ABSTRACT This piece addresses a prominent question that arose from the author’s presentation of her paper, “Turning Points in Adolescent Analysis”. Specifically, the adolescent patient who was the subject of the paper was unable to work within the transference relationship, despite the author/analyst’s pursuit of this feature of their exchange. Reasons for the patient’s inability to do this are discussed, including the patient’s neuropsychological challenges and ADHD and their impact on psychic structure formation and her concrete-ism. More useful to the patient were mirroring transference interventions as well as those which capitalized on assisting the development of inchoate ego structures and functions; and aiding the transformational pull forward into young adulthood. A child and adolescent analyst (as well as an analyst of adult patients) must choose arrows from her quiver of therapeutic action based upon which ones the patient is capable of using, and which ones target the nature and symptoms of the patient’s disturbance which prevent her from using the transference relationship. The author draws from Anna Freud as well as contemporary thinkers on this topic.

中文翻译：

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“当患者无法在转运中工作时”：Lament医生的回应

摘要本篇文章解决了作者提出的论文“青少年分析的转折点”引起的一个突出问题。具体来说，尽管作者/分析人员追求这种交换特性，但作为论文主题的青春期患者无法在移情关系中工作。讨论了患者无法执行此操作的原因，包括患者的神经心理挑战和注意力缺陷多动障碍及其对心理结构形成和她的具体主义的影响。对于患者而言，更有用的是镜射移情干预措施以及那些有助于协助早期自我结构和功能发展的干预措施。并帮助他们迈向年轻成年。儿童和青少年分析人员（以及成人患者的分析人员）必须根据自己的治疗能力来选择箭头，具体取决于患者可以使用的箭头，以及针对患者疾病的性质和症状的箭头，以防止她使用转移关系。作者从安娜·弗洛伊德（Anna Freud）以及当代思想家那里汲取了关于这一主题的知识。