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Adolescent Psychotherapy

Counsellors and psychotherapists are faced with ever-increasing complexity in

their work with adolescents. In this book, Bronagh Starrs offers an understanding
of developmental and therapeutic process from a relational-phenomenological
Gestalt perspective.
Starrs shows how the adolescent’s presenting symptom issues are statements
of compromised lifespace integrity and demonstrates therapeutic sensibility to
the adolescent’s first-person experience. Throughout the book, the clinician is
offered extensive relational and creative strategies to support integrity repair
for the adolescent. The developmental impact of various lifespace contexts are
discussed, including parental separation, complex family configuration, grief,
adoption and emerging sexual orientation and gender experience. Therapeu-
tic responses to common creative adjustments are explored, including anxiety,
school refusal, depression, self-harm, suicide, eating disorders, alcohol and drug
use and sexual trauma.
Adolescent Psychotherapy: A Radical Relational Approach will help
counsellors and psychotherapists to develop deeper levels of competency in
their work as adolescent psychotherapists, as they navigate the complex and
fascinating experience of therapy with teenagers. This exceptional contribution
is highly suitable for both experienced practitioners and students of counselling
and psychotherapy.

Bronagh Starrs is Creator and Programme Director for the MSc Adolescent
Psychotherapy at Dublin Counselling & Therapy Centre, Republic of Ireland and
University of Northampton, UK. She is also Director of Blackfort Adolescent
Gestalt Institute and maintains a private practice in Omagh, Northern Ireland, as a
psychotherapist and clinical supervisor, specialising in working with adolescents
and their parents.
“This practical and sensitive book should be in the hands of every adolescent psychotherapist.
Bronagh Starrs brings both therapist and ‘parenting adults’ to hear the young person’s often
devastated experience – lost, confused, excluded, and so on. Then the disturbing behavior
begins to make sense to everyone, and often to become less necessary. So well-written that
it is hard to put down, this book is a humanistic treasure.”
—Donna M. Orange, Ph.D., Psy.D., author, The Suffering Stranger:
Hermeneutics for Everyday Clinical Practice (Routledge, 2011) and
Nourishing the Inner Life of Clinicians and Humanitarians:
The Ethical Turn in Psychoanalysis (Routledge, 2015)

“Every committed teacher waits their career for that student who not only ‘gets’ what they
are trying to teach, but gets it better than they do themselves, taking an insight or perspec-
tive to a new place, revealing entirely new implications and applications. For me, that stu-
dent has been Bronagh Starrs. Over the years, I have watched her develop a brilliant vision
and a fierce commitment to understanding and healing troubled adolescents. If you work
with adolescents and their families, read this book; and then read it again. It will change
the way you work.”
—Mark McConville, Ph.D., author, Adolescence:
Psychotherapy and the Emergent Self

“Not since McConville’s eminently readable and accessible book, Adolescence, have I read
such an informative, readable, and humane book on therapy with suffering adolescents.
In every chapter, her love and practical wisdom shine through her words. A trove of help-
ful inspiration and ideas, as well as theory to support your practice, for anyone who treats
adolescents.”
—Lynne Jacobs, Ph.D., co-founder of the Pacific Gestalt Institute, and
Training and Supervising analyst at the Institute of Contemporary
Psychoanalysis, Los Angeles

“I once saw an expert kayaker take only one precise paddle stroke before calmly navigating
a terrifying rapid. This image was brought to mind while reading Bronagh Starrs’ incisive
reflections and advice about the best ways to help adolescents in the therapeutic context. She
provides keen recommendations on how to help teens keep their own boats from rolling dur-
ing tricky passages. She also makes clear how therapists can maintain, in her words, “robust
composure during decidedly tense moments.” All of us who either have teenagers or work
with them will benefit from her expertise.”
—Peter Mortola, Ph.D., Professor of Counseling and
School Psychology at Lewis and Clark College in Portland,
Oregon, and the author of Windowframes: Learning the art of
Gestalt play therapy the Oaklander way

“For years colleagues have raved to me about Bronagh Starrs’ work with adolescents
and their worlds; now I understand why. This book is essential reading not only for thera-
pists, counselors, teachers, and others who work with adolescents (or with their parents),
but also for the parents and families themselves, and others who live with adolescents, love
them, are alternately charmed and frustrated by them (and frustrate them in their turn), find
them at times uncommunicative, unpredictable, even maddening, (and of course drive their
adolescent loved ones crazy as well) – and/or all of the above!
Starrs places the emphasis of her approach right where outcome research shows it
should be: on the therapeutic relationship itself, that crucial contact space which precedes
and underlies all the acronyms and ‘how-to’s’ or ordinary models of other manuals. If this
is a ‘how-to’ book, it’s about how to build that “meaningful therapeutic relationship,” on
which everything else depends. The goal and result are not just the ‘fixing’ of a temporary
symptom, but a restoration of healthy development and growth.
Each chapter offers rich, practical insights, grounded and unified by this clear relational
perspective. I’ve been in practice for over 40 years, have raised six adolescents, and my
foster son is now a high school principal in his later thirties. And in the chapter on Foster-
ing, for example, I read insights that I wish I had had twenty years ago when he was in
his turbulent years. Thank you, Bronagh Starrs, for this gift to all of us who live and work
with the issues of this great inflection-stage of life, and through us to our clients, students,
children, grandchildren and others.”
—Gordon Wheeler, Ph.D., President and CEO,
Esalen Insititue, Big Sur, California, and
author of Gestalt Therapy in the APA book series
Major Methods in Psychotherapy, and co-editor
(with Mark McConville) of The Heart of Development:
Gestalt Approaches to Children, Adolescents, and their
Worlds (Vol. I: Childhood; Vol. 2: Adolescence)
Adolescent Psychotherapy

A Radical Relational Approach

Bronagh Starrs
First published 2019
by Routledge
2 Park Square, Milton Park, Abingdon, Oxon OX14 4RN
and by Routledge
711 Third Avenue, New York, NY 10017
Routledge is an imprint of the Taylor & Francis Group, an informa business
© 2019 Bronagh Starrs
The right of Bronagh Starrs to be identified as author of this
work has been asserted by her in accordance with sections 77
and 78 of the Copyright, Designs and Patents Act 1988.
All rights reserved. No part of this book may be reprinted
or reproduced or utilised in any form or by any electronic,
mechanical, or other means, now known or hereafter invented,
including photocopying and recording, or in any information
storage or retrieval system, without permission in writing from
the publishers.
Trademark notice: Product or corporate names may be trademarks
or registered trademarks, and are used only for identification and
explanation without intent to infringe.
British Library Cataloguing-in-Publication Data
A catalogue record for this book is available from the British
Library
Library of Congress Cataloging-in-Publication Data
Names: Starrs, Bronagh, 1970– author.
Title: Adolescent psychotherapy : a radical relational
approach / Bronagh Starrs.
Description: Milton Park, Abingdon, Oxon ; New York, NY :
Routledge, 2019. | Includes bibliographical references and index.
Identifiers: LCCN 2018034621 (print) | LCCN 2018034958
(ebook) | ISBN 9780429460746 (Master) | ISBN 9780429864636
(Web PDF) | ISBN 9780429864629 (ePub) | ISBN
9780429864612 (Mobipocket/Kindle) | ISBN 9781138624252
(hardback : alk. paper) | ISBN 9781138624290 (pbk : alk.
paper) | ISBN 9780429460746 (ebk)
Subjects: LCSH: Adolescent psychotherapy.
Classification: LCC RJ503 (ebook) | LCC RJ503 .S717 2019
(print) | DDC 616.89/140835—dc23
LC record available at https://lccn.loc.gov/2018034621
ISBN: 978-1-138-62425-2 (hbk)
ISBN: 978-1-138-62429-0 (pbk)
ISBN: 978-0-429-46074-6 (ebk)
Typeset in Times New Roman
by Apex CoVantage, LLC
For Gráinne
Contents

Acknowledgementsx
Introductionxi

1 Development, shame and lifespace integrity 1

2 Contact assessment 10

3 Ongoing parental involvement 26

4 One-to-one engagement with the adolescent 39

5 Separation and complex family configuration 58

6 Complex parenting spaces: adoption, fostering and loss 70

7 Anxiety, depression, self-harm and suicide 86

8 Eating disorders 103

9 Alcohol and drugs 117

10 Sexuality and gender: emerging identity and boundary

development 125

11 Sexual trauma 137

12 The diagnosed adolescent 150

13 Case management 161

Index 166
Acknowledgements

This book is a synthesis of my understanding of the dynamics of development in

adolescence and how psychotherapy can support the unfolding of this process.
Without support and collaboration from others, this book would not have been
possible. My special and foremost thanks and admiration goes to the many ado-
lescents I have had the privilege of coming to know in therapy, especially those
who gave permission for their stories and images to be represented throughout
the book. My appreciation also to the parenting adults who have trusted me help
navigate these young people through their developmental challenges. Identifying
information has been altered to ensure anonymity for both adolescents and parent-
ing adults.
As a critical influence in my evolution as an adolescent psychotherapist, I owe
deep gratitude to Mark McConville for his wisdom, friendship and encourage-
ment over the years. A sincere thank you also to Maeve Lewis and Pat Deery
for their support and guidance through the years. For reading of chapters of this
manuscript, I wish to thank Tim Hannon and Leslie Brown.
I owe a special and ongoing debt of gratitude to all faculty, staff and students at
Dublin Counselling and Therapy Centre. In particular, Paul O’Donoghue, Brian
Howlett, Jennifer Foran and Anne Randolph.
I wish to thank Joanne Forshaw, editor, and Charles Bath, senior editorial assis-
tant, at Routledge, for their interest and support throughout the project. I would
also like to acknowledge Sheri Sipka, production editor, and the production team
at Routledge for their thoughtful attention to the manuscript.
Finally, I want to thank my family. My husband, Colin, for his unwavering
encouragement and his graceful accommodation to my dedication to my work.
I am grateful to him and to Edel, Anita, Stephen and Nicola for their boundless
support and for the sense of belonging they bring to my life. And to Emily and
Odhrán, my niece and nephew – two wonderful emerging adolescents who have
my heart.
Introduction

The aim in writing this book is to offer an alternative to the typical treatment
manuals which are available to clinicians who work with an adolescent client
population. In the last number of years schools, counselling organisations and
those in private practice have experienced a notable increase in both referrals and
direct requests for therapeutic support for adolescents. Many professionals have
undertaken either a child- or adult-oriented training and feel out of their depth
with the complexity of the work with adolescent clients. What follows are my
interpretations and conclusions, from my accumulated experience, regarding the
dynamics of development and therapy with this age group, which have fascinated
me from my earliest days as a therapist. This model is anchored in Gestalt therapy
theory and in recent advances in the study of both neuroscience and developmen-
tal trauma.
Establishing relationally meaningful therapeutic alliances with both the ado-
lescent and his parents and securing the adolescent’s commitment to becoming
a client in the first place require rich appreciation and close attention to nuanced
contact episodes from the outset. Much of the literature is written from beyond
this point, as if it is a given that the helping professional innately possesses the
required contact skills to engage meaningfully with an adolescent. In my exten-
sive experience as a trainer and supervisor, this is certainly not the general experi-
ence for professionals, irrespective of therapeutic orientation, who typically find
themselves challenged by the frequently directionless and bewildering experience
of therapy with a teenager. Many books are written from a cognitive and behav-
ioural modification perspective and are focused on finding solutions for problems.
Strategies are offered which relieve symptoms and outcome is evaluated on symp-
tomatic amelioration in the short term.
This book is unique in that it offers a radical relational methodology which not
only addresses symptoms, but also attends to the adolescent’s wider developmen-
tal process. Therapeutic work with adolescents is approached from a relational-
phenomenological perspective and offers strategic guidance to clinicians from the
assessment process right through to specific clinical presentations (e.g. anxiety,
eating disorders, suicide, etc.) and case management issues. Attention is afforded
to a broad spectrum of clinical tasks, including formulation of a developmentally
xii Introduction

appropriate therapeutic plan, ongoing work with parents, development of a

meaningful therapeutic alliance with the adolescent, ethical and legal issues and
working within a multi-disciplinary context. A methodology is presented, which
provides specific relational techniques for an array of presenting situations, all of
which will be immediately translatable within the therapeutic space for any pro-
fessional who reads the book.
The book’s focus is on demonstrating to the reader the art of contact assessment
and intervention. Exploration of therapeutic praxis includes detailed deconstruc-
tion and elucidation of contact process in the work with adolescents and their
parents – demonstrating a relational approach to working with struggling ado-
lescents. Emphasis is placed on development of the therapeutic relationship and
commitment to the adolescent’s first-person experience. This model of develop-
ment and therapy has been created over 18 years of working as an adolescent
psychotherapist. The first four chapters set out the methodology. Most of the
remaining chapters deal with specific clinical presentations and case management
issues. Rather than simply instructing the reader on what to do, this book also
attempts to illustrate how to do it as I describe the detailed nuances of contact
with the adolescent.
The opening chapter offers an exploration of how presenting symptom issues
are understood from a relational perspective, drawing on and extending Gestalt
therapy theory with regard to defining adolescent developmental process. Chap-
ter 2 deals with assessment in adolescent psychotherapy and includes commen-
tary on differences between counselling and psychotherapy in work with young
people. Several principal difficulties encountered in psychotherapeutic work with
adolescents are identified and management of these challenges is discussed.
Chapter 3 emphasises the art of supporting parents to develop deeper attune-
ment to their adolescent children. Parenting strategy work is described, and
instruction is offered on how to identify and manage family dynamics which may
be influencing the adolescent and the therapeutic enterprise. This section includes
discussion of how the complexity of confidentiality is managed in therapeutic
work with adolescents.
Chapter 4, focusing on one-to-one engagement with adolescents, offers a
deconstruction of the detailed nuances (both verbal and nonverbal) in contact
with adolescent clients to extend the clinician’s capacity to develop trusting and
meaningful therapeutic relationships with this age group. The reader is offered
an in-depth description of how to work with creative process to support contact,
which includes an introduction to a creative therapeutic approach which I have
developed and named Sandspace.
The structure of family systems has changed and very often these dynamics of
family experience create additional challenge for the adolescent as she attempts
to find a newly emerging sense of belonging and identity in the world. Chap-
ter 5 explores the impact of separation and complex family configurations for the
adolescent, paying particular attention to the adolescent’s first-person experience.
A clear relational framework for organising therapeutic intervention is presented,
which includes intervention with parenting adults.
 Introduction xiii

