Adolescent Psychoanalysis

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The Adolescent- As Whole Person

Chapter 7

 

The concept of ‘defense’ (negatives) in and of themselves is both confusing and, confining.  ‘Offense’ (positives) should also get proper billing, be seen, and noted.  Even a casual observation of life certainly shows that there are genuinely reality-based positives in life, perhaps particularly for adolescents.  Adolescents generally find a good deal more joy in life than most of us, some of which are and some not reality-based.   Not all their happiness is the product of delusion and grandiosity. In fact, many would argue that in life, including those of adolescents, positives far outweigh negatives. For adolescents the mass and volume of experiences of pleasure vastly outweigh negatives, most of which are based in reality.  Most people, including adolescents, live to find ‘positives’. Moreover, positives may also be the fuel to knowing the patient and to discovering problems that would otherwise go unnoticed.  Having both positives and negatives to search out would at least broaden the scope of our work—we would then have two categories in our patients’ associations on which to focus our attention—100% more.

Expanding our purview to include positives would make our work more realistic and broader.  If a ‘defense’ is designed to obscure, then it would follow that an ‘offense’ (positive) would be designed to illuminate.  All ‘defenses’ are not negatives. They certainly can be ‘positives’ in disguise. There are clearly times when a ‘defense’ has positive results.  There are also times when a seeming ‘positive’ is in fact a negative, and so forth. These various combinations and permutations of these states of mind can realistically only be determined by analyzing the patient.

These two categories, even if they could be usefully defined, are still limiting.  There are elements of adolescents and other humans experience, that cannot  be defined as positive or negative.  For example, there are elements that involve nei-ther the negatively or positively ‘valenced’ aspects of a person. They are ‘neutral’ but clearly important.  This area is probably where we live most of our lives. Further, clearly, what is neutral may become a negative or a positive.  Unfortunately, in our largely problem-oriented world of psycho-analysis, attention would be drawn to those elements only if they turned ‘negative’.  In present day analysis, we would be drawn to them only if they suggested that although they appeared neutral or positive, they weren’t. They could be deemed a resistance, a defense, denial, etc.  In that sense, our view of people is psycho-analysis decidedly negative.

We, therefore, are not treating the whole person, only their drawbacks (negatives).  This is, I hope, a further clarification of Dr. Grotstein’s earlier statement, roughly put, that we must treat the whole person.  A patient seen as only ‘negatives’ (problems) is simply not a whole person.  Neutrals and Positives must be included.  If all three are included, theoretically at least, we are analyzing the whole person.  There is no way to overstate the importance of this view when it comes to the psycho-analysis of adolescents.  If we fail to see what are positives and neutrals in adolescents, there can be no treatment.  The insistence on the ‘negative’ being both present and supervening defeats the analysis of adolescents. There really is more to them.  We don’t spend much time analyzing ego strengths, only weaknesses.

Our goal should be to analyze the ‘whole person’.  Of course, from a practical and philosophical point of view, we should not think in terms of categorizing the elements of an adolescent’s personality at all.  They are not good, bad and indifferent, although such divisions may be tempting.  Many find such divisions mandatory to be able to stand the thoughts and actions of adolescents. To think of them as a unified being is often unbearable since that ‘unified’ being is so uniquely unified. To see adolescents as fractured into parts makes the treating of them more palatable. We can hide behind the parts and not have to see the whole.  ‘That’ was done by the ‘bad’ part, not ‘that’ was done by the whole adolescent.

These parts can be integrated into a whole. If, contrarily, we divide people’s personality into parts, and look for parts we will then find evidence to support that theory. As said before, we are very good at finding evidence to support our theories. As Darwin put it, “judgment obscures observation”. This same Darwinian prin-ciple applies to ‘expectations’ and ‘pre-conceptions’, which are both judgments prevalent in our work.  If one knows what to look for, it will be looked for and found.  If we look for parts, we will find parts. Careful listening to an adolescent, based on our pre-conception that they are possessed of a severe and ‘unfathomable’ illness, will affirm our opinion.  They sound ‘crazy’ to us, they are known to be ‘crazy’, therefore they are ‘crazy’.  We must remember that we have all been cautioned for many years to make no diagnoses of adolescents, on the grounds that they were too disturbed to be diagnosed.

