Analytic Work with Adolescents: Reflections on the Combination of Strict Method and Creative Intuition in Psychoanalysis. Anders Zachrisson, pp. 106-114.

Quite often, we have the experience that adolescents do not accept an offer of treatment, in spite of the fact that they feel miserable.

Or they may start in treatment and then change their minds and break off contact. The author reflects on factors and conditions contributing to these analytic failures. He discusses elements of the analytic method, the setting, the neutral position, the analytic relationship, and how analytic frames are put under pressure in work with adolescents.

Zachrisson presents some vignettes and examples of analytic work, in which intuitive interventions and interpretations appear against a background of ordinary psychoanalytic method. For the analyst, these interventions can feel unexpected, incidental—like ideas out of the blue. On second thought, however, we may sometimes be able to trace and understand how these intuitions were based on unconscious processes, such as countertransference feelings, or an understanding of the patient that is still unclear and unarticulated internally by the analyst, or perhaps a last desperate attempt to reach the patient at a decisive or critical moment.

Finally, the author reflects on the double face of psychoanalysis: while it is a contemplated, carefully described, and systematic method, it is also a craft with elements of intuition, creativity, and —sometimes—inspiration.