Psychotherapy For The Gifted
Jerald Grobman M.D.
Madelon Sann L.C.S.W.

All sessions are on Zoom, join easily from any location.

Case Study: Underachievement in a Gifted Adolescent Girl – Gail

Underachievement & Self-Destructive Behavior in an Exceptionally Gifted Young Writer

Gail is a 24-year-old strikingly attractive young woman who came to therapy when she was two years out of college. At that time she was working in an advertising agency.

What Were Her Complaints?

She thought she’d been doing well until several months before calling me when she was unable to hold back tears at work. She realized she’d become depressed, couldn’t concentrate on her work, was losing sleep, and thought she might be returning to an earlier pattern of anorexia–losing her appetite and losing weight. When she began having suicidal thoughts, she thought she might be losing her mind. She became panicky and asked for help.

History and Background

She was raised in a middle-class, suburban family. Her parents were both in their mid-fifties. Both had college degrees.

Father: A Successful businessman.

Mother: A College teacher.

Brother: Two years older than Gail and a very accomplished young man, who consistently earned high grades in all subjects. When he was younger, he had a painful illness that, for a time, preoccupied the family, but it resolved. Today he has a graduate degree and runs a very successful business.

Marital Tensions: During Gail’s early teens, her father felt he had opportunities to make a considerable amount of money, but her mother worried he was spending too much time away from family. Generally, they communicated well and resolved their differences without too much turmoil.

Both parents knew their children were very smart. They valued these traits and went out of their way to provide extra educational opportunities for both children when necessary.

Traumatic events of childhood: None.

Educational Setting

From grade school through high school, Gail attended public schools. Many of her classmates were smart and motivated. The majority went to college. Generally, Gail’s teachers and classes were stimulating. For the most part, she enjoyed school. Occasionally she felt bored but she certainly did not feel that school was a waste of time. She often got the highest grades in each of her classes.

First Signs of Giftedness

Appeared at age four when she began piano lessons. She had an unusually accurate sense of rhythm and seemed to have a natural ability to figure out appropriate fingerings. Music theory came easily. She enjoyed weekly lessons and began to compose. Throughout high school, she kept up her piano studies and continued to compose.

Language Study and Writing Emerge as Exceptional Gifts

Her most dramatic gifts emerged in language study and writing. She was an early reader and quickly began to play with the sounds and inflections of other languages. She started a collection of dialects.

For example, when she was learning Hebrew as part of her Bat-Mitzvah study, she began to practice her Torah portion in Hebrew but with an Indian, French, German, and even Norwegian inflection (she had a Norwegian classmate). She clearly had a remarkable ear for languages.

In her writing projects, she used advanced vocabulary and sophisticated thematic material, and sentence structure. As she began to get special recognition from teachers some of her classmates began to tease her. Some were even hurtful and cruel. But, because many of her friends admired her, she was able to shrug off those who tried to undermine her.

Latin Becomes a Specialized Area of Expertise

Her literary skills exploded in high school when she and her classmates began to study Latin. She was drawn to the language in a way that confused her. Learning it seemed to come naturally. Working at it seemed effortless. Everyone said she had a special gift for language – Latin in particular. At first, she resisted this idea, but slowly came to accept it.

It was hard to believe how much pleasure she got from absorbing the rules and vocabulary of this difficult language. She seemed to have a natural appreciation for its structure. When she got into her “Latin zone,” as she called it, she felt transformed by a physical, mental, and emotional power that she had never experienced before. This was especially true when she was writing poetry. It felt too easy – “kind of uncanny.” She began to think some sort of grand destiny awaited her – maybe someday she’d be famous. The grandiose nature of all of this was disturbing and scary.

As a freshman in high school, Gail was always considered one of the smart kids. But she was never that far ahead of her classmates.

In Her Sophomore Year She Leaves Her Classmates Far Behind

By the middle of her second year of high school, Gail began to leave her classmates behind in Latin study. As they struggled, she probed deeper into the language. More doors opened in her mind and her appreciation and understanding of the language became richer and deeper. She could feel her intellect expanding and she felt more powerful as a young woman. But she also began to feel guilty whenever she reveled in being the best.

Beginning Anxieties About Becoming Too Powerful

At times she felt flooded by the pleasure of the learning process. However, the experience was often accompanied by disturbing fantasies: imagining herself as a great translator and poetess got mixed up with plans she hatched to manipulate men with her sexual prowess. She tried to tone down her excitement and control her fantasies.

