Object relations in severe trauma

Dr. Stephen Prior's Object Relations in Severe Trauma: Psychotherapy of the Sexually Abused Child offers unique insight into the suffering and treatment of seriously disturbed, traumatized children. It outlines an object relational theory of the consequences of sexual traumatization as well as a detailed portrait of child treatment. By integrating a psychodynamic and relational understanding of psychic disorganization with a more contemporary account of trauma-induced anxieties, Dr. Prior gives an account of what he calls "the psychodynamics of trauma.". Building upon the theoretical work of Ferenczi, Fairbairn, and Berliner, the author describes four basic relational patterns in the lives of abused children: the reliving of abusive relationships, either as victim or as perpetrator; identification with the aggressor; masochistic self-blame; and the seeking of object contact through sex or violence. The interweaving of these patterns creates what Dr. Prior calls "relational dilemmas." According to him, these four basic relational patterns are held in place by the child's profound fear of falling into primitive states of unrelatedness and consequent annihilation anxiety. The presence of such powerful and primitive anxieties is, state Dr. Prior, the fundamental reason that the treatment of interpersonal trauma is so long and arduous. In order to develop new object relations and consequent transformation of the self, the child must give up his attachment to his bad objects. Relinquishing the only internal objects he has ever had requires tolerating profound emptiness and coping with transferential fears of retraumatization by the therapist. He contends that the therapist must often enter the violent and perverse sectors of the child's psyche in order to prevent an artificial "therapy of the good self," in which traumatic memories and identification with the aggressor are left out of treatment.