‘Finding a room of one’s own’: exploring therapists’ understanding of adolescents’ experiences of beginning and settling into intensive psychoanalytic psychotherapy.

This qualitative study uses Interpretative Phenomenological Analysis (IPA) to explore trainee psychoanalytic psychotherapists' understanding of adolescent patients' experiences at the beginning stages of intensive psychotherapy. Focusing on the conscious and unconscious expectations, anxieties, and phantasies that emerge, as well as the role of transference, countertransference, and the adolescent’s use of creative mediums such as the arts and dreams. The findings reveal a complex atmosphere characterised by a flood of feelings, discomfort, and initial mismatches between therapist and patient as they navigate the beginnings of the therapeutic relationship. Adolescents bring fears of being overwhelmed and phantasies of the therapist as a passive receptacle, alongside hopes for containment and deeper self-understanding. Transference and countertransference dynamics are prominent, with early infantile transference re-emerging and challenges related to dependency and independence surfacing in the therapeutic dynamic. The arts and dreams serve as vital tools for adolescents to express repressed aspects of their inner world, object relations, and anxieties about therapy. These creative modalities also provide a ‘transitional space’ for exploration within the therapy. The intensive frequency provides a space for confronting previously unbearable aspects of the self, fostering growth, and supporting processes of separation and individuation. These findings highlight the non-linear nature of beginning psychotherapy with adolescents, marked by shifts in emotional states and unconscious dynamics. The research underscores the importance of frequency in therapy, enabling emergence of infantile transference and exploration of negative transference. The study emphasises the significant learning experience that intensive therapy offers for trainee therapists. Clinical implications suggest that the beginning stages are uniquely intense, requiring therapists to navigate oscillations between dependency and autonomy, which are crucial for the adolescents’ reworking of their internal psychic landscape. The study advocates for the continued availability of intensive therapy in the NHS, emphasising its value in addressing adolescents' unique therapeutic needs, particularly as resources increasingly shift toward shorter treatments.