Page - 210 - in Psychoanalytic Perspectives on Puberty and Adolescence - The Inner Worlds of Teenagers and their Parents

210 Lost by the wayside – overstepping limits you out” as a concrete threat and fell into a panic. He often seemed to look into the left corner of the room in a particular way, as if he saw something concrete – a hallucination – and could not tear his eyes away. When he was so afraid, he began to rock with his whole body like a baby in a cradle in order to calm himself down. He often only identified himself by name reluctantly on the intercom, as if he wished to come in quickly without any obstacles. Speaking seemed to cause him fear, as if he would have to recognize that we were two different persons and his fantasy world would collapse. His favorite books, which he read for hours at home, were by Stephen King; they completely enthralled him, as his mother remarked. Accordingly, I also read some books by Stephen King, in order to enter into Mark’s magical thinking. His mutism in our friendly atmosphere could mean he was convinced that he and I were one person, bound together without words. At the end of the session, separation then constituted a shock. In other sessions, his silence could be a cruel form of torturing me, mistreating and controlling the situation. He triumphed by determining whether he attended our sessions, what he chose to show or hide of himself. His triumph over me was manifested in an arrogant mode of expression, which Bion sees as an expression of the death wish, when possible links to an analyst are attacked (Bion 1957b, 87). Analytic inter- pretation investigates the patient’s inner world and is experienced by a seriously disturbed patient as a “penetrating component of a disaster”, that must be mas- sively defended against. The first year moved from crisis to crisis, always threatened by Mark’s breaking off therapy. After some months, his mother could admit how disturbed he was and how urgently he required help. She became more cooperative and tried to make him attend our sessions. She brought him more often to the session or telephoned with him to remind him to come. I asked myself how long I was willing to bear this painful and frustrating situation. Not attending therapy sessions is a com- mon form of communication by adolescents to demonstrate their independence and resistance. Waiting for Mark elicited various feelings in me: I sometimes had the impulse to deny my interpretation of his absence and see it as a sign of his independence; sometimes I was worried I would lose him. Sometimes he was so confused that he rang my bell but did not come up. I discussed his case with Betty Joseph in London, and she encouraged me to tolerate his tardiness or absences as long as possible. I had announced I would tell his mother if he did not show up for more than two sessions in a row, which never became necessary. His mother then began to call me up to ask whether he had attended the session, to which I answered truthfully. Did Mark worry about a kind of claustrophobia – of get- ting stuck in therapy and not being able to end it? That could be the reason why he often showed up for a mere five minutes. Or did he wish to experience how relieved I was when he finally showed up? Or did he want to demonstrate he didn’t care about the analysis, thus treating me so contemptuously that I experi- enced it as cruelty? Separation at the end of the session was always painful and difficult for him, and could enormously irritate him, which presumably increased his fear of coming back the next time.