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 to 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 case reports and clinical excerpts that illustrate issues for both patient and therapist and describe how psychotherapy can unfold in predictable stages.
The Psychoanalysis of Gifted Children
Kerry Kelly’s report describes psychoanalytic treatment of a precocious 4½-year-old who developed symptoms related to family dynamics and extraordinary expectations. The clinical material is divided into phases illustrating how play psychotherapy lets the child express repressed wishes and find healthier solutions to conflicts.
Psychotherapy of Children
William Dahlberg’s case of a profoundly gifted 9-year-old treats multiple family members and addresses issues including parental misunderstanding and social isolation. The goals were to help the child engage in age-appropriate social tasks and find an appropriate educational setting.
The issues addressed included:
- Parental misunderstanding of giftedness
- The patient’s social isolation caused by
- Peer rejection
- An idiosyncratic, precocious intellect that permitted secretive, spiritual, and magical thinking
- An inadequate educational setting
- The parentification of the patient and his sister
The psychotherapy was relatively short-term with ongoing availability for periodic consultations.
Psychoanalysis of Gifted Adolescents
Case reports (e.g., Colarusso) show exploration of conflicts such as identification with defective relatives, oedipal conflicts, and underachievement used to express aggression. Group projects (Adolescent Gifted Project) illustrate analysts discussing creative patients and common clinical observations.
Common observations included:
- The nature of unconscious conflicts
- The special difficulties facing analysts in understanding highly specialized subjects
- The process of sublimation, where partial repression and ready access to instinctual material infused creative work with vitality
Psychotherapy of Gifted Adolescents and Adults
Diedra Lovecky describes traits encountered in gifted adults (divergent thinking, excitability, sensitivity, perceptiveness, entelechy) and works across cognitive, behavioral, and experiential realms to help clients manage these traits and improve social connectedness.
She notes difficulties in therapy such as clients distrusting therapists or challenging therapeutic authority, and recommends setting short-term goals to avoid impatience. She also suggests using shared intuition to help clients feel appreciated and views work with gifted clients as professional growth for therapists.
Jerome Oremland’s case of a talented musician shows conflicts about delayed adolescence and family dysfunction, including guilt, disappointment, limiting abilities to control anger, and self-punishing behavior; resolution improved intimacy and self-esteem.
Mary Elaine Jacobsen emphasizes identifying gifted traits in adult histories and cautiously integrating giftedness into therapy while respecting defenses and client readiness. Suggested psychotherapeutic tasks include following a client’s interests, being active, avoiding competition, transparency about giftedness, respecting idiosyncrasies, not representing social norms, confronting self-destructive behavior, and advising on enhancing energy, creativity, and self-realization.
Jacobsen also alerts therapists to a wide range of feelings they may experience, from exhilaration to envy.
Jerald Grobman reports on psychodynamic psychotherapy for exceptionally gifted adolescents and younger adults who became underachievers because of unresolved conflicts about their inner experience of giftedness. Treatment stages often lead patients to accept emotional conflict as a universal aspect of growth and to integrate giftedness with other personality parts.
Grobman presents an eclectic approach that modifies psychodynamic psychotherapy to include cognitive/behavioral techniques and psychologically informed mentoring, coaching, and advising, discussing issues and therapist challenges across stages of therapy.
Crisis Intervention
In crisis intervention an active, take-charge approach is required, with accurate symptom diagnosis to guide medication use, concrete stress-management techniques, and extensive family history to establish a guiding dynamic formulation.
Psychotherapy Proper
Beginning Phase
Patients resolve guilt about being gifted and receive mentoring, coaching, and advising to clarify a vision for their giftedness; therapeutic transparency can be useful.
Middle Phase
Patients begin to relinquish exclusive autonomy and learn to rely on others for inspiration and guidance.
Late Phase
Patients identify extracognitive capacities (inspiration, imagination, intuition, curiosity, special sensitivities) as core to their giftedness, use these abilities in therapy and life, and experience less conflict, anxiety, and underachievement.
See also
Adolescent, Gifted; Adult, Gifted; Career Counseling; Coaching; Precocity; Supporting Emotional Needs of Gifted; Underachievement
Further Reading
Colarusso, C. A. (1980). Psychoanalysis of a severe neurotic learning disturbance in a gifted adolescent boy. Bulletin of the Menninger Clinic, 44 (6), 585–602.
Dahlberg, W. (1992). Brilliance—The childhood dilemma of unusual intellect. Roeper Review, 15, 7–10.
Grobman, J. (2006). Underachievement in exceptionally gifted adolescents and younger adults: A psychiatrist’s view. Journal of Secondary Gifted Education, 17 (4), 199–210.
Grobman, J. (2008). A psychodynamic psychotherapy approach to treating underachievement in exceptionally and profoundly gifted adolescents and adults: A psychiatrist’s experience (unpublished manuscript). Retrieved January 20, 2009, from http://www.psychotherapyservicesforthegifted.com
Jacobsen, M. (1999). Arousing the sleeping giant: Giftedness in psychotherapy. Roeper Review, 22 (1), 36–42.
Kelly, K. (1970). A precocious child in analysis. Psychoanalytic Study of the Child, 25, 122–145.
Lovecky, D. (1990). Warts and rainbows: Issues in psychotherapy of the gifted. Advanced Development Journal, 2, 107–125.
Oremland, J. D. (1975). An unexpected result of the analysis of a talented musician. Psychoanalytic Study of the Child, 30, 375–404.
Copyright © 2009 by SAGE Publications, Inc. All rights reserved.
