Adolescent Psychoanalysis

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Adolescent Speak

Chapter 2

Part 2

There is a song by Crosby, Stills and Nash, “Thorofare Gap”

“Sometimes I consider my pace
I’m reminded of a train gathering speed for the climb to the pass;
In whose shadow it already lies
A small metal dragon approaching the ever present ascending rise
To the Seventh Mountain.

Reeling and snaking and leaping it seems
like it wants to come loose from it’s path cast in iron;
But you can’t slow down now
As the Earth has presented a new crest to reach
Without barely a rest from the last one.

Can you wonder what lies beyond?
Though you’ve been there before
And forget about the effort and the strain;
Always ascending, each yard as a mile
To the never ending pull of the steepening grade that’s before you.

A valley, a forest, a desert, a stream,
With an oversized bridge for the trickle beneath;
You remember the torrent it turned to last spring,
From the snow melting fast,
And the river it became in the summer.

Perhaps it is ruin from a fire that has scorched it
So badly that nothing will grow without rain;
To wash away the blackened soil
Now useless until called upon again
In a future as distant and far away as the next range of mountains.

Then take it as far as you see and beyond
With eyes you don’t use enough gather up strength;
As Thorofare Gap
Will await forever you see
When you get there of even before;
It’s no matter. No distance. It’s the ride.

I spent considerable time studying the lyrics of “Thorofare Gap”— from my experience, a variety of dictionaries, interviews, and other sources. Thoroughfare is ‘the main road in town, usually relatively short, predictable, visible, end and beginning’, etc. ‘Gap’ is a word that has many meanings. Of course, one is obvious—a gap, an opening, a gap in the thoroughfare, unpredictable, often unsee-able, etc. ‘Gaps’ are everywhere and are found in everything. We find ‘gaps’ in reasoning, ‘gaps’ in logic, etc.

For adolescents now is now, a moment in time. For most of us analysts, ‘now’ is a combination of the past and predictions of the future. I don’t think that we manage much ‘present’ in our work. The results of this conflict are immensely negative, causing huge problems in the treatment of adolescents and being one of the leading causes of failure. We want to talk about the past and how it predicts the future and adolescents, in all but rare circumstances, live, think and talk in the present. Depending on ones analytic school, we take whatever is supposedly the ‘now’, find how it really is the past relived and how this past will impact the future. The only signs of the present are found in the transference which is, of course, the past in the person of the analyst.

A 16 year old patient said to me “I want to have sex with Mary, but she won’t”. The adolescent is interested in talking about what he means at this point in time. He will want to talk about Mary, why she won’t have sex with him in the present. I ask the patient about Mary, “How come Mary,?” “I don’t know, probably how she looks”. “looks”? “yeah, mostly it’s her hair.” “hair” I question. “Yeah, she has the prettiest hair at school”. “Select girls that way?” I joke. “Pretty much. I know that sounds weird”. “Weird”? “Yeah”, laughing. I mean she is really pretty, and all I see is her hair”.

In this brief episode, this patient analysis is briefly illustrated. From the adolescent’s point of view, a variety of things happened. First, in no definite order, my relationship with the patient maintained itself. Second, his ‘free associations’ are clearly present. By that I mean he was speaking freely, telling me apparently without censorship, what was on his mind. Third, there is clear development of these associations during the course of the session. The unconscious is interpreted, but in a way we are not used to. Statements such as ‘How come Mary?” are interpretations of the patient’s material. By my statement I have called his attention to part of what he is talking about, elements of which he clearly does not consciously know. What I have not done is to try to link his ‘hair love’ to anything, past or future, and certainly have made no attempt at any kind of transference interpretation about me. For a variety of reasons I have not done this. Firstly, I had no evidence. Also, importantly, is that the patient wants to discuss ‘Mary’, ‘hair’ and ‘weird’, nothing else. I can continue in this vein and this and other sessions progressed beneficially. The past, perhaps, in the view of the patient, will or will not arrive in the present. I know by the content that the patient probably has a variety of feelings towards me, one being that he trusts me. What’s on his mind now, however, is about Mary, that she won’t, and this ‘weird’ hair thing. He has no overt interest in talking to me about his estimate of me and even less interest in his past where he probably suspects the ‘hair thing’ comes from. There is undoubtedly a history the ‘hair thing’, but it’s not present yet.

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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.