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WHENEVER I AM CONFRONTED with a paranoid adolescent in the analytic situation, I become uncomfortably aware of the deficiencies in my theoretical and technical resources. The experiential components of treatment predominate over the work of insight and frustrate efforts to deal with the patient "classically." On a conscious level, there is a deliberate and persistent effort to thwart the setting up of an analytic situation, and I find myself reacting to the seemingly willful sabotage that goes beyond the familiar neurotic resistances. I need to remind myself, as I carry out my "analytic toilet" (to use Glover's elegant euphemism) that I must adapt to the patient's difficulties if he is to adapt to the rigors of treatment.
Like adult analysts, child analysts have been brought up on a fairly strict adherence to the classical model, only to find in their subsequent analyses of immature psyches that certain modifications and substitutions become a necessity. Thus, the primary learning model is often at variance with the secondary models, derived from child analysis. Not surprisingly, this engenders conflicts within us in relation to our analytic ideals, but these inherent technical problems also furnish us with a flexibility for adjusting to unusual requirements in therapy.
In the special case of the paranoid adolescent, my primary training urges me to trace back the disturbance as far as theory and technique will allow. I am also concerned to discover how the paranoid propensity will manifest itself in the defenses