography contains many titles of importance on the subject, but a more com- plete bibliography would make the book much more valuable to the student and teacher.

Every thoughtful reader will recognize the integrity, judicious thinking, and careful preparation of this report. The Committee on Adolescence has earned our praise not only for a good report on their subject, but for their courage and objectivity in choosing to emphasize the inevitability and tolerability of this turbulent period of development which too often is presented in terms of

. sensational pathology.