PSYCHOTHERAPY OF A BOY WITH A DEPRESSION AFTER 2 OF HIS BROTHERS DIED

The author describes the psychotherapy of about 2 1/2 years duration o f a 14-year old boy. This psychodynamically oriented psychotherapy dea lt with the aftermath of two desasters in his family: The accidental d eaths of two older brothers five and four years ago. These events had a lasting effect on the family which negatively interferred with the a chievement of developmental tasks in adolescence in the patient. He ha d erected massive defenses against his own wishes and became withdrawn and depressed. The main issues dealt with in therapy were: (a) The bo ys fear to step out of his position as the families ''child'' in consi deration of his grieving mother. (b) The boy's difficulty to tolerate and integrate aggressive fantasies and feelings because of his guilt f eelings and fear of another loss due to these fantasies and feelings. The working through of conflictual issues in psychotherapy enabled the boy to gain awareness regarding his own needs and wishes, and to find ways to fulfill them. Subsequently, he succeeded in making an adequat e professional choice and to go into training for it.