Child & Adolescent
Psychotherapy & Psychoanalysis:
Areas Of Expertise:
Psychotherapy and Psychoanalytic treatment helps the child or adolescent understand and manage feelings more effectively; recognize and change poor coping strategies; and re-examine negative feelings about him/ herself and others. My goal of treatment is not simply to overcome immediate troubles but to help each child or adolescent reach his or her full potential in all areas of life and to build deep, long-lasting strength and resilience.
The first thing I do is to build a strong, trusting relationship with my patient and to become a partner with the child or adolescent and my patient’s family in understanding the child’s struggles and capabilities. In undertaking this process I rely heavily on work with the parents and do so during every phase of the treatment. In addition to helping the child or adolescent return to the path of normal, healthy development, I aim to strengthen and restore the relationship between my patient and his/her parents.
In addition to my academic doctoral training as a mental health professional I have had extensive post-doctoral training in understanding child development and how a child or adolescent’s mind works. By virtue of my training and experience I am particularly sensitive to the multiple (including biological, genetic, neurological, familial, and social) factors that influence a child’s or adolescent’s personality development. I am always mindful of the importance of developing an understanding of the complex interaction of all these factors in determining each patient’s unique developmental trajectory and establishing an individualized treatment plan specifically tailored for each patient.
Autism Spectrum Disorders
Anxiety
Depression
Separation Anxiety and Fearfulness
Sleepiness and Nightmares
Night terrors or sleepwalking
Excessive sadness or depression
History of neglect or abuse (emotional, physical, and/or sexual abuse)
Extreme aggression
Oppositional Defiant Behaviors or Disorders
Disturbances in conduct
Excessive sibling rivalry
School Readiness
Aggressive behaviors at school
Compulsive thinking or rituals
Inattentiveness and disinterest in learning
Educational issues
Excessive shyness and separation problems
Social development and preparedness for school
Eating disorders
Emotional disturbance
Working with Children:
I have worked with children throughout my career. I utilize play therapy as an important component of the specialized child psychoanalytic training process that enables me to develop a relationship with the child. Through play the child (often non-verbally) in a non-threatening way can demonstrate recurring issues. In this manner the child leads and creates the content of our sessions. And through this process I can and do develop an understanding of the thoughts and feelings that the child is communicating. As the child plays, I look for and find the underlying meaning of the content of the play and its relation to the presenting issues. It is at that point that I am able to help the child realize and understand those underlying issues.
Play therapy may include the participation of the child’s parents. Using the comfortable vehicle of the play area, I can demonstrate the child’s issues for the parents. This exercise enables the child to feel accurately understood. Parental involvement provides parents with practical methods to use in dealing with problematic behavior at home. The troublesome behavior(s) can thus be reduced in occurrence and intensity.
Play therapy is usually conducted two to four times a week in sessions of about 45 min. each. The length of treatment may range from 6 months (minor adjustment problems) to 2 years or more depending on a variety of factors including symptoms. As an analyst I also coordinate with school teachers and other professionals who relate to the child. Again, working with the parents we can reduce behavioral issues at school and develop an awareness by all relevant of the child’s emotional issues, enabling all to support appropriate emotional changes.
Working with Adolescents:
Parents often recognize a palpable change in their relationship with their youngster as adolescence approaches. The younger child frequently thinks in terms of “super heroes” or other ideals; the adolescent, however, comes to recognize that ideals are a goal, not a reality. This change can lead to a great sense of loss. Adolescents without the prerequisite skills or strengths to face the changes in themselves, the increased complexity of their relationships, their altered outlooks on their expanding world – including their increasing responsibilities – will run into conflict which can result in social withdrawal, academic problems, self-harm, fighting, and other kinds of acting out. If this does occur, I am available as a psychoanalyst and psychotherapist to consult with both the adolescent and his/her parents to try to understand what will be helpful in getting the adolescent on track.
Adolescent treatment generally takes place face to face and I talk with the teen about what he or she is passionate. We meet a few times a week. Learning is more durable and efficient with consistency and frequency — the reason, for example, that youngsters attend school five days a week. Moreover, teen’s have the need to be back on track as soon as possible in order to moderate the distress experienced by the patient in feeling different and isolated from his/her peers. Success in psychoanalysis is measured in the capacity to think about oneself in a realistic way and to express oneself in words in a way that promotes self-regulation, connection and self protection.
As noted above, parents are an important source of information about the difficulties with which their adolescent is struggling. I can help parents think about the typical developmental tasks that teens need to master. Teaming with parents I can integrate the parents’ knowledge about their child and my knowledge about how the unconscious mind works. Together we can craft a narrative that accurately describes the complexity of the internal struggles the teen is facing, and this is instrumental in helping change take place.
