Analytic Work With Adolescents: Reflections on the Combination of Strict Method and Creative Intuition in Psychoanalysis

Quite often we have the experience that adolescents do not accept an offer of treatment, in spite of the fact that they feel miserable. Or, that they do start in treatment and then change their minds and break off contact. The author reflects about factors and conditions contributing to these analytic failures. He discusses elements of analytic method, setting, neutral position, analytic relationship, and how the frames are put underpressure in work with adolescents. He thereafter presents some vignettes and examples of analytic work, where intuitive interventions and interpretations appear against a background of ordinary psychoanalytic method. For the analyst, these interventions can feel unexpected, incidental, like ideas out of the blue. On second thoughts, we may sometimes be able to trace and understand how these intuitions are based on non-conscious processes, like counter-transference feelings, an understanding of the patient still unclear and unarticulated for the analyst or perhaps a last desperate attempt to reach the patient and get in contact at a decisive or critical moment. Finally, the author reflects on the double face of psychoanalysis: both a contemplated, carefully described and systematic method and a craft with elements of intuition, creativity and, sometimes, inspiration.