Fertility in the Transference: Analytic Collaboration and Reproductive Conflicts

Psychoanalytic treatment is a collaborative effort between the patient and analyst. When the patient is an adolescent, the nature of the work often may seem far from this conceptualization. The analyst or therapist may feel not only challenged, but also frustrated by an adolescent's seeming unwillingness to become engaged in the treatment process. This is often understood as a function of the needs for privacy, separation, and autonomy…all major tasks of the adolescent phase of development. However, the transference may reveal more about the nature of such resistances, so that the analyst may address them with greater specificity.

During adolescence, the experience of the sexually changing body and its new attributes and capacities must be integrated gradually into the self-representation. If oedipal and preoedipal fantasies remain poorly resolved, then the internal representation of the sexually mature body may be experienced as threatening. The sexual maturation of the body means that early fantasies must be altered to accommodate the new sexual realities. In turn, those early fantasies with their conflicts and resolutions affect the adolescent's experience of his or her body with its sensations, attributes, capacities, and functions. In this paper I examine a particular aspect of the mature body…the capacity to reproduce…and how conflicts around that can lead to struggles expressed in difficulties with analytic engagement. Through case material I illustrate how the adolescent's unconscious fantasies