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American Imago 59.4 (2002) 447-458
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Affective Response and the Analyst's Freedom in Work with Traumatized Adolescents
To Ambra, Irina, and all my other "second-rate children"
"I shall write it in my diary tonight."
"That a burnt child loves the fire."
—Oscar Wilde, The Picture of Dorian Gray
Clinical work with adolescents who come to us after traumatic experiences involves a total availability of the therapist as a human being, a readiness to accompany patients along the painful path of psychic change and to suffer for them and with them, even to immerse oneself concretely in the emotional catastrophe that once overwhelmed them.
The analyst who works not simply in an office but also in public institutions (such as a hospital or juvenile court) knows very well that emotionally absent and indifferent—if not actively negligent and abusive—parents (who are always too absorbed by their own suffering to listen to children's needs) plough a furrow in their sons' and daughters' psychic worlds. This injury, often compounded by complacency or denial, will inevitably remain open and, in successive periods of life or particularly critical moments (such as adolescence), give rise to severe neurotic symptoms, narcissistic pathologies, or even to psychic death, to suicide of the self.
These seem to be—and are—up-to-date words, but the concepts belong to Ferenczi, who found that trauma "is far more rarely the result of a constitutional hypersensibility in children (causing them to react neurotically even to a commonplace and unavoidable painful experience) than of really improper, unintelligent, tactless, or actually cruel treatment" [End Page 447] (1930, 120-21). Ferenczi frequently stresses in his writings that parental insensitivity, hypocrisy, exploitation, terrorism of pain, and sexual trauma are experienced by children's vulnerable minds as "attacks on the self," ruthless "soul murders" that will lead to defensive narcissistic splittings, psychic fragmentations, and petrifications.
The care of these wounded, camouflaged children, who are often terrified by emotional contact and closeness, requires an inordinate willingness to let oneself be permeated even physically by feelings and emotions that may be unknown, unpleasant, or unbearable. Cordiality, benevolence, tenderness, sympathy, tact, humility, concern, patience, playfulness, and spontaneity are some of the human qualities recommended by Ferenczi, who opposes them to the coldness and inhumanity of an analyst excessively prone to defensive precepts or distancing interpretations. He acknowledges that his patients' "lack of mothering" gives rise to a "nostalgia for tenderness," and strongly asserts: "It might justly be said of my method with patients that it is like 'spoiling' a child. . . . The analyst's behavior is thus rather like that of an affectionate mother, who will not go to bed at night until she has talked over with the child all his current troubles, large and small, fears, bad intentions, and scruples of conscience" (1931, 137).
So, it is in the analytic milieu, in the peculiar idiom that arises between each of us and one particular patient, that we must search for the sources of psychic change. The elasticity of analytic technique, on which Ferenczi insisted in working with patients who suffered traumas, is no less necessary today than ever. To relive the traumatic experience, first in the patient's stead and only later together with him, frequently means giving up any logical thinking, theoretical constructions, and even the words that are most familiar to us. What Ferenczi terms "general encouragement" (1931, 134) can be sufficient, but a patient will benefit above all by our availability to take inside of us what his words are still unable to formulate, along with the feelings that he conveys outwardly only with difficulty. By listening to the responses of our unconscious and our body, we will feel emerging in us often unknown emotions and images that, we soon discover, belong to the patient's inner [End Page 448] world, that violated and wounded world which emerges from the traumatic past. We must not miss this second opportunity; for, as Franco Borgogno says, "catastrophe has to happen and happen again in the course of...