Adolescent development occurs within a lifespace context which is often com-

plex and traumatic. The adopted or fostered child’s personal biographical context
creates additional layers of complexity as she rises to the developmental chal-
lenge of taking ownership of the self. And so, Chapter 6 will explore the complex
lifespace dynamics which form self-experience for the adopted and fostered ado-
lescent. Living with parental loss will also be explored. Content will include dis-
cussion of the core existential and phenomenological issues for these adolescents;
appreciation of the challenge of identity integration relating to both domestic and
international transracial adoption; exploring the meaning behind impulsive, anx-
ious and insecure presentation. Strategies will be presented to support the ado-
lescent to find language for and make meaning of his experience; and to explore
family-field dynamics and find ways of supporting parent-adolescent relational
connections.
The following three chapters focus on the most common presenting symp-
toms which are encountered in adolescent psychotherapy. Chapter 7 explores the
dynamics of anxiety, depression, self-harm and suicide. The nature of anxiety,
as a clinical presentation in adolescence, is explored from a phenomenological
perspective and the multi-layers of context enquiry are demonstrated through a
comprehensive case example. Emphasis is placed on fostering both curiosity and
relational connection in the work, rather than employing specific techniques.
This chapter also explores a relational-phenomenological approach to work-
ing with adolescents whose presenting symptom issues include depression, self-
harming behaviours and suicidal presentation. The symptom structure of these
clinical presentations is examined and description is included of how contextually
relevant dynamics influence the adolescent’s self-experience. I outline how under-
supported developmental process, transitional insecurity, the presence of trauma
and wider environmental influences may be shaping the adolescent’s lifespace,
resulting in the manifestation of these symptoms. Relational methodology for
working with depressed and self-harming adolescents is presented.
Chapter 8 offers an exploration of the phenomenological experience of the
eating-disordered adolescent. Readers will be introduced to my specific manner
of working with this client group, which includes an understanding of the deeper,
developmental meaning of the eating disorder for the adolescent and interventions
aimed at heightening the adolescent’s self-concern and choicefulness. Chapter 9
focuses on the issue of impulse-driven behaviour with regard to substance use
and its implications for the developing adolescent physically, psychologically and
interpersonally. Strategies are presented which aim to support the adolescent in
adopting greater choicefulness and ownership of his experience.
Chapters 10 and 11 address the area of sexual development in adolescence. The
prevalence of sexual assault, sexually transmitted disease and unplanned preg-
nancy continues to increase, despite us being more open than ever before in dia-
logue with adolescents about sexual matters. It is evident that information alone
is insufficient for the adolescent to support the adolescent’s adoption of full and
responsible ownership of his sexual identity, and so I present to the reader a meta-
phorical manner of supporting choiceful sexual decision-making and expression,
xiv Introduction

which I have been successfully implementing with clients. Supporting and chal-
lenging the adolescent who has engaged in sexually maladaptive behaviour will
also be discussed. In addition, strategies for supporting the adolescent who is
exploring and embracing his sexual orientation and gender experience are also
offered. Attention will also be given to therapeutic intervention with sexually
traumatised adolescents, supporting their recovery from devastation to a more
empowered and safe experience of lifespace identity. The many aspects of recov-
ery and meaning-making are outlined.
Many adolescent clients have already acquired one or multiple diagnoses.
Chapter 12 offers a phenomenological approach to understanding the adolescent
by exploration of the adolescent’s lifespace dynamics through the lens of diagno-
sis, his capacity to make contact and the manner in which he creatively adjusts in
the world through this label. In it, I attempt to demonstrate how to depathologise
the adolescent’s self-experience through meaning-making and non-shaming inte-
gration of the diagnosis into overall experience, supporting movement away from
a sense of the self as pathologised, to adopting greater ownership of experience
and choicefulness in his life.
The final chapter addresses case management issues which the therapist is
bound to navigate in the course of her work with adolescents. Therapeutic work
with this age group is often situated within a wider multi-disciplinary context
which can create anxiety for the practitioner who may be unclear and uncon-
fident with regard to her and others’ roles in situations where interprofessional
collaboration is required. These anxieties can make it difficult to continue to hold
the adolescent therapeutically. This chapter also defines the adolescent therapist’s
role and responsibilities with regard to child protection, therapeutic, ethical and
legal issues with arise in the work with young people. Strategies will be presented
which support clinicians to adopt greater competence within the wider profes-
sional arena. Broad guidance regarding case meetings, report writing and legal
work will be included.
The focus of this book is to illuminate the transformative possibility of the
therapeutic enterprise with adolescents. In it I offer the reader a weave of my
understanding and case examples which, I hope, will render its contents clinically
useful and immediately transferrable to the clinician’s own therapeutic practice.
My hope too is that it may contribute to the wider attempts at understanding how
to intervene therapeutically to make a difference in the lives of adolescents who
are struggling. It is an immense privilege to steward a lost, distressed adolescent,
through the process of healing, towards the authoring of a personally meaningful
future. I passionately believe that this is always possible with sufficient support.
Unfortunately, however, not every troubled adolescent has access to the extent of
support that he needs.
Chapter 1

Development, shame and

lifespace integrity

Fourteen-year-old Daniel lives with his mother and two younger siblings. His
parents separated during the fifth month of his pregnancy. His father, who was
violent and alcoholic, punched his mother in the face and stomach as she sat in
the passenger seat of their van. She opened the door and jumped out of the moving
vehicle. This marked the end of their relationship. Daniel, the child in her womb,
survived. His mother, who has been medicated for depression for over a decade,
has been in several relationships since and is now pregnant with her fourth child.
Her new partner, this child’s father, has recently moved into the family home.
Daniel spends much of his time playing his game console and hanging out with his
friends. He was diagnosed with ADHD when he was 6 years old and has been in
trouble often in school for disruptive and aggressive behaviour. He is verbally and
sometimes physically abusive to his mother and siblings. The school principal has
spoken to Daniel’s mother, suggesting therapeutic support to help him manage his
behaviour. Both she and the school are at a loss as to how to reach and influence
him. The adolescent comes unwillingly to the initial session with his mother, hav-
ing been promised a new pair of trainers in return for his attendance.
Sixteen-year-old Louise is the youngest of three girls. Her siblings are both
studying medicine at college, and she lives at home with her parents. High
achievement in academics and career has been a core family value and focus
throughout the children’s lives. Louise is a perfectionist, spending long hours
studying and sometimes re-starting a homework assignment from scratch late on
a school night, if she deems it sub-standard. She is top of her class across all sub-
jects and has never received less than 92 percent in any examination. Louise is
also involved in a number of extra-curricular activities, including music lessons,
drama and football and is a keen member of the local athletics club. Recently
Louise has been losing weight at a concerning rate and looks very thin, although
she assures her mother that she is eating sufficiently. She has become vegetarian
and has cut wheat and refined sugar from her diet. Louise’s mother is becoming
concerned. Her father is less so and feels that his wife’s insistence on making an
appointment to see a therapist is an overreaction. Louise feels strongly that there
is no problem, though she obliges her parents by attending this one session.
2 Development, shame and lifespace integrity

As more and more adolescents find their way to therapy, practitioners are
encountering increasingly complex clinical scenarios. Most of these young peo-
ple, like Daniel and Louise, have been nominated by concerned adults as suit-
able candidates for psychotherapy. Some engage willingly, responding readily
to dialogue and interventions. Others arrive sceptical and oppositional, resolved
neither to say a word nor to come back a second time. The adolescent therapist is
presented with some intriguing dilemmas: How does she create a rich and mean-
ingful therapeutic relationship with someone who may not even want to show up?
How does she recruit him as a client in the first instance? How does she engage
with someone whose capacity for self-reflection will, in all likelihood, be limited?
How does she understand what is happening, or trying to happen, developmen-
tally in his life? What it is that he needs? How might she intervene to make a
difference in the growth and development of this adolescent who has found a way
into her office and her life? I have pondered these questions for years and in the
process have attempted to grasp the dynamics of the adolescent journey and to
appreciate the unique subtleties of therapeutic engagement with this age group.
When an adolescent is referred for psychotherapy, this is generally an indication
that there is a lack of support for and momentum within his developmental process.
This will often manifest in the emergence of symptoms. For example, the adolescent
may present with an eating disorder or anxiety or may be engaging in high-risk or
self-harming behaviours. There are three principal categories of referral:

Direct Issues: The adolescent is or is not doing, feeling or thinking something

which is troubling him and/or others. Examples include anxiety, depression,
substance misuse, low academic motivation, aggression, etc.
Indirect Issues: The adolescent’s environment is creating complexity and strife
for him. These issues include separation, trauma, grief, adoption, peer isola-
tion, etc.
Overt Developmental Issues: The adolescent’s ‘attitude’ and ‘lack of respect’
for parents, his ‘treating this house like a hotel’ or battling with parental
control are seen as the problem.

Referral typically comes with expectation to eliminate these issues. Symptoms are
regularly misinterpreted as instances of maladaptive behaviour and as problems to
be solved. It is always advisable to look beyond presenting issues to understand
the dynamics which are influencing an adolescent’s experience in the world, as
this will help orient the therapist with regard to intervention. Praxis with any
adolescent client is predicated on the clinician’s tentative assessment, which is
not primarily attuned to symptoms or problem behaviours, but to the underlying,
unfolding, developmental drama.

The concept of development

Human experience has always been the subject of fascination for psychothera-
pists, philosophers, psychologists, anthropologists, educationists and sociologists.
 Development, shame and lifespace integrity 3

Theories of adolescence include biological, cultural, psychosocial and cognitive

aspects of experience. Development is understood as the maturation of various
functions, such as pathways of sexual energy (Freud and Strachey, 1949), struc-
tural cognitive schemes (Inhelder and Piaget, 2013), capacity for social learning
(Bandura, 1962) and so on. Schools of psychotherapy have traditionally formu-
lated developmental models as meta-psychological frameworks, often integrat-
ing these concepts into their theoretical constructs. These models contain each
school’s presumptions concerning what it means to be human and serve implicitly
as theories of psychopathology. For example, an anxious adolescent’s presenta-
tion might be understood as evidence of intrapsychic conflict, perhaps triggered
by emergent adolescent libido; as evidence of family dissonance; or as maladap-
tive thoughts and behaviour which require modification. How meaning is made
of the information presented, depending upon the psychotherapist’s theoretical
orientation, will shape therapeutic interventions.
My understanding of adolescent development has been influenced by Gestalt
psychology and psychotherapy, specifically the work of Kurt Lewin (Lewin,
1939) and Mark McConville (McConville, 1995), who conceive of the essence of
adolescent developmental process from a holistic, phenomenological perspective.
Gestalt psychologist Kurt Lewin (1890–1947), in his theory of adolescence Field
Theory and Experiment in Social Psychology (1939) asserted that adolescents do
not develop in isolation, but that development is an integrative process of biologi-
cal, psychological and social circumstance which shapes how we construct our
experience and move forward in the world. Lewin created the term lifespace to
describe this mutually influential ground of environmental and personal elements
which comprise the adolescent’s phenomenological and ever-expanding world of
experience. It is a dynamically evolving and mutually influential process whose
spatial and temporal dimensions are continuous. Perception is constructed and
behaviour is shaped at every moment within this interactive self-in-and-of-­the-
lifespace phenomenon through reciprocal contact.
Our relationship to the lifespace resembles our relationship to oxygen: we
are continually breathing in and out; we do this unconsciously, even when we
sleep. We cannot see the oxygen and are mostly unaware that we are breathing at
all, even though our very existence depends on it. Similarly, our lifespace is the
framework within and around which we have our existence. It houses our body,
mind, feelings and thoughts; our familial, social, cultural, political and geographi-
cal contexts; our biographical context, including pre- and perinatal experience. It
shapes everything about us. Self cannot exist outside of this lifespace and is not
separate from it. There is no such thing as self-development. There is only self-in-
and-of-the-lifespace development. The adolescent’s experience will always make
sense when we situate the detail of his presentation within his wider lifespace
context.
Contact, for Gestalt Therapy theory is the cornerstone of psychological func-
tioning, referring essentially to the way an individual engages and interacts with
the world and with himself. In the magnum opus of Gestalt Therapy, Gestalt
Therapy: Excitement And Growth In The Human Personality (1951), the concept
4 Development, shame and lifespace integrity

of contact was postulated as the defining characteristic of the self, in sharp con-
tradistinction to the dominant intrapsychic psychoanalytic models of the day. The
authors spoke of the contact boundary as the concrete, experiential meeting place
of self and other. It is the evolution of this meeting place, its organisation and
functioning, that Mark McConville offers as the critical issue for understanding
adolescent development (McConville, 1995). His model tracks the evolution of
the contact boundary via recursive processes of differentiation of the adolescent
in the family field. He contends that as the adolescent develops, his sense of dif-
ferentiation in and from his environment increases and he begins to feel somehow
different in terms of subjective experience of himself. These changes lead him to
engage his world in new ways.
Adolescence is universally described as a time of separation and individuation.
These terms are misguiding: human beings are neither separate nor individual.
We do not become separate from our families: we may live without them in our
day-to-day world, even managing to maintain rigid psychological boundaries
which prevent us thinking about them or feeling into memories from our child-
hood. However, like it or not, we are imprinted by and forever connected to our
formative relational experience. During adolescence our relationship to these
relationships evolves with ever-increasing sophistication. Characteristically dur-
ing the teenage years, adolescents begin to create more definitive boundaries in
relation to their families, their peers and the wider adult world. The adolescent’s
relationship to the world of other becomes progressively more differentiated as
she searches for balance between relational intimacy and personal agency. Devel-
opment in adolescence is the defining of these contact boundaries (McConville,
1995). The adolescent’s behaviour and experience begins to make greater sense
through appreciation of the growth of contact functions through adolescence.

