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Shifting Levels of Communication in Treatment of Adolescent Character Disorders

AMA Arch Gen Psychiatry. 1960;2(1):94-99. doi:10.1001/archpsyc.1960.03590070096011.
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That psychotherapy with youngsters tightly organized around acting-out presents difficulties of a serious order has long been recognized.1,5,6 It seems that when psychopathology manifests itself in immediate tension discharge, and forms of thought, usually intervening between impulse and action,7 are conspicuous by their absence, prognosis is poor and many treatment techniques fail.4 It becomes necessary to look for general patterns in the treatment of these young patients, in the hope of finding adequate explanations for our successes and failures. Since communication problems are particularly severe in these cases, it is the purpose of this paper to highlight these and to point to ways in which communication problems may be met.

That a casual “let me be your friend” attitude on the part of the therapist at the beginning of treatment is sure to mobilize an incredible amount of anxiety in these patients has already


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