Adolescent Psychoanalysis Research Articles

The Best of Times, the Worst of Times: A Century of Child Psychoanalysis

ABSTRACT There is a tendency to see the status of contemporary child and adolescent psychoanalysis in pessimistic terms. But a careful comparison of the current-day scene with the past suggests that the situation is more nuanced. These are both the best and the worst of times. Looking back at the evolution of child analysis over the past 100 years reveals significant current-day progress despite some worrisome difficulties that can be rectified. This history is reviewed, and the many positive signs are delineated. In summary, modern day child analysts must continue to be proactive in demonstrating the value of knowledge and experience with development and clinical child work for analysts who work with all ages. Supporting an integrated curriculum is key to keeping child analysis in the forefront of psychoanalysts' minds.

Babies on the Brink: Training in Parent-Infant Psychoanalytic Interventions

ABSTRACT Parent-Infant psychoanalytic interventions have not been well integrated into child and adolescent or adult psychoanalytic training programs. Although many institutes have development courses on infancy and early childhood and even infant observation, it is rare that an infant or toddler case is supervised as a control case. This training gap has resulted in a relative paucity of psychoanalysts engaged in infant mental health and public health to meet massive societal needs. A case vignette is used to demonstrate the sophistication and effectiveness of early psychoanalytic dyadic intervention. Through the International Psychoanalytical Association (IPA) Committee on Child and Adolescent Psychoanalysis (COCAP), a pilot program for a two-year training in psychoanalytic interventions for infants and parents is being developed, geared to psychoanalytic candidates, analysts, and faculty with theoretical, research, observation, and clinical components.

Extending Child and Adolescent Psychoanalysis to Special Populations: Regulation-Focused Psychotherapy for Children (RFP-C) and Transference-Focused Psychotherapy for Adolescents (TFP-A)

ABSTRACT In the last decade clinicians and researchers have developed Regulation-Focused Psychotherapy for Children (RFP-C) and Transference-Focused Psychotherapy for Adolescents (TFP-A), two manualized, evidence-based, time-limited treatments derived from child and adolescent psychoanalysis. These therapies are designed to treat special, complex patient populations including children with severe externalizing behaviors and adolescents with nascent or actual severe personality disorders, youth thought to be beyond the reach of traditional psychoanalysis or thought to benefit from modifications of standard psychoanalytic technique to maximize the effectiveness and efficiency of psychoanalytic treatment. Despite the effectiveness of psychoanalysis, manualized cognitive-behavioral approaches like parent management training and dialectical behavior therapy are currently the most popular treatments for these patients, partially because there are too few child and adolescent psychoanalysts to meet demand. The authors describe RFP-C and TFP-A and illustrate their effectiveness using clinical material. The authors advocate for wider acceptance and utilization of these two broadly teachable manualized treatments by the psychoanalytic and psychotherapeutic communities to extend the reach of psychoanalysis to severely suffering patients who can reap the unique benefits of these essentially psychoanalytic approaches.

“The Times They are A-Changin”: Introducing the Section on Contemporary Child Psychoanalytic Education

ABSTRACT Bob Dylan’s classic song, “The Times They are A-Changin,” is used to emphasize the importance for child analytic educators to address the urgency for the profession and those training future practitioners to accept the need for evolutionary change. Refusing to change our traditional ways of work and training will lead child analysis to go the way of the dinosaurs. There is already ample evidence that our field is dying as manifested in decreasing numbers of child analytic cases, child analytic candidates, and child analytic teachers and supervisors. This paper introduces a section devoted to various contemporary shifts and ideas that represent the sort of evolutionary changes required to ensure the survival and revival of child and adolescent psychoanalysis. These transformations involve expanding the role and presence of child analysis, integrating child and adult psychoanalytic curricula, redefining child analytic frequency, and incorporating parent work into child analytic theory of technique.

« De la Prophylaxie infantile des Névroses », de Marie Bonaparte. « La Psychanalyse infantile et son rôle dans l’Hygiène mentale », de Sophie Morgenstein

Les deux rapports montrent comment la psychanalyse avec l’enfant et l’adolescent s’est développée en France en 1930. Marie Bonaparte et Sophie Morgenstern en retracent l’histoire par leurs réflexions théorico-cliniques spontanées et vivantes. Elles interrogent le devenir de la psycho-sexualité chez l’enfant et l’adolescent ainsi que ses achoppements, insistant sur le rôle de l’éducation surtout par rapport à l’activité masturbatoire. L’éducation devient alors partie intégrante des traitements psychanalytiques avec l’enfant.

Turning Points in Adolescent Psychoanalysis and the Centrality of Transference Interpretation: A Discussion of Dr. Lament’s Case of Grace

ABSTRACT In the discussion of Dr. Lament’s evocative and moving presentation of 15 year old Grace’s treatment, I focus on the technical necessity of transference interpretation in adolescent analysis. I believe that the pendulum may have swung too far in the direction of developmental help and that a correction is indicated. Issues of turning points in analysis, countertransference, apres-coup, and termination are also briefly discussed.

Child and Adolescent Psychoanalysis as Contemporary Psychotherapy: Insights From a Semistructured Interview of Practitioners.