Creative adjustment
As Gestalt therapy theory understands development as the evolution of contact
boundary process, the mechanism by which development takes places is concep-
tualised as creative adjustment (Perls, Hefferline and Goodman, 1951). The ado-
lescent’s lifespace is imprinted with the people and experiences he encounters.
This imprint shapes how he thinks of himself and of his world, as well as influenc-
ing his contact style within his lifespace. He is creatively adjusting to the condi-
tions within his lifespace at every given moment: attempting to balance his needs
with given or perceived environmental conditions. If the lifespace is experienced
as generally supportive, then we can expect that the adolescent will come to trust
this support and will develop faith in himself and in his world. Similarly, a hostile
imprint within the lifespace engenders feelings of exposure and mistrust, creating
low expectation of being supported, very often translating into a self-statement of
inadequacy, where the adolescent finds himself lacking.
If we attend to an adolescent’s phenomenological experience, we inevitably
discover developmental wisdom in any creative adjustment. However, the rigid
 Development, shame and lifespace integrity 5

quality of thoughts and behaviours may have long since outlived their useful-
ness and may themselves pose the biggest threat to his integrity. For unsupported
adolescents these creative adjustments may become destructive and inflexible.
Feelings of shame naturally emerge in response to compromise within the ado-
lescent’s lifespace. Lee and Wheeler (2003) describe shame as the experience of
one’s needs not being received, potentially resulting in a disconnect both from
others and from the need. This is a familiar experience, especially in adolescence,
where there is potential for shame at every turn. However, if an adolescent has
been persistently compromised and support is typically inadequate or absent, the
individual becomes saturated with ground shame (Lee and Wheeler, 2003). This
pervasive experience of shame becomes the lens through which he views himself
and his world.
There is no such thing as ‘normal’ development; there is only supported or
under-supported development. The Gestalt premise of adolescent development
as contact boundary development (McConville, 1995), encompassing biological,
psychosexual, cognitive and social development in a whole-field phenomenon,
together with the concept of creative adjustment as the process by which develop-
ment unfolds, emphasises that development is neither linear nor pre-determined.
This developmental approach orients the clinician to understand an adolescent’s
presenting issues not so much as symptoms of a diagnosable disorder but as the
manifestation of an under-supported developmental process and of a lifespace
situation infused with shame. Each adolescent lifespace experience is appreci-
ated as a uniquely personal developmental narrative, and as such, this approach
offers an implicitly respectful, existential model of adolescent development. It
follows, then, that all therapeutic intervention emerges from the ground of this
appreciation. And so, this theoretical orientation directs the therapist to assess
the lifespace conditions that contextualise the symptomatic adolescent, becoming
curious about how the adolescent’s presentation is experienced and responded
to – a response which includes his parents and also now his therapist. Rather than
being a technique-oriented methodology, it is, at its heart, a genuinely existential-
relational encounter which creates possibility to deepen and enrich contact – that
is to say, to support development.

Unsupported development and trauma

Over the past number of decades, considerable research has been undertaken as
we continue in our attempts to understand trauma and its impact on the experi-
ence of being human. Recent developments, particularly in the field of neurosci-
ence, have contributed significantly to our understanding. The various modalities,
including Eye-Movement Desensitization and Reprocessing (Shapiro, 2001),
Dialectical Behavioural Therapy (Linehan, 2015), Cognitive-Behavioural Ther-
apy (Beck, 2011), Sensorimotor Psychotherapy (Ogden et al., 2015) and Psycho-
dynamic Psychotherapy (Jung et al., 1983), have each developed approaches to
treat trauma survivors. Divergent methodologies include emphasis on cognitive
6 Development, shame and lifespace integrity

processing, behaviour modification and physiological experiencing, with varying

degrees of appreciation of the complex nature of trauma.
I have long been fascinated in figuring out (phenomenologically at least) what
precisely it is that becomes traumatised and how it is healed. My experience as
a clinician over the years has taught me that the adolescent is motivated by three
principal yearnings. These yearnings are for physiological, psychological and
interpersonal integrity. By integrity I mean an experience of wellbeing, security
and comfort which emerges when these yearnings are sufficiently supported. The
adolescent has a fundamental yearning to inhabit a body which is healthy, able
and safe; to have a sense of belonging with others who care for and appreciate
him; and to experience himself and his world with benevolence. When I speak
of trauma, I am describing an experience which creates considerable disruption
and compromise for the adolescent within these physiological, psychological
and interpersonal domains of experience. Trauma can be a single event, a cluster
of events, or a chronic situation which is negotiated on a repeated basis. The
experience falls outside the range of what is normative, and it is not possible for
the adolescent to process the experience in the present moment; subsequently he
enters a state of alarm and overwhelm. The aftermath of trauma for any adolescent
typically includes a detrimental impact on sensory and affect regulation, self and
world-concept and interpersonal relating (Van der Kolk, 2015).
The adolescent’s level of distress is commensurate with both the gravity of
the situation and the level of support available to him. So, for example, Shane is
ambivalent about continuing to play soccer as he and his friends have recently
formed a band. When he is not selected for the school team, this does not cause
him much consternation. Support comes from his emerging identity as a rock
guitarist, his newly forming music friendships and his waning interest in soccer.
He shrugs it off, and there is no insult to his integrity. Conversely, when an ado-
lescent is forced to tolerate serious compromise to his integrity without adequate
support, he is traumatised by the experience and this contact episode begins to
shape how he feels, thinks and behaves. An adolescent who is traumatised by an
experience tends to have a vested interest in dumbing down contact and faces
many more developmental challenges and vicissitudes than his more supported
counterparts. For example, Karen, who has become accustomed over the years
to hearing her father’s footsteps ascend the staircase and enter her bedroom,
knowing what is to follow, endures an ongoing and pervasive threat to all aspects
of her integrity. Due to the years of molestation, Karen experiences her body as
a grotesque and dangerous shell which encases her. She trusts nobody, and like
many traumatised adolescents, prefers the company of animals to humans. The
interpersonal world is threatening: “people are idiots”. Psychologically, there
is a tightly held vitriol present in her feelings and thoughts about herself and
her world. She despises herself and feels that life is pointless, wishing she had
never been born. Karen has recently made several serious attempts to end her
life. My young client has known neither body nor relational integrity, resulting
in pronounced psychological anguish. Her lifespace has always been a hostile
 Development, shame and lifespace integrity 7

landscape which has not supported her yearnings for integrity. Sadly, for too
many adolescents, trauma is the ground of their lived experience. Their trauma
happens within the home; within parental relationships. Their legacy includes
despair, self-experience saturated with shame and powerlessness and a deep-
seated conviction that they are defective human beings. This adolescent’s integ-
rity has been devastated, though as we will see, this devastation is reversible,
with adequate support.
Bessel van der Kolk, in his seminal text The Body Keeps The Score (Van der
Kolk, 2015), explains the impact and legacy of trauma physiologically, psycho-
logically and interpersonally; and thanks to continuing advances in neuroscience
research (Porges, 2011), our understanding is becoming increasingly refined. In
any traumatic situation, activation of the sympathetic nervous system occurs. This
state of hyperarousal does not necessarily recede and may become a chronic phys-
iological experience, which has a cascade effect on all levels of functioning. The
psychological and interpersonal impacts potentially result in a lifespace infused
with overwhelm, dissociation, mistrust and scepticism (Van der Kolk, 2015). The
adolescent who endures pervasive trauma within his lifespace, due to chronic
abuse or neglect, remains defensively prepared to negotiate an expanding lifes-
pace which he expects will meet his yearnings with hostility. The imprint of an
unsupported lifespace is difficult to disregard as he moves through adolescence,
and so, the extreme stress of integrity compromise shapes his experience: shame,
despair and meaninglessness begin to define his self-experience and expectations,
as a result of the profound integrity loss he has suffered. A repertoire of feeling,
thought and behaviour-level responses emerge as he adjusts to a compromised
lifespace. His contact may be characterised by inertia, where he feels depressed,
passive and despairing. Similarly, he may display aggressive and impulsive ten-
dencies. Yet again, he may be determined to transcend his difficulties by finding
ways to create more supportive conditions within his lifespace, as many adoles-
cents do in a remarkably impressive manner. Though, for many, their creative
adjustments have a tendency to generate adversity.

Restoration of integrity: an integrity model

As the adolescent creatively adjusts to the limitations of an inadequately sup-
ported expansion of his lifespace and capacity for contact, the aim of therapy
is to steward him towards a life of integrity. The adolescent may be referred for
psychotherapy, with the presenting symptom defined as a direct or indirect issue,
an overt developmental dilemma or a combination of all three. The therapist is
typically under considerable pressure to intervene at the creative adjustment level:
to make the adolescent feel, think and behave more positively and productively.
Those bringing him to therapy have a wish for the young person to feel happier,
refrain from risky behaviour, stay alive, improve grades, obey rules and talk to
family members and other adults with less attitude and more respect. And whilst
the adolescent psychotherapist wishes all of these for the adolescent also, for they
8 Development, shame and lifespace integrity

are the hallmarks of a supported adolescent lifespace, the principal focus for the
therapist is the restoration of integrity within the young person’s lifespace.
The psychotherapeutic steps I have identified in this process of integrity res-
toration involve responding to physiological, psychological and interpersonal
integrity compromise; attending to the legacy of shame; and transforming crea-
tive adjustments within the lifespace. They are broadly outlined below and further
developed throughout subsequent chapters:
Physiological: Attention is afforded to physiological experiencing to establish
more grounded, embodied contact for the adolescent. This may happen indirectly
through the diffusion of the therapist’s grounded and embodied presence within
the therapeutic space (it is amazing how subtleties in the depth of her own breath
and physical presence are transformative for her client). Use of creative devices
such as sideways contact and sandspace (see Chapter 4) which diffuse intensity
and promote calmness in contact are also relevant interventions in therapy with the
dysregulated adolescent. Similarly, focusing directly on the adolescent’s somatic
experience during sessions may be healing. However, the therapist’s enthusiasm
for initiating sensorimotor techniques can prove too intense for many clients, who
are not so much affected by their somatic experience as by what is happening in
the contact between client and therapist. Feelings of vulnerability and exposure
during these exercises are common for even the most ostensibly cooperative ado-
lescent. As a consequence, I employ these sorts of direct techniques sparingly.
Psychological: Development of perceptual, cognitive, affective and motiva-
tional potential supports an emerging capacity for meaning-making in adoles-
cence. This is the time when human beings begin in earnest to assign personal
meaning to significant lifespace experience. And so, a tremendous gift for the
adolescent is to have a therapist support him to make sense of his lifespace expe-
rience in such a manner that his self-experience and his future are not shaped by
the hostility he may have had to endure in his young life. The therapist’s influence
in the acknowledgement and validation of the mental and emotional effects of
adverse lifespace situations enables the young person to understand and appreci-
ate his experience through a less individualistic, self-critical lens.
Interpersonal: Integrity repair at this level of being is addressed through reflec-
tion on the adolescent’s experience of the interpersonal dimensions of his lifes-
pace, especially his relationships with parents, wider family, peers, educators and
others whose influence has been significant. In addition, cultivation of a respect-
ful and developmentally appropriate therapeutic space acts as a healing balm for
any interpersonal violation he has experienced, as the therapist fosters mutuality
and empowerment. The seeds of lifespace transformation are planted through the
experiencing of therapeutic space integrity. The adolescent is supported to become
increasingly choiceful in forming and maintaining relationships which are sup-
portive and which validate his yearnings for authentic connection and belonging.
As shame is addressed and neutralised, the sense of self as defective, contami-
nated or accountable recedes. As this happens, it is important that the adolescent’s
unmet yearnings and the legacy of his loss is acknowledged and grieved. The
 Development, shame and lifespace integrity 9

therapist’s active empathy guides the young person through this aspect of the
work towards a sense of hope and belonging. Subsequently, momentum is created
within the traumatised adolescent’s lifespace. He begins to take himself seriously
and finds his voice and his vision. Restoration of integrity and the generation of
self-compassion, activated through acknowledgement of and grieving for what
might have been, organically modulates creative adjustment responses to some
degree. This is further supported by therapeutic interventions aimed at deepen-
ing the adolescent’s inclination to live with integrity, as the therapist highlights
discrepancies between creative adjustments which have begun to outlive their
usefulness and the adolescent’s emerging capacity for more authentic ownership
of his experience.
The adolescent is healed when he no longer defines himself by the trauma he
experienced, which is to say, when his capacity for contact is rich.

