Teen Therapy in Washington, DC: Understanding the Developmental Crisis of Adolescence
The teenage years can be difficult for parents to understand or even to remember.
A teenager who once talked easily with a parent may suddenly answer questions with one word. A young person who seemed confident may become intensely self-conscious. Schoolwork that was once manageable may become overwhelming. Friendships can take on enormous importance. There may be anxiety, anger, sadness, perfectionism, withdrawal, impulsivity, or conflict at home.
Parents often come to therapy with an understandable question:
“What is happening to my teenager? Is this ordinary teen behavior or does my teen need therapy?”
Adolescence is not simply a period in which problems sometimes emerge. Adolescence is itself a developmental crisis.
Adolescence as a Developmental Crisis
Adolescence requires an extraordinary amount of psychological reorganization in a relatively short period.
The body changes. Sexuality becomes increasingly important. Relationships with parents have to change. Peers take on new significance.
The teenager begins to encounter romantic relationships, rejection, competition, sexuality, independence, responsibility, and increasingly consequential choices about the future.
And underneath all of this is a much larger psychological task: “Who am I?”
A teenager is no longer a child, but is not yet an adult. A teenager often feels oneself to be oscillating from childish wishes to adultomorphic ideas.
For example, they may desperately want independence while still needing reassurance. They may push away the very parents whose approval matters enormously. They may insist that they do not care what anyone thinks while being acutely sensitive to how other people perceive them.
These contradictions are part of adolescence.
The teenager is trying to establish a self that increasingly belongs to them.
When Something Feels Different
Sometimes the reason parents seek therapy is clear. For example, a teenager is depressed. Anxiety is interfering with school. There has been a significant loss, breakup, family change, or other painful experience.
At other times, parents simply recognize that something has changed that may not reach the level of alarm, but is still cause for concern. For example, their teenager spends more time alone. Anger seems to come out of nowhere. Grades fall. Symptoms of anxiety are more visible. A young person who has always been conscientious suddenly cannot complete assignments.
Or the opposite happens: achievement becomes increasingly rigid. A teenager who appears extraordinarily successful becomes terrified of making a mistake.
There may be physical complaints, difficulty sleeping, social withdrawal, problems eating, conflict at home, or a general sense that ordinary life has become harder.
Behavior tells us that something is happening. It does not necessarily tell us what that something means. The same behavior can have very different meanings for different teenagers.
This is why therapy is interested not only in what a teenager is “doing”, but in understanding the particular young person who is doing it and why.
Strong Feelings That Are Difficult to Understand
Teenagers can experience feelings with tremendous intensity. Shame can make someone want to disappear. Anger can feel overwhelming. Anxiety can feel like an emergency that has to be solved immediately.
Sometimes the teenager has very little language for what is happening.
Part of adolescent development involves becoming able to recognize increasingly complicated internal experiences. A teenager may know that they feel terrible without yet knowing whether they are angry, embarrassed, jealous, frightened, lonely, disappointed, ashamed—or several of these at once.
Therapy gives the teen greater understanding of these experiences.
Knowing Yourself Can Help You Feel More Regulated
One of the things therapy can offer a teenager is a greater understanding of their own mind.
Something that initially feels like rage may begin to be understood as humiliation. Indifference may protect against disappointment. Procrastination may be connected to a fear of discovering that one's work will not be perfect. A fight with a parent may contain both a wish to be left alone and a wish to know that the parent is still there.
As teenagers become better able to recognize their emotional states and understand what tends to provoke them, those experiences can become less mysterious and overwhelming. This is one way that knowing oneself better can help someone feel more regulated.
Regulation means developing a greater capacity to have a feeling and think about it, without immediately needing to escape it, act on it, or make someone else get rid of it.
There is gradually more room between feeling and action. For example, “I’m pretending I don't care because I feel left out.”
Recognizing a feeling does not make it disappear, but it can make the feeling easier to bear.
Regulation That Belongs to the Teenager
This distinction is particularly important during adolescence.
When a teenager is struggling, adults naturally want to help.
Parents may offer advice, reassurance, reminders, solutions, consequences, or strategies for calming down. Sometimes these interventions are necessary and useful.
But adolescence is also the period when a young person increasingly needs to experience themselves as capable of managing their own internal life.
If emotional regulation comes primarily from adults telling the teenager what to do, regulation itself can become another struggle over control.
Therapy can offer something different.
Rather than simply telling a teenager what to do when they are anxious, angry, ashamed, or overwhelmed, therapy helps them become more familiar with their own mind.
