Seite - 220 - in Psychoanalytic Perspectives on Puberty and Adolescence - The Inner Worlds of Teenagers and their Parents

220 Lost by the wayside – overstepping limits “I still find myself wondering what on earth went wrong. Did something go wrong? Will we ever know?” (Magagna 2012, 28). The mother writes at the end of the article that Milo has now finished university. One can imagine how difficult it is – both for the child and the therapist – to gain emotional access to the parents through such a concrete wall of defenses in order to understand their sick, desper- ate but also very powerful child. With psychotic episodes, it is impossible for parents to overlook their child’s wholly disturbed behavior. Here is another case study. Case study of an adolescent psychotic episode: Chrissie The symptoms of a psychotic breakdown, such as hearing voices, hallu- cinations, withdrawal into a private world and refusal to participate in the outer world, cannot be overlooked. For parents, these symptoms are a shock, although parents report in the introductory session that their daughter was “always different”. Since the adolescent cannot distinguish clear borders between reality and fantasy, her fears and the persecuting quality of fantasy can become so threatening that death constitutes the only escape (see Bion 1957a). It is therefore very important to define clear areas of responsibility to be assumed by various institutions for these adoles- cents. These include juvenile psychiatry clinics, parents, school and the analyst. In the crisis situation embodied by the adolescent’s testing of reality –her retreat into a fantasy world – the goal of analysis is to construct a bridge between madness and normal thought. Referral Chrisse’s mother got my telephone number from a youth psychiatric ward, called me up and informed me that her 15 -year -old daughter had stopped attending school, had taken to her bed and had thoughts of suicide. Chrisse herself then called me up and we arranged an appointment. Our first session Chrisse arrived with her mother, whom I then asked to pick her up in 50 min- utes. Chrisse told me her medical history in a very distanced fashion. She wanted to make a birthday party, but her best friend, who wanted to take her own life, wanted to make a “farewell dinner”. She then told of the argument with her friend and her retreat into her room, where she withdrew into fantasy while listening to loud music. She had always been an outsider, had no friends in elementary school, was always alone, and considered herself ugly and unloved. Then Chrisse became much more animated and began to report on her fantasy world. Using a pendulum, she could induce a trance state in herself. In her world, there was a snow maiden that was occupied by a bad spirit. She could see this