References
Bandura, A. (1962). Social Learning Through Imitation. Lincoln, NE: University of
Nebraska Press.
Beck, J. S. (2011). Cognitive Behavior Therapy, Second Edition: Basics and Beyond. New
York: Guilford Press.
Freud, S. and Strachey, J. (1949). An Outline of Psychoanalsis. New York: W. W Norton &
Company, Inc.
Inhelder, B. and Piaget, J. (2013). The Growth of Logical Thinking from Childhood to
Adolescence. London: Routledge.
Jung, C., Storr, A., Jung, C. and Jung, C. (1983). The Essential Jung. Princeton, NJ: Prince-
ton University Press.
Lee, R. and Wheeler, G., eds. (2003). The Voice of Shame. Cambridge, MA: Gestalt Press.
Lewin, K. (1939). Field theory and experiment in social psychology: Concepts and meth-
ods. American Journal of Sociology, 44(6), pp. 868–896.
Linehan, M. (2015). DBT Skills Training Manual. New York: Guilford Press.
McConville, M. (1995). Adolescence: Psychotherapy and the Emergent Self. San Fran-
cisco: Jossey-Bass Inc.
Ogden, P., Fisher, J., Del Hierro, D. and Del Hierro, A. (2015). Sensorimotor Psycho-
therapy. New York: W. W. Norton & Company, Inc.
Perls, F., Goodman, P. and Hefferline, R. (1951). Gestalt Therapy: Excitement and Growth
in the Human Personality. New York: Julian Press.
Porges, S. (2011). The Polyvagal Theory. New York: W. W. Norton & Company, Inc.
Shapiro, F. (2001). Eye Movement Desensitization and Reprocessing. New York: Guilford
Press.
Van der Kolk, B. (2015). The Body Keeps the Score. New York: Penguin Books.
Chapter 2

Contact assessment

Content vs. contact assessment

Content assessment is primarily focused on the gathering of information for the
sake of clinical evaluation and treatment planning. It commonly involves match-
ing observable behaviours to lists of psychopathological symptoms to arrive at
appropriately specific treatment techniques. The assessment process may take dif-
ferent forms, depending on the therapeutic setting. For example, in private prac-
tice, the therapist undertakes all aspects of the assessment herself. If the therapist
is working in a counselling organisation or within a wider health care system,
an appointed clinical assessor will often be the initial point of contact with the
adolescent and/or parental figures. In either case, the process typically involves
uncovering details of the presenting issue and family background. There are also
practitioners who, somewhat alarmingly, elect to proceed with individual counsel-
ling work directly with the young person, by-passing any system of assessment.
They frequently are working in places such as schools and youth clubs, although
sometimes also in counselling organisations. In these instances, a concerned adult
has identified the need for support for the adolescent, parental consent has been
sought, some broad details about the presenting issue are shared with the coun-
sellor, who then undertakes a limited number of sessions with the young person.
To complete an adequate assessment, it is important that the therapist is clear
about precisely what she is assessing. She is certainly interested in determining
information with regard to family configuration, developmental milestones, nota-
ble experiences and social interaction throughout childhood and adolescence thus
far. And whilst this information is important to gather, there are several equally or
even potentially more illuminating strands to assessment work with adolescents.
Particularly revealing are relational themes and contact dynamics between the
adolescent and parenting adults, as well his emerging personality dynamics within
his lifespace. This type of assessment is referred to as contact assessment and is
concerned with the therapist’s attention to contact boundary dynamics, in addition
to presenting issue information. To undertake this type of assessment, it is almost
impossible to grasp the essential nuances of contact within the lifespace without
involving parents in the assessment process to experience episodes of contact as
they unfold in the live encounter.
 Contact assessment 11

Assessment in adolescent psychotherapy is one of the key components of the

work. Incomplete assessment creates difficulty and frustration within the thera-
peutic space and inevitably the work moves into counselling mode (which is not
to say the work will not be of value). However, if the therapist fails to challenge
dynamics which pose threat to the integrity of the therapeutic process, she runs the
risk of professional compromise.

Power struggles
There are four specific power struggles which are frequently encountered in the
work as an adolescent psychotherapist. By this I mean that there are four scenarios
where clinical work is being directed by someone other than the therapist. If the
clinician finds herself caught in any one, or possibly all of these situations, then
it is virtually a given that both therapeutic contact and her professionalism are
compromised:
The Adolescent: The young person directs the work by being selective about
topics for discussion, talking endlessly about interests, friendships and his social
calendar. Whilst it is not unusual to dialogue about these things, the therapist
understands implicitly that they cannot progress to more central issues which are
shaping the adolescent’s experience, as this will not be tolerated. There is a redun-
dantly circling feeling to therapy; contact has a plastic quality to it; the therapist
feels bored, undervalued and has a vague sense that nothing is happening in the
encounter.
Adolescent-directed work also happens when the young person refuses to give
permission to the therapist to engage with parents or is demanding a level of
confidentiality which compromises the therapeutic space. For example, it is not
uncommon to hear of an adolescent disclosing some information about his drug
use or sexual activity which comes with an “I’ll kill myself if you tell my parents”
clause. This is not a useful dilemma for anyone.
The Parenting Adults: Over-engagement or lack of engagement with parents
can present a challenge to the work. For example, a parenting adult may see his
role in the therapeutic process as simply someone who delivers the young person
to the door of the therapist’s office and pays for the service, much like bringing
one’s car to a mechanic for repair. A question universally asked is, “How long will
this take?” Elsewhere, marginal parents often feel estranged from and suspicious
of the entire therapy process, and for the adolescent, his parents’ tacit embarrass-
ment and disapproval of therapy can be a huge impediment.
Contrastingly, the time-consuming parent may be very keen to make contact,
telephoning, texting or emailing before and after every session, requesting pro-
gress updates – this is particularly prone to happen when there is anxiety in the
field or when separation is an issue. In these cases, as much or perhaps even more
time is spent in contact with parents outside sessions than with the adolescent
himself, which feels draining and frustrating for the therapist, ultimately creating
resentment. Parental expectation can be high in these situations and the question,
“is there anything more we can be doing?” often translates as, “is there not more
12 Contact assessment

you should be doing?” Worse still, parents frequently show up at the beginning of
sessions having pre-selected the themes for discussion between therapist and ado-
lescent: “I’d like you to talk to him about his attitude around the house and also
to get him motivated to study for his exams”, essentially locating responsibility
for how he interacts with family and his academic performance with the thera-
pist. The concluding assumption is that, following the session, if the adolescent
fails to come up to standard in either attitude or study, this is a statement of the
therapist’s incompetency. In all of the above scenarios, parents have not become
genuine collaborators in the therapeutic process, which creates expectation and
shame potential for the adolescent therapist.
The Organisation: Here, the organisational setting within which the work takes
place imposes limitations. Often funding is an issue, and perhaps there is a finite
number of sessions afforded to each client which, for some, equates to a drop in
the ocean of support realistically required. For example, six individual therapy
sessions for a traumatised adolescent whose lifespace is hostile is most likely
not going to be adequate. The organisation may have a particular model of ther-
apy which is adhered to, say a cognitive-behavioural or solution-focused manner
of working, with the expectation that every therapist will treat every adolescent
within an identical methodological framework. This would be effective . . . if only
all adolescents, their developmental location and their lifespace contexts were
alike.
Additionally, environmental conditions may not support the work, which
makes the therapeutic space both unsafe and uncomfortable. School counsellors
know this only too well: they regularly find themselves working in a cramped
store room at the end of a long corridor, because space is at a premium. During the
session, a teacher may interrupt the session, apologetically searching for French
grammar books; a few minutes later a bell sounds to signal a lesson’s end and doz-
ens of students move past the makeshift counselling room in boisterous exchange.
The following week, counselling is located in another equally small and unsatis-
factory space, because someone else is using last week’s allocated room today.
We would never consider working under these conditions with adult clients, yet it
perplexes me that they are somehow deemed acceptable spaces for our adolescent
clients. The level of support and space afforded to the school counselling process
is also usually commensurate with the extent to which the school principal values
the service.
The Wider System: There are times when the work is situated within a wider
system context, for example, a legal process may be concurrent. Correspondence
is received, not so much requesting, as demanding disclosure of all details of
therapeutic work, including clinical notes. This may happen following disclosure
of say, a child protection issue such as sexual trauma. It is our ethical duty to col-
laborate appropriately with these requests. However, it is a different matter when
these petitions are made by legal representatives of divorcing parents who are at
war with one another and who wish to recruit the therapist into their drama, con-
taminating the therapeutic space for their already distressed child.
 Contact assessment 13

Returning to the scenario of sexual abuse disclosure, the therapist may be the
only person to whom the adolescent is willing to talk, and very often, the dia-
logue is sparse because trauma and shame are so prevalent. Other professionals
are, necessarily, keen to discover as much detail as possible. In these scenarios,
social work departments, as part of the broader national health and care system,
may attempt to influence the therapist to adopt more of an investigative, rather
than therapeutic emphasis in the work. I know a number of therapists who have
attended interprofessional meetings in which an agenda for ongoing therapeutic
work was established by others in attendance. This is an example of failure to take
ownership of our profession par excellence.
When the therapist is not the only professional involved in supporting an ado-
lescent, as is the case when she is also attending a child and adolescent mental
health service, under the care of a psychiatrist, cooperative collaboration is not
always assured. Insistence on termination of the therapist’s work is common, irre-
spective of how effectively the work is progressing or how therapist, adolescent
and parents feel about this stipulation. Sometimes this call is appropriate, and at
other times, it very definitely is not. In these instances, or when the case becomes
‘interesting’, an external decision to transfer therapeutic work to another profes-
sional within the system risks being dismissive of the adolescent’s integrity, not to
mention professionally insulting to the therapist.

Locating the dilemma

When external direction in any or all of these four scenarios is present, psycho-
therapeutic work and psychotherapy as a profession are undermined. Hence, it is
important that the clinician works as much as possible on her terms for therapeu-
tic work to proceed with integrity. Power struggles must be acknowledged and
attended to, which is not to say that they will be eliminated. One cannot work
under perfection conditions with every adolescent. The presence of power strug-
gles does not suggest that the work will be of little benefit; often therapy under
these conditions makes all the difference in the world to the adolescent. My point
is that unless power struggles are addressed, disempowerment will infuse the
therapeutic space and the therapist’s professional identity. This disempowerment
manifests in therapy sessions being tediously hard work; in the therapist adopting
personal responsibility for how the work is progressing, shaming herself when
progress is not evident; and in holding herself accountable to adolescents, parents,
organisations and systems who have their own ideas about how the process should
be unfolding.
I compare this to an orthodontist who fits a brace for a patient whose teeth are
slightly crooked and who desires a ‘Hollywood smile’. The orthodontist informs
his patient that it will take approximately 12 months for her teeth to straighten.
However, the patient dislikes wearing the brace, choosing to disregard it most of
the time. At the end of the year, the patient is, naturally, frustrated at the disappoint-
ing result. Both patient and orthodontist hold the latter personally responsible for
14 Contact assessment

the failure. He begins to doubt his competence: perhaps the braces were ill-fitting,
or maybe he’s just losing his touch and wonders if now might be a good time to
change occupation or retire altogether. Of course, this is a ridiculous scenario: he
would never consider these possibilities. However, deflections and power strug-
gles are much more frequent and challenging in adolescent psychotherapy than
in orthodontia. The art of holding one’s ground develops with experience and
support.
And so, if an adolescent is unwilling to talk; if parents cannot or will not
engage; if there are only a limited number of sessions; if the office setting is less
than ideal; or if there are other professionals involved who are making decisions
which directly impact the work, it is vital that the therapist places the dilemma of
professional ownership with those external directors, rather than internalising the
situational shame and making a statement about her lack of competence. Yet still,
inadequate practice may also be at play.
Expressing to others, in a composed, dispassionate, non-shaming manner,
the dilemma that the work will be compromised at best under these condi-
tions, ensures a more realistic perspective for all. If the dilemma remains rigidly
defended against, this is the point where it may be advisable to disengage. The
orthodontist cannot make his patient wear the brace. Similarly, the psychothera-
pist cannot enforce collaborative alliances or magically cure symptoms.

Attachment and contact

I use the term ‘parenting adult’ to indicate any adult who has adopted, either by
choice or default, a parenting role in the young person’s life. This includes bio-
logical, step and adoptive parents; temporary foster carers; parenting relatives
from the wider family field, for example, grandparents, aunts and uncles; staff
from residential settings which have been home to the adolescent at points in his
life, and so on. Some adolescents may have at most two parenting adults in their
life, whilst others will have had multiple parenting adults. It is important that
assessment of each of these relational connections is made for both adolescent and
therapist to fully appreciate the influence of interpersonal dynamics on his sense
of self and wider developmental narrative.
Attachment theory has given us one valuable mode of understanding human
experience and motivation (Ainsworth and Bowlby, 1991). The attachment lens,
however, may not provide us with a sufficiently clear and accurate description
of the evolution of contact which occurs as adolescence gets underway. Whilst
the research indicates that the more secure the attachment, the more likely the
adolescent is to navigate the adolescent years with greater success and less incli-
nation towards mental health problems and the risks associated with impulsivity
(Allen and Land, 1999), nevertheless, the rapid and radical transformation which
is undergone within the parent-child relationship is not necessarily reflected in
an experience-near manner through the description of its attachment security
status. For example, 6-year-old Mary and her mother enjoy a close and loving
 Contact assessment 15

bond; there is an ease in their relating and their connection bears the hallmarks
of a secure attachment. Fast-forward ten years: Mary is a feisty 16-year-old ado-
lescent. Communication between them almost inevitably results in tension and
contempt, although Mary can be charming and responsible – usually when she
wants something. The adolescent believes that her mother’s agenda in the world
is to make her daughter’s life a misery; her mother feels that Mary’s ‘attitude’ and
new-found friends are the problem and laments the loss of her lovely little girl. In
a few short years, there is a good chance that Mary and her mother will experience
an easier, more companionable relatedness. Attachment and contact are different
phenomena; and whilst Mary and her mother might well continue to have a funda-
mentally secure attachment – by adolescence, the quality of their contact certainly
has undergone dramatic change. So what happens to the child-parent connection
during adolescence that can create such fraught and shaming interaction? Surely
we cannot put it down merely to hormones.

The parenting space

The nature and influence of the connection between adolescents and the parent-
ing adults in their worlds has considerable potential for support, and equally for
adversity, as the young person journeys towards existential selfhood. For the ado-
lescent, his principal environmental context is his parents. This relational context,
which is referred to as the parenting space, is a continuous interplay between the
intrapsychic and interpersonal worlds of experience, with mutual influence and
ongoing co-creation of self-experience occurring in the encounter between self
and other. There are varying degrees of receptivity within the parenting space
which impact the adolescent’s emerging sense of self and manner of engaging
with her environment. There are three general grades of receptivity which can be
experienced in the parent-adolescent dyad. These include receptive, non-receptive
and hostile parenting. These descriptions are organised according to a parenting
adult’s capacity to manage the transitioning contact boundary in an appropriately
supportive, non-shaming manner, according to the developing adolescent’s needs.
These are not rigid categories of parenting experience: rather, one of these quali-
ties of receptivity will usually emerge as the dominant style of contact within the
dyadic encounter. The parenting space is a dynamic, fluctuating experience for the
parent-adolescent dyad.

