On the edge of representability: memory, narration and oblivion of trauma in the psychotherapy of young victims of abuse and violence

Renzo Di Cori, Ugo Sabatello

Abstract


On the basis of metapsychological issues on the representation of trauma, this paper investigates how psychoanalysis supports the re-integration of the traumatic event in minors who, as victims of serious forms of violence, see memory as a threat to their defense strategies and are at risk of psychological collapse. What emerges from the experience of the authors is how the most relevant element in psychotherapy for child and adolescent abuse victims is their potential and ability for representation, as well as the intricate connections between external traumatic factors and internal dispositional factors. From a treatment perspective – referring to some of the arguments involved in the debate on changes to the basic model technique according to the internal organization of the patient – the authors suggest a technique that, by respecting the internal time frame of the patient, the fluctuations of transference and psychological functions, alternates between a supporting and an explorative function (especially in cases in which the Ego remains relatively intact) with different patients, or even with the same patient in different phases of therapy. The therapeutic objective is to rebuild a “sense” of an event, which, having broken any logical order, forces the subject into an existential “non-sense”.

Keywords


Victim of Abuse; Memory; Narration; Psychich Trauma; Psychoterapy

Full Text:

PDF

References


Agamben, G. (1999). Remnants of Auschwitz - The Witness and the Archive. New York: Zone Books.

Akhtar, S. (1992). Broken Structures Severe Personality Disorders and Their Treatment Northvale. NJ: Jason Aronson.

Bibring, E. (1943). The conception of the repetition compulsion. The Psychoanalytic Quarterly 12: 486-519.

Blum, H.P. (2003a). Repression, transference and reconstruction. International Journal of Psychoanalysis 84, 497–503.

Blum, H.P. (2003b). Response to Peter Fonagy. International Journal of Psychoanalysis 84, 509-513.

de Jonghe, F., Rijnierse, P., Janssen, R. (1992). The role of support in psychoanalysis. Journal of the American Psychoanalytic Association 40, 475-499.

Dewald, P. (1989). Effects on an adult of incest in childhood: A case report. Journal of the American Psychoanalytic Association 57, 997-1014.

Diamant, I. (2001). On not being able to know others’ minds: The debate on recovered memories of abuse from a relational perspective. British Journal of Psychotherapy 7, 344–52.

Eissler, K.R. (1953). The effect of the structure of the ego on psychoanