ABSTRACT This commentary addresses the case of Sam, analyzed by Dr. Kristin Whiteside. It suggests that a possible reason for the patient’s premature and unilateral decision to terminate his analysis after only a short period of time was due to his analyst focusing excessively on impulse–defense conflicts. The analytic literature on attention deficit hyperactivity disorder (ADHD) is reviewed to suggest heuristically that it might have been more fruitful to consider his difficulties with the analytic frame as related to a variety of ADHD developmental limitations and his shame at having them seen. Problems with affect regulation, object constancy, and narcissistic regulation are emphasized as compromised mental functions that affected his approach to the analytic encounter. The value of integrating adult and child psychoanalytic training in institutes is suggested as a way to teach analysts to consider multiple determinants in pathogenesis in a manner consistent with dynamic, nonlinear systems theory.

中文翻译：

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分析成人多动症患者时考虑发展的重要性：Whiteside评论

摘要该评论针对由克里斯汀·怀特塞德（Kristin Whiteside）博士分析的Sam案。这表明，患者过短而单方面决定在短时间内终止分析的可能原因是由于其分析人员过分关注冲动—防御冲突。审查有关注意力缺陷多动障碍（ADHD）的分析文献，以启发式的方式提出，考虑到他与各种ADHD发育限制有关的分析框架的困难以及在看到这些缺陷时的羞耻感，可能会更有成果。影响调节，对象恒定性和自恋调节方面的问题被强调为影响他的分析方法的受损的心理功能。