Much of the work that goes on in psychoanalysis focuses on modifying the behaviors that arise in some patients in response to traumatic experience. Writing about his experiences treating sexually abused boys, Massachusetts analyst Stephen Prior notes how “neglect and abuse distort fundamental needs and psychic structures in the child.” He writes that “the psychological response to trauma [includes] the repetition of abusive patterns of relationship, identification with the aggressor, self-blame, and the seeking of object contact through sexuality or violence.”
Prior’s 1996 book, Object Relations in Severe Trauma, alerts readers to a resurgence in interest in trauma among professional therapists. That resurgence, Prior says, forms part of “a greater recognition of the impact of real events, persons, and relationships on emotional development.”
He states further that, for some children, sexual victimization is not an isolated event or an aberration, but part of a pattern of events in their lives of neglect and injury. This pattern constitutes chronic trauma, and sexual abuse is an acute form of trauma within that chronic pattern. Psychic distress in children who have suffered both acute and chronic trauma can be especially severe, Prior says.
In such children, the responses to sexual trauma are tied up with the effects of neglect, other traumas, and the ways in which children defend themselves emotionally against these problems. Therapists working with this group of children must keep in mind each of these issues, and craft a treatment plan that addresses them all.
A key dynamic of trauma in child sexual abuse is that many traumatized children share the deeply held belief that they caused and deserved the abuse. Psychoanalytic interventions into traumas such as this seek to get patients’ internal states in a way that most other therapeutic techniques do not address. Clinicians using psychoanalytic techniques also seek to understand why sexual abuse produces certain kinds of psychological effects and not others.
