Underachievement in Exceptionally Gifted Adolescents and Young Adults

A Psychiatrist’s View

originally published in the Journal of Secondary Gifted Education vol.17 #4 summer 2006 pp.199-210

A group of exceptionally gifted adolescents between the ages of 14 and 25 were each treated in individual psychotherapy over the course of a number of years. They were referred for symptoms of anxiety, depression, self-destructive behavior, and under-achievement. Each phase of their gifted development was accompanied by particular anxieties and conflicts. In adolescence they developed a powerful personal vision, a sense of destiny, and a charismatic personality. Their inability to resolve conflicts about these particular gifted traits led to their most dramatic forms of underachievement and self-destructive behavior.


In 34 years of psychiatric practice, no clinical problems have been more intriguing to me than underachievement and self-destructive behavior in exceptionally gifted adolescents and young adults. Early in my career as an associate clinical professor in Tufts University School of Medicine’s Department of Psychiatry, I was stimulated by the challenge of establishing a community-based mental health service (Morrison, Shore, & Grobman, 1973), organizing and running a psychiatric clinic in a municipal court, and developing and supervising the extensive clinical work in a group psychotherapy training program (Grobman, 1978, 1980, 1981). Later, as a senior staff psychiatrist at Lenox Hill Hospital, I had the opportunity to learn about and treat patients whose depression and anxiety were caused by cardiac surgery (Collins & Grobman, 1983). In addition to these activities, I have always maintained a private practice. It has been in this setting that I have encountered the 15 exceptionally gifted adolescents and young adults who are the subjects of this paper. Writing about the clinical problems I encountered and the patients I treated has always served several purposes. It helped me organize my thinking, helped me learn what others thought in the fields of community psychiatry, group psychotherapy, and consultation/liaison psychiatry, and it allowed me to share ideas I considered to be useful. This paper, about the psychodynamics of under-achievement and self-destructive behavior in exceptionally gifted adolescents and young adults, is written in the same spirit.

This report is not based on a research study. As with my other publications, it is a report of my accumulated clinical experience. These young people had unique sets of exceptional gifts and unique ways of expressing them. Yet, when they explored their developmental histories and motivations for underachievement and self-destructive behavior, several patterns emerged. My hope is that this description and analysis of the difficulties these young people encountered will add an important dimension to the general description of what we know about gifted underachievement.

As Coleman and Cross (2000) stated:

In our view universal developmental theory is unlikely to yield significantly deeper understanding of giftedness than it already has. Our knowledge has been relatively static in that area for decades. We use the term static not in the sense that useful research is not going on, but rather that what is studied are finer and finer delineation of aspects of development that have yielded small dividends. (p. 208)

In the same article they also said:

To understand social-emotional development, we need to understand more closely the personal experience of persons who are gifted. The pressures, joys, worries, conflicts and satisfactions of the experience of being a person who is gifted in various settings can become known as we gather evidence from empirical studies, biographies, clinical stories, life stories, etc. The experience of development contains much of the evidence of what social-emotional development is for this group and for subgroups. (p. 208)

I believe this clinical report may supply some of the missing pieces to the puzzle of gifted underachievement and to what Coleman and Cross (2000) refer to as “the personal experience” of being gifted.

During the past 20 years, I have had the good fortune to work with many exceptionally gifted adolescents and young adults. I treated the adolescents using a combination of cognitive/behavioral, as well as psychodynamic psychotherapy and provided guidance for their parents.

Intimate and intense involvement in the lives of these gifted individuals and their parents gave me an unusual opportunity to make observations about many aspects of their giftedness. I learned how these individuals thought and felt about their gifts and discovered how their internal responses to these gifts affected their accomplishments and their relationships. I learned how their gifted traits developed in tandem with other aspects of their personality from childhood, latency, adolescence, and into young adulthood. My special role with these adolescents, young adults, and their parents also allowed me to develop an understanding of the conflicts and anxieties associated with their giftedness and to see how these differed from the conflicts and anxieties typically associated with “normal” growth and development.

For these particular gifted individuals, the powerful inner drive to explore and master felt like an obligatory force of nature. When they gave into their explosive drives and permitted themselves to gratify their special sensitivities, they felt possessed. But, this same excitement and animation also made them feel peculiar and strange. From their earliest years through latency and into mid-adolescence, their powerful drives, special sensitivities, and precocious abilities were rarely a source of consistent self-esteem. Instead, their giftedness frequently led to anxiety and shame, and they tried to keep it a secret by denying or restricting it.

Their parents accepted their giftedness and encouraged its development. They were awed by their children’s precocious accomplishments but were equally dismayed by their extremes of emotion and behavior. Because of their children’s self-destructive behavior, they frequently wondered whether giftedness was more of liability than an asset.

For some, the emotional pain associated with giftedness could only be relieved by stopping its growth or limiting its use. For others, it meant slowly drifting away from their giftedness in ways similar to the prodigies described by Feldman (1986). However, some chose to continue in psychotherapy beyond initial symptom relief. For these gifted adolescents, active efforts to resolve their deeper conflicts enabled them to feel much less shame and guilt and helped them control their self-destructive behavior.



The exceptionally gifted adolescents and young adults who are the basis of this clinical report were middle-class and between the ages of 14 and 26 years of age. Eight of these adolescents and young adults were male and seven were female. They were referred to me for symptoms of depression, anxiety, poor peer relations, and isolation, as well as intellectual and artistic accomplishment that fell well beneath their highly gifted potential. Some felt they were losing their minds. Some felt suicidal.

Many of these gifted individuals had reached extremely high levels of accomplishment but could not be consistent. Others never could achieve close to their full potential. All of these young people were highly gifted either in the fine and performing arts, science, literature, and music. Some were highly gifted in several areas. They were generally accepted and even admired by their peers, had families that accepted and supported their giftedness, and were in educational environments that, although not perfect, generally validated their individualistic nature and extraordinary accomplishments. None had learning disabilities, attentional disorders, or medical illnesses. Thus, the standard explanations for their gifted underachievement did not seem entirely adequate—a poor educational fit (Gross, 2002, 2004; Whitmore, 1980, 1986); peers who rejected them; inadequate parents; environmental mismatches of various kinds; internal factors such as perfectionism, low self-esteem, self-regulatory problems, maladaptive strategies, social immaturity, or asynchronous development (Reis & McCoach, 2002); parents with serious psycho-pathology, or parents who neglected or misperceived their children’s gifts (Gedo, 1972, 1979, 1996a, 1996b; Keiser, 1969; Newman, Dember, & Krug, 1973), or parents who were controlling or domineering (Conway & Siegelman, 2005; Slenczynska & Biancolli, 1957; Wiener, 1953).

What follows is a description of the gifted traits shared by this particular group of exceptional adolescents and young adults and a description of the evolution of these traits from childhood through latency, adolescence, and into young adulthood. The anxieties and conflicts that accompanied each stage of gifted development will be identified and discussed. Each of these young people were aware of their worries about acceptance by their peers, an educational system that was reasonable but did not meet all of their needs, and their difficulties with their parents. However, their conflicts and anxieties about their powerful internal drives, their uncanny abilities, and especially their secretly developing personal vision, sense of grand destiny, and charisma were largely out of their awareness. They came to light only after they began psychotherapy. It was these unconscious conflicts that led to their most dramatic forms of self-destructiveness and underachievement. Lastly, I will discuss the ways in which psychotherapy helped many of these exceptionally gifted people address their emotional needs.