Late adolescents, often in conflict over establishing an adequate personal identity in a discordant world, are at special risk. Some feel an ideational and affective emptiness and an absence of meaningful “external” experience, which can be likened to screaming in a vacuum. Clinical material from three adolescents is described. Theoretical formulations incorporating the long-term impoverishment of object relationships and lack of definition of “the self” are seen as central issues. The therapeutic task, aimed at establishing an acceptable and reliable self-awareness, is discussed.
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