Some Considerations in the Introduction to Therapy in Puberty

The analytic method encounters special problems in work with the child in puberty. In a real sense we can say that the aims of puberty and the aims of analysis are hostile to each other. At a time when the ego must strengthen its defenses against the powerful resurgent drives, analysis must disturb the defensive structure in order to do its work. The precarious balance of the pubertal ego makes exceptional demands upon the analytic method. If the method succeeds in undermining the pathological defenses, it may, in some instances, precipitously release the dammed-up impulses to wreak new havoc upon the character of the child and upon the environment. If the method is perceived as a threat to the defensive structure, the ego may further strengthen the defenses, bring forth new defenses and elaborated symptoms, and marshall its resistances against the intruder, the analyst. The therapist, therefore, must walk a tight-rope in his work with the pubertal child.

As we pursue the problem further we see other contradictions of aim. Puberty is the age of secrecy. It closes the door upon the prying adult; it suspects the well-intentioned overtures of the parents, the invitations to confide. It hoards its secrets and, at times, sees the world of adults in grand conspiracy to spy upon them and ferret them out. The classical analytic technique requires the surrender of secrets. The spectre of the analyst as Spy who haunts the dreams of patients in analysis can be a tangible flesh and blood enemy to certain children in puberty. Where the enmity between parents and child is very strong, the analyst is certain to be suspect. Isn't he "hired by" the parents "to find out things"?

The pubertal child fears analysis for other and darker reasons. He is aware, as his parents are, that powerful forces are disrupting his psychic equilibrium. He experiences strange, overwhelming impulses, new sensations. He is frightened by the cyclic swings of affect which buffet him between th