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This paper examines the psychotherapeutic treatment of two preadolescent boys who presented with recurrent episodes of diabetic ketoacidosis. The diabetic ketoacidotic episode is interpreted as a developmentally primitive response to stress in emotionally immature patients who have failed to master age-appropriate developmental tasks in areas of separation, gender identity, and self-esteem. Individuation, differentiation, and acquiring the capacity to use language to express emotions are major therapeutic goals.

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