From “Adapting” to “Adoption”:
Adolescents and Communication in the Modern Day
With the increase in technology and a pandemic keeping us stuck at home, adolescents and children are now, more then ever, reliant on technology for school, fun, and socialization. However, while this “artificial social interaction” might feel like the real thing, proper communication skills of adolescents are on the decline. Communication, especially during this time, is vital for parents and may require more effort then before. Establishing better communication skills involves patience and persistence on the part of the parent. Some tips we recommend for parents include:
Shared meal times - While eating all three meals as a family may be the most beneficial, we know that it might be impossible. Attempt to eat a meal together at least once a day, or establish a routine shared meal time sometime in the week (ex. Monday, Wednesday, and Friday Dinners)
Family activities - Whether that be through family outings to the grocery store or a Friday night board game.
Attempt to limit excess screen/social media time - Phones, especially during designated school time, should be turned “off” and left in a different room (if they provide too much distraction)
While it might take time to apply all of these suggestions into routine, we know that while at first you might be “adapting” to our new circumstances, eventually you’ll “adopt” these skills and improve your communication with your adolescent, pandemic or not.
Parenting: Reward and Discipline
Telling parents what they should or should not do is difficult, because each one decides what they want for their children. We all have our own personal experiences in their parenting models and in what each one has lived and wants for their children. However, it is important as parents to visualize the future child you want to have, and to work for it. Positive and firm language, without blackmail or punishment, makes a big difference. Feeling taken into account, understood, respected, and valued is important in raising our children. I hope it helps you in some way to understand the disadvantages of approaching a parenting model based on rewards and punishments. Draw your own conclusions. For any advice for individual cases contact me!
CHILD PSYCHOANALYSIS
WHAT IS CHILD PSYCHOANALYSIS?
Psychoanalysis is a form of psychotherapy conducted 3 or 4 times a week. The goal is the restoration of healthy progressive development so children can achieve their full potential. This approach is not a quick fix, instead, it helps the child or adolescent to overcome troubles and delays while building deep, long-lasting strength and resilience.
WHO IS A CHILD PSYCHOANALYST
Child psychoanalysts are highly trained and experienced professionals, and beyond their initial education and training, psychoanalysts compete additional years of education and training, b anywhere between 5 and 10 years after a doctoral or medical degree. The goal of a child analyst is the modification of psychological roadblocks so children and adolescents can achieve their full potential. In other words my job is to put development back on track.
HOW DO WE DO PSYCHOANALYSIS WITH CHILDREN?
In the analyst’s consulting room, younger children usually play with toys, such as puppets, animals, toy cars and houses, or draw, paint, or model with clay, as they talk. Words, play, and activity are ways children express their inner world. Children play and adolescents talk.
Whatever activity they choose to express their emotions, the analyst is there to listen and understand, and to share this understanding with the child or adolescent. The latter part is what makes psychoanalysis unique. Psychoanalysts are able to help children and adolescents verbalize problems in a way that they were unable to do on their own.
The other very important component to psychoanalysis is that exploring the relationship with the psychoanalysts and its similarity to important family relationships can free the child from acting on his or her feelings and allow more intentional, self-directed action and growth.
WHAT IS THE ROLE OF PARENTS AND OTHER ADULTS
Parents are the most important adults in the lives of children and adolescents, and they also are a very important component during psychoanalytic treatment. I usually say to parents “without you I can’t do my job, I need you in order for me to help you child.”
Other adults are also very important, for example teachers are key. Although I do not discuss content with teachers, the teacher can tell me things that I can’t see for myself. For example, how the child relates to others, is the child focused in school, and if so, what distracts the child from concentrating. And paying attention. The teacher can also help us understands the social life of the child. Is the child shy, does he/she plays with other children, what is the quality of the interaction, and finally, what is the interaction with the authority figures in the child’s lives. I do genuinely believe that every parent wants to be a good parent, but sometimes they need a little help in understanding their children’s emotional life. Sometimes the problems stem from within the child or teen, as we know children and adolescents have complex emotional disturbances, and understanding them is key for a successful navigation of childhood.
Historically, child psychoanalysis has been a preferred treatment of choice in Europe, Latin America, and South America. I believe the US is behind in accepting psychoanalysis as a way to treat children. My opinion is that there is a lack of information about the benefits of child psychoanalysis. Also, the treatment can be expensive, because of the duration of treatment, also because it requires a great of emotional investment from the parents. In child psychoanalysis, I need to see the child anyway from 3 to 5 sessions a week. I can see that it can intimidate people, but what they child gets in a psychoanalytic treatment will change the child’s live forever. Since I can’t disclose any information about my patients, there are many studies that demonstrates the success of child psychoanalysis. If you would like more information about child psychoanalysis, please visit my website www.drboscan.com, or visit the American Psychoanalytic Association website at www.apsaa.org, the International Psychoanalytic Association (IPA) or the Association for Child Psychoanalysis (ACP) for further information.