Issues in the Transition from Therapy to Analysis in Patients with ADHD: Commentary on Dr. Whiteside’s Case Presentation

ABSTRACT

This written description of an analysis conducted while the analyst was in analytic training demonstrates the complexities of treating patients with attention deficit hyperactivity disorder (ADHD). This discussion focuses on that treatment and the treatment of similar patients in whom cognitive deficits have influenced development and led to difficulties with affect regulation and behavioral inhibition. These patients often fear a loss of control during an analytic regression that might expose the deficits that they have felt to be shameful. They might require a longer preparatory therapy before a transition to analysis, to gain a sense of trust and safety in the therapeutic process and to decrease their shame sensitivity. The analyst’s confusion in the countertransference often mirrors the patient’s lifelong confusion because of his deficits, and is a hallmark in such treatments. This analyst demonstrated significant analytic perspective as she reexamined her experience during the writing about it.

KEYWORDS:

• Attention deficit hyperactivity disorder
• ADHD
• countertransference
• preparatory therapy
• transition to analysis
• writing about analysis

Additional information

Notes on contributors

Stephen B. Bernstein

Stephen B. Bernstein, MD is a Training and Supervising Analyst at the Boston Psychoanalytic Society and Institute. He is a Clinical Professor of Psychiatry at the Tufts University School of Medicine.