Medicine: Parent-&-Child Analysis

Psychoanalysis puts great store by strict privacy: there must be nobody but analyst and patient in the room, and anything unearthed in the patient's ruminations must be guarded as top secret. Last week psychoanalysts discussed a new approach in which a parent and child (usually a problem adolescent) get analytic treatment together, or even in a group that may include as many as four parents and four youngsters.

Manhattan's Dr. B. Bohdan Wassell described the method and results to the new and growing Association of Medical Group Psychoanalysts. At first, he said, his aim was to help children of parents who were in psychoanalysis but could not afford the extra cost (going rate: $20 an hour) of analysis for the troubled child. Psychiatric treatment in groups has been gaining popularity as a means of relieving the gap between the supply of scarce psychiatrists and the heavy demand, but it has been mainly of the brief, non-analytic kind. The benefits that Dr. Wassell discovered in the interactions of parent and child during joint analysis led him to raise his sights and accept a few patients who could have afforded to pay the full individual rate.

Intertwined Problems. Often, Dr. Wassell found, parent-child problems are too intertwined to be solved separately. One patient, D., a boy of 13, was thin, withdrawn and inoffensive. His mother was divorced, as her parents had been. D. lived with his mother and 17-year-old sister and resentfully felt that they had a world of their own from which he was excluded.

He had to trail behind while they window-shopped, and he got no encouragement for his mechanical interests. When his mother told him how much she loved him, he answered defiantly: "I hate you." He was doing badly in school, playing hooky, and could not make friends with classmates.

In group sessions, said Dr. Wassell, it soon became clear to him that D.'s mother "feasted and famined" him. She would coax him to talk, for example, but when he began she would take over and do the talking for him. Eventually she came to realize that because of her own uncon scious feelings of worthlessness, she would push aside anybody who was more powerless, including the son she loved, to give herself some sense of power and accomplishment. As she gradually came to understand that motivation, she stopped trying to show power. D. in turn stopped "hating" her, which increased her self-esteem as a mother. He got better grades, learned to make friends easily. A teenage girl and three women in the group taught him that girls have their own problems, and relieved his resentment against females.

Increased Understanding. In sessions such as these, said Dr. Wassell, the child and one parent can talk freely about the other parent. Sometimes, for better balance, he has had the second parent substitute for the first in a few sessions. The adolescents he has treated have not been outright delinquents, but because they were in such open rebellion against their parents, he thinks they might have slipped into delinquency.