The receptive parenting space

The adolescent’s emerging experience of ‘self’ is, in every moment, exposed to the
environment in a dynamic process of living. To be wholly received by his environ-
ment means that the adolescent experiences a consistent, attentive, supportive and
responsive interpersonal world. This experience of being received, in turn, nur-
tures and encourages the construction and development of a rich lifespace experi-
ence. He grows by experimenting with and exploring his environment – hopefully
16 Contact assessment

finding that his experimentation and exploration is received and affirmed by that
environment. This support and validation promotes ownership of experience and
the emergence of a firmly grounded sense of self and connection to others. Life is
meaningful, interesting, rich with possibility; life is worth living.
Receptive parenting is the capacity to attend to the relational needs as well as
to the more practical, functional needs in the adolescent’s developmental jour-
ney. The parent ideally relates to his son in a manner which cultivates a sense
of being cared for, of mattering, and creates the expectation of being received
and supported by her environment. Throughout childhood, the parent has hope-
fully received and encouraged the development and expression of his child’s inner
world, which in turn supports the emergence of a strong, grounded sense of self for
the child. During adolescence, the parent intuitively understands that the young
person’s inner world of private experience, which is deepening and expanding, is
becoming more and more the adolescent’s business. The parent’s role now is to
continue to influence his son by holding him accountable for actions and decisions
in a way which is affirming and non-shaming of the adolescent’s attempt to define
who he is in the world. This is a developmentally healthy posture for parents of
adolescents, though not always sustainable – particularly when he rolls in at 2.00
a.m., smelling of cigarettes and cider.

Non-receptive parenting
An ongoing process of boundary definition within the ever-expanding lifespace
occurs throughout adolescence, which frequently is played out at the contact
boundary between the adolescent and her parents, particularly during earlier ado-
lescence. This can result in running battles themed with responsibility, freedom,
power and boundaries. When the therapist encounters an adolescent and parent,
for whom conflict has become a fixed pattern within the parenting space, I very
often find that difficulties have arisen not simply because the adolescent has
become moody, hormonal, has fallen in with a ‘bad’ crowd, etc. but because the
parent has not quite understood that his mode of parenting is failing to support his
teenager developmentally. He is still trying to parent in a manner that worked with
his son as a younger child and feels powerless to influence him now. Shame is sure
to be present in the encounter; and it is not uncommon to hear a parent describe
how he finds it very hard to like his son and issue (another) ultimatum – either
behave or be gone. Parents surprisingly have little awareness of how hurtful and
isolating the impact can be on their adolescent children.
No parent or caregiver can be receptive 100% of the time. Life happens, and
it is beyond our capacity as human beings to maintain perfect relational connec-
tions. Sometimes the most well-meaning and supportive parents cannot ‘be there’
for their adolescent children. A parent can become distracted and preoccupied
with his own life situation, and the adolescent experiences diminished receptivity
within the parenting space during these episodes. A parent, for example, might be
hurting; or becomes distracted by the excitement of a new relationship; he may
 Contact assessment 17

be intensively focusing on a work project to the detriment of family life, or the

adolescent’s parents are in the process of separating. As these experiences become
less figural for the parent, the parenting space becomes increasingly receptive
once more. However, in many cases, non-receptivity characterises the parent-
adolescent relational space. The adolescent who has inhabited a non-receptive
parenting space characteristically does not feel known to his parent and is often
agenda-driven, where the adolescent’s life is closely directed and managed by
the parent who has a desire for his son or daughter to be a “success” e.g. the
adolescent having a pre-determined, non-negotiable academic path and career.
The agenda can emerge in a compensatory manner in respect of the parent’s own
life experience and the adolescent does not have much of a voice in determining
the direction of her life. The parent fails to notice or fully take into account the
wishes and sense of emerging self of the adolescent. When I meet adolescents
whose lives are agenda-driven, I hold the image of a topiary tree while we work: a
dedicated and thoughtful gardener has created a structure around which the plant
will grow and take shape, and so each is perfectly sculpted. Adolescents are not
topiary trees. In other experiences, absence or some experience of separation has
created a lack of receptivity within the parenting space. Perhaps there is irregular,
insufficient or no contact between an adolescent and his parent. This can be the
case when, for example, the parent-adolescent relationship has faded after paren-
tal separation. An adolescent who experiences a habitual lack of receptivity within
the parenting space often describes feelings of insignificance and invisibility. This
creates sufficient support to challenge his deep belief that he does not matter is
the challenge.

Hostile parenting
This is the experience of a parenting adult’s behaviour and way of relating which
is actively shaming and destructive for the adolescent’s emerging self-experience.
In fact, it can be positively dangerous for the adolescent’s sense of self to emerge
at all within the parenting space. The parent-adolescent relationship is organ-
ised around the parent’s abusive/addictive behaviours and the adolescent adjusts
accordingly. He learns to be hyper-attentive to parental needs and the parent’s
feeling world, and to relinquish his own – this is in direct contrast to receptive
parenting. In these cases, perhaps the parent is verbally, physically and/or sexu-
ally abusive; the parent is addicted to some substance or behaviour; or the parent
is living with significant mental health issues which impact the parenting space. A
directly hostile parenting space is one in which the parenting adult is actively and
directly harming the adolescent, for example, through verbal, physical or sexual
assault. Indirect hostility is created, not because of a direct insult, but where the
adolescent is living with the fallout of a parent’s addiction; abusive treatment of a
partner; or symptoms of serious mental health diagnosis which severely impacts
that parent’s capacity to function, as an adult in general and as a parent in particu-
lar. An adolescent’s recent description comes to mind of bringing her boyfriend
18 Contact assessment

home to meet the family. Her mother is a loving and caring woman, who, when
she is agreeable to taking medication for her schizophrenic presentation, func-
tions well in the world. She had ceased her medication for the moment, and just
as my client and her boyfriend arrived home, her mother came running out of the
house screaming and gesturing aggressively to the sky. A helicopter had flown
overhead – a rare occurrence now, though a regular and unsafe feature of this
woman’s traumatic childhood, growing up at the height of the Troubles in North-
ern Ireland. Her daughter’s chagrin was pervasive, as the experience echoed the
familiarity of this feature within the parenting space.
In the instance of hostility, whether direct, indirect, or frequently both, it is the
parenting adult who is creating and maintaining the distress and danger in the ado-
lescent’s experience. Whilst non-receptivity within the parenting space can create
feelings of hopelessness at times, hostile parenting creates despair. The burning
existential question for these adolescents is not, “Who am I?” but rather, “What’s
wrong with me?” Despair is a mixture of powerlessness, hopelessness and rage.
This despair is internalised and is translated into a deep and core belief, namely,
“There must be something wrong with me”. Psychological chaos ensues.
The yearning and residual shame which many adolescents experience as they
come to terms with the trauma of being parented in a hostile relational space can
be immense. A deep sense of loss emerges which has to do with the absence of a
meaningful parental presence in the adolescent’s life. I am reminded of a 17-year-
old client’s description of standing by the graveside on the day of her father’s
funeral. She felt sad; though not about the man who had passed away – she was
relieved he was gone from the world, which would now be a safer place for her.
My young client felt sad because she became poignantly aware that she was bury-
ing her one chance to have a father. She described feelings of intense disappoint-
ment and emptiness as she stood by the grave: “I wanted and needed a dad, but
not that dad”.
Parenting space assessment is fundamental as it is primarily within these spaces
that children experience, or fail to experience a sense of wellbeing and empower-
ment, the level of which is dependent upon the extent to which their yearnings
for physiological, psychological and relational integrity are honoured. As adoles-
cence gets underway, the young person is already deeply imprinted by the quality
of receptivity within each parenting space. This synthesis of relational themes and
experiences significantly determines his unique phenomenology, creative adjust-
ment responses and wider lifespace expectation, especially with regard to contact
with other people.

Other relational spaces

Assessment of relational dynamics which may be influencing the adolescent’s
self-experience also includes an interest with regard to the quality of connection
between the young person and the wider cast of characters who populate his lifes-
pace, both past and present. These include significant family members, the wider
 Contact assessment 19

adult world and of course the peer landscape. The therapist is curious to discover
how the adolescent and his siblings relate; if he is particularly close to grandpar-
ents and other relatives; if he is popular amongst peers, struggles to connect unless
online with adolescents who share similar gaming or animation interests, or if he
is essentially isolated. She also wishes to learn about how he relates to teachers
and adults in authority; if other professionals are involved; and if she is seen as
merely another interfering person in the long list of people who have become
involved in his young life.

Wombspace as lifespace
Somewhat surprisingly, I have discovered that the adolescent’s earliest experi-
ence may be exerting considerable influence on his present-day experience, and
so I have learned to pay attention to this aspect of his life narrative also. Having
worked for many years with younger children, whose parents implicitly under-
stood that this experience directly impacted their children’s functioning, and who
readily and spontaneously volunteered details regarding their children’s womb-
space and birth experience, I became curious about how this context of pre- and
perinatal process might continue to shape the individual through adolescence.
This aspect of assessment is almost always revealing to me and fascinating for
the adolescent.
My clinical hunch regarding the relevance, for the adolescent, of life before
and during birth has been validated and informed by recent research, particularly
within the disciplines of transpersonal psychology (Bennet and Grof, 1993), neu-
roscience (Krueger and Garvan, 2014) and biology (Lagercrantz and Changeux,
2009). Conception, gestation and birth are relationally embedded phenomena, and
it makes sense to me that a relational field Gestalt understanding of development
would include each person’s unique wombspace and birth experience as notably
formative.

Extending field theory

We are born into a field which exists long before our conception. These field
conditions are relevant, and so, the therapist’s interest extends to two years prior
to conception, as she assesses the wombspace and wider lifespace conditions
with regard to parental relational dynamics, other children, miscarriages, sig-
nificant experiences and trauma. Typically, human beings inhabit a wombspace
for 38 weeks, which is a considerable length of time. The wombspace may be a
receptive, non-receptive or hostile environment for the developing foetus who,
it has been established, is a sentient, responsive and relationally curious being.
(Salihagic-­Kadic et al., 2005) How parents feel about the pregnancy, the mother’s
temperament and the physiological aspects of the pregnancy for both mother and
child, are all revealing of how the wombspace may have been experienced by
the developing infant. Consider the scenario of a supported woman, in a loving
20 Contact assessment

relationship, who has yearned for a child and is delighted to experience a healthy
and stress-free pregnancy, compared with a woman whose pregnancy is the result
of a sexual assault by an abusive partner who continues his tirade of physical,
emotional and sexual abuse throughout her pregnancy, who feels overwhelmed
by having an unwanted child, and who sometimes drinks to escape her situation.
Wombspace quality will be very different for each of these developing foetuses.
Given the emergent body of knowledge from scientific studies of unborn and
newborn children (Zimmerman and Connors, 2010), it is conceivable that events
and experiences in utero not only imprint the infant, but that the imprint might
endure throughout childhood and into adolescence.
Birth itself, when we think of it, must be a monumentally arduous journey
creating physiologically, psychologically and interpersonally an entire lifespace
paradigm shift. The change in the infant’s life, following departure from the dark,
cramped and muffled amniotic wombspace, could not be more pronounced. He
now finds himself in an expansive sensory world of direct contact with the other
as he encounters breath, touch, voice and gaze. Experiences during the initial
moments, hours and days following entry into this new landscape for the delicate
and vulnerable child are significant, with the potential for a loving, peaceful bond-
ing process to intensify or for the trauma of invasive medical procedure, neglect
or maltreatment to terrify him. Prior to, during and following birth, the develop-
ing infant experiences his lifespace as largely benevolent or as a threatening and
dangerous environment.
It is possible that we accumulate experiential data and are meaning-makers
right from our earliest moments of life, so that wombspace and birth experience
shapes how we creatively adjust to subsequent lifespace conditions. Thus, includ-
ing this major event from wombspace through perinatal experience in assessment
can shed light on the adolescent’s present lifespace experience. More often than
not, the description mirrors the young person’s contemporary struggle, reveal-
ing something of his phenomenology. For example, a wombspace saturated with
maternal anxiety will likely infuse the child’s emotional field who will be prone
to anxious experiencing. Similarly, an adolescent whose creative adjustment
seems an exaggerated response to everyday stress, and who habitually feels over-
whelmed and in threat of annihilation, frequently will have experienced an essen-
tially torturous birth. Even the smallest challenge seems crushing to him.

Structuring the assessment

Relational dialogue
A question-and-answer format, whilst satisfying the therapist’s curiosity with
regard to biographical and presenting symptom information, tends to implicitly
set the therapist apart as some sort of expert. Adolescents, and often parenting
adults, may take umbrage or feel disempowered at this power differential dynamic
and already there is shame in the encounter. It is preferable to co-create a dialogue
 Contact assessment 21

which fosters authentic relational contact, opening the possibility of support and
adding a richer dimension to the meeting. The therapist aims to grasp a rich appre-
ciation of this adolescent’s lifespace, which includes interpersonal, intrapsychic,
interprofessional and wider lifespace aspects of his experience. She also pays
attention, with heightened curiosity, to the way in which contact is made within
the lifespace, of which she has now, at least momentarily, become a part.
After a warm welcome, she immediately states her intention to extricate herself
from any potential power struggle with the adolescent by articulating that she does
not assume his attendance at today’s meeting to be willing and that his active par-
ticipation is not required. Attempting to foster his curiosity and communicate to
him that he will be neither exposed nor shamed, she invites him to make his own
appraisal of her and informs him that the principal decision-maker with regard to
engaging in any ongoing therapeutic process will be himself. Adolescents often
appear visibly more empowered and relaxed following this interaction alone. At
various times throughout their meeting she will invite the adolescent into dialogue
in a manner which conveys minimal risk of exposure, reminding him that he does
not have to engage at all. They often do.
Regularly, parenting adults enter her office feeling uncomfortable, suspicious
and prepared for an onslaught of ‘bad parent’ shame. So, openly conceding that
it is a daunting prospect to present one’s parenting to any professional, together
with an invitation to parenting adults to also make their own assessment of the
therapist, is both empowering and de-shaming. The assumption and acknowl-
edgement of hesitancy and scepticism, on the part of both adolescent and parents,
contributes markedly to the co-creation of a genuinely consensual and collabora-
tive encounter. She supports each one to remain curious, mindful that they are all
assessing.
The therapist intentionally spends as little time as possible in communication
with parents prior to the initial meeting, despite their usual eagerness to furnish
her with as much detail as possible about the situation. In hearing how the present-
ing issue is defined, she is most interested to witness how people respond to each
other’s description of experience. She invites the parent who made initial contact
to begin by saying a little about what has brought them here today, always mind-
ful of the potential for shame, particularly for the adolescent. And so, as the story
unfolds, the therapist steps in and begins to shape the pace, direction, tone and
interactive style of the meeting. Her questions and statements reveal an interest
in coming to know the adolescent’s experience in the world, who often is either
unwilling to say much in front of parents or has no language for his experience.
Even the most subtle nuance in her relating is an indicator to them all of the pos-
ture she will hold as this adolescent’s potential therapist. The supportive relational
tone through which she uncovers various aspects of the adolescent’s experience
matters considerably.
In paying attention to contact boundaries, the therapist notes the adoles-
cent’s capacity to hold his own in parental contact, how he makes contact with
the therapist and his capacity for self-reflection, as she attempts to situate him
22 Contact assessment

