Some challenges in working with older adolescents in psychoanalysis

Detailed clinical material is presented in order to illustrate the challenges associated with carrying out analytic work with disturbed adolescents, and to investigate whether the adolescent's ambivalent responses to analysis are primarily pathological or are inevitable, given the developmental drive to become independent, to find an identity, and to separate from parents. In reviewing the case material in which the adolescent patient's opposition to treatment is primarily treated as a pathological solution, the author suggests that this emphasis was mistaken. Instead, he proposes a perspective that emphasizes the adolescent's healthy propulsion toward autonomy. Finally, the implications for psychoanalytic treatment are considered.