Adolescent Psychoanalysis

(Anonymous comments may be left by clicking the response button at the end of each section).

 

Adolescents - A Rose By Any Other Name Would Smell as Sweet

Chapter 9

Part 2

 

What we often talk to adolescents about are the ‘manifestations/secondary manifestations’ of what they think and do. For example, they may talk of having indiscriminate sex. We try to call their attention to the ‘secondary manifestations’ of that issue—consequences. Adolescents often don’t consider these issues, such as disease, pregnancy, etc. The ‘secondary manifestations’ that we talk about become ‘things in themselves’ to us—absolute truths to us. Further, these ‘absolute truths’ are virtually always negative, presenting another sometimes serious additional problem—‘absolute truths’ which are negative that are ‘known’ to be false to the adolescent. In this situation, for example, the analyst will not investigate the meaning of ‘indiscriminate sex’ to the adolescent, but will assume that they know the meaning of ‘indiscriminate sex’ and the drawbacks that go with that practice. This they will tell the adolescent, what is wrong with their ‘belief’ and/or practice, even though the meaning to the adolescent is not known to that analyst.

We may discuss, as mentioned above, the obvious drawbacks of such practices, that of indiscriminate sex. We, therefore, are discussing the negative ‘thing in it-self’ of us, not the patient. At the same time the adolescent is being his ‘the thing in itself’. Thus, we are addressing the patient in ways that make no sense to the patient. In this situation, we have dueling ‘things in themselves’. From the patient’s point of view, there are no ‘secondary manifestations’, let alone negative ones. Although it is difficult to describe, we are addressing argumentatively our ‘thing in itself’ to another ‘thing in itself’. The analyst and adolescent are having a meaningless discussion.

However, we can meaningfully talk to adolescents about the ‘thing in itself’ of them:

A 16 year old boy said to me that he and his friends had been having group sex.

“How does that work out for you?” I asked.

“For the most part it’s really fun.” He said

“Most part?” I asked.

“Yeah. But my girlfriend is really jealous and thinks we’re stupid.” He said.

“Jealous?” I asked.

“Yeah. She doesn’t want me with other girls. She thinks it’s wrong for me to do that and she won’t do it.” He said.

“Wrong?” I asked

“Yeah. She’s jealous no matter what I tell her. Also, she thinks that a lot of the girls are dirty and that who knows what diseases they might have.” He said

“Dirty?” I asked

“ Yeah. Like who knows where they’ve been. Actually, I think it’s a bad idea, too. Probably ought to quit. I just don’t want to tell her I agree with her. She’ll lord it over me.” He said.

“Is this a case of win some, lose some?” I asked.

“(laughing) Yeah I know. I just hate to be wrong.” He said.

The definition for this patient of ‘group sex’, based on the information given by him and questions from me is: mostly fun, but not always, jealousy, stupidity, some-thing girlfriend doesn’t want him to do, something girlfriend won’t do, dirty, diseases, bad idea, grandiosity and selfishness.

This distinction of whatever we may think is the definition of ‘group sex’ is irrelevant in psycho-analysis. Our duty is to analyze the patient as he is, not what we think the patient ought to be.

In this example, what was discussed with the adolescent was his ‘thing in itself’, at that moment in that session, was having group sex. As nearly always happens, in this sort of analytic environment, the patient ends up reflecting on what was his ‘thing in itself’. That is to say he begins, using the Kantian model, to reflect on the ‘secondary manifestations’ of his ‘thing in itself’, which ceases to be his ‘thing in itself’ but a ‘thing in itself’ that has ‘secondary manifestations’ in this case negative consequences. He had been lectured about his deviant behavior by many outside parties, about the negative consequences of his behavior, with no results, except for arguments. In this instance, however, he begins to ‘lecture’ himself. He is much more receptive to being lectured by himself than by others. He doesn’t have to defend himself except to himself.

In this example, in the Kantian sense, both the analyst and the adolescent are wrong. We both believe that we know the unknowable, ‘the thing in itself’. Adolescents believe they are ‘the thing in itself’ and live their lives accordingly. They ‘know’ one set of ultimate ‘truth’s; we ‘know’ another. According to Kant, they are both wrong. Woe be to the analyst who treats adolescents, but doesn’t this aspect of Kant’s work. Matching an analyst with an adolescent, who both have their different ‘ultimate truths’, will inevitably lead to a fight in which both lose: the adolescent will lose his analyst, his analysis and his respect for analysis: the analyst will lose his patient, his chance to treat his patient, the respect of the patient and, perhaps, sadly, join the large group of analysts who regard adolescents as untreatable and the bearer of an unfathomable illness.

Ideally, there should be no ‘thing in itself’ of psychoanalysis. Theories used correctly are not ‘things in themselves’. They are theories with ‘secondary manifestations’. We should be occupied with our observations of the ‘secondary manifesta-tions’ of the theories we espouse, testing the correctness of these theories. We will have failed if we decide that what we know is in fact the ‘ultimate truth’. Not only would such a belief be catastrophically incorrect, it yields what may be a more serious problem. Our study and consultation with like-minded believers may strengthen our belief in our ‘ultimate truth’ and our resolve to defend it.

