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Tijdschrift voor Psychiatrie 15 (1973) 1, 89 - 98

Korte bijdrage

Adolescenten roepen gevoelens op

J. L. v. d. Lande

'Adolescents evoke feelings' A 4-facetted personal sketch of the feelings of a psycho-analyst during 21,5 years of intensive work with adolescents: the feelings towards the adolescent therapy unit; the feelings which can arise working in the unit; the feelings which arise consequent to contact with the parents of the adolescent patients and finally the meaning of the adolescent phase for psychoanalytic training. On starting a new modern unit in a traditional setting the young psychiatrist becomes confronted with his feelings of grandeur and omnipotence which contribute to a polarisation between the new unit and the rest of the mental hospita!, leading to difficulties in staffing the new unit and ambivalent feelings in the staff of the hospita! at large towards the unit staff and the adolescents. This can manifest itself through the therapist's flaunting established norms and mores of the hospita!. The Laios complex in turn plays a part in influencing the backlash of the hospital. This conflict can be resolved by opening the lines of communication and interchange so that the old can become familiar with the new. The new-resident-therapist faced with a multiplexity of roles generally passes through 3 phases before being able to function adequately as a group-therapist. First, a phase colored by a depressive cast of fighting one's way into an existing structure. This is broken through by the first general expression of rage and exasperation. Second, a phase of overidentification, characterized by resistances such as minimalization, normalization and saviour fantasies. Frustration of these leads to angry acting-out. Finally, the phase of integration, during which the resident learns to apply appropriately his own feelings to the therapy. These phases are further characterized by specific feelings of the resident-therapist. The first phase by feelings of helplessness and depression. The depression in fact being the therapist's introjected aggression towards the patient which when directly expressed dissipates. Counter-transference can interfere with this expression. The second phase is characterized by counter-transference feelings whereby the therapist relives his own adolescent hang-ups, but frightens the adolescent who recognizes in them the incestuous desires of his own parents. The countertransference feelings can express themselves in a number of reaction- patterns, reflecting his own experience of parental separation: rage towards parents, the atttitude we'll be better parents, undertaking a prestige con test, fought out by therapist and parents above the head of the adolescent, ignoring the existence of the parents and closing feedback channels. These negative patterns of behaviour towards parents fed by countertransference conflicts have been dealt with in 'Amstelland' through open-forums with parents, intervision sessions and through self-reflexion. Such institutions reveal the deep emotions of the parents viz. anxiety, doubt, aggression, anger and jealousy. A psychoanalytic education can be of great value in working-through the above mentioned feelings and belles the deplorable situation that many analysts are reluctant to treat adolescents. This reluctance can be traced to the dynamics of the adolescent phase and the threats it poses the analyst. This in turn finds its roots in the training-analysis situation, where Laios-feelings also play a role, as well as the dearth of reliving adolescent feelings during this training. In sight of these realizaions he author expresses his hopes that more analysts will open their doors and talents to adolescent patients.