Discussion

Psychoanalysts in general have not had much experience in the treatment of drug-dependent adolescents. Historically their expertise has been applied first to neurotic disorders. With the “widening scope” of psychoanalysis, progressively more disturbed patients have been treated, sometimes with straightforward psychoanalytic technique, sometimes with modifications of it. One might include the psychoanalytic treatment of children and adolescents in referring to the well-known widening-scope phenomenon, as it has come to be more accepted that a technique based strictly on psychoanalytic principles and applied to properly selected younger patients is also psychoanalysis. In adult analysis one only needs to add to the goals “to love and to work” that the child or adolescent patient be restored to the path of normal or optimal development (A. Freud, 1965).

In addition to the questions of technique and goals, the problem of how to select those patients most likely to benefit from psychoanalysis has also attracted analysts' attention as a consequence of the broader range of psychopathology under consideration. For example, a patient may be suitable for analysis according to one set of criteria but deemed unanalyzable by another (Tyson & Sandler, 1971). Drug-dependent adolescents typically have been viewed as double pariahs, thought to be neither suitable in terms of the requirements to come, to pay, and to associate freely, nor