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That adolescence represents a problematic period of life, not only for the youngsters themselves but also for those surrounding them, is nothing new. Even Socrates spoke of the selfishness, rebelliousness and moodiness of adolescents.
This time has frequently been considered to be a particularly difficult one for embarking upon an analysis, because ‘normal’ adolescent processes are seen to work against it. The upsurge of the drives and the fluidity of the defence organization tend to make the adolescent feel threatened by the treatment, and her need to distance herself emotionally from the original objects often results in her leaving the therapist in reaction to the intensification of the transference. In this paper, I will focus on an external factor which added to my patient's normal adolescent struggles and contributed towards the particular conflicts she experienced.
Lisa had a mentally retarded sister, two years older than herself. The difficulties which developed in response to growing up with a damaged sister seemed to be compounded by her mother's surgery for gallstones, with severe complications, which occurred when Lisa began her menarche at the age of 10.
Little has been published in the psychoanalytic literature concerning the reaction of healthy children and adolescents to the experience of growing up with a physically handicapped or retarded sibling. There is, however, the pilot study conducted by Thesi Bergmann and Sidney Wolf (1971). The study was based on interviews with 25 youngsters, some of whom were observed over a period of time. Although none was in analytic treatment, it is interesting to note that some of the features observed by Bergmann and Wolf were also seen in Lisa. The problems of the children studied by these authors were directly connected with the handicapped sibling and manifested themselves in behavioural disorders, academic under-achievement or neurotic conflicts. The anxieties of the parents appeared to be polarized between two ex