developmentally. For example, she might meet a 17-year-old adolescent who is

bright and articulate, whose dialogue reveals an impressive level of insight, and
who connects readily with parents and with the therapist. Contact is fluent and
supported. Conversely, the next 17-year-old client she encounters demands life
on his terms, inhabiting an utterly impulse-driven lifespace and seems intent on
blaming the adult world for his struggles. Contact is tentative; the risk of power
struggle and of shame is high. This adolescent expresses his sentiments more like
a huffy, belligerent 12-year-old than someone on the cusp of emerging adulthood.
Through careful observation of their intersubjective relatedness i.e. of what is
said and what remains unspoken, language used, feeling responses, yearning, eye
contact, breathing rhythms, tension, physical posture and their embodied experi-
ence in this relational configuration, the therapist begins to assess the various
contact boundaries and considers how she may need to situate herself in response
to these. Her unswerving focus is the emergent developmental status of the
adolescent-­parent relational space and her commitment to conveying her attempt
to understand the adolescent’s phenomenology.
Many adolescents enter a therapist’s office determined not to say a word and
find themselves warming up as they experience receptivity, realising that she
might genuinely be interested in their experience. It is important that the therapist
keeps the adolescent in mind at all times, filtering and translating information
through his phenomenological lens and actively empathising with him, all the
time careful to avoid entering into power struggles. Active empathy, tentatively
offered, communicates to the adolescent that, whilst the therapist may not always
be accurate, she is at least interested in grasping his experience. This in itself
is a considerable statement of support and is almost always appreciated by the
adolescent. Each time she tentatively and respectfully offers a hunch about how
the adolescent may have experienced a particular lifespace situation, contact with
him becomes subtly richer and less remote. If she is sufficiently attuned and her
attempt to be actively empathic hits the nail on the head, this encourages even the
most reticent adolescent into richer contact. The therapist pays careful attention to
the fragments of contact between the adolescent and herself, noting any increase
in verbal and nonverbal cues, such as eye contact, direct dialogue between them
and other moments of reaching. The first witnessing of spontaneity from the ado-
lescent informs her that trust is emerging – a fledgling trust in her to appreciate
and support his yearnings for integrity.
All the time the therapist is also fostering connection with, validating and
perhaps offering challenge to parenting adults. Her intention is to support their
attunement to the adolescent’s experience, whilst assessing their capacity to be
receptive, careful here also to avoid shame. Her aim is to evaluate the potential
for support available to the adolescent within each parenting space and to create a
non-shaming context in which to situate his ‘problem’, reframing the presenting
issue through a relational lens. It is important that she remains attuned to how she
is experiencing the others and herself in the encounter, paying attention to imme-
diate contact dynamics within the therapeutic space. Her embodied experience
 Contact assessment 23

is especially revealing as she attempts to de-code and communicate a supportive

appreciation of each person’s moment-to-moment response, including her own.

Confidentiality
This is a complex area as the issue of confidentiality collides with development.
Contact boundary development involves heightened experimental curiosity, cou-
pled with inadequate developmental maturity, naturally leading in many cases, to
problematic and dangerous situations. The therapist’s dilemma is one of balancing
the adolescent’s need for privacy and ownership of experience against her ethical
and legal responsibilities with regard to the young person’s safety and wellbe-
ing. (See Chapter 13 for in-depth discussion on case management issues.) It is
important to raise the question of confidentiality during the assessment process
to establish how much to disclose to parents and other professionals, aware that
confidentiality is essential to the adolescent’s trust in the therapist and therapeutic
process. To establish clarity with regard to one’s role with parenting adults, it is
important that they distinguish between therapist as a provider of information,
furnishing them with detail about the adolescent’s exploits or as someone who
is supporting overall development. The therapist invites the adolescent and his
parents to consider the issue in an inclusive dialogue, framing confidentiality in
terms of black and white issues and grey issues.
Following disclosure, black and white issues pose no dilemma as informing
parents and potentially other agencies is non-negotiable. Examples include dis-
closure of sexual abuse, cases of suicidal or homicidal gestures, serious chemi-
cal dependence or the presence of a significant eating disorder. Grey issues offer
a somewhat more obscure dilemma. It is helpful to acknowledge expectations
which are likely held by both adolescent and parenting adults so as not to adopt the
role of co-conspirator with the adolescent or information gateway with parents.
Stating that adolescents typically reveal information to the therapist which might
be concerning to parents, say perhaps cannabis use or experimental sexual activ-
ity with peers, she describes how an impasse will soon emerge if she reveals this
information to parents: The adolescent is likely to understandably feel betrayed
and withdraw from the process, probably resolved never to talk to an adult again.
The parenting adults are likely to feel grateful to have this information. However,
information alone is redundant in these situations. They may restrict his move-
ments, discipline and lecture him – and adolescents being adolescents, he will
find ever more creative ways to circumvent their influence and continue with his
risk taking.
The therapist offers an alternative to them all in trusting her to hold these grey
issues with the premise that she is interested in supporting the adolescent to become
a more credible and responsible choice-maker. This has the effect of dissipating
any anticipation of collusive alliance on the side of either adolescent or parent.
It also creates additional safety for the adolescent who, otherwise, perceives the
therapist as untrustworthy, withholding important aspects of his experience from
24 Contact assessment

therapeutic dialogue, thus compromising the work. This dialogue does not resolve
grey issues; rather it draws conscious awareness to them, establishing confidenti-
ality as an ongoing process to be negotiated, mirroring the shifting privacy bound-
ary within the parent-adolescent relationship. It also importantly creates scope for
the therapist to decipher how best to intervene when these issues emerge in the
work. After all, artful intervention with grey issue material has the potential for
developmental transformation. It is imprudent to proceed if reticence regarding
the question of confidentiality is expressed at this point, otherwise power strug-
gles are inevitable. In these instances, slowing down and supporting dialogue as
confidentiality parameters are negotiated may very well reach to the heart of the
developmental dilemma. This dialogue is the therapy, as contact boundaries are
evolving within the encounter.

Initial session closure

As the initial meeting comes to an end, the therapist reviews the principal themes
of dialogue, acknowledging and appreciating people’s openness to exploring fam-
ily process with her. She enquires about each person’s feelings with regard to their
meeting and the possibility of continuing their dialogue, reminding the adolescent
of his opt-out clause and his balance of power with regard to decision-making.
In truth, she knows already, having remained attuned to the adolescent’s quality
of contact during the meeting, whether he is readily willing to meet again. If the
therapist senses uncertainty or ambivalence, or if her hunch is that an expression
of openness to returning would be seen by him as a submission to the adult world,
then rather than pressing him for commitment, she makes one of two interven-
tions: she posits the dilemma that she has not gathered sufficient data with which
to make an informed decision regarding engagement in an ongoing process of
therapy and so suggests that they meet one more time so he has a greater sense
of her and of what will be involved (i.e. she buys time). Or she invites him to
go off and reflect on today’s conversation; to consider the possibility of coming
back and to get in touch if he feels like it. Through this intervention the therapist
acknowledges that the more defended an adolescent, the more crucial it is for him
to concretely experience empowerment in their contact episodes, and she is aware
that requesting a direct response may compromise his integrity. It is unusual that,
following this type of interaction, a guarded adolescent does not return at some
point in the future.
Commonly by the end of the initial meeting, the therapist is satisfied that the
assessment process has been thorough and has drawn to a natural conclusion,
providing she feels that she has an adequate grasp of contact boundary dynamics
within parenting spaces; that the adolescent is amenable to becoming her client
and his parents are willing collaborators; that there is not an unexplored interpro-
fessional domain in which to situate herself; and that she has adequate clarity with
regard to direct, indirect and overt developmental issues. In situations where any
or all of these strands are incomplete or lacking, she considers that the assessment
 Contact assessment 25

process will be ongoing until all these potential power struggles have been defined
and explored.
The therapist makes a call, based on the assessment’s progress and on the ado-
lescent’s developmental location, with regard to the following session’s configu-
ration, assuming a subsequent appointment has been agreed upon. She may decide
that it is most appropriate for them all to meet together again; that the adolescent
and one parent should be in attendance; that she needs to meet other parenting
adults (in the case, for example, where two acrimoniously separated parents will
not tolerate sitting together in the same room); or that an individual meeting with
the adolescent might be most useful next time. The therapist generally does not
look for any future commitment beyond one or two subsequent sessions, which
makes the process feel more tolerable for the adolescent.

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Ainsworth, M. D. S. and Bowlby, J. (1991). An ethological approach to personality devel-
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Allen, J. P. and Land, D. (1999). Attachment in adolescence. In J. Cassidy and P. R. Shaver,
eds., Handbook of Attachment: Theory,Research, and Clinical Applications. New York:
Guilford Press, pp. 319–335.
Bennett, H. and Grof, S. (1993). The Holotropic Mind: The Three Levels of Human Con-
sciousness and How They Shape Our Lives. New York: HarperCollins.
Krueger, C. and Garvan, C. (2014). Emergence and retention of learning in early fetal
development. Infant Behavior and Development, 37(2), pp. 162–173.
Lagercrantz, H. and Changeux, J. (2009). The emergence of human consciousness: From
fetal to neonatal life. Pediatric Research, 65(3), pp. 255–260.
Salihagic-Kadic, A., Kurjak, A., Medić, M., Andonotopo, W. and Azumendi, G. (2005).
New data about embryonic and fetal neurodevelopment and behavior obtained by 3D
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New York: Springer.
Chapter 3

Ongoing parental involvement

The adolescent’s environment is predominantly, though not exclusively, a world

influenced and shaped by parental connections. Healthy evolution of the parent-
adolescent relational space during adolescence necessitates a transformation of
the contact boundaries. Frequently the therapist encounters parents whose love
for and worry about their child is comparative, though who often feel powerless
to influence or help their son or daughter. Many parents experience the adolescent
years as a loss, rather than an evolution of the parent-child relationship, as they
stand helplessly by whilst their beloved and struggling adolescent rebuffs any
parental attempts towards affection or advice. Parents do not matter any less than
they did during childhood; they merely assume a more influence-based, less out-
wardly active role in the adolescent’s world. Supportive reassurance from parents
is immensely validating for the adolescent, whose ongoing experience of being
received by his environment becomes integrated into overall self-experience:
They have faith in me; I can have faith in myself and my expanding world.
The therapist’s intention is to harness parental care and concern for the adoles-
cent in a developmentally appropriate manner by facilitating parents to become
more attuned and receptive. She does this by directing the assessment dialogue
beneath presenting symptom issues (and its associated shamefully exposing
descriptions of volatile behaviour or vulnerability) to the integrity level – making
explicit each person’s yearnings for physiological, psychological and interper-
sonal integrity within the parenting space.
The adolescent is often genuinely surprised to discover that a parent still loves
or even likes him and had no idea that parents could be so understanding. He is
heartened to learn that parents miss him and want him to be happy. These revela-
tions can be transformative, as the adolescent may be inclined to assume parents
to be hostile, judgemental, ignorant, controlling and lacking any capacity to relate
meaningfully. Reparative dialogue which uncovers relational yearning functions
to dissipate the isolation which frequently characterises the parenting space. This
intervention can make all the difference in the world.
During assessment, a rationale for ongoing contact with parents is almost
always offered as the relevance of their involvement in the work is usually sig-
nificant. Exceptions include situations where exclusively one-to-one work with
 Ongoing parental involvement 27

an adolescent is deemed the most appropriate intervention, or perhaps because

of direct hostility within parenting spaces. Parental involvement may translate as
peripheral support and an occasional few episodes of dialogue. More frequently,
however, participation of parenting adults in therapeutic work is crucial for devel-
opmental progression.
Frequently, the adolescent’s presenting issues are entangled in family process.
This can easily be detected with careful attention to themes of dialogue and choice
of language employed by parents. If the words attitude, respect and trust are used
to describe the adolescent’s manner within the family, one can assume the pres-
ence of overt developmental issues. Parenting adults will describe not being able
to trust their son; who are concerned about his attitude and how he speaks to
them; and who worry at his spectacular lack of motivation for anything with the
exception of gaming and partying. The adolescent’s experience is always a perfect
complement to this, as he expresses his grievance about not being trusted; being
treated like a child; and that his parents are trying to control his life.
(It may interest the reader to note that I view the developmental journey to
adulthood as typically beginning around age 11 and ending in the late 20s.
Legally, a 22-year-old is deemed to be an adult; developmentally, however, he is
far from adulthood. To this end I regularly involve parents of older adolescents
and emerging adults in the process as this is often both developmentally appropri-
ate and therapeutically helpful. Turning eighteen is not the same as becoming an
adult, yet many clinicians will deem these young people ‘adult clients’. This, to
my mind, is clinical absurdity. For the psychotherapist, developmental status, not
chronological age, ought to be the determining factor in field intervention work
with adolescent and emerging adult clients.)

