Treating The Adult Survivor Of Childhood Sexual Abuse: A Psychoanalytic Perspective

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Basic Books, Mar 21, 1994 - Psychology - 259 pages
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Entering the tumultuous, dissociated world of the adult survivor of childhood sexual abuse presents an intimidating challenge for clinicians. But as the authors of this innovative book argue, therapists must be willing and able to work within the powerful and rapidly shifting relational paradigms of transference and countertransference commonly found in treatment of these patients. Such dual roles enacted in treatment include the unseeing, uninvolved parent and the unseen, neglected child; the sadistic abuser and the helpless, enraged victim; the idealized rescuer and the entitled child; and the seducer and the seduced. This is the first model for treatment of adult survivors of childhood sexual abuse that takes advantage of a relational approach and that integrates psychoanalytic thinking with the latest findings from the literature on psychological trauma and sexual abuse. Diverging from a more classical perspective, the authors view dissociation as the means by which a person adapts to and expresses traumatogenic material and by which such patients defend against traumatic memories, affects, and fantasy elaborations emerging into consciousness. The authors also detail how dissociation helps organize the patient's personality and presentation of self. Richly illustrated case examples bring to life the authors' treatment model and show how clinicians can work through the relational paradigms between patient and therapist and, ultimately, reach the core of the patient's deeply buried experiences of self and other.
  

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Contents

CHAPTER 1 Trauma and Childhood Sexual Abuse in Psychoanalysis
11
CHAPTER 2 LongTerm Sequelae and Diagnosis of Childhood Sexual Abuse
26
CHAPTER 3 An Integrative Model of Childhood Sexual Abuse
43
CHAPTER 4 Dissociation
62
CHAPTER 5 Disclosure and the Recovery of Memories
86
CHAPTER 6 Reality Testing and the Question of Validation
103
CHAPTER 7 Exposure to Danger the Erotization of Fear and Compulsive Selfabuse
129
CHAPTER 8 The Impact of Trauma on Transference and Countertransference
149
CHAPTER 9 Eight TransferenceCountertransference Positions
167
A Case Example
186
CHAPTER 11 Technical Considerations in Treatment
198
Theoretical Implications and Reconsiderations
216
References
237
Index
248
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Page 237 - REFERENCES Amir, S., Brown, ZW, & Amit, Z. (1980). The role of endorphins in stress: evidence and speculations. Neuroscience and Biobehavioral Reviews, 4, 77-86.

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