Adolescent Psychoanalysis

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Cogito ergo Cogito

I think therefore I think

Chapter 11

Part 3

(Revised 11/9/08)

I am very unsure of the psycho-analytic ‘positive’ value of writing this brief history of Betty or any other adolescent, or, for that matter, of anyone.  I say that because such a ‘history’ is by definition ‘wrong’ and ‘misleading’. It is ‘wrong’ in the sense that it is based on heresay-heresay-heresay, interpretations of these events by a variety of people, the patient, other communicators, medical records, verbal communications, written communications, sensual communications, all of which are subject to infinite variations of humans and their understandings of most anything, etc.. Furthermore, and most importantly, we are psycho-analysts who realize that the meaning of virtually anything can only be determined by the essence of our work.  Were we mathematicians, we could add numbers and get the answer in the form of a sum, which we likely could agree upon.  An essential thesis of this book is that anything that is done to lead the analyst to stray from their duties as a psycho-analyst should be avoided as much as is possible, particularly with adolescents.  ‘History’ is an excellent example. I have quoted the following passage from Freud in a number of places, and it is particularly relevant yet again:
“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 every-thing 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 Psy-cho-Analysis).
As a reminder, put as an equation, the result is
S1→ S2→S3 →S4  and so forth
Each S represents statements, ‘truths,’ made by the adolescent. Each “→” is very complicated and important.  Although these arrows may denote a connection, such as a computer to the internet, it is important to note that these arrows do not necessarily denote a connection to anything including the next S and so forth. These ‘connections’ may say nothing about the quality or specificity of a ‘connection’.  That is to say, except temporally, statements may connect, may not, or may not be known to connect or not to connect.
 At each S or →, questioning, clarifying, gestures, commenting, remembering, connecting, listening quietly, laughter, etc. may be found to attempt to define, at least somewhat, the meaning of or the truth of the statement or connection.
It must be born in mind that none of these statements or connections or investigations are based on any ‘theory or predisposition’. This topic is also written about extensively in the ‘Commentary’ section of Bion’s book “Second Thoughts” which furnishes extensive material illuminating this topic.
Nevertheless, in spite of my reservations, below is a brief ‘history’ of Betty. One last reservation is that the ‘history’ itself is of no use, except to provide confusion and non-analytic thinking in the analytic consulting room. (Sources used to write this ‘history’ include verbal and written records of previous psychiatrists, treatment centers, hospitals, family members, especially her adoptive mother, Departments of Mental Health Reports, and the patient)
Betty is a 16 year old girl.  Her history is very complicated.  Allegedly, she is the off-spring of a drug addicted mother, an adoptive mother, who was allegedly a drug user herself, an alcoholic father and stepfather, and a family whose determination that on a ‘good’ day Betty was and is only intolerable and indescribably bad on ‘bad’ days.  The definition of ‘good’ and ‘bad’ remains very unclear both to me and to Betty, although Betty’s attempts at making these distinctions are few and far between.  Betty’s denial of the impact of these various relationships, circumstances, and events ranges from some to virtually complete.
One of the issues that apparently happens frequently, which may give a flavor of how things appear to go in her family, is that her family’s assessment of her behavior on a ‘home’ pass may be both to Betty and the staff, ‘good’, and yet in a latter report to the staff/Betty about the same pass, ‘bad’.  During the first two sessions with her, contrary to many, many later sessions, Betty reported with considerable animation her anger at her mother, and that she, Betty, was ‘perfect’ and that how her treatment by her mother made no sense, except to demonstrate how ‘crazy’ she (mother) was.
This theme of ‘perfect’ arose then and consistently appeared as her analysis proceeded. I jokingly recommended during a ‘perfect episode’, that she get a T-shirt that said “Perfect Girl”, lest there be any doubt by an observer that she was indeed perfect.  This idea entranced her and she had an actual “Perfect Girl” T-Shirt made for her. As her analysis proceeded, the T-Shirt creations expanded considerably, much to her delight.  Some ‘shirt’ themes based on their magnitude grew into statues. Most of the later versions of these shirts were imaginary.