Luke
Sixteen-year-old Luke was showing no interest in studying for his approaching
GCSE exams, much to his parents’ concern. As the dialogue swiftly moved away
from study to adolescent-parent contact dynamics, it became apparent that Luke
and his parents had reached a developmental impasse. As accusations and criti-
cisms were being cast, I opened these issues for exploration by inviting them
all to describe a typical school morning. A scene was described involving the
adolescent refusing to get out of bed and having to be called repeatedly by an
increasingly frustrated mother who was aware that the cascade effect of her son’s
tardiness (due to his playing a game console until 12.30 a.m.) was that everyone
would be late. Luke recounted how his mother would badger him for not having
packed his bag the night before, for not doing homework, for not eating break-
fast, for keeping everyone late, for being irresponsible and for rolling his eyes
when she was speaking to him. I turned to the adolescent and sympathised at
how stressful these mornings must be for him with all the nagging. He agreed –
finally, someone understood! I then asked his mother how she experienced these
morning episodes. It surprised the adolescent to learn that his mother was equally
28 Ongoing parental involvement

miserable. I shaped the dialogue so that she articulated how she detested the role
of ‘nag’ which she had assumed by default, and Luke’s mother described what
kind of contact she longed for with her son in the mornings. She painted the pic-
ture of a relaxed, drama-free, contactful morning where they both got along. This
parental dialogue extended to exploration of the wider parent-as-nag and cor-
responding adolescent-as-blasé relational pattern which had become established
since early adolescence. The father described his experience of shuttling between
aggressive confrontation and indifference as he struggled to get Luke to heed his
sound advice about how to conduct himself. Again, making explicit his yearning
for more satisfying contact with his son created a softening of relational ground
within the parenting space for both the adolescent and his father as I supported
deconstruction of the monster myth which had been reciprocally created.
At this point I offered my support to move the adolescent and his parents out
of this fixed and counterproductive mode of relating, aware that the adolescent’s
collaborative interest in proceeding would be paramount if power struggles were
to be avoided. I shaped and facilitated their mutual agreement of a quid pro quo
experimental arrangement (Kegan, 2003) that, providing the adolescent packed
his bag the night before, got himself out of bed and was ready to leave the house
at an agreed time; his mother, in return, was forbidden to nag in the mornings.
Luke was charmed by the prospect of a parent being held to account for her totally
unreasonable behaviour and so committed to honouring his part in the experiment.
His parents were pleased with this arrangement, if somewhat sceptical. Having
agreed to try out an alternative morning schedule, I reminded each party that this
was simply an experiment, supporting them to hold interest in how it unfolded
rather than investment in its successful outcome. I encouraged the adolescent to
remain choiceful, opting out of the experiment whenever he wished, and sym-
pathising with his predicament that if he did so, his parents would likely feel
compelled to resume the nagging. In a playfully collusive tone, I indicated to the
adolescent that I had figured out how this all worked and how to get parents off his
back, adding that I would be happy to reveal my thesis in a private dialogue with
him sometime . . . if he was interested. I suggested that we all convene to review
the situation in two or three weeks. (I find a weekly rhythm to be too intense for
adolescents who scarcely have time to experiment with or to integrate any insight
between sessions. My hunch is that this insistence on weekly sessions accounts for
the notoriously high incidence of sporadic attendance and premature disengage-
ment of any client group. No-shows are an unusual occurrence if the therapist is
committed to following the work’s natural momentum.)
This intervention introduced the possibility of empowerment within the parent-
ing space for both adolescent and parent, creating hope that the fixed pattern of
fraught relatedness, which so unnecessarily defined their contact, might be tran-
scended. Rather than the merit of the experiment hinging on how effectively the
adolescent had managed to complete his morning tasks on time (in truth, I have lit-
tle expectation of immediate success), I was attempting to support the adolescent
to develop an inkling of insight that taking ownership of his experience would
 Ongoing parental involvement 29

advance his capacity for leverage within parental relationships. Establishing this
experiment, irrespective of its success or failure, was a figural step in supporting
the filial contact boundary towards a more mutually satisfying and developmen-
tally evolved status for both Luke and his parents.

Parenting strategy work

I suggested a separate appointment with Luke’s parents, careful to assure the ado-
lescent that the focus of our dialogue would strictly be supporting them to develop
a less antagonistic parenting style towards him, and that I was not interested in
indulging any diatribe against their son: it would be an opportunity for them to
reflect on their behaviour, not on his. This created the assuredness of preservation
of his integrity and a burgeoning notion that he had recruited the therapist as his
advocate. He had.
I used this time with Luke’s parents to explain to them that in all likelihood,
their son was not, as they feared, exhibiting traits of some personality disorder,
due to his spectacularly erratic and self-obsessed presentation. As they explored
their expectations with regard to Luke’s behaviour and their ensuing exaspera-
tion when he failed to exhibit a similar mindset to them with regard to house-
work, study and sobriety, they began to appreciate the unproductiveness of their
approach. These very reasonable parents could not understand why their adoles-
cent son was so infuriatingly unreasonable: life would be so much easier if only
he would heed their advice and promptly follow all parental directives. I informed
them that, as a psychotherapist, I do not diagnose . . . but if I were to proffer
my analysis in this instance, it would be that this is an acute case of rearing-a-
16-year-old syndrome, as an attempt to inject humanity into the situation and
remind them of my non-judgemental posture. I offered them an explanation that
throughout adolescence contact boundaries develop rather than instantaneously
transform into the bilateral and differentiated contact we expect from mature adult
relating. His father and mother began to appreciate that they themselves were
shaping and facilitating the contentious dynamic with Luke. These parents real-
ised that their expectations, as they stood, were a little unrealistic and were both
grateful for and open to suggestion.
I coached them to obligate their adolescent to honour curfews and behavioural
limitations and to complete tasks in return for increased freedom and other bene-
fits, which would render the parents more influential and empowered. I also aided
them in compiling two lists: the first of their expectations with regard to their
son’s behaviour and the second of things which were important to him (it is almost
always possible to find things that matter to an adolescent: time with peers, social
events, screen time, attire, smartphones, game consoles, etc.), supporting them to
establish a simple contract with Luke whereby he stacked the dishwasher each
evening after dinner in return for attendance at a local disco on Friday night; and a
more complex contract involving parental contribution to his saving for a first car
as payoff for containment of his verbal and physical aggression towards family
30 Ongoing parental involvement

members. Luke’s parents could now, with some continued input on my part, begin
to shift the balance of lifespace power to the adolescent, as was developmentally
appropriate. This leant itself to the establishment of increased receptivity, trust
and warmth within the parenting space.
I find that the universal difficulty with implementing parental strategies is not
the adolescent’s unwillingness to participate, but lack of parental consistency.
In other instances where parental involvement will support the therapeutic and
developmental process, I choose, where appropriate and as much as possible,
to include the adolescent in this dialogue. Ongoing work in adolescent psycho-
therapy typically involves spontaneous inclusion of parenting adults in any given
session. This is why I have designed my practice with two adjoining soundproofed
offices and request a parent’s attendance for the duration of the session to facili-
tate this process. At the end of each session, I may solicit the presence of one
specific or several parenting adults for the following session, depending on how
the work is progressing.

Parenting spaces and trauma

A sizeable percentage of adolescents who are referred for psychotherapy have
experienced trauma (Briggs et al., 2013). The therapist examines the presence of
trauma from the adolescent’s phenomenological perspective, specifically focus-
ing on the implications of parental influence on the adolescent as he attempts to
lay claim to his life. Understanding the quality of parental connection in these
instances is crucial as this will inform and underpin any therapeutic intervention.
Following a traumatic event, it is not unusual for a disconnect to be experienced
between the adolescent and his parents, as he becomes unreachable and frozen
in his manner of relating. Remorphing the trauma-infused parenting space from
non-receptive to receptive is a major aspect of the healing process, transforming
the adolescent’s lifespace experience. In other instances, it is the parents who are
the traumatisers.
I am interested in the phenomenological experience of trauma for adolescents,
and the consequent impact of this trauma on development. Ongoing dialogue with
many adolescents over the years has led me to identify two qualitatively different
experiences of trauma which I have named Trauma-Within and Trauma-Without.
Trauma-without is an experience of trauma which is created from outside the
family field, e.g., a family member’s death through illness, a road traffic accident,
rape by an outsider. These testing and often overwhelming experiences thwart
the adolescent’s developmental path; there is rupture and distress in the adoles-
cent’s experience of contact boundary. Trauma-without is often experienced as
life-changing, with adolescents frequently expressing a sense that “life will never
be the same again”.
Trauma-within is the experience of trauma which emerges from the ground
of family experience (e.g. parental addiction, abuse in all its forms of children/
adolescents by caregivers). Hostile parenting is traumatising for the developing
Exploring the Variety of Random
Documents with Different Content
Clytæm. Ye citizens, ye Argive senators,
I will not shrink from telling you the tale
Of wife's true love. As time wears on one drops
All over-shyness. Not learning it from others, 830
I will narrate my own unhappy life,
The whole long time my lord at Ilion stayed.
For first, that wife should sit at home alone
Without her husband is a monstrous grief,
Hearing full many an ill report of him,
Now one and now another coming still,
Bringing news home, worse trouble upon bad.
Yea, if my lord had met as many wounds
As rumour told of, floating to our house,
He had been riddled more than any net; 840
And had he died, as tidings still poured in,
Then he, a second Geryon[334] with three lives,
Had boasted of a threefold coverlet
Of earth above, (I will not say below him,)[335]
Dying one death for each of those his forms;
And so, because of all these ill reports,
Full many a noose around my neck have others
Loosed by main force, when I had hung myself.
And for this cause no son is with me now,
Holding in trust the pledges of our love, 850
As he should be, Orestes. Wonder not;
For now a kind ally doth nurture him,
Strophios the Phokian, telling me of woes
Of twofold aspect, danger on thy side
At Ilion, and lest loud-voiced anarchy
Should overthrow thy council, since 'tis still
The wont of men to kick at those who fall.
No trace of guile bears this excuse of mine;
As for myself, the fountains of my tears
Have flowed till they are dry, no drop remains,
And mine eyes suffer from o'er-late repose, 860
Watching with tears the beacons set for thee,[336]
Left still unheeded. And in dreams full oft
I from my sleep was startled by the gnat
With thin wings buzzing, seeing in the night
Ills that stretched far beyond the time of sleep.[337]
Now, having borne all this, with mind at ease,
I hail my lord as watch-dog of the fold,
The stay that saves the ship, of lofty roof
Main column-prop, a father's only child, 870
Land that beyond all hope the sailor sees,
Morn of great brightness following after storm,
Clear-flowing fount to thirsty traveller.[338]
Yes, it is pleasant to escape all straits:
With words of welcome such as these I greet thee;
May jealous Heaven forgive them! for we bore
Full many an evil in the past; and now,
Dear husband, leave thy car, nor on the ground,
O King, set thou the foot that Ilion trampled.
Why linger ye, [turning to her attendants,] ye maids, whose task 880
it was
To strew the pathway with your tapestries?
Let the whole road be straightway purple-strown,
That Justice lead to home he looked not for.
All else my care, by slumber not subdued,
Will with God's help work out what fate decrees.[339]

(The handmaids advance, and are about to lay the

purple carpets on the ground)
Agam. O child of Leda, guardian of my home,
Thy speech hath with my absence well agreed—
For long indeed thou mad'st it—but fit praise
Is boon that I must seek at other hands.
I pray thee, do not in thy woman's fashion 890
Pamper my pride, nor in barbaric guise
Prostrate on earth raise full-mouthed cries to me;
Make not my path offensive to the Gods
By spreading it with carpets.[340] They alone
May claim that honour; but for mortal men
To walk on fair embroidery, to me
Seems nowise without peril. So I bid you
To honour me as man, and not as God.
Apart from all foot-mats and tapestry
My fame speaks loudly; and God's greatest gift
Is not to err from wisdom. We must bless 900
Him only who ends life in fair estate.[341]
Should I thus act throughout, good hope were mine.

Clytæm. Nay, say not this my purposes to thwart.

Agam. Know I change not for the worse my purpose.

Clytæm. In fear, perchance, thou vowèd'st thus to act.

Agam. If any, I, with good ground spoke my will.[342]

Clytæm. What think'st thou Priam, had he wrought such deeds...?

Agam. Full gladly he, I trow, had trod on carpets.

Clytæm. Then shrink not thou through fear of men's dispraise.

910
Agam. And yet a people's whisper hath great might. [343]

Clytæm. Who is not envied is not enviable.

Agam 'Tis not a woman's part to crave for strife

Agam. Tis not a woman s part to crave for strife.

Clytæm. True, yet the prosperous e'en should sometimes yield.

Agam. Dost thou then prize that victory in the strife?

Clytæm. Nay, list; with all good-will yield me this boon.

Agam. Well, then, if thou wilt have it so, with speed

Let some one loose my buskins[344] (servants they
Doing the foot's true work), and as I tread
Upon these robes sea-purpled, may no wrath
From glance of Gods smite on me from afar!
Great shame I feel to trample with my foot 920
This wealth of carpets, costliest work of looms;
So far for this. This stranger [pointing to Cassandra] lead thou in
With kindliness. On him who gently wields
His power God's eye looks kindly from afar.
None of their own will choose a bondslave's life;
And she, the chosen flower of many spoils,
Has followed with me as the army's gift.
But since I turn, obeying thee in this,
I'll to my palace go, on purple treading.
930
Clytæm. There is a sea,—and who shall drain it dry?
Producing still new store of purple juice,
Precious as silver, staining many a robe.
And in our house, with God's help, O my king,
'Tis ours to boast our palace knows no stint.
Trampling of many robes would I have vowed,
Had that been ordered me in oracles,
When for my lord's return I then did plan
My votive gifts. For while the root lives on,
The foliage stretches even to the house,
And spreads its shade against the dog-star's rage;
So when thou comest to thy hearth and home, 940
Thou show'st that warmth hath come in winter time;
And when from unripe clusters Zeus matures
And when from unripe clusters Zeus matures
The wine,[345] then is there coolness in the house,
If the true master dwelleth in his home.
Ah, Zeus! the All-worker, Zeus, work out for me
All that I pray for; let it be thy care
To look to what Thou purposest to work.[346]

[Exeunt Agamemnon, walking on the tapestry,

Clytæmnestra, and her attendants

Strophe I

Chor. Why thus continually

Do haunting phantoms hover at the gate
Of my foreboding heart?
Why floats prophetic song, unbought, unbidden? 950
Why doth no steadfast trust
Sit on my mind's dear throne,
To fling it from me as a vision dim?
Long time hath passed since stern-ropes of our ships
Were fastened on the sand, when our great host
Of those that sailed in ships
Had come to Ilion's towers:[347]

Antistrophe I
 And now from these mine eyes
I learn, myself reporting to myself, 960
Their safe return; and yet
My mind within itself, taught by itself,
Chanteth Erinnys' dirge,
The lyreless melody,
And hath no strength of wonted confidence.
Not vain these inner pulses, as my heart
Whirls eddying in breast oracular.
I, against hope, will pray
It prove false oracle.
970

Strophe II

Of high, o'erflowing health

There is no bound that stays the wish for more,
For evermore disease, as neighbour close
Whom but a wall divides,
Upon it presses; and man's prosperous state
*Moves on its course, and strikes
Upon an unseen rock;
But if his fear for safety of his freight,
A part, from well-poised sling, shall sacrifice,
Then the whole house sinks not, 980
O'erfilled with wretchedness,
Nor does he swamp his boat:
So, too, abundant gift
From Zeus in bounteous fulness, and the fruit
Of glebe at harvest tide
Have caused to cease sore hunger's pestilence;

Antistrophe II
 But blood that once hath flowed
In purple stains of death upon the ground
At a man's feet, who then can bid it back
By any charm of song?
Else him who knew to call the dead to life[348]
*Zeus had not sternly checked,
*As warning unto all; 990
But unless Fate, firm-fixed, had barred our fate
From any chance of succour from the Gods,
Then had my heart poured forth
Its thoughts, outstripping speech.[349]
But now in gloom it wails
Sore vexed, with little hope
At any time hereafter fitting end
To find, unravelling, 1000
My soul within me burning with hot thoughts.

