Adolescent Psychoanalysis

Leading and Following

Chapter 16

Part 4

Tuesday

“This isn’t as comfortable as I thought it would be.” She said.

“The chair? Laying that way?” I asked.

“Yeah. Not at all.” She said.

“Speaking of comfort. Just out of curiosity, what do you think the purpose of the cause you are pursuing to try to get at me? To get under my skin? Make me uncomfortable. I’m not sure what it is.” I said.

“I don’t know. I think I like to piss people off. I’m really into shock value. I like to do things. I like to test people. See how much I can do before they snap.” She said.

“Why do you think? You like to test people. You push them until they push away. What’s the point?” I asked.

“What’s funny is that, you’re going to laugh at me, but this is like the only way I can put it. Jim Morrison was the same way. He was fuck’in crazy but he was a genius. But he was fuck’in crazy.” She said.

“Morrison?” I asked.

“He just would do… Do you know anything about him?” She asked.

“A little.” I said.

“You know, he would do the most insane things for shock value. To see how much he could do to you before you would go away. To see if you would ‘go all the way.’ The only the person of course who would do that, was his wife. He would do shit like that. He would do crazy shit to see if you’d walk away, and he’s dead. She said.

“How do you tell? If you are doing that, ‘going all the way’, being dead, to see if they’ll ‘go all the away’. If you’re dead, how would you know if they’d have snapped”. I said.

“How are you ever going to tell? Good question” She said.

“If he’s going to be there, because you’re going to keep doing things. Okay, so you do one more, and he’s still there. Was your triple threat suicide attempt like that? And if so, who was to go ‘all the way? Or ‘snap’” I asked.

“Why do you think he’s fuck’in dead? Dude. That’s my point. It’s not the healthiest thing. Look it’s 6 feet under at 28. Should have died 3 years later.” She said.

“27?” I said.

“Nice.” She said.

“Just to show you…” I said.

“What? No one here gets out alive?” She said.

“That is your plan. Push things until your dead?. And I’m dead” I asked

“We’re the Jim Morrison of…” I said.

“No we’re not. That’s just the only way I could put it. You know he used to walk around after Jimmy and Janis were gone, he’d say, ‘you’re looking at number 3.’ He would just do stupid shit like that. Like chasing Nico around, from the Velvet Underground. When they went to New York. He slept with her too. He would chase her around and around the courtyard and shit like that.” She said.

“Velvet Underground?” I said.

“Yeah. I know you know them. You’re just being coy. John Kale, Lou Reed and Nico. He would do the same shit. He would do all this shit to people to try and push them away. To see how far they would go. I do the same thing. I’ve lost faith in people. I do that I think.” She said.

“They’ll fuck you over. Yeah. I’m hell bent on being right.” She said.

“Remember your ‘hope burns eternal’ hope. Do you think this would be an example—-you’re killing yourself. And you’re tough. Three what appear genuine serious suicide attempts: one tree and two bags of tyelenol. Were they that, suicide attempts, or you just trying to see, even though you’re dead, who would still be around” I asked.

“Yeah. Exactly. Hope does burn eternal. I will continue to push away and I will continue to hope.” She said.

End

Leading and Following

Chapter 16

Part 3

Monday

“Got your dog to lick me. What next? You just can’t get rid of me now. It’s almost like that boyfriend that your whole family likes and wants you to marry, but you are so over it. Wait, you’re a man.” She said.

“So what’s a man got to do with this? Maybe I’m the boy?” I asked.

“No, I’m sorry. The girlfriend that everybody likes, your mother wants you to marry and all that. You liked her before but now you’re getting sick of her.” She said.

“Alright. I’m either the man or the boy, both of whom want to get rid of you. And what’s with ‘I’m sorry”?” I asked.

“I don’t know. You listen too closely. I’m the girl because I’m latching onto your dog now.” She said.

“Okay, but the dog is a girl”… “ I said, confused.

“Think of it as a metaphor. Like the chick you can’t get rid of.” She said.

“No, no. I understand that. I’m still trying to figure out who’s whom.” I said.

“I don’t think you’re the boyfriend. It’s just… how do I…. I give up. You’re dumb.” She said frustrated.

I laugh.

“I’m struggling to not be dumb.” I said.

“You clearly struggle with that a lot.” She said.

