Object Relations in Severe Trauma: Therapy of the Sexually Abused Child

Article excerpt

STEPHEN Pmo, PfLD., PsY.D.: Object Relations in Severe Trauma: Therapy of the Sexually Abused Child. Jason Aronson, Northvale, NJ, 1996, 188 pp., $40.00, ISBN 1-56821-554-1.

In Object Relations in Severe Trauma: Psychology of the Sexually Abused Child, Stephen Prior outlines an object relational theory of the consequences of childhood sexual trauma. His goal is to develop a coherent perspective on this trauma in children and its treatment. He carries this out by way of a synthesis of a number of existing conceptualizations, including those current in the literature on borderline disorder and other severe disturbances, and those present in what the author refers to as "trauma theory without depth." Prior aims at restoring to trauma its rightful place in the etiological constellation underlying these disorders. He advocates a paradigmatic change where trauma is the central etiological factor in new (or revised) theories on the nature and origins of emotional distress.

He defines trauma, after Freud, as an event that stimulates thoughts and/or affect in such a disruptive way that the overwhelmed psyche is unable to integrate the stimulus event and the ensuing psychological disruption. By evoking annihilation anxiety and producing specific relational dynamics, trauma damages the capacity of these children to relate to others.

Four pivotal factors explain what happens to sexually traumatized children: 1. the repetition of abusive relational patterns; 2. identification with the aggressor; 3. self-blame; 4. the seeking of object contact through sexual and/or violent means. These factors are to be understood as deeply entrenched defenses against annihilation anxiety. The author points out that be has worked mostly with boys, and his theory is derived mostly from boys' experience.

A central core issue for these children is the relentless reliving of abusive relationships either as victim or as perpetrator. As a basic mode of psychological defense, identification with the aggressor is an antidote to the immense feelings of vulnerability, of fear and weakness. It is also a means of preventing perceived revictimization. On the one hand, the identification with the aggressor gives these children a sense of strength, but on the other hand, it leads to guilt as they perceive themselves to be sadists, perpetrators, victimizers, and therefore punishable. They carry an unshakable conviction of being the cause of the abuse, as well as deserving the abuse for being utterly bad.

They develop a sense of self as monstrous and evil. Mistreated children carry forward both the capacities for being mistreated and for mistreating others. They develop an abuser/victim dyadic working model by internalizing the abusive relationship itself and identifying with both abuser and victim role. …