Many fairy tale characters attracted/attract her.  “Tinker Bell” is a favorite of hers, which emerged as a favorite only after months of analysis.  In fact, according to her, she apparently owns virtually all of the Tinker Bell paraphernalia, including lunch boxes, clothes, shoes, etc., etc.. Her omnipotent creation of this ‘fairyland world’ may amount to her only solution to the apparently ‘terror land’ in which she apparently does live. The names and concepts of these T-Shirt names have varied widely and have gone from little girl fantasies to a much broader and more ‘mature’ and seemingly less fantasy based.  Recent names have included “Miss Unreliable”, “Miss Smart”, “Miss Room Restriction”, “Miss Obnoxious”, etc..  At present there are 21 active descriptions.
Although 18, Betty usually looks 13-14, but often acts older, sometimes younger, and is particularly ‘cute’.  She is commonly regarded, so I am told, as the ‘cutest’ girl in her high school.  ‘Cuteness’, according to her, makes her very sought after by the boys.  In the meantime, she talks with me about her ‘relationships’ which she conducts according to her ‘relationship’ principles.  For example, she likes to tell her next prospect ‘everything’ about her and expects them to do the same.  Absent this, she wants to be rid of them.  I don’t know as yet what her definition of ‘everything’ is, although this topic has emerged many times in sessions with Betty.  Lest I give a misleading impression, Betty is very bright, does well in school, and will graduate next June.
Further complicating matters and seemingly contradictory, as will be seen in the session below.  There is a clear-cut vicious, sadistic anger harbored in Betty, of which she is apparently primarily unconscious, sometimes consciously, which expresses itself partially towards her mother’s cat.  There is a long history of problems between Betty and the family cat. Her mother is a veterinarian’s assistant. As such, she is apparently especially close to animals, and especially the family cat.  Allegedly, on one occasion that is mentioned by Betty in the session material below, Betty threw the cat into a cardboard box.  This incident created an immense amount of anger and distrust by mother of Betty, and revealed Betty’s hatred of the cat.
My reason for the exercise below, annotation, one which I repeat frequently, is to review what I supposedly ‘did do’ at least as it is represented by my written recollections of the content of the session.  Mistakes I make are my main target. Of course, realistically, my notes are incomplete and inaccurate. First of a long chain of inaccuracies is that the notes rely on my memory, which is at best suspect. That my writing of notes can in any way reflect numerous variables such as tone, movement, looks, interruptions, etc., etc.  This exercise seems to be quite useful, often educational and fun, although sometimes revealing just how wrong I am able to go.
I will annotate this session using the principles expressed above of S1→ S2→S3 →S4  and so forth.
1  “By the way what’s the deal with the cat?” I asked.
As always, I try to be as non-specific and non-narrowing in interpretations I make.  With adolescents, this is particularly important.  The ‘S’, (truth) of ‘cat’ to Betty, is not known by me.  Her mention of the ‘cat’ just prior to my question, lead to that question about ‘cat’.
2  “Um, she took it away from me and I got mad. Now the cat doesn’t like me any more, but yet it’ll come up to me and want me to pet it every once and a while and then when I go up to it, it doesn’t want me to.  It’s bipolar.” She said, laughing.
3  “So you have a cat that needs some lithium or something like that?” I said laughing.
At that point in time, as often, to cast what she says, her ‘truth’ at that moment, in a way not ‘matching’ the apparent emotional ‘valence’ or thrust of an interchange, usually badly damages the session.  Here, she is laughing about the cat.  Laughing along seems to be the appropriate matching and is natural, not forced.
4   “And the only reason I try and pet it; is because it is the only cat in the house,” She said.
5  “So what, your mother tells you not to, but you go ahead and do it?” I asked.
6  “Sort of; like I’ll pet it and then she’ll tell me not to any more after I have already pissed it off.” She said.
I missed the point somewhat, but as so often happens, a correction in an appropriate environment, usually follows with the ‘correct’ material.  I think she’s talking about what her mother tells her to do about many things; she’s still talking ‘cat’.
7   “if the cat gets pissed off with you, what happens?” I asked.
She has gotten me back on track.
8  “I mean sometimes it’s fine; I’ll sit there and pet it and it will be fine and then it will snap.” She said.
So now, the ‘definition’ of the ‘cat’ is expanding. It is now the pissed off, snapping, bi-polar thing called  ‘cat’.
9  “Snaps—(shrug)?” I asked.

