When trauma persists, those affected resort to self-harm, alcohol, drugs, and destructive self-help measures, leaving the therapists who work with them feeling helpless and at a loss. Annette Streeck-Fischer shares her knowledge based on many years of experience in addressing these challenges. As a psychoanalyst, child and adolescent psychiatrist, and head physician of a clinic department specializing in children and adolescents, she is deeply engaged with difficult developmental trajectories and the treatment of complexly traumatized youth. Concisely, vividly, and also critically questioning, she sheds light on various issues, including: How do normal adolescent development trajectories differ from pathological ones, and what neurobiological restructuring underlies adolescent risk behavior? What psychological and cognitive factors are involved?.