We all know of people who are “negative”.  They can find something wrong in anything.  We, as analysts, can find problems in anything.  We can find evidence of our ‘right’ thoughts in anything.  If we look for a ‘defense’, we will find a ‘defense’. If we learn and then look for examples illustrating our learned explanations of mental mechanisms, we will find them.  Hence, we will always find material supporting our theoretical stance.   Wedded to our theories, we have no chance to make observations, only confirmations.

These are some session notes from a very disturbed young girl.  One, in terms of a segmented her, would be tempted to think or her as a drug addict, who is promiscuous, brain damaged (from Meth), mistreated and misunderstood by her mother, having accused a drug puchaser of rape, and ‘slow’ but ‘bright’ young girl.  If she is looked as a part-object adolescent, the essence of her total self is missed.  She could be seen as a ‘bad’ girl, based on her history, more suited to ‘treatment’ in the justice system.  In the course of this book, there are other sessions of hers that are presented, giving many other perspectives on her.

This adolescent girl, 16 y.o., in two consecutive sessions with me, amongst other topics, told me material on one day which she ‘repeated’ the next day, but the content was considerably different. In session 1, she stated that her boyfriend was adamantly opposed to her bartering sex for drugs.  In fact, she said, if he knew he would probably kill her.

During the second session, the next day, the same topic arose - her talking about the same boy friend she had talked about earlier and the same topic which was him not being willing to allow her to barter sex for drugs. The content was considerably different, however. Now, he would ‘allow’ her to have sex with up to two boys for drugs.

When this topic arose again, I asked.

…………..“Did you notice that what you said about xx today was different than yesterday?” I asked.

Long pause

“yeah, probably, but I don’t remember” , she said

“What’s with that?”, I asked

“I have a lot of trouble remembering”, she answered.

I shrugged

Long pause

“I can’t get a picture of things any more. Like in class today.  I used to be able to have a picture of things.  I can’t do that now.  Everything is blurry. I have no picture of what the classroom looks like today.”, she said.

“picture” ? I said.

(a place where she would hang out/live and use lots of “yeah. You know, how things ‘look’.  Just before I came here today, I was leaving class and had no picture of how the room looked. I can remember things that happen,  I just can’t put them in order.  Like at the xxxxxmeth, amongst other drugs).  I remember things that happened there, but I can’t put them in order” she said.

“long time”?

Long Pause

“yeah.  I don’t know why?. Could it be drugs”  she asked.

“drugs” I asked.

“yeah.  Does meth do that?” she said.

I looked at her quizzically

Long Pause

“I’ve heard it does.  Lots of people at the xxxx really seemed weird.  They were crazy and couldn’t remember anything”

Long Pause

“When we talk, does it seem to you that there are long times between a question and an answer”  I asked.

“I know. That’s right. Lots of people, especially my mother, say that and speak for me.  They say that my mother and I are ‘enmeshed’ because she talks for me.  She can’t wait for me to talk”  She said.

“Wait?” I asked.

“Yeah, like doesn’t give me a chance to say what I think. I really do think, but slower” She said.

“slower?” I asked.

“yeah.  It may take me a long time”, she said

“Is what she says what usually what you were thinking?” I asked

“no” she said.

“do you argue?” I asked.

“No”, she said.

“Why do you think?” I asked

“I don’t know.  I just don’t do it” she said.

“Especially since you don’t argue, is there any way that I could tell if I’m doing the same thing you say your mother does—-not giving you enough time to put your thoughts together before I speak, perhaps seeming that I am speaking for you”? I asked.

“I don’t think so.  I only know when my thoughts come together when they have come together.  I don’t think you could tell until then” she said.