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This paper will be based on more than 35 years experience working with adolescents, primarily in an office-based practice. The first 10 of these years was in New York City, where the therapist easily assumes an anonymous posture. He seldom, if ever, encounters his patients or their families outside of his office and is known primarily to them by reputation. Even his office in a city setting tends to be similar to those of his colleagues and to reveal little of the analyst personally. For the past 25 years my practice has been located in Bennington, Vermont and Williamstown, Massachusetts: small, semirural towns where everyone of necessity is highly visible. The therapist is not only known by reputation but often personally by referral sources, parents, school personnel, and even the patient himself.
At first this change of locale with its stripping of anonymity was disturbing. What should one do in a situation where I would often meet my patients in public places or social gatherings where they might know more about me initially than I did about them, where my patient could be a colleague with whom I had to consult professionally or, more often, a parent or teacher of my adolescent patient. I had to confront this problem quickly, especially since 25 years ago, in this area, there were almost no other professionals trained to work with adolescents, certainly no other analysts. Clearly, I had to make a decision: either to isolate myself professionally and especially socially or expose myself to a totally different professional and personal lifestyle than I had had in New York City.
Isolation was clearly unacceptable. If I were to remain in an area I loved and wished to reside, I would have to change many of