Adolescents with sickle-cell anemia deal with life and death.

Confusion associated with the developmental problems of adolescence is intensified and prolonged for those suffering from sickle-cell anemia. Feelings of isolation and dependence due to a life-threatening disease can impede the transition to responsible, self-actualizing maturity. Weekly group meetings with nine young women suffering form sickle-cell anemia helped them move toward maturation and a sense of their own competence. The experience of closeness with other adolescents who shared the same vulnerabilities was mutually facilitating. These young women had been caught by a sense that it was impossible to progress to independent maturity, and so became resigned and passive. Yet an inner sense of vitality and their emerging sexuality occasionally sparked rebellion against this helplessness. Sexual senations and potential for family life were available counter-balances against recurrent association with pain and death. Through group support these linkages with hope were strengthened.