A teenager may gradually begin to recognize:
I become angry when I feel embarrassed.
When my parents become anxious about me, I feel controlled and pull away.
Knowing these patterns gives the teenager more choices.
Instead of immediately acting on a feeling, there may eventually be an internal thought:
I know why this affects me so strongly.
I don't have to do something about this feeling immediately.
Knowing oneself better and why one feels a certain way is emotionally containing. This is regulation that develops from the inside.
It increasingly belongs to the teenager rather than being imposed by adults.
And that is itself part of growing up.
Why Privacy Matters in Teen Therapy
Teenagers need privacy in order to speak freely.
It is difficult to talk honestly about friendships, sexuality, anger, embarrassment, relationships with parents, things one regrets, or thoughts one does not completely understand if everything said in therapy is expected to return immediately to the parents.
Within appropriate safety, ethical, and legal limits, confidentiality allows therapy to become a space that genuinely belongs to the teenager.
This is not about excluding parents.
It is about recognizing that developing an inner life that is not entirely accessible to one's parents is part of adolescence.
Privacy makes it possible for the teenager to experiment with thoughts, discover feelings, contradict themselves, and say things they may not yet know how to say anywhere else, especially to themselves.
A teenager needs the opportunity to discover that therapy can become a relationship of their own—not simply an extension of their parents' authority.
The confidentiality of the therapeutic relationship facilitates trust in the therapist.
Why Friends Can Feel Like Everything
Peer relationships take on enormous psychological importance during adolescence.
This makes developmental sense. Teenagers are gradually moving outward from the family and building a social world of their own.
But this also means friendships can carry tremendous emotional weight.
Being left out of a group chat, discovering that two friends spent time together without you, not receiving a response to a message, or watching social plans unfold online can produce feelings that adults sometimes underestimate.
To the teenager, these experiences may touch larger questions:
Do people like me?
Do I belong?
Who am I in relation to other people?
Is there something about me that makes people leave?
Social media can intensify this because evidence of other people's social lives is almost continuously available.
Telling a teenager not to care so much usually does very little.
Therapy offers somewhere to understand why a particular relationship matters so much and what feelings of belonging, exclusion, desire, competition, or rejection evoke in this particular teenager.
Parents Still Matter
Psychological separation from parents does not mean parents become unimportant.
Quite the opposite.
Parents remain enormously important during adolescence, even when their teenager seems determined to demonstrate otherwise.
But the relationship has to change.
Parents who once knew almost everything about their child's life have to tolerate knowing less. They have to decide when to intervene and when to allow their teenager to struggle. They have to remain available while recognizing that they may not always be invited in. This can be difficult for parents too.
What Psychoanalytic Therapy in Washington, DC Offers Teenagers
Psychoanalytic and psychodynamic therapy are interested not only in reducing symptoms but in understanding the person experiencing them.
If a teenager is anxious, we want the anxiety to become more manageable. But psychoanalytic therapy is less interested in making a feeling go away than in understanding the young person who is having it — what the anxiety is about, when it tends to arrive, and what it might be protecting.
That understanding is what makes the difference. A teenager who begins to know their own mind gains something that can't be handed to them by an adult: the capacity to have a feeling, think about it, and decide what to do with it. Symptoms may ease, but the deeper gain is a teenager who is becoming more himself or herself — more able to tolerate strong feelings, more curious about their own inner life, and more genuinely in possession of a self that belongs to them.
This is slow, individual work. It doesn't look like advice or quick fixes. It looks like a young person gradually discovering that their inner world can be thought about, spoken about, and understood — often for the first time.
Start Psychoanalytic Therapy in Washington, DC
If something about your teenager has felt different — more withdrawn, more anxious, angrier, or more rigid than before — you don't have to figure out on your own whether it's ordinary adolescence or something that deserves attention. Psychoanalytic therapy in Washington, DC offers your teen a space of their own to understand what they're feeling and why. You can start your therapy journey with Nina Van Sant, LICSW, by following these simple steps:
Meet with a caring therapist
Start getting the support you and your teen deserve!
Other Services Offered with Nina Van Sant, LICSW
Psychoanalysis isn’t the only service that Nina Van Sant, LICSW, offers. I’m happy to provide a variety of services to support the mental health and well-being of my clients. Other services offered include infertility-related stress, postpartum therapy, and therapy for teens and older adults at different developmental stages. I also work with expats and international professionals managing cultural adjustment, relocation stress, and the emotional weight of major life changes. You can visit my blog or about page for more helpful information!