“Okay. You walk in saying that I can’t get rid of you. That’s what you say. Then you go on to say like the boyfriend the whole family likes, blah, blah, blah. And then ‘I’m a man”. So I’m thinking, I’m the boyfriend that everybody likes…” I said.

“No, no. I am.” She corrected.

“Okay, and I’m the girl.” I said.

“I guess?” She said.

“Okay.” I said.

“You know, I can’t get rid of her, kind of thing?” She said.

“Okay, so you can’t get rid of me.” I said.

“No, I can’t, you can’t…” She said.

“No hold on, be patient here.” I said, laughing.

She laughed.

“I’m still having trouble figuring out who’s who here. You can see why it would be confusing to me can’t you?” I asked.

“Yes. No, actually I can’t. It’s not that hard a concept to grasp. You got the concept of the guy whose got this girlfriend and at first he likes her and he takes her home. The whole family loves her and he gets sick of her.” She said.

“So he takes her home, but he… ” I said.

“Let me guess. You like some guy and he wants to get rid of you, but his family really likes you. And—call me wild and crazy, but your also worried that I want to get rid of you.” I said.

“Aren’t you a fucking genius. Duh.” She said

“Yeah and everybody loves this chick. ‘Oh are you going to marry her?’ She’s the greatest girl in the world. Have you ever seen the movie “How to Lose a Guy in 10 Days?”” She asked.

“No.” I said.

“It’s fuck’in hysterical. It’s like she does all these things that she’s not supposed to do, all in 10 days. The mother loves her and she’s calling the mother without his knowledge. You know what I mean? They’re all in cahoots together and then he’s like, ‘wait. I don’t like you anymore.” She said.

“Getting back to this concrete deal. I’m like the guy, you’re like the girl. My whole family’s saying this is wonderful, you’re going to marry her aren’t you. And you want to marry me. And then you try to get rid of me by being in cahoots with the mother who wants me to marry you but is helping you to get rid of him. And for good measure, I can’t stand you.” I said.

“No! I am the person that the guy can’t stand.” She said.

“That’s what I just said. I’m the guy and I can’t stand you. I said.

“Yes, and your whole family likes me.” She said.

“Okay. So I kind of had it right the first time around and you didn’t.” I said.

“Maybe I was just confused. No.” She said.

“Well there you go. So I used to be really entranced with you. But now I’m thinking, you’re out of here. You’d need a roadmap to follow all these changes.” I said.

“That’s what I’m talking about! You always reading into things! I could have been like it’s really pretty today, and you’d be, ‘what’s different about today?’ You would have made a whole session about it! This is your fault!” She said.

“Wait. Did you walk in the door out of the blue saying, ‘you know what? I remind me of a girl that I used to really like, but no more. I’m trying to get rid of you and …” I said.

“I was joking around. Your dog hated me and all of a sudden, Zoom made her hop up on the couch and I made friends with her. And now you’re screwed. I was just joking!” She said.

“Alright” I said.

“My god! Were you always like this? What did your parents do with you when you were a kid? ‘Oh, how was school today? Did you have a fun time on your field trip?’ ‘well, define fun.’ Fuck’in hell.” She said.

“Define field trip” I joked.

“Yeah, define field trip. Why do you think they call them ‘field trips’? Jesus Christ! You must have been obnoxious.” She said.

I laughed.

“Did your parents put bullets in their heads? Are they still living? Jump off buildings?” She said.

“They’re both severely handicapped. Because of all the bullets and so forth.” I said.

She laughed.

“Did they have a celebration when you turned 18? ‘Yes, we don’t have to answer his questions anymore!’ Oh, I’m sorry, am I making you feel bad?” She asked.

“Nope.” I said.

She laughed.

“I know that is a major goal of yours. Which you have not met.” I said.

“I have not met. But I will. I’m very tired. I didn’t fuck’in sleep last night. 2:30 in the morning. Jessica, I feel bad. She never sleeps. She’s always working. I was going in there to ask for a benadryl. Then I realized she had to call you in order to get that. I was thinking that wouldn’t be too bad, I could piss him off. I could get something out of this. But I like Jessica or else you’d be up at 2 am every day of the week.

“Boy is that confusing. Your goal is to disturb me, but then you don’t want to bother Jessica, both because of her and me. Very nice. What am I to think? And then today, whatever relationship that may or may not have to being nice to me, I’m either your boyfriend, a boyfriend who wants to get rid of you but is stuck with you, the girlfriend or pretty much any other person that I could be”, I said.

