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Martin Silverman opened the panel by making some observations and posing some questions regarding psychoanalytic process with children, adolescents, and adults. A crucial factor in treatment with children is the role of their parents. Parents typically initiate the treatment and also have some ongoing involvement with the analyst, with potential for facilitating or interfering with the unfolding process. Also, there are factors that distinguish the child from the adult in terms of capacities to engage in an introspective process: the child's limited ability to verbally free associate, to reliably distinguish between reality and fantasy, and to tolerate strong affects with any consistency. But how clear are these distinctions? Silverman quoted Sam Abrams' observation that analyzing children has similarities to analyzing borderline adults. Silverman also quoted Judith Kestenberg's recommendation that a child analyst can help the child strengthen the capacities that psychoanalytic work will call upon.
Silverman focused on additional differences that development makes. Very young children are still forming basic psychological patterns and ego structures, and may have limited tolerance for a procedure which challenges a precarious psychic equilibrium. Adolescents are developmentally also at cross-purposes with psychoanalytic investigation. Their focus is on the present and the rapid change they are undergoing, with little inclination to explore formative experiences.