ABSTRACT
The complexity of treating adolescent patients has proved to be a significant challenge to the analytic paradigm (A. Freud, 1958; Blos, 1967; Erlich, 1988; Slavin, 1996) in part because adolescents struggle to assimilate an adult identity that is somewhat distinct from childhood identifications and from parental authorities. The serious resistance analysts face when engaging these young people in long-term psychoanalytic treatment has led some (e.g., Slavin, 1996) to the conclusion that adolescents cannot engage in psychoanalytically oriented treatments due to the developmental press to break ties with parental authorities—which leads to premature terminations when parental transference develops. Experience with seriously disturbed adolescents confirms observations that adolescents resist the emergence of parental transference, but we find that isolated dyadic treatments run the risk of overlooking the current struggles within the family to deal with the adolescent’s identity crisis and the family’s struggle to separate from the adolescent. Treatment approaches that integrate individual and family therapy in the context of the adolescent’s efforts to define his or her place in a larger community often help to articulate unconscious projective processes that interfere with the family and patient’s capacity to allow the developmental stage of identity formation and separation to occur (Berkowitz et al., 1974; Zinner and Shapiro, 1974; Shapiro, 1982b; Shapiro and Carr, 1991). For such adolescents and their families, the focus of treatment often involves the discovery and articulation of deeply held unconscious convictions that lead family members into chronically destructive interactions that exacerbate the adolescent’s struggle toward identity formation.
