Clinical aspects of adolescent issues are reviewed, particularly the importance of emotions. The work of Jaak Panksepp, with regard to core affects, is highlighted as a potential for the elaboration of an overarching theoretical frame of reference for psychoanalysis and psychotherapy. The paper highlights the importance of understanding the power of defeqnses against painful emotions, implicit emotion regulation, and the cortical/subcortical imbalance in adolescence. A case example is provided to illustrate these ideas.