ABSTRACT
It is a familiar situation for general practitioners (GP) to see a patient who is showing signs of acute anxiety and distress, but they need to develop appropriate ways of absorbing this anxiety (the 'thoughtful sponge' effect), demonstrating to the patient that his anxiety can be understood and contained. The GP's ability to listen to and make time for a disturbed (and disturbing) adolescent creates an opportunity to substitute thought for action. There is also a need to try to detect the potential suicidal adolescent, that is, the distressed adolescent who has not yet made a direct overt suicidal attempt, but for whom there is nevertheless a danger that such self-destructive consequences may follow. This chapter provides several brief case histories illustrate some of these issues. The case, Anthea, illustrates the difficulty in containing a rampant anxiety state bordering on psychotic breakdown, and the problems in arranging appropriate specialist help speedily.
