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Boys who abuse… Woods describes how he establishes an agreement with his patients
which states that he will disclose to the authorities if his patient commits an offence, such
as abusing another child, during the treatment. He explains that by refusing to keep the
secret he is conveying to his patient that he rejects becoming an accomplice to the offence.
Woods defends his attitude by saying that he considers his task to be to prevent his patient
from committing further offences. He communicates to the patient his disapproval of the
acts the patient has committed, and indicates that the purpose of treatment is to help him
to contain and change his delinquent impulses.
others, like don Campbell, say that the purpose of his intervention is much more
strictly psychoanalytic: to analyze the patient, and help him understand why he commits
these acts. if the therapist maintains his role, focusing his attention on the internal world of
the patient, it implies that others (like the judicial authorities) are the ones who have to take
charge of controlling, watching over, and restricting the potentially delinquent adolescent.
the therapist does not approve of the delinquent actions of the patient, but that does not
mean that he has to abandon his role as therapist. the fact is that the therapy is, almost
always in these cases, the last resort for the patient. if the patient cannot confide in the
therapist and divulge his worst fantasies, however violent or sadistic, how can there be any
hope that the patient will have an opportunity for a real exploration of his internal world?
it is essential for the patient to believe and trust that someone can tolerate what torments,
excites and fills his mind.
this is particularly important with adolescents, since omnipotence and rivalry are
prominent elements that are manifested in the transference. if the therapist puts himself
forward as the one who will prevent the adolescent from transgressing, he would be
enacting an omnipotent fantasy of rescuing or saving the patient; if the therapist allows
his work of analyzing the internal world of the patient to be sabotaged by the demands
of the authorities, it would transform him into a denigrated victim, just like the patient
feels he is. there is a dilemma in the transference-countertransference dynamic when the
patient encounters either a punitive object that might denounce him to the authorities, or
an object that “only listens and interprets” a perverted and denigrating description of the
analytic attitude taken as evidence of the complicity of the therapist.
the importance of the work that is done with parents of patients is something on
which all the portman child and adolescent psychotherapists agree. parents are offered
sessions at intervals that vary between two and six weeks. the aim is to contain the anxieties
that parents feel, and to encourage an understanding and support of the child’s treatment.
even when the patient lives in an institution or a foster home, the Clinic offers sessions to
the adults who care for the young person. the therapist working with the parents is also in
charge of the case management: contact with school, social services, the Gp, or any other
person concerned with the patient, as the need arises. His or her role in protecting the
child’s therapy should not be underestimated.
Perversions
in general, when we speak of perversions we refer to adults who have reached a more
precise and permanent definition of their identity and sexuality. perversion reflects a trauma,
or a disturbance in development which has affected the sexuality of the individual.
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