Treating the Adult survivor of Childhood Sexual Abuse: a Psychoanalytic Perspective
There are many elucidating books about trauma, and many enriching psychoanalytic volumes, but this one holds a distinct place in my heart because of its original synthesis of both schools of thought, applied to a population who make urgent use of therapy. Published more than two decades ago, it still feels relevant.
Messler-Davies and Frawley are immersed in trauma treatment literature, and use this knowledge to establish a holding environment. But they notice that within this "relational matrix...state-dependent traumatic memories are triggered off by aspects of transference-countertransference reenactment" (p.5). These enactments lead both therapist and client into deep and murky waters which, they argue, need not be affect-regulated away.
The authors helpfully bring to life (with realistic vignettes) the roles that may shock therapists when we are "press-ganged" into various disturbing dyads. These include: "The Unseeing, Uninvolved Parent and the Unseen, Neglected Child" (since most child abuse requires the blindness of at least one caregiver), "The Sadistic Abuser and the Helpless, Impotently Enraged Victim" (a brutal echo of the original trauma) and "The Idealized, Omnipotent Rescuer and the Entitled Child" (a tempting position if the therapist is being called upon to play ‘rescuer’). These dyads are vividly described in the 9 th chapter, which is worth the price of admission. Here, the authors provide signposts to help work through minefields. They show that "it is the clinician’s ability to assume, enact, observe, and ultimately, to help make explicit all of the relational stances taken on by each member of the therapeutic dyad without becoming locked into any particular role...that moves the treatment along, facilitating the patient’s identification, working-through, and integration of long-fragmented self and object representations" (p. 185). This practical and ultimately hopeful book, a true labour of love, is a must-have for any therapist.
Review by Rachel Fulford (CTP Dipl, member of CAPT).
by: Jody Messler Davies and M