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I have been curious about my enduring interest in analytic work with adolescents, and have even wondered if it is masochistic, since at times they can be so peculiarly difficult (e.g., patients who won't speak to you, patients who mock you, patients who disregard analytic rules and so-called decorum, patients who are frequently on the verge of needing more help than our relationship can offer). I have thought about what I am reworking from my own adolescence — no doubt a substantial ingredient. However, I believe there are intrinsic elements that make the treatment of adolescents such a distinct experience.
First, the body of the analyst and the body of the patient are the subjects of analysis in a far more urgent way than is the case in treating younger children or adults. The experiences of puberty can lead to especially charged erotic transferences and countertransferences. Second, the treatment of adolescents is taking place in “real time,” which creates a special intensity. The events of adolescence may be remembered or evoked in the treatment of adults, but adolescence is a phase in which things happen — the first wet dream, the beginning of menstruation, the first boyfriend, the first job, getting drunk for the first time, etc. Third, subversion is more central and necessary to the treatment than is the case with younger children and adults. The family is subverted, the analyst is subverted, as the adolescent finds her own sexuality and her own ideas. This fact leads to particular rejections as the roles we have had with adolescents are shifted or toppled. Risk-taking behavior on the part of adolescents raises unique transference-countertransference interactions and challenges. The adolescent can and should expect a requisite protectiveness from adults, yet the adolescent can throw her lack of concern for her own safety in the face of the analyst or parent. Fourth, there are specific transference/countertransference scenarios when parents have (intentionally o