Her success in Latin galvanized her writing in other areas. Her stories were infused with a special energy and a razor-sharp ability to observe and invent characters. She was becoming very confident as a writer. Everyone said she had a special glow about her.

In her junior year of high school, she won first prize in a national literary contest. She became a sensation overnight. She was honored at school and written up in the local newspaper. Teachers as well as students said they were “in awe” of her. Everyone wanted to be her friend and her popularity soared. People described her as charismatic.

Self-Destructive Behavior Begins After Winning a National Literary Competition

Within two weeks of her success, she began to cut herself and started having what she described as “paranoid” thoughts. She began to wear long-sleeved shirts to cover the scars. Although less intense, her paranoid thoughts continued. She was slowly convincing herself that her popularity was a sham and that the lavish attention and praise were devious methods people had developed to manipulate her. She tried to constantly remind herself that these thoughts were stupid and not true, but she couldn’t completely shake them off.

Things began to settle down for her. Her “paranoid” thinking receded and she only cut herself twice more. She continued her Latin and other literary studies. At the end of her junior year, she took several of her teachers’ suggestions and attended a summer writing camp.

Placement in a Graduate-Level Writing Seminar as a College Freshman

Her counselors were so impressed with her work and encouraged her to apply to several Ivy League universities. After she was admitted to one, her portfolio was reviewed and she was placed into a graduate-level writing seminar conducted by one of the school’s most popular professors, a distinguished and published author. She enjoyed campus life at this big university, made friends easily, and joined the volleyball team. Within several months, she was made captain.

The writing seminar was her favorite course. She enjoyed the personal attention and intellectual stimulation of this small setting. Engaging, appealing, and attractive, she knew that many of the other students liked her a great deal. Some openly admired her work. She even sensed that some of the men were physically attracted to her. She began to worry that their praise and admiration was a cover for malicious envy. Fantasies of becoming a dangerous seductress returned and disturbed her.

Each of the other students complained about difficulties finding authentic material and establishing a “personal voice.” Gail had a different problem. She was frequently so flooded with ideas for stories that she had difficulty “toning them down” and sorting through the many possibilities. Her stories were interpretations and adaptations of real-life experiences. Some were so infused with energy that they were described as “white hot.” Others had a special blend of fantasy and reality that produced an “otherworldly” quality. White hot or otherworldly, they were never gimmicky and always seemed to ring true.

An Offer to Publish Her Writing Causes Self-Doubt

At the end of the second semester, the professor asked to meet with her privately. He told her that her work needed to be published and that he would be happy to find her an agent.

By this time, however, Gail had become worried that her writing had developed a flaw. Because she used only autobiographical material for her stories, she began to think she was operating in an artificially narrow range. Despite continued praise from her professor and fellow students, her suspicion slowly became a conviction.

She thought the use of autobiographical material was a cheap trick and that she had become “inauthentic”. Slowly she felt the edge was coming off her work. She thought she’d become superficial and glib.

Self-Doubt Turns into Self-Defeating Rejection of Her Giftedness

Instead of sharing these concerns with her professor, fellow students, or parents, she quietly decided writing was simply not her forte and she began looking for a different focus.

Science seemed like a good choice. The comfort of something structured – hours of memorizing facts and no more worries about whether or not she was genuinely creative. No more worries about being an imposter.

Next semester, she dropped her writing courses, and never spoke with her professor again. As her scientific study progressed, she stopped attending volleyball practice. When she refused to give her former teammates an explanation, they became furious with her.

Anorexia Completes the Negative Downward Spiral

Later in the semester, she became anorexic and started smoking cigarettes.

She limped through the rest of college, barely scraping by with adequate grades. When she graduated, she had no idea where to find a job and impulsively took a low-level position in an advertising agency. She worked there for two years before she came to see me.


Gail’s story is typical of the many patients we have seen that illustrate the nature of the internal psychological conflicts that can exist as part of the “inner experience” of giftedness. Her story also demonstrates how these conflicts can exist even if the educational, social, and family environments are fully supportive of giftedness and its growth and development. Gail’s story also illustrates how an inability to resolve conflicts about the “inner experience” of giftedness- anxieties about the uncanny nature of it, the way it distinguishes a young person from his/her peers, and its potential for being used in destructive ways can lead to self-destructive behavior and ultimately to a disavowal of the giftedness itself.

In psychotherapy, Gail was able to resolve many of these internal conflicts about her giftedness. She now is a very successful freelance writer in the entertainment field and is able to have satisfying relationships with men without fears of being manipulated or having to hide her giftedness.

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Jerald Grobman M.D.

Madelon Sann L.C.S.W.​

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