An important element of adolescence is the development of an awareness of one’s identity with respect to ethnic, racial, religious, gender, sexuality, and class factors. These cultural factors are looked at in the context of their sameness and difference from the adolescent’s parents. They often become fraught in relations at home and in the adolescent’s world of peers. Therefore, when adolescents are in treatment, it is almost inevitable that socio-cultural factors will enter the therapeutic relationship. The intensity that the adolescent brings to the work with regard to these issues is often mirrored by the intensity with which the therapist comes to feel a response.

This clinical vignette and discussion is an effort to look at the complexities of the transference/counter-transference matrix that can arise when both members of the therapeutic dyad’s cultural selves come into play with this intensity. It focuses on clinical decisions and an underlying clinical approach in the midst of the therapeutic tension.