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Chapter 14 The Young Adult: Basic Assessment and Health Promotion
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TABLE 14-6
Levinson’s Theory of Early Adulthood
Era
Age Range
Life Structure
Preadulthood
0–22
17–22
17–45
22–28
Preparing for adulthood. Transition to early adulthood. Begin novice phase; person is
guided out of adolescence.
Combine social and occupational roles that are adapted to personality and skills.
Enter young adulthood. Novice phase tasks:
a. Form dream for life
b. Establish or enter relationship
c. Select occupation
d. Establish love relationship
Age 30 transition: reappraise life plan and modify it.
Culminating life plans and structure for early adulthood: seek to realize goals.
Transition to or preparation for midlife.
Early adulthood
28–33
33–40
40–45
Adapted from reference 135, 136.
body image, sexual concerns may become paramount. Sublimation
is an effective adaptive mechanism. (See Chapter 1.)
Developmental Crisis: Intimacy Versus Isolation
According to Erikson (65–67), the psychosexual crisis is in intimacy versus self-isolation. Intimacy is reaching out and using
the self to form a commitment to and an intense, lasting relationship
with another person or even a cause, an institution, or creative effort
(65–67). In an intimate experience there is mutual trust, sharing of
feelings, and responsibility to and cooperation with each other. The
physical satisfaction and psychological security of another are more important than one’s own. Involvement with people, work, hobbies, and
community issues is an expansion of personal intimacy. He or she has
poise and ease in the lifestyle because identity is firm. There is a
steady conviction of who he or she is, a self-acceptance, and a unity
of personality that will improve through life (65–67, 108). Intimacy, according to Sullivan (228), is a situation involving two people that permits acceptance of all aspects of the other, self-disclosure,
and a collaboration in which the person adjusts behavior to the other’s
behavior and needs in pursuit of mutual satisfaction. A person’s mental health is dependent on the ability to enter into a relationship
and experience self-disclosure. In so doing, the support and maintenance of the relationship alleviates feelings of loneliness.
In the intimate relationship, as in friendships, females are more
concerned than males with the relationship and are interested in
the process rather than the product of something. Females also recognize their vulnerability and can self-disclose and acknowledge
the need to change more readily than males. Interpersonal dependency, an element of the normal adult personality, encompasses attachment and dependency. Anxious or insecure attachment
develops when a natural desire for a close relationship with another
is accompanied by apprehension that the relationship will end. If
anxiety is transferred to the other person, the response may be a
withdrawal from the relationship, contributing to feelings of loneliness. If a healthy balance between dependence and independence
exists, social relationships and intimacy are maintained more eas-
ily, and the risk of experiencing loneliness and isolation decreases
(66, 67, 108, 201).
Although intimacy includes sexual intercourse and orgasm, it
means far more than physical or genital contact. With the intimate
person, the young adult is able to regulate cycles of work, recreation, and procreation (if chosen), and to work toward satisfactory
stages of development for offspring and the ongoing development
of self and the partner. Intimacy is a paradox. Although the person
shares his or her identity with another for mutual satisfaction or
support (via self-abandon in orgasm or in other shared emotional
experiences), he or she does not fear loss of personal identity. Each
does not absorb the other’s personality (65, 67, 108).
Many in late adolescence or early-young adulthood do fear a
loss of personal identity in an intimate relationship. In an increasingly complex society the search for self-definition is a difficult
one. Identity is not always solidly possessed by the time one is 20,
25, or 30 years old. Achieving a true sense of intimacy seems illusive to many of this generation. Movies, novels, plays, and pornographic media glorify sex for self-gratification. Many are puzzled,
hurt, or dismayed when they find such sexual encounters are disappointing.
Isolation, or self-absorption, is the inability to be intimate,
spontaneous, or close with another, thus becoming withdrawn, lonely,
and conceited, and behaving in a stereotyped manner. The isolated
person is unable to sustain close friendships. The person may not
marry; there is avoidance of a bond with another. If he or she does
marry, the partner is likely to find personal emotional needs unmet while giving considerably of the self to the isolated, selfabsorbed person (65, 66). Box 14-8, Consequences of Isolation,
summarizes behavior and feelings of the person (65, 66) to utilize
in assessment and intervention strategies.
Love and Marriage
The feeling that is the basis for intimacy is love (65, 66,
228), and love and intimacy change over time (51, 181, 228).
The young adult often has difficulty determining what is love. A
LOVE