Meetings of the New York Psychoanalytic Society

December 13, 1966. PROBLEMS OF TECHNIQUE IN THE ANALYSIS OF A JUVENILE DELINQUENT (TRANSFERENCE AND THERAPEUTIC ALLIANCE). George Zavitzianos, M.D.

The author describes the case of a twenty-year-old girl who was referred for treatment because of delinquent behavior. The patient belonged to the type of delinquent whose disturbances reveal an interference in transition from primary narcissism to object love. She sought treatment in order to be readmitted to a college from which she had been expelled for stealing. There were no complaints of symptoms. Besides stealing money, she also confessed to the analyst that she frequently stole clothes, jewelry, and cosmetics. She lied consistently and had had a promiscuous sexual life from the age of thirteen although she was completely frigid. Despite a professed strong desire to have children, she told of how she frequently mistreated and neglected children placed in her care. She experienced no remorse or guilt, due to mechanisms of denial and splitting of her self-image. Ego functions of self-observation and introspection were poor and she was not aware of bodily feelings; integration was markedly deficient. Symptoms indicating oral greed, penis envy, and anal possessiveness were clearly exhibited but were to a great extent ego-syntonic. Despite the diagnosis of 'juvenile delinquency', the patient was treated with the classical analytic technique, to which she responded with the development of a full-blown transference neurosis.

The patient had a strong symbiotic relationship with her mother, an alcoholic psychopathic personality who had confessed past stealing and promiscuities to her daughter. Early in the analysis the patient was untruthful, deliberately hid material, and either did not listen to interpretations or 'put them out of mind'. After more analysis of her defenses and interpretation of her ego-superego conflict, she became anxious and guilt feelings began to emerge. Her contempt and hostility were r