Silence in Adolescent Psychotherapy

Abstract

Therapists are often frustrated when they work with adolescents who do not talk about their experience. This article presents a way of working with these teens. The underlying theory assumes that most teenagers (including those who are often silent in therapy) are capable of being mutually engaged with someone else. This capability is seen as a self-state that can be dissociated by anxiety and replaced with another self-state that is withdrawn and unengaged. Three clinical vignettes describe silent teenagers with whom the therapist eventually can activate self-states that allow for engagement; in these cases, through mutual help, fair play, projective identification, controlling or sadomasochistic connections. Other self-states are withdrawn and silent. For a long initial period, the family and developmental histories that create these self-states are usually more unknown than known, and the shifts in self-states are dealt with in the therapist-patient interaction more than in psychodynamic interpretations, explanations or reconstructions of family or developmental experience.

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Daniel Gensler

Daniel Gensler, PhD, received his certificate in psychoanalysis from the William Alanson White Institute in 1987. He is a licensed clinical psychologist in private practice doing psychotherapy, supervision, and psychoeducational evaluations in Manhattan and Great Neck, New York. At the White Institute, he is Director of Training of the Child Adolescent Psychotherapy Training Program, and also Director of the Child-Adolescent Externship, training and supervising analyst, and instructor.