Special problems in borderline adolescents from wealthy families

Borderline adolescents from wealthy families pose a number of special problems in psychotherapy. The family may use great affluence to cushion the lives of their children in such a way as to diminish motivation for work, avocational pursuits, or anything requiring self-discipline. This in turn may exacerbate problems in the formation of identity, already impaired in the borderline adolescent. Antisocial tendencies may go unchecked because of the wealthy family's unusual ability to get around the authorities whenever its children are apprehended for an offense. Appropriate limit setting, imposed in ordinary families partly out of economic necessity, may fail to be imposed where family wealth has nullified the necessity for it. Parental deprivation, encountered often among the very poor, may also be seen among the wealthy, some of whom insulate themselves against their children to a marked degree, via household servants to whom almost all parental functions may have been allocated. From such deprivation, various character deformations may develop, including pathological narcissism. Clinical vignettes, illustrating these points and containing some suggestions for therapy, have been included.