From Freud’s blank slate to Helen’s colour-changing embroidered quilt.
Therapy with Young Adults in a Complex World
We were once sold Freud’s idea of the blank slate, the therapist as neutral, anonymous, and removed, simply the therapist. In some training, this still lingers as an ideal. But we know now this can’t be entirely true. The blank slate is a myth. So much is inferred the moment we enter the room: from body language, clothing, tone, room setup, word choice, when we smile - and when we don’t. None of this is neutral. It’s all relational data.
These impressions don’t land in a vacuum. They’re filtered through the young person’s world, their culture, environment, personal experiences, and through the many roles we may represent to them. Young people experience and project shifting roles. To a young person, I might be viewed as a parent figure, an authority, a school staff member, a social worker, or simply "another adult." These projections shape the work, moment to moment.
Alex’s perspective: When I entered the room, I entered with the swagger of my friends. I had just held court at break time, telling the funniest joke, I swear Hassan had tears in his eyes. That beautiful moment when you feel on top of the world, if only it lasted. I wanted Helen to view me the same way, to think I am cool. Maybe to fancy me a bit? My eyes travelled her body to her wedding band. If she liked me, that would prove I have value, I'm worth something. If she knows my flaws and still wants me. To see me with respect, as an equal.
But as we talk about the week, about how things have been at home, my worries about my Dad, I sense my shoulders creep up, my chin drops, looking up at her from lowered eyes. I don't know how to hold her in my mind. I have a ridiculous urge to sit at her feet, in the folds of her skirt. I want to be held in her arms, my head in her lap, told it's all going to be ok. Just as my voice breaks, the swing from adult to child embarrasses me, my body confused and my mind even more so
The swing between adult and child, this pendulum shift, is common in adolescence. And as therapists, we must track it gently, not just their shifting identities, but also our responses. Practitioners need to hold awareness of their own frameworks and responses. Holding the threads of these ever-changing layers is so complex.
A recent case conference for Alex, a Team Around the Family (TAF) meeting, drew all of this into focus. I was invited but couldn’t say much. Confidentiality limited my input. I came prepared to defend his right to privacy, stepping into the conference room already prickly.
His dad announced dismissively, “He’s basically an adult. When I was his age, I was working.” I already have a perception of Alex’s Dad as aggressive and resisted the urge to retort, but he’s never had a childhood! He’s been watching, waiting, constantly alert to every family shift. Observing his Mum sitting in submissive silence, I feel the urge to rescue, knit him a cardigan - and I can’t knit. I squash this down; it is not appropriate in my role. But, I hold awareness of this maternal need. Was it mine? Was I reacting to Alex’s unmet need, or even his Mother’s? I also know from experience that his parents are also assessing me, the person their son confides in, which is unsettling for most, dangerous for some.
The social worker, tapping their pen on paperwork, spoke in policies and presumptions. I wish he'd pause and let Alex speak, he’s articulate and thoughtful. His head of year focused on grades, missed homework. I felt my anger rise. Give the kid a break, let him have some fun with friends, a rest is far more likely to boost his grades.
In this meeting, I was not just a therapist. I was holding Alex in many roles: advocate, maternal figure, reflective witness. And he was holding me in roles, too. These relational layers don’t stop at the therapy door; they stretch into our community, culture, education, systems, and even our online identities.
Working therapeutically with teenagers and young adults is not neat or linear. Work is layered, shifting, and full of contradiction, too complex to explore fully here. And yes, it’s hard. But it’s also beautiful.
We could hold fear in all that complexity.
But me? I remain enchanted.
💛🍃 Reflective Prompt: When working with young clients, how do you notice and hold the shifting roles you occupy — advocate, adult, ally, authority?