It is over 90 years since D. H. Lawrence gave this eloquent evocation of the ordinary, yet extraordinary, impact of puberty on the personality and the ensuing course of adolescence. Yet adolescence remains the ‘hour of the stranger’, when the personality painfully develops into its adult self. Lawrence does not make gender distinctions, but there are significant differences between growing up female and growing up male. Below are some comments from girls attending a specialist adolescent clinic.

Each of these statements is a powerful expression of the intensities of adolescent pain and confusion, and of the often unstoppable urge to act, or act out – that is, to attempt to manage internal conflict by action, rather than by thinking or feeling. Girls tend to act against themselves, as a result of intellectual pressure, depression, poor body image, lack of self-esteem and separation anxiety (this last taking the form of a fear of rejection). The statements describe responses to unmanageable states of mind, and the problems they describe will be familiar to many.

What happens in the mind (the internal world) cannot be separated from what happens in the body and external world.