Adolescent Psychoanalysis

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Adolescent Speak

Chapter 2

Part 1

Sadly, for our patients and us is our virtually complete lack of attention to semantics, the meaning of words. As philosophers, including semanticists, we make better bricklayers. Even though this subject, semantics, has been the focus of many philosophers for centuries, our study of such philosophical knowledge is absent. We assign a meaning to words we use, asserting that to be the true meaning—words such as envy, projection, depression, anxiety, transference, oedipal, etc. These words are expected to be understood by our patients as we understand them. Worse yet these words/meanings vary from analytic school to analytic school.

The dramatically negative effect this practice has on adolescent treatment cannot be underestimated. Ironically, the term ‘psychobabble’ is a used by many to refer to this phenomenon and to deride us. We ignore these critics often based on our thought that this term does not apply to us. Further, such a descriptor, ‘psycho-babble’, has an element of sarcastic derision that makes it unpalatable to us, perhaps justifiably. Nevertheless, there is an element of truth to this rude criticism.

In our profession, we assign extremely narrow meanings to ‘clinical’ words but use them broadly AND maintain these narrow meanings as though cast in gold, and for the most part, forever. This practice sadly turns out to be an enemy of our work, especially with adolescents. We are narrow to begin with and static thereafter. For example, a word such as ‘abandoned’, has been assigned a meaning by many of us in the mental health field. Yet the truth is that ‘abandoned’ has many meanings, including: Having been given up and left alone, bereft, derelict, deserted, desolate, forsaken, lorn. We say, not directly, that this word has only one meaning and treat it as such. Breast, another key word: chest, external body part, chest, bosom, nourishment, white meat, helping, serving portion, converge, meet, summit, arrive at, reach, gain, hit, make, confront, face, sexual organ, suck, sexually suck, caress, nipple, size, shape, etc. Our insistence on both the rigidity of our language, terminology, and labels and of our theories are often our undoing.

Adolescents are remarkably different in this regard. Words to them have a broad meaning. And these meanings stay broad. Not only does their vocabulary have broad meanings and definitions, but these broad meanings/usages change rapidly. To make the task even formidable, many of the words that are used by adolescents are widely different than those used by many adults. All these factors make adolescents a truly a moving target. An example: There is a widely agreed upon progres-sion in the formation of relationships. “talking” means that two people, often, but not exclusively, a boy and a girl, talk on the phone and get to know each other. This is a monogamous activity. If you ‘talk’ to two people’ you are unfaithful. “seeing” is next and means being in groups, including the boy and the girl, doing things in a group. For either that step or the next the mother must approve. The next step, ‘hanging out’ is when a the boy and the girl do things together or in groups, like go to the park. This may be followed by ‘dating’. In dating our example boy and girl go out alone, maybe to movies, lunch, dinner, etc. Some sexual activity is expected but not definitely required. Boy friend and girlfriend is next. Exclusivity is crucial. Sex for many, but not all, including intercourse. ‘going out’ is the next step. It is like boyfriend girlfriend and all that includes and planning for engagement, marriage, etc.

A 15 year old patient of mine recently accused her friend of raping her. It appeared that there was no rape but drinking and physical closeness lead to sex. She said that when watching a movie at home with her friend, which had happened frequently, that she would wear only a tee shirt and lay up against him. Further they would drink, especially her. Intercourse sex then occurred.

In spite of all of the above, the girl insisted and still does insist that she was raped. Her mother knew the alleged rapist and went to talk to him. His story about what happened and hers were identical. She concluded that her daughter was not raped. Apparently what did happen was not rape, at least as we would understand that concept. Her standard, please see progression above, was that she would never have sex with anyone until she was ‘going out’ with them. She had widely violated her own standard (see above) by having sex with someone she was ‘hanging out with platonically’. Her answer to that problem was, rather than suffer the pain, indignity and guilt of her violation of her own standard, was to accuse her friend of rape. This is, of course, an illustration of the importance of the above progression.

To have any hope of treating adolescents, we must be able to understand and speak their language, know the difference between their values and practices and ours. The differences are not as great as learning Spanish when one only speaks English, but close. This finding does not and must not involve collusion or ‘trying’ to be ‘hip’. One doesn’t need to be Hispanic to learn Spanish. By collusion I mean the temptation to be your patients friend, issue judgments, advise, etc. Although some adolescents like this approach, they should be referred elsewhere, where such practices are commonplace and the practitioners in this field are undoubtedly better than us. Such practices have little or nothing to do with psychoanalysis.

There is an irony here. Obviously, as good analysts, we have to analyze what we are brought by the patient, whether or not it corresponds to our values, language usage, etc. Why it is necessary to emphasize this fact with regards to the treatment of adolescents may speak more to how easy it is to be closed minded and full of known to be true theories, whom ever may be the patient. However, the interests and actions of adolescents, to some of us at least, are very far a field from our ordinary life and analytic experiences, making the task of being unbiased, non-judgemental and open minded much more difficult.

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