Imaginary Audience / Personal Fable - Just a Phase or More?
Submitted by Michael C. LaFerney RN, PMHCNS, BC, Ph. D
Tags: adolescents development disorder mental health
Sherrie, a 14 year old girl has just been told by her boyfriend that he is breaking up with her.
She was devastated by this news and spoke little about it. But as time passed she begins to feel others were watching and laughing at her, feels unique in this experience and starts cutting her arms to relieve the pain she is feeling. When others notice these cuts she then begin cutting her things where the marks can't be seen. Her mother has noticed she is becoming more withdrawn and tries to talk about to her what is going on. Sherrie responds with “ You'd never understand how I feel-you've never been in love with anyone as deeply as I am! “Her mother then schedules her for a mental health evaluation where Sherrie admits to cutting to relieve pain. She is not suicidal. She will receive psychotherapy when she will be encouraged to discuss her feelings. Sherrie is in the imaginary audience/personal fable stage of teenage development. It is considered a normal stage of development and not a mental health disorder.
Imaginary audience is the belief in early adolescence that many people are enthusiastically observing, listening to, and interested in them. The personal fable is a stage where the teen thinks he or she is unique, and due to this others cannot possibly know how they feel. It usually occurs between the age of 11-13, peaks around age 14. and declines as teens go through adolescence. BUT what if it doesn’t? The teen may proceed into another mental health category based on the DSM-5. Up until age 18 behaviors such as stealing, lying, and run ins with the police in teens are called a conduct disorder. After age 18 we will begin diagnosing this person as an antisocial personality disorder.
What if an 18 year old still feels everyone is watching him, feels he is the center of attention, or is unique and special? We might see the beginning of several psychiatric disorders. Everyone watching him could be seen as symptoms of paranoia or social anxiety. Unique and special could be signs of a narcissistic personality disorder or the grandiosity seen in Bipolar disorder. (1)
We do know that cutting is usually occurring because the teen is unable to express her feelings and as she talks more and gets support the cutting will usually stop and normal development continues. So is the imaginary audience/ personal fable stage of development a hypothetical concept, a normal stage of development, a mental disorder, or a precursor of mental health disorders that may come in early adulthood?
This developmental phase coincides with the beginning of puberty and is a difficult time in adolescence. Teens are seeking more independence for adults. Even with this teens want to be listened to and not dismissed. Empathy can go along way in getting through that you do understand and are supportive. Don't be dismissive but also give the child space. These early teen “romances” can be intense and should not be dismissed as “puppy love,”(2) They are learning relationship skills that will determine how they the cope with positive and negative experiences in the future.
In summary the ages 11-15 are very important in future good mental health and brain development. Helping them to understand and self-regulate their emotions in early adolescence will greatly help them on their journey to early adulthood.
References
- LaFerney, M. (2019) Do the following diagnoses belong in the DSM-5? Taken from the internet August 3, 2024 at: https://www.elitelearning.com/resourcecenter/nursing/specialties/mental-health/do-the-following-diagnoses-belong-in-the-dsm-5/
- LaFerney, M. (2019) RNL, Point of Care: And they call it Puppy Love Taken from the internet August 3, 2024 at: https://nursingcentered.sigmanursing.org/stories/view/point-of-care-andthey-call-it-puppy-love
Michael C. LaFerney is a Psychiatric clinical Nurse Specialist at Healthdrive, Framingham, MA.