Feinstein C B
Adolesc Psychiatry. 1983;11:147-62.
In this chapter I have reviewed observations from clinical consultation and group-therapy work with early adolescent deaf boys in a special day school for the deaf. I have stressed how problems in communication exert a profound effect on the lives of these youngsters, both by virtue of their past and present influence on family life and by their ongoing effect on peer-group processes and academic adjustment. Primary consideration was given to certain "here and now" aspects of these boys' lives: ongoing problems in the social fabric of their home and school; narcissistic vulnerabilities and defenses against shame; and language-processing difficulties. The ways in which these problems undermine the supportive effect of the peer group at a time when it plays a particularly important role in development were reviewed. By emphasizing current sources of difficulty, using a biopsychosocial approach, I hope to point out fruitful opportunities for significant psychiatric intervention in a psychiatrically vulnerable population whose needs for professional service have never been met.
在本章中，我回顾了在一所特殊的聋人日间学校对青春期早期失聪男孩进行临床咨询和团体治疗工作时所观察到的情况。我着重强调了沟通问题如何对这些青少年的生活产生深远影响，这既体现在其过去和现在对家庭生活的影响上，也体现在其对同伴群体互动过程和学业适应的持续影响上。我们主要关注了这些男孩生活中某些“此时此地”的方面：他们家庭和学校社交结构中持续存在的问题；自恋的脆弱性以及对羞耻感的防御机制；还有语言处理困难。文中回顾了在同伴群体在发展过程中发挥特别重要作用的时期，这些问题是如何破坏同伴群体的支持作用的。通过采用生物心理社会方法强调当前的困难来源，我希望能指出在一个精神上易受伤害且其专业服务需求从未得到满足的人群中，进行重大精神科干预的富有成效的机会。