Adolescents ‘things in themselves’ are derived not of thought and deliberation, but in an entirely different way. Perhaps a useful way to say it is that the adolescent and the adolescents being—a ‘thing in itself’, are joined. They and their truths, created spontaneously, are synonymous. No thought or study or knowledge of philosophy is required. No reflection is required. Their beliefs and themselves are the same and are ‘things in themselves’. These ‘things in themselves’ just are. They spring into existence. However, and most crucially, to be able to treat adolescents, we have to respect theirs, hear theirs, listen carefully to theirs, try to understand theirs, talk with them about theirs and analyze them accordingly. We must analyze them as they are, not as we are. It is not their duty to conform themselves to us. It is our duty to attempt to understand theirs.

………”The first problem confronting an analyst who is treating more than one patient in the day will seem to him the hardest. It is the task of keeping in mind all the innumerable names, dates, detailed memories and pathological product which each patient communicates in the course of months and years of treatment, and of not confusing them with similar material produced by other patients under treatment simultaneously or previously. If one is require to analysis six, eight, or even more patients, daily, the feat o memory involved in achieving this will provoke incredulity, astonishment or even commiseration in uninformed. Curiosity will in any case be felt about the technique which makes it possi-ble to master such an abundance of material, and the expectations will be that some special expedients are required for the purpose

The technique, however, is a very simple one. As we shall see, it rejects the use of any special expedient (even that of taking notes). It consist simple in not directing one’s notice to any thing in particular and in maintaining the same’ evenly suspended attention” as I have called it In the face of all that one’s hears. In this way we spare our-selves a strain on our attention which could not in any case be kept up for several hours daily, and we avoid a danger which is inseparable from the exercise of deliberate attention. For as soon as any one deliberately concentrates his attention to a certain degree, he begins to select from the material before him; one point will be fixed in his mind with particular clearness and some other will be correspondingly disregarded, and in making this selection he will be following his expectations or inclinations. This, however, is precisely what must not be done. In making the selections, if he follows his expectations he is in danger of never finding anything but what he already knows; and is he follows his inclinations he will certainly falsify what he may perceive. It must not be forgotten that the things one hears are for the most part things who’s meaning is only recognized later on.

It will been seen that the rule of giving equal notice to everything is the necessary counterpart to the demand made on the patient that he should communicate everything that occurs to him without criticism or selection. If the doctor behaves other wise, he is throwing away most of the advantage which results from the patient’s obeying the ‘fundamental rule of psychoanalysis”. The rule of the doctor may be expressed;’ he should withhold all conscious influences from his capacity to attend and give himself over completely to his “unconscious memory., or, to put it purely in terms of technique:, he should simply listen, and not bother about whether he is keeping any thing in his mind., (what is achieved in this manner will be sufficient for all requirements during the treatment….” (Freud, Standard Edition, Volume 12, pgs 111-112 Papers on Technique, Recommendations to Physicians Practising Psycho-Analysis)

More from Mary, 7 weeks into treatment, very early on in her analysis. The last notes, in part one this chapter, were from a session 7 months into treatment.

Although there were associations that seemingly begged for interpretations, they were not made. There are intense ‘issues’ Mary has with the girlfriends. I don’t know what they mean. Hence, I have no basis to make interpretations of that ‘issue’. Further, that material was not the central subject of the session. The subject(s) of this session had to do with: the massive confusion that she felt about herself; her sanity; her hatreds (mostly of her family and father’s girlfriends); her ambivalence about her hatred of her family (father); and how incredibly different she feels from her ‘sane’ peers.

Mary

“When I was 6. We were camping and my father brought his girlfriend of the time and she kept making me mad. She wasn’t doing anything. She was just happy. I was just getting mad. I said I didn’t like her or something. She called me a brat because I started giving her an attitude. So I said ‘you want to see a real brat? I took my shoe off started hitting myself in the head, over and over. What kind of 6 year old does that?” She asked.

“A 6 year old who wants to hit themselves in the head,” I said.

“It’s kind of weird.” She said.

“Weird?” I asked.

“’Cause 6 year olds don’t do that. Do they?” She asked, laughing.

“Well, you think they don’t. We know of at least one who does.” I said, laughing.

“Me.(she chuckles) I don’t know 6 year olds who bang their heads against the wall. I know girls that stomp their feet and kick the floor.” She said.

“So you were having a tantrum but what you would do is different?” I asked.

“I would bang my head on the closet door and just sit there banging. I don’t know why I would do that.” She said.

“I take it you thought you were crazy?” I asked.

“Yeah. Really. And they would just yell at me.” She said.

“Yell?” I asked.

“Yeah.” She said.

“Yeah?” I asked.

“My dad would pull me off the wall and say that I was in trouble. He would ground me. When we were camping and it was hitting myself in the head with the shoe, he pulled me into the tent and zipped the tent up and made it so that I couldn’t come out for the rest of the night. I was not allowed to go out. My brother was out there and everybody was out there in front of the tent. I could see their shadows and they were all having a good time. I was just sitting there by myself, crying. I was wide awake and I didn’t want to be there. You obviously don’t want to be in tent somewhere you don’t know and everybody is outside having the time of their life.” She said.