Re-enter Clytæmnestra
Clytæm. [to Cassandra, who has remained in the
chariot during the choral ode]
Thou too—I mean Cassandra—go within;
Since Zeus hath made it thine, and not in wrath,
To share the lustral waters in our house,
Standing with many a slave the altar nigh
Of Zeus, who guards our goods.[350] Now get thee down
From out this car, nor look so over proud.
They say that e'en Alcmena's son endured[351]
Being sold a slave, constrained to bear the yoke:
And if the doom of this ill chance should come,
Great boon it is to meet with lords who own
Ancestral wealth. But whoso reap full crops
They never dared to hope for, these in all, 1010
And beyond measure, to their slaves are harsh:[352]
From us thou hast what usage doth prescribe.

Chor. So ends she, speaking words full clear to thee:

And seeing thou art in the toils of fate,
If thou obey, thou wilt obey; and yet,
Perchance, obey thou wilt not.

Clytæm. Nay, but unless she, like a swallow, speaks

A barbarous tongue unknown, I speaking now
Within her apprehension, bid obey.
1020
Chor. [to Cassandra, still standing motionless] Go with her. What
she bids is now the best;
Obey her: leave thy seat upon this car.

Clytæm. I have no leisure here to stay without:

For as regards our central altar, there
The sheep stand by as victims for the fire;
For never had we hoped such thanks to give:
If thou wilt do this, make no more delay;
But if thou understandest not my words,
Then wave thy foreign hand in lieu of speech
Then wave thy foreign hand in lieu of speech.

[Cassandra shudders as in horror, but

makes no sign

Chor. The stranger seems a clear interpreter

To need. Her look is like a captured deer's.
1030
Clytæm. Nay, she is mad, and follows evil
thoughts,
Since, leaving now her city, newly-captured,
She comes, and knows not how to take the curb,
Ere she foam out her passion in her blood.
I will not bear the shame of uttering more. [Exit

Chor. And I—I pity her, and will not rage:

Come, thou poor sufferer, empty leave thy car;
Yield to thy doom, and handsel now the yoke.

[Cassandra leaves the chariot, and bursts

into a cry of wailing

Strophe I

Cass. Woe! woe, and well-a-day!

Apollo! O Apollo!
1040
Chor. Why criest thou so loud on
Loxias?
The wailing cry of mourner suits not him.

Antistrophe I
Cass. Woe! woe, and well-a-day!
Apollo! O Apollo!

Chor. Again with boding words she calls the God,

Though all unmeet as helper to men's groans.

Strophe II

Cass. Apollo! O Apollo!

God of all paths, Apollo true to me;
For still thou dost appal me and destroy.[353]

Chor. She seems her own ills like to prophesy:

The God's great gift is in the slave's 1050
mind yet.

Antistrophe II

Cass. Apollo! O Apollo!

God of all paths, Apollo true to me;
What path hast led me? To what roof hast brought?

Chor. To that of the Atreidæ. This I tell,

If thou know'st not. Thou wilt not find it false.

Strophe III
Cass. Ah! Ah! Ah me!
Say rather to a house God hates—that knows
Murder, self-slaughter, ropes,[354]
*A human shamble, staining earth with blood.
1060
Chor. Keen scented seems this stranger, like a
hound,
And sniffs to see whose murder she may find.

Antistrophe III

Cass. Ah! Ah! Ah me!

Lo! [looking wildly, and pointing to the house,] there the witnesses
whose word I trust,—
Those babes who wail their death,
The roasted flesh that made a father's meal.

Chor. We of a truth had heard thy seeress fame,

But prophets now are not the race we seek.[355]

Strophe IV

Cass. Ah me! O horror! What ill schemes she now?

What is this new great woe?
Great evil plots she in this very house, 1070
Hard for its friends to bear, immedicable;
And help stands far aloof.

Chor. These oracles of thine surpass my ken;

Those I know well. The whole town rings with them.[356]

Antistrophe IV
Cass. Ah me! O daring one! what work'st thou here,
Who having in his bath
Tended thy spouse, thy lord, then ... How tell the rest?
For quick it comes, and hand is following hand,
Stretched out to strike the blow.
1080
Chor. Still I discern not; after words so dark
I am perplexed with thy dim oracles.

Strophe V

Cass. Ah, horror, horror! What is this I see?

Is it a snare of Hell?
Nay, the true net is she who shares his bed,
Who shares in working death.
Ha! let the Band insatiable in hate[357]
Howl for the race its wild exulting cry
O'er sacrifice that calls
For death by storm of stones.

Strophe VI

Chor. What dire Erinnys bidd'st thou o'er our house

To raise shrill cry? Thy speech but little cheers;
And to my heart there rush
Blood-drops of saffron hue,[358]
*Which, when from deadly wound 1090
They fall, together with life's setting rays
End, as it fails, their own appointed course:
And mischief comes apace.

Antistrophe V
Cass. See, see, I say, from that fell heifer there
Keep thou the bull:[359] in robes
Entangling him, she with her weapon gores
Him with the swarthy horns;[360]
Lo! in that bath with water filled he falls,
Smitten to death, and I to thee set forth
Crime of a bath of blood,
By murderous guile devised.

Antistrophe VI

Chor. I may not boast that I keen insight have

In words oracular; yet bode I ill.
What tidings good are brought 1100
By any oracles
To mortal men? These arts,
In days of evil sore, with many words,
Do still but bring a vague, portentous fear
For men to learn and know.

Strophe VII

Cass. Woe, woe! for all sore ills that fall on me!
It is my grief thou speak'st of, blending it
With his.[361] [Pausing, and then crying out.]
Ah! wherefore then
Hast thou[362] thus brought me here,
Only to die with thee?
What other doom is mine?

Strophe VIII
Chor. Frenzied art thou, and by some God's might swayed,
And utterest for thyself 1110
A melody which is no melody,
Like to that tawny one,
Insatiate in her wail,
The nightingale, who still with sorrowing soul,
And “Itys, Itys,” cry,[363]
Bemoans a life o'erflourishing in ills.

Antistrophe VII

Cass. Ah, for the doom of clear-voiced nightingale!

The Gods gave her a body bearing wings,
And life of pleasant days
With no fresh cause to weep:
But for me waiteth still
Stroke from the two-edged sword.

Antistrophe VIII

Chor. From what source hast thou these dread agonies

Sent on thee by thy God,
Yet vague and little meaning; and thy cries
Dire with ill-omened shrieks 1120
Dost utter as a chant,
And blendest with them strains of shrillest grief?
Whence treadest thou this track
Of evil-boding path of prophecy?

Strophe IX
Cass. Woe for the marriage-ties, the marriage-ties
Of Paris that brought ruin on his friends!
Woe for my native stream,
Scamandros, that I loved!
Once on thy banks my maiden youth was reared,
(Ah, miserable me!)
Now by Cokytos and by Acheron's shores
I seem too likely soon to utter song
Of wild, prophetic speech.

Strophe X

Chor. What hast thou spoken now

With utterance all too clear?
*Even a boy its gist might understand;
I to the quick am pierced
With throe of deadly pain,
Whilst thou thy moaning cries art uttering
Over thy sore mischance,
Wondrous for me to hear.

Antistrophe IX

Cass. Woe for the toil and trouble, toil and trouble
Of city that is utterly destroyed!
Woe for the victims slain
Of herds that roamed the fields,
My father's sacrifice to save his towers! 1140
No healing charm they brought
To save the city from its present doom:
And I with hot thoughts wild myself shall cast
Full soon upon the ground.
Antistrophe X
Chor. This that thou utterest now
With all before agrees.
Some Power above dooms thee with purpose ill,
Down-swooping heavily,
To utter with thy voice
Sorrows of deepest woe, and bringing death.
And what the end shall be
Perplexes in the extreme.

Cass. Nay, now no more from out of maiden veils

My oracle shall glance, like bride fresh wed;[364]
But seems as though 'twould rush with speedy gales 1150
In full, clear brightness to the morning dawn;
So that a greater war than this shall surge
Like wave against the sunlight.[365] Now I'll teach
No more in parables. Bear witness ye,
As running with me, that I scent the track
Of evil deeds that long ago were wrought:
For never are they absent from this house,
That choral band which chants in full accord,
Yet no good music; good is not their theme.
And now, as having drunk men's blood,[366] and so
Grown wilder, bolder, see, the revelling band,
Erinnyes of the race, still haunt the halls, 1160
Not easy to dismiss. And so they sing,
Close cleaving to the house, its primal woe,[367]
And vent their loathing in alternate strains
On marriage-bed of brother ruthless found
To that defiler. *Miss I now, or hit,
Like archer skilled? or am I seeress false,
A babbler vain that knocks at every door?
Yea, swear beforehand, ere I die, I know
(And not by rumour only) all the sins
Of ancient days that haunt and vex this house.

Chor. How could an oath, how firm soe'er confirmed,

Bi ht f h li ? L I l t th
Bring aught of healing? Lo, I marvel at thee,
That thou, though born far off beyond the sea, 1170
Should'st tell an alien city's tale as clear
As though thyself had stood by all the while.

Cass. The seer Apollo set me to this task.

Chor. Was he a God, so smitten with desire?

Cass. There was a time when shame restrained my speech.

Chor. True; they who prosper still are shy and coy.

Cass. He wrestled hard, breathing hot love on me.

Chor. And were ye one in act whence children spring?

Cass. I promised Loxias, then I broke my vow.

Chor. Wast thou e'en then possessed with arts divine?

1180
Cass. E'en then my country's woes I prophesied.

Chor. How wast thou then unscathed by Loxias' wrath?

Cass. I for that fault with no man gained belief.

Chor. To us, at least, thou seem'st to speak the truth.

Cass. [Again speaking wildly, as in an ecstasy.] Ah, woe is me! Woe's

me! Oh, ills on ills!
Again the dread pang of true prophet's gift
With preludes of great evil dizzies me.
See ye those children sitting on the house
In fashion like to phantom forms of dreams?
Infants who perished at their own kin's hands, 1190
Their palms filled full with meat of their own flesh,
Loom on my sight, the heart and entrails bearing,
(A sorry burden that!) on which of old
(A sorry burden that!) on which of old
Their father fed.[368] And in revenge for this,
I say a lion, dwelling in his lair,
With not a spark of courage, stay-at-home,
Plots 'gainst my master, now he's home returned,
(Yes mine—for still I must the slave's yoke bear;)
And the ship's ruler, Ilion's conqueror,
Knows not what things the tongue of that lewd bitch
Has spoken and spun out in welcome smooth,
And, like a secret Atè, will work out 1200
With dire success: thus 'tis she plans: the man
Is murdered by the woman. By what name
Shall I that loathèd monster rightly call?
An Amphisbæna? or a Skylla dwelling[369]
Among the rocks, the sailors' enemy?
Hades' fierce raging mother, breathing out
Against her friends a curse implacable?
Ah, how she raised her cry, (oh, daring one!)
As for the rout of battle, and she feigns
To hail with joy her husband's safe return!
And if thou dost not credit this, what then?
What will be will. Soon, present, pitying me
Thou'lt own I am too true a prophetess. 1210

Chor. Thyestes' banquet on his children's flesh

I know and shudder at, and fear o'ercomes me,
Hearing not counterfeits of fact, but truths;
Yet in the rest I hear and miss my path.

Cass. I say thou'lt witness Agamemnon's death.

Chor. Hush, wretched woman, close those lips of thine!

Cass. For this my speech no healing God's at hand.

Chor. True, if it must be; but may God avert it!

1220
Cass Thou utterest prayers but others murder plot
Cass. Thou utterest prayers, but others murder plot.

Chor. And by what man is this dire evil wrought?

Cass. Sure, thou hast seen my bodings all amiss.

Chor. I see not his device who works the deed.

Cass. And yet I speak the Hellenic tongue right well.

Chor. So does the Pythian, yet her words are hard.

Cass. [In another access of frenzy.] Ah me, this fire!

It comes upon me now!
Ah me, Apollo, wolf-slayer! woe is me!
This biped lioness who takes to bed
A wolf in absence of the noble lion,
Will slay me, wretched me. And, as one 1230
Mixing a poisoned draught, she boasts that she
Will put my price into her cup of wrath,
Sharpening her sword to smite her spouse with death,
So paying him for bringing me. Oh, why
Do I still wear what all men flout and scorn,
My wand and seeress wreaths around my neck?[370]
Thee, ere myself I die I will destroy: [breaks her wand]
Perish ye thus: [casting off her wreaths] I soon shall follow you:
Make rich another Atè[371] in my place;
Behold Apollo's self is stripping me
Of my divining garments, and that too, 1240
When he has seen me even in this garb
Scorned without cause among my friends and kin,
*By foes, with no diversity of mood.
Reviled as vagrant, wandering prophetess,
Poor, wretched, famished, I endured to live:
And now the Seer who me a seeress made
Hath brought me to this lot of deadly doom.
Now for my father's altar there awaits me
A butcher's block where I am smitten down