Discussion of Dr. Padouvas' Case

What can we learn from a short analysis that has been interrupted precipitously? It is difficult to learn from such failures because we do not have the patient's associations after the failure to either confirm or disconfirm hypotheses as to the cause of the failure. At the same time it is easy to second guess the analytic work retrospectively since we, as readers, already know the ending. With adolescents and children the work and the critique is even more difficult because one not only has to understand the nature of the work with the patient but one has also to take into consideration the work with the parents who are not our patients. However, with adolescents, the adolescent, him-or herself, is the patient. Although the parents pay the bill, one has to work analytically with the patient in order to understand and interpret resistances to the treatment.

With this last point in mind, two statements by Dr. Padouvas frame the analysis. At the very end, he says that D had wanted to stay in New York for the summer in order to continue the analysis. This wish was undermined by the parents. This retrospective comment had its mirror component at the beginning of the analysis. After a great deal of resistance, the parents allowed the analysis to begin. We were told that, to the contrary, D was very eager to begin the analysis. In the body of the analytic report the resistances to analysis are handled with the parents and not with D. It is as if the analytic work with D occurs independent of understanding the nature of D's resistance to analysis. The ambivalence is split: D seems all-eager to be in analysis and the parents a force to be counteracted. Since the parents are not in treatment, the work with them is doomed to failure.

However, the major themes in the sessions provide a clue which may have opened a window to explore a source of D's resistance. In addition to the themes of loss, fear of ruining relationships, and a