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“One for all”. A title that sums up very well the position of the adolescent in the family, as the scapegoat and pathological actualizer of the parents' unresolved conflicts, and also the position of the psychoanalyst, the therapeutic piggy in the middle between the adolescent's difficulties and the parents' projections. With adolescents in particular, but also with children, individual analytic therapy is not possible in the classic sense: there is the risk of working in vain, because the members of the family continue to produce and support the pathology which needs to be treated. Nevertheless keeping the setting as analytical as possible is no easy matter either, even when the therapist is capable of flexibility and adaptation to a wide variety of situations. Not only considerable technical ability but also an accurate diagnosis are required to decide on the most suitable kind of intervention.
Of course, if the analyst has only had experience with adults, he is more likely to view certain modifications as non-analytic. In the psychoanalytic treatment of adults, any involvement with the patient's family is usually avoided. However, as Limentani points out in his preface, a rigid approach is a handicap. Even with adults, if the patient requests it, it is impossible at times to refuse an interview with a family member and the patient together, and not only in the early stages of treatment. But these are exceptions.
Instead, where adolescents and children are concerned, it may actually be necessary to involve the whole family. Otherwise, the therapy may be impracticable. In these cases, it can be very difficult for a psychoanalyst to choose between individual treatment and family therapy, since he has received a specific training based strictly on a dual relationship, in which any attempts by the family at interference are usually seen as intrusions to steer clear of.