VI. Adolescent Confusions

Some children in the practice were born around the same time as our own, and the identity of interests led, with several friendly families, to a monitoring of progress through the years, like farmers discussing their crops.

But painful emotions are generated when tragedy comes to a family with whom one identifies – the death of a child or a parent – and sympathy with their loss mingles with uneasiness at one's own escape. Confusion in adolescence is notable enough in any case, between infantile and adult sexuality, between inner and outer reality, between physical and mental maturity, but the experience in childhood of the death of a parent must undermine hopefulness and optimism about adult life. The opportunity to act in loco parentis for such an adolescent is poignant and irresistible.

Many adolescents in this practice do not understand the concept of ‘psychotherapy’ nor, if it is explained, feel it is what they want or need. But at an opportune moment, confidential discussion and informed guidance aimed at containment of anxiety and depression, and resolution of psychosomatic confusion, establish a context for continuing support.

An industrious Asian man of forty-five died suddenly from coronary thrombosis, leaving his widow with two boys, aged fourteen and seven. The parents had been unusually friendly from our first meeting, but were overburdened by the experience of unsuccessful pregnancies due to thalassaemia. Of her six pregnancies in six years they were left with only two live children. Their worst moment was the death of a two-year-old child at home while the wife was in hospital having a medical termination. No doubt these terrible events contributed to her husband's early death which occurred within a month of her reluctant agreement to sterilisation.

After his death she wept for weeks and diminished to a wraith, dressed always in black. I was often called out to her by her frightened sisters who had taken over responsibility for the house and the children.