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Jacobs, T.J. (1993). Discussion of Dr. Padouvas' Case. J. Clin. Psychoanal., 2(1):120-128.

(1993). Journal of Clinical Psychoanalysis, 2(1):120-128

Discussion of Dr. Padouvas' Case

Theodore J. Jacobs, M.D.

Dr. Padouvas' excellent case report of this brief analysis gives us much to think about. Many of us have had similar experiences working with adolescent patients. It is not at all rare that work with an adolescent is interrupted, so that, as Carl Adatto has pointed out, the analysis of an adolescent often takes place intermittently over a period of some years.

Often the interruption is initiated by the adolescent himself, who, falling in love, achieving symptomatic improvement, or because he is faced with having to confront issues that he perceives are too threatening, breaks off treatment. Here the situation was different. So far as we can tell, the interruption of the analysis was initiated by the parents. Clearly, as Dr. Padouvas so well described, the parents agreed to analysis very reluctantly. They were not in favor of it and in fact they really did not believe in it. They agreed, it seems, out of feelings of desperation, but they were never behind it. Both parents resented paying for it, a fact that was clearly demonstrated by the long delays in payment that occurred.

This case clearly reminds us that in many instances the adolescent is as dependent on his parents to sustain the treatment as is the child. Without the parents in our corner, there is a good chance that undermining of our efforts will occur and the youngster will be pulled out of treatment.

What then can be done in such a situation? It is easy, of course, to pull out the old retrospectoscope, look back, and say how things might have been handled differently. The fact is that these parents may have been so negative toward analysis, or have had so strong a need for the status quo to be maintained (with D's troubles playing an important and stabilizing role in the family dynamics), that no intervention might have availed to turn the tide in this situation.

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