Page - 55 - in Psychoanalytic Perspectives on Puberty and Adolescence - The Inner Worlds of Teenagers and their Parents

Psychosexual development in puberty 55 often quite addictive worlds of social media . . . some may try to rely on clev- erness and cognitive acquisitiveness as a mode of defence against facing and thinking about new, turbulent, and often contradictory feelings – as a way of avoiding intimacy and evading engagement. (Waddell 2018, 115–116) Only when this defensive system fails does an adolescent (or his parents) turn to a therapist for help. I consider it very important that the adolescent himself contacts a therapist, even if he is only doing so “because my parents want it” – in fact, even if the parents are standing next to him at the telephone. In this way, the message is conveyed that his opinion and wishes count. Even after a crisis such as attempted suicide, panic attack, self -mutilation, or disorders in eating, work and relationships, the adolescent’s own insight that he wants help is central. During an assessment (usually up to four sessions), it is necessary to explore the extent of the patient’s own motivation in seeking help: will he endure the requisite self - examination under the analyst’s guidance and the resulting discoveries or changes this entails? Can he bear the possible discovery of his fears and ambivalence in reflection together with the analyst? Bion said that “pain is easier to bear if it can be thought” – a process of “detoxification”. The therapist must pay special attention to the feelings the young patient evokes in him (i.e., countertransference). Anderson points out that When adolescents are assessed, professionals often find themselves in a parental type of role, in receipt of these projections. This is uncomfortable, and at times unnerving, but it also very informative, and enables them to get a feel of what is going on. (Anderson 2000, 12) When adolescents threaten to harm themselves, and it is difficult to avert this risk, a considerable emotional burden devolves onto the analyst. Adolescents may try to provoke or involve their therapists (as they do their parents) in their self- destructive behavior. The patient might also perceive his attempt at self -reflection as a regression into childlike dependency. It is particularly difficult when they are put in touch with their infantile and childhood longings. They can feel as if they have lost their often fragile grip on adulthood and collapsed back into a child world from which they will never escape. For this reason, we attach great importance to how we open a dialogue with our young patients. We try to show them that we respect their fragile sense of separation from their parents, often by asking them to contact us themselves even after they have been referred by a parent or professional. (Anderson and Dartington 1998, 4)