Articles I don't like #1: Teen therapy

It took most of a session, but I eventually proved to my 16-year-old client that she has always been unheard in her family. To therapy, she brought the problems of insecurity and fear of displeasing anyone, with an undercurrent of vindictive anger. (Along with these was a growing global pessimism, but this wasn’t a “presenting” issue.) The psychoeducation was impelled by her belief that she had already obtained healing justice with her parents and could continue to get it, through naming her grievances and anger to them. With parents thus removed as a cause or factor, her disabilities must come from other sources.

What this teenager didn’t know is that the home atmosphere remains hypnotic from cradle to grave; parents’ eyes may never open to their child’s separate personhood; her upset and grievances cannot really be accepted in a culturally moralistic or religious home. What she didn’t know is that the past doesn’t heal through present expression: Early pain requires regression to reach it.

Adult clients say that they were able to stand up to their parents at some fiery moment in their teen years. That’s when they voiced their anger at unfairness. What they would not let themselves know was that this was effete or worse: Brief storms, little fires of attitude generally reinforced her impotence because mom didn’t care or dad didn’t want to hear it; there were punishments; and teens are still children. 

What she didn’t know is that all the days of the past, not healed, folded under moments of unreceived catharsis in the present, forge the character of the future. 

I wonder: Do therapists think it makes any sense to show young people such a truth? I don’t know what the majority do, but discussions with some therapists lead me to suspect that adolescent work becomes hollow if it is future-oriented with a cognitive approach. I believe it is generally palliative of a terminal disease – death by parental lack of empathy – that hasn’t happened yet.

What, if not to reveal the parent’s flaw, is the best answer? Let her continue to think she is defective? Let her blame teachers and disloyal friends? Help her force skills and optimism upon a foundation of unresolution? Let her continue to think her parents are “doing the best they can”? The answer is there is no answer. Teens are in the twilight zone where they can’t grieve loss of caregivers, who are still the fountainhead. Even mother’s or father’s epiphanic transformation would be too late to redo their child. I recently saw a 22-year-old who sat stunned through the second half of a session when he realized he was right to hate yet also love and need his mother. Teens are a few years premature to that capacity.