She laughed.

End of Session

Leading and Following

Chapter 16

Part 2

(revised 6/3/10)

Agent of Whom?

A supervisee was presenting material from sessions with an adolescent at Linden Center. The 17 yo boy complained, according to the supervisee, that there were too many rules at Linden Center, many of which were ‘unfair’. The supervisee, who had been following the material very well, stopped following and started leading, abruptly. “Of course there are more rules. This is a treatment center into which you have gotten yourself and has to have more rules in order to help you”. I was surprised, to say the least, and asked the psychologist why he had taken that position with his patient. He said, “well, I am an agent of Linden Center. They pay me”. It was easy enough to point out to him that he was not hired to be an agent of Linden Center, but of his patient. He was somewhat shaken, but could easily see the point I was making.

This same principle applies to all patients, especially adolescents. Treating an adolescent, when the analyst is agent of third parties, i.e. parents, hospital clinicians, outside clinicians, friends, AA sponsors, educational reports, written hospital records, and the Department of Mental Health assessment, etc. makes analysis difficult at best, impossible at worst. This is usually a difficult situation, but one must be the agent of the child, participating ‘appropriately’ with outside agencies, and trying to cleanse one’s mind of the content of those meetings.

The same principal of agency, applies to the ‘history’ of the patient. If the analyst is an agent of the patient’s ‘history’ he will serve that master and will be in a position to analyze the ‘history’ of the patient, not the patient. The same principle applies to psychoanalytic theories. If the analyst is the agent of a set of psychoanalytic theories, the theories, not the patient, will be the available object of analyses. The theories will be the object of the analyst, and will become the new ‘patient’.

The concept, ‘history’, presents many other problems. I cite one of the many in particular. The patient’s ‘history’, at best, is heresay, no matter who is saying it. Descriptions of an event usually say a great deal more about the observer than the event. Cluttering the landscape with elements of the mind of the observer is obviously a cluttering that inaccurately, but for coincidence, says little or nothing about the actual patient. The account presented by the patient is also ‘hearsay’, but is the ‘truth’ of the patient, which changes frequently.

The account presented by the patient purports to represent exactly the meaning attempting to be conveyed by the patient. If the patient ‘leads’, what he presents can be considered his version of himself, and the analyst can be the agent of understanding or integrating those elements of the patients account. If the patient ‘follows’, his associations will reflect those of the analyst’s beliefs and desires.

This account presented by the patient of and by the patient is analyzable. This is the stuff of psychoanalysis. Another function of this process is that it forms memories in the mind of the analyst, ideally unconscious. Elements of these memories are derived from the sessions and nowhere else. These ‘memories’ are fragments of thoughts that may emerge spontaneously, in the present or future, in the mind of the analyst and in the actual analysis, stimulated by the associations of the patient. These may be usable in giving further meaning to the adolescent’s associations and memories. They represent the analysts equivalent of Freud’s Basic Rule for the patient, that of ‘free association’. The analyst as well as the patient must be able to free associate in analytic sessions. They must be able as well to think about these associations lest meaning be derived from these associations. These thought or feeling fragments are free associations of the unconscious of the analyst drawn to consciousness by the associations of the patient.

Ideally the material of the session should be ‘forgotten’ by the analyst so that he may continue his analytic work. This is particularly true of adolescents. The material with adolescents is particularly changeable and often very charged. By charged I mean that the material is often laden with ideas that are ego-dystonic to most analysts. These ideas may be particularly obstructive to the analyst, if allowed to be dwelled upon. Nevertheless, all of us know that there is no way for us to cleanse our minds of all conscious memories, and desires and hopes for ‘cure’. One major source of aid to the analyst, perhaps the only source available, is the analyst’s own analysis. The best we can do is be well analyzed and try hard, knowing that we will ultimately fail.

All this being said, below I will present a series of sessions from a 16 year old adolescent girl. What, retrospectively, turned out to be the case, is that these sessions seemed to fit together in what seemed to be a sequential order. This week of sessions, again retrospectively, had the quality of being one long session, one seemingly building on the previous and leading to the next, very unusual in my experience. The sessions of this week also contained the first direct mention of sexuality.