“Crying?” I asked.

“I used to do that a lot. Cry and Cry. I hurt so much.” She said.

“Wide awake?” I asked.

“Yeah. I wanted so much to be asleep.” She said.

“Does banging your head put you to sleep?” I asked.

“No it keeps me awake”. She said

“It was like I wasn’t there. Nobody came to see me. I don’t know. I used to do that (head bang) when people weren’t around too when I was younger.” She said.

“Less than six?” I asked.

“Yeah. Isn’t that what kids usually do. They would roll their eyes, yell. Me, I take off my shoe and I look at it and I remember looking at her. And it was really hard. I wasn’t even like tapping it. And so some reason I didn’t want to stop. Once I started, I wasn’t going to stop. My dad was telling me to stop and I wouldn’t so he took away my shoes when I was in the tent so I wouldn’t hit myself.” She explained.

“But how do you suppose your answer to you being more ‘bratty’ was to beat your-self in the head?” I asked.

“Yeah. I don’t know why. it was like an alternative for me, too. When I was mad when I was younger, I would always hit my head. It was never me scratching myself or something else. Just hitting my head.” She said.

“When you were hitting your head, how did your head feel?” I asked.

“I didn’t really feel it. It didn’t hurt until after I stopped. That’s why I didn’t stop, because it didn’t hurt so I kept on going harder and harder. The first few I think kind of hurt. And then I kept going and going.” She explained.

“Going and going?” I asked.

“Yeah, they would leave me alone.” She said.

“If I remember right, you said that you both wanted them to leave you alone and not leave you alone?” I asked

“Yeah, I know. Doesn’t make any sense.” She said.

“Were there are helpful parts of you banging on your head?” I asked.

“Nothing. Now that I think about it. I didn’t think about what I could do her get her mad, or anything like that. Or how can I get them to leave me alone. It was just automatic for me. I didn’t do it in school, I didn’t do it outside the home. I just I did it only at home with my family. I guess it’s because they are the ones that make me the maddest out of everyone I’ve ever known. You have bad times with your family.” She said.

“Maddest?” I asked.

“I was still mad. I know that I would keep one thought in my head. I wasn’t rambling. I would have one thought on my mind like “fuck you” “you’re so annoying.” She said.

“Head banging better than ‘fuck you’?” I asked.

“Yeah, I don’t know why. I honestly don’t know why I go to that right away. I would do it in the closet or by myself or with my family. I would be walking down the street and I would start hitting my head when they got me angry. It would be a place were nobody was, a secluded area. It’s weird I know.” She said as she chuckles.

“Anybody do anything?” I asked.

“Well my dad did something about it.” She said.

“Well most the time he would just hold me back. After I got out of that stage, I would just go into the closet. I wouldn’t say anything. I would just go into my closet and cry if something was wrong. I just started being quiet about it. I didn’t really say that that hurt my feelings or anything. I was more like, I would yell. I know I would yell a lot. Sometimes. Other times I would just go quietly to my room if something happened. When I get mad for some reason, I have never known myself to get a little mad.” She said.

“If I understand, banging yourself in the head didn’t make you less mad, but it might cause you to not think about being mad while you were banging your head.” I said.

“Yeah.” She said.

“You were saying, at least you mentioned it a couple of times, that you were crying. This last time you were crying in a closet. What kind of things were you crying about?” I asked.

“(silence) Like I’d cry about how much I hated my family. That’s the words that I would use, but I don’t hate my family. You know when you were younger you would say “of I hate this, I hate that”. That’s what mostly my thoughts were, or I’d be crying about something like… it was always about my family. I was nothing about the kids beat me up. A lot of the times my parents would ask my what was wrong and I would say “it’s nothing. Just some troubles at school”. I did get made fun of at school, but I didn’t want to talk about it.” She said.

End

(I had a great deal of trouble reconstructing this session and preparing these session notes. One ongoing factor was a distinct split between the content of her associations and her affect. Her words told of disastrous times for her. Her affect was, on the other hand, light hearted with a good deal of laughing and smiling. Further, there were many overt contradictions of which I was aware but, for the most part, couldn’t address. Finally, the material came very rapidly, again making it very hard to reconstruct. One saving grace, for the sake of preparing session notes, was that there were few themes with multiple examples.

One should add, however, that preparing notes is largely unrelated to the list of important factors of Mary and her personality. I prepare them after sessions and hope that they convey some feeling about my treatment of Mary. Such notes are, however, by definition, inaccurate, destructive and misleading. They are misleading since they depend on me preparing them and misleading in that they purport to convey an experience of mine with Mary, in notes and words. I believe that is impossible. As Bion said, however, in spite of their defects, they may be the best alternative currently available. Further, hopefully, this preparation is neither destruc-tive to her nor misguiding to me. Sadly, these hopes are not true. My attention, in spite of my best intentions, is misguided. Me being distracted is clearly not in Mary’s best interest.)

Trackback URI | Comments RSS