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In her introductory remarks, Agneta Sandell emphasised the challenges met with in adolescent psychoanalysis. Work with adolescents demands close contact with patients and with their mental states, and this is often a difficult thing to achieve. However, the fact that psychoanalysis with adolescents is difficult work is no reason not to do it.
Often we meet with strong depressive anxiety connected with experiences of separations, an anxiety to destroy the object, sometimes increasing to an unbearable anxiety really to have destroyed it, resulting in deep guilt feelings. It is important that a space is offered where these mental states are tolerated and contained. Actually, the containment is central in an analysis with an adolescent. It is a central function of the analyst to try to gather in the analysis, and contain (in Bion's sense, i.e. also metabolise) all the psychic contents that the adolescent cannot contain within himself and therefore is so prone to project and externalise. To be in close contact with and to help contain over time all the difficult mental states is a central function.
Howard Lerner presented material from the analysis of a boy aged 14 years with quite a traumatic and dramatic life. He was adopted at 6 weeks of age. When he was 6, a paternal uncle shot himself when he was on a visit there, and at 8 he was deposited with his maternal grandfather and sexually abused by him for 10 days. Shortly after that, he attempted to hang himself. The reasons for the referral included drug abuse, break-ins and stealing.
In the evaluation phase, the boy was referred to psychological testing, which revealed a high IQ, emphasis of disengagement, ‘slippery thinking’, massive constriction and an impression of ‘a paranoid character in its formative stages’. Two consecutive sessions two years into the analysis were presented. Both sessions concerned the boy's relation to a young woman, with whom he had had sex for the first time some days before, and a young man, wh