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It is never surprising to contend, in the countertransference, with polarised feelings about safety and threat, vulnerability and risk, victim and perpetrator, when engaging with a young person who has at the least suffered neglect and exposure to sexual trauma, and who has acted sexually and aggressively towards others as his only means of dealing with his feelings. The struggle, often, is how to integrate these different perceptions in one’s own mind as a therapist, and how to hold these divergences together, in an internal middle-ground, at the one time. The paralysis that this can engender has been a part of Charlie’s experience from a very early age, seriously limiting his psychological and emotional development and functioning; Charlie’s therapist equally experiences it as s/he describes the effort in sessions ‘not to descend into disjointed, isolated thoughts, or a state of drowsy non-thinking’. Technically, it leads us to the need to respond to both polarities, not to be drawn by the force of the transference to either pole; and it makes us reflect on what is not being said or expressed, what has to be avoided, as thought becomes difficult. These moments of drift experienced by all therapists are critically important with young people like Charlie for whom potency, sexuality and normal relating have become perversely difficult and where aspects of these have to be concealed or denied: it is a primitive and important countertransference response.
Alongside, in this interesting and full session write-up, we find the theme of intrusion, a theme that is expressed by both patient and therapist, and is played out by both all along the continuum that ranges from intrusion to exclusion.
Charlie arrived in the therapy room at the age of 12, a year into his foster placement. His history is not uncommon but nonetheless painful for that. The child of addictive parents who separat