Adolescent time and waiting in time-limited psychoanalytic psychotherapy.
Social Life of Time
University of Edinburgh, 5-7 June 2018
Time-limited psychoanalytic psychotherapy has become increasingly prominent in recent years, following the development of the 28-week model, Short-Term Psychoanalytic Psychotherapy, for adolescents with severe depression. This evidenced-based treatment, recently tested in the largest randomised controlled trial of psychoanalytic psychotherapy for adolescents to date, is currently being adopted in CAMHS services in the UK.
Is 28 sessions too much, too little, or enough? While for many psychoanalytic psychotherapists, this hardly seems to scratch the surface, for many adolescents 28 weeks seems like a very long time. What is it for the adolescent to engage in a therapy that will end at a specified point? What is it for the psychotherapist to wait for such a therapy to unfold? Can this be borne – by patient, therapist or family – where the young person’s distress is expressed through dangerous activities such as deliberate self-harm? How is the young person to understand what they are engaging in and what they are waiting for: to feel better? Or to feel that life is worth living?
In this paper, I describe the development of the STPP model, and consider its implications for clinical psychoanalytic work with depression and risk, and in relation to adolescent time.
Compassion, Sadism, Words and Song: Development and breakdown in the intensive psychotherapy of an adopted boy.
‘Waiting for Psychoanalysis’ invites three researchers who form part of a 5-year research project on what it means to wait in and for healthcare to reflect on how psychoanalysis helps us to understand the difficulties and potentialities of waiting within contemporary lives that are increasingly experienced as frenetic, harried and time-starved, while also, paradoxically, impeded and stuck. Psychoanalysis is a practice that takes and uses time self-consciously, working and thinking through rhythms that run counter to the values of immediacy, productivity and efficiency that orientate many of our experiences of contemporary life. By committing to the long timeline of psychoanalysis, the patient is brought into contact with something different: a demand for patience, for suffering and endurance in which processes of mourning, or the emergence and working through of traumatic memory, cannot be sped up but must be endured through time and ameliorated through a practice of endurance on the part of both patient and analyst. This discussion will invite academic researchers who also work clinically with patients in three different psychoanalytically-informed traditions to reflect on how psychoanalytic modes of care function through practices of waiting with – through the suspension of the everyday, the repetitions of the transference and processes of working through. They will discuss what this particular use of time might have to offer a social world in which, at one level, waiting seems increasingly devalued or intolerable, while at another the promises of a progressive future seem to be slipping from view – where all one can do it wait.
Adolescent time and waiting with risk in psychoanalytic psychotherapy.
Montclair State University, 25-26 October 2019