The adolescent who comes for psychoanalytic treatment has probably experienced a developmental breakdown—a rejection of his or her body and a distorted image of himself or herself as being male or female. A critical requisite for work with such adolescents is an understanding of one's own adolescent development.

The internal freedom of the psychoanalyst is an essential ingredient in the treatment of the adolescent. This means that the psychoanalyst of the adolescent can separate his own sexual life and thoughts from what is lived out in the analytic sessions and thus can ensure that the treatment will confront whatever is essential and that he will avoid deriving gratification from the treatment process through taking over the adolescent's body or feeling that he is secretly sharing the intimacies of the patient.