10  “Start’s hissing.” She said.

The meaning of the concept ‘cat’ continues to expand:  snapping, pissed off, hissing, and bipolar thing called a ‘cat’.
11  “Does it ever bite you?” I asked.

12   “No, if it did I’d frick’in throw it like a football.” She said.

The ‘cat’ is now a snapping, pissed off, hissing, bipolar, football suited to be thrown thing, called a ‘cat’.
13   “That’s kind of what happened before?” I said.
14   “And I like animals too. Well, I didn’t mean to throw it.  Like there was a box, it had a whole bunch of blankets and I was trying to hold it and my mom got pissed at me. So I put it back in and I like tossed it in. Whatever and I didn’t like throw it. Whatever. I don’t think it has to do with that; cause animals, it has nothing to do with frick’in hitting them once.  If you hit them once ok whatever, they get over it.  But something to do with something else.  I think the cat’s racist; because she’s black and I’m white; and she only likes my mom because my mom feeds her.” She said.
The definition of ‘cat’ to Betty is expanding exponentially: The ‘cat’ is now a snapping, pissed off, hissing, bipolar, football suited to be thrown, tossed, not thrown, to be hit once, racist thing called a ‘cat’, which is related to mother since the cat is black and Betty is Caucasian and fed by the mother.
16   “A racist cat.  Never heard of one before.” I said.
17   “My mother thinks that I walk all over her, like with the cat.” She said.
Now the ‘cat’ = mother.  Mother thinks that the Betty walks all over the cat and herself.
18   “I don’t remember that. I don’t walk all over her at all, I always ask her can I do this can I do that and I whatever.  In the past yeah; but now, no.” She said.
Paraphrased: I used to walk all over her in the past, but not now and besides, I don’t remember anyway.
19   “How do you do at home when she says no. You ask her about something you want to do and she says no.” I said.
20     “Then I just take it as ok maybe later. She sucks, because I went straight from Colorado and I was home for like almost two weeks and then I came here.  It’s not like I even got a chance to even see if I could come home from Colorado and do good. So, I don’t now.  It’s frustrating.  I just want to go home. Uh, I’m frustrated you know.” She said.
21    “Want some Cheese It’s?” She said.
Back to T-Shirt Betty
For the sake of simplifying the S1→ S2→S3 →S4  …Sn model, I have, in this discussion, designated  “→” the investigator of, for example, S1 or as constructed,   an investigator/connector which leads to the following S.

The concept of ‘leading to the following S’ is extremely problematic.  With adolescents, as well as adults, we have no way of knowing what the following S may be unless we are lead there.  Should we presume we know the ‘next’ S and the pathway to it, the fabric of the analysis is shredded. That this is so results from the fact that we are providing pathways to an S, both of which are truly unknowable. We, in that instance, have fallen back on our theories in the consulting room—-a fatal mistake, especially in the analysis of adolescents.  Worse yet, If we ‘know’ the unknowable and yet lay out the ‘pathway’ to the unknowable, then insult is added to injury.  One more person who doesn’t listen, is full of theories and tries to apply them.

The ‘truth’, S1, of Betty’s ‘cat’ has meanings Betty has  attached to ‘cat’. As the investigation of these ‘truths”  (S’s) were investigated, it was found that ‘cat’ contained many qualities/meanings that one would not ordinarily associate with ‘cat’—e.g. fur, purring, playing, etc.  Or, if they seemed ordinary, these ‘ordinary’ cat elements had idiosyncratic meanings to Betty.  For example, ‘discovered’ elements of S1. etc., (cat hissing, getting pissed off, being racist , mother not wanting to have/take care of Betty, not wanting to feed her) are a partial list of elements of ‘cat’ meanings to Betty.  These ‘cat’ elements also show themselves to lead to actions and reactions between Betty and her mother.  For example, getting the cat to ‘hiss’, ‘get pissed off’, ‘assaulting the ‘cat’ in fact put into action Betty’s ‘cat’ feelings towards the intended object of these actions - her mother.  Hence, contained in S1, are both meanings and actions, which, in this instance, are both discoverable and of great importance.