Calvin Colarusso’s case report is of the successful psychoanalysis of a twice-exceptional (gifted/learning disabled) 13-year-old boy. Clinical vignettes of major themes and conflicts are provided: The identification with a defective uncle, an oedipal conflict with the father, and learning as a homosexual submission because of passive identification with the father.
The patient was helped to explore the different levels of meaning of each of these conflicts and helped to express unconsciously repressed affects that accompanied each of these conflicts. Special mention is made of how frequently his underachievement and learning disabilities were used as unconscious mechanisms to express aggression toward his parents.
Leo S. Loomie, Victor H. Rosen, and Martin H. Stein’s report on the Adolescent Gifted Project is perhaps the first report of a group examination of the creative process using full psychoanalytic clinical material. In what was described as a “clinical research project,” a group of experienced analysts, led by Ernst Kris, met monthly to discuss the psychoanalytic treatment of “young people with creative gifts.” Strict adherence to psychoanalytic principles was maintained for treatment parameters. Although labeled as “adolescent” gifted, the ages of patients ranged from 9 years to 36 years. They included a gifted sculptor, a writer, a painter, a composer, two mathematicians, a choreographer, and a dancer. The child had many musical, graphic, and literary talents.
The techniques of psychoanalysis were not described. The substance of the report concerns general observations that evolved from each patient’s treatment:
- The nature of their unconscious conflicts;
- The special difficulties facing the analyst in attempting to understand highly specialized subjects;
- The process of sublimation in each of these patients did not involve complete repression of their instinctual material. At times, these gifted patients had easy access to it and this duality of partial repression and ready availability infused their creative work with remarkable vitality.
Psychotherapy of Gifted Adolescents and Adults
Diedra Lovecky describes five traits of giftedness that she encountered in her psychotherapy practice with gifted adults: divergent thinking, excitability, sensitivity, perceptiveness, and entelechy (the need for self-determination).
Her therapeutic work takes place in the cognitive, behavioral, and experiential realms. Cognitively, she helps clients learn strategies for working with these traits so they can be used more effectively. She helps them determine if and how to compromise in order to be effective in work and social situations.
Awareness of one’s own limits and the limits of others is the key to higher levels of social connectedness and thus higher levels of self-esteem because isolation can be avoided.
Lovecky also describes certain difficulties that arise in the therapeutic process: Clients often have difficulty trusting the therapist and present ongoing challenges to therapeutic authority, expertise, and the basic premises of psychotherapy. Struggles also occur with the therapist when his or her empathy is perceived to have failed. She suggests setting short-term goals with clients when appropriate to avoid impatience with the therapy process.
Experientially, she suggests the use of shared intuition in the therapeutic process to help clients feel deeply appreciated for their special gifted traits.
Last, she describes psychotherapeutic work with gifted clients as an opportunity for the therapists to grow professionally as they develop new therapeutic techniques in working with these clients.
Jerome Oremland describes the successful psychoanalysis of a 20-year-old trombonist and composer. Only passing mention is made of Oremland’s analytic techniques. Details are provided about how this man’s talent as an instrumentalist and composer became enmeshed in conflicts about his biologically delayed adolescence and his deeply dysfunctional parents. Oremland discusses the specific conflicts that emerged in the different phases of this young man’s treatment:
- His guilt when he discovered that he was more powerful than his alcoholic father.
- His disappointment when he realized that his mother cared more about his talent than about nurturing him.
- His continual struggle to limit his abilities so as to control his anger at his parents.
- His self-punishing behavior: He would permit his talent to gain him only admiration, but not intimacy.
As his delayed adolescence finally unfolded, he discovered that his talent also included an exceptional ability to compose. As a result, his self-esteem improved, which allowed him to develop intimate relationships.
Mary Elaine Jacobsen discusses how gifted adults can achieve what she describes as a “corrected personal history” by identifying as gifted, personality traits that were thought to be liabilities. She offers two case illustrations: A middle-aged man who achieved enormous success but felt increasingly empty and a professional woman whose extreme sensitivity and empathy for others’ pain left her feeling depleted.
For Jacobsen, the psychotherapy process begins when the therapist examines patients’ histories for gifted traits and unusual areas of interest and curiosity. In this early stage, the therapist may need to be intuitive, as adults rarely identify themselves as gifted. She also urges caution in this identification process so that client’s chief complaints can be addressed first and to give clients an opportunity to work through negative connotations of giftedness. In addition, the client must be allowed to not explore giftedness even though it has been identified.
The working-through process requires a respect for the client’s defenses. Appropriate but camouflaged stories of other clients can facilitate this process. Inquiring about unfulfilled purposes or dreams may enhance the therapeutic relationship.
Jacobsen suggests a number of other psychotherapeutic tasks:
- Follow a client’s interests even though they may be complex or abstract.
- Be active.
- Avoid competing with the client.
- Be transparent about your own giftedness.
- Respect idiosyncrasies.
- Do not represent social norms.
- Confront self-destructive behavior.
- Give advice about enhancing energy, creativity, and self-realization.
Jacobsen also alerts therapists to expect a wide range of positive and negative feelings of their own, such as exhilaration, hurt, rejection, envy, and intimacy.
The most recent articles are by Jerald Grobman. His first report is about the psychodynamic psychotherapy of 15 adolescents—exceptionally gifted in arts, music, dance, writing, and science—who became underachievers primarily because of unresolved conflicts about their “inner experience of giftedness” rather than because of conflicts about school, work, peers, and family.
In each of his cases the psychotherapy unfolded in predictable ways. Once their presenting crisis was resolved and more practical concerns about school, peers, work, and family were successfully addressed, these patients began to accept that emotional conflict was a universal aspect of all growth and development. They also realized that having ambivalent feelings did not mean that they were weak or defective. These insights prepared them for deeper explorations about all the unconsciously conflicted aspects of their gifted endowment: their special sensitivities, sensibilities, the power of their curiosity and inner drive for mastery; their conviction about a grand vision and personal destiny to make valuable contributions as well as a feeling that they had become charismatic.
As these conflicts became conscious, open and frank discussion about them helped his gifted patients find more mature methods of conflict resolution, minimize underachievement, and integrate their giftedness with the other parts of their personality.
In an unpublished manuscript, Grobman presents an eclectic form of psychotherapy for exceptionally gifted individuals. His approach modifies traditional psychodynamic psychotherapy to include cognitive/behavioral techniques as well as “psychologically informed” mentoring, coaching, and advising. He discusses the issues that arise for patients in each stage of their psychotherapy and the corresponding challenges for therapists.
Concrete stress management techniques are suggested. Taking an extensive history from all family members can establish a central dynamic formulation that will be used to guide the therapy.