Psychotherapy Published Chapter in the Encyclopedia of Giftedness, Creativity, and Talent

By Jerald Grobman, M.D.

Psychotherapy

Psychotherapy is a term originally meant to describe a method, closely related to psychoanalysis, for the treatment of patients with various forms of psychological illness. Today, the term has evolved to describe any method used by specifically trained therapists who use the relationship with their patients (sometimes referred as clients) and various techniques of verbal and nonverbal communication. Its purpose is to eliminate, change, or suppress psychological processes that interfere with psychological and personality development. Techniques may involve a combination of confrontation, clarification, interpretation, insight, advice, support, encouragement, guidance, and reassurance, as well as strategies for cognitive and behavioral modification.


There are no research studies that suggest standardized procedures or uniform approaches for the psychological treatment of gifted individuals. Nevertheless, clinicians are often faced with the need to help gifted individuals in psychological distress. A review of the limited psychotherapy literature may provide some useful insights.


A range of approaches is described. Cognitive and behavioral methods address conscious aspects of psychological difficulties. Psychoanalytic and psychodynamic methods address unconscious factors. One eclectic approach describes how both approaches are combined.

The literature includes a case report of the psychoanalysis of a young, gifted girl; clinical excerpts from the psychoanalysis of adolescents; a case report of the psychotherapy of a young boy. Other authors give general descriptions of the issues for both patient (or client) and therapist as they arise in psychotherapy. A recent unpublished manuscript gives a detailed description for how a traditional psychodynamic psychotherapeutic approach can be modified when treating exceptionally gifted adolescents and adults. The report also describes how their psychotherapy unfolded in predictable stages.


The Psychoanalysis of Gifted Children

Kerry Kelly’s report is of the successful psychoanalytic treatment of a 4-1/2–year-old precocious child. Functioning at 2–3 years beyond her chronological age in many areas, she developed sleep difficulties, refused to read or write, and began to wet herself day and night. Her parents were psychologically deeply disturbed individuals unable to gratify each other in their marriage. Instead, focused on their daughter, they got great pleasure from her precocious accomplishments but were unable to nurture her more age-appropriate childish needs. The child’s own self-criticism and high expectations caused feelings of intense inadequacy and poor self-esteem.


The clinical material is divided into four phases: oral, anal, phallic, and terminal. It provides an excellent example of how psychodynamic/ psychoanalytic play psychotherapy works. In the sessions, the child acted out her unconsciously repressed wishes and conflicts and was allowed an opportunity to express her emotions freely. The patient used the therapist to act out different versions of important relationships while the therapist, at times, interpreted different levels of the unconscious meaning of these relationships as well as gratified some of the patient’s basic needs. In this process, the patient found healthier solutions to painful conflicts—no longer needing symptoms to express herself. Of particular interest is a discussion of how psychoanalysis helped this young patient express her childish needs while simultaneously retaining her precocious level of functioning.


Psychotherapy of Children

William Dahlberg’s case report is of the successful treatment of a profoundly gifted 9-year-old boy who entered psychotherapy because he had become suicidal and homicidal. Dahlberg’s approach is a flexible one: Both parents, the patient, and his sister were treated individually. The parents were also seen as a couple.


The issues addressed in the psychotherapy were as follows:


· Parental misunderstanding of giftedness


· The patient’s social isolation caused by

a. Peer rejection b. An idiosyncratic, precocious intellect that permitted secretive, spiritual, and magical thinking c. An inadequate educational setting d. The parentification of the patient and his sister


The goals of the psychotherapy were to help the patient engage in age-appropriate social tasks and to find an appropriate setting for the full expression of his remarkable gifts.


The length of the psychotherapy, although not exactly specified, appears to have been relatively short term. Rather than terminate the psychotheapy, Dahlberg made himself available in an open-ended way so that all members of the family could and did request periodic consultations.


Psychoanalysis of Gifted Adolescents

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.