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Adolescence is, as we know, characterised by a sense of turmoil and upheaval as the unresolved conflicts of childhood and relationships (particularly Oedipal relationships) require working through once again. By mid-adolescence there is a focus on the adolescent finding his or her identity which is different from the childhood self. This period is usually characterised by fluctuating states of mind which shift rapidly between dependency and independency and between the paranoid–schizoid and depressive positions. In contrast to this more ordinary turmoil the therapist introduces us to 16-year-old Alex who we are told has been in psychotherapy for about one year. The rich material reminds us that the way in which the challenges of the adolescent period are negotiated play a vital part in the development of the personality. It is these pressing challenges that Alex appears to be resolutely trying to avoid and defend against. Although we are informed that Alex (along with his family) has chosen not to pursue hormone blockers there is much evidence that his adolescence has indeed been blocked in many different ways.
We learn about Alex’s focus on his intellectual studies – achieving the ‘highest grades’ (despite missing periods of college) and Waddell’s (2002) descriptions of adolescents who over achieve academically as a way of not engaging with adolescent emotional conflict come to mind. There is a danger that the intellectualisation at which Alex is clearly adept will
be replayed in the therapeutic encounter. Here I mean that the therapist and Alex can so easily become embroiled in ‘thinking about’ the difficulties rather than truly learning from emotional experience. I think Alex touches on this towards the end of the session when he states that ‘people who research it do not know how it feels’. The descriptions of his fatigue, eating difficulties, food intolerance, OCD symptoms also serve to reinforce the sense that Alex struggles to really take in and digest emot