In response to an emerging consensus that research is important to maintain and develop the field of child and adolescent psychoanalysis, 20 child and adolescent psychoanalysts underwent a semistructured interview concerning their current practices, background, and professional values. Grounded theory methodology was applied to a section of the narratives to produce shared concepts. A significant difference was found between how child and adolescent psychoanalysts are traditionally characterized and taught and how they currently practice. This distinction was supported by findings concerning the importance of active work with parents, the therapeutic relationship, and insight. These findings underscored the similarity of child and adolescent psychoanalysis to other fields of contemporary psychotherapy. They can be used to form a bridge between psychoanalysis and the other fields of psychotherapy and to maintain some presence of the field in contemporary academic research.

From biography to theory: the role of Anna Freud in the emergence of the ‘adolescent process’

ABSTRACTSome aspects of Anna Freud’s life reveal the existence of specifically adolescent conflicts, which can be tied to some of her theoretical and clinical discoveries in the field of adolescent psychoanalysis. Her historical input in the gradual construction of a theoretical corpus on adolescence has often been ignored. These links between biography and theory gave rise to a movement of conceptualisation, making it possible to develop a psychoanalytic metapsychology of adolescence: indeed, emerged such notions as asceticism, intellectualisation in relationship with anorexia and the struggle against the genitalisation of the adolescent body. Today, the Annafreudian school of thought has remained the main source of investigation and theoretical transmission of what is now called the adolescent process.

From Biography to Theory: the role of Anna Freud in the emergence of the “adolescent process”

Some aspects of Anna Freud's life reveal the existence of specifically adolescent conflicts, which can be tied to some of her theoretical and clinical discoveries in the field of adolescent psychoanalysis.

Commentary: The Neural Bases of Emotion Regulation.

Commentary: The Neural Bases of Emotion Regulation.

Attention deficit hyperactivity disorder (ADHD): An affect‐processing and thought disorder?

In the literature on child and adolescent psychoanalysis attention deficit hyperactivity disorder () is described as complex syndrome with wide‐ranging psychodynamic features. Broadly speaking, the disorder is divided into three categories: 1. a disorder in early object relations leading to the development of a maniform defence organization in which object‐loss anxieties and depressed affects are not worked through via symbolization but are organized in a body‐near manner; 2. a triangulation disorder in which the cathexis of the paternal position is not stable; structures providing little support alternate with excessive arousal, affect regulation is restricted; 3. current emotional stress or a traumatic experience.I suggest taking a fresh look at from a psychoanalytic vantage point. With respect to the phenomenology of the disorder, the conflict–dynamic approach should be supplemented by a perspective regarding deficits in α‐function as constitutive for . These deficits cause affect‐processing and thought disorders compensated for (though not fully) by the symptomatology. At a secondary level, a vicious circle develops through the mutual reinforcement of defective processing of sense data and affects into potential thought content, on the one hand, and secondary, largely narcissistic defence processes on the other. These considerations have major relevance for the improved understanding of and for psychoanalytic technique.

A Cross-Sectional Survey of Child and Adolescent Analysts in New York City

The field of child and adolescent psychoanalysis has been considered an endangered specialty for many decades. This study surveyed the nature of the practice of child and adolescent analysts (graduates and candidates) affiliated with three institutes accredited by the American Psychoanalytic Association in the New York City area. Sixty-one percent of those surveyed (63 of 103) responded. The child and adolescent analysts in this cohort treat a total of 201 adult, child, and adolescent analytic cases (M = 3.2, SD = 2.6). Of these cases, 17% are at a three-times-weekly frequency. Child and adolescent analytic practice is small, with a total of 56 analytic cases (M = .9, SD = 1.2). While 64% of these analysts have no child or adolescent analytic cases currently in treatment, 24% have very active child and adolescent analytic practices, conducting 73% of all the child and adolescent analyses reported. Implications of these findings and recommendations for future work are discussed.

Adolescent psychoanalysis: How we work‐Clinical models in practice: Two clinical cases with detailed session material

Adolescent psychoanalysis: How we work‐Clinical models in practice: Two clinical cases with detailed session material

Margo and Me II

Practicing child and adolescent psychoanalysis requires an understanding of the interdependence of analytic and developmental processes. Child analysts work with children whose organizing and regulating systems are still developing, allowing the analyst and her patient to tap the child's transformational potential as new hierarchies evolve and consolidate in the course of an analysis. The use of the narrative building technique is helpful to that process and is informed by and makes clinically applicable recent research data in development and therapeutic process. Narrative building can help the child develop phase specific organization that has been impeded by conflictual and non-conflictual elements in the child's inner and outer world, promote the developmental process, provide more flexible regulatory systems for emotional and cognitive development, lead to innovative views of people and relationships, and facilitate the organization of emerging structures necessary for progressive development.

The archaic superego: the guard of instincts from childhood to adolescence

In this paper, the author describes the primitive emotional roots of the development of the archaic superego and its repetition during adolescence regression, „the second chance” of one's psychosexual development. According to the author, the phase during which the baby is able to feel concern is fundamental to the development of the superego. During adolescence, a generation gap and confrontation are a prerequisite for the creation of the potential space (the adolescence hut) which is needed for an age-appropriate development. The author argues for a conception according to which the re-integration of the archaic superego can take place in this space. Even though the archaic superego is strict and unconditional by nature, it is still the provider of the safety and shelter which are needed in one's internal development. The author discusses the implications of these ideas for the techniques in adolescent psychoanalysis. The ideas presented here are in accordance with Sigmund Freud's initial views on the caretaking nature of the superego and its development in the interaction between the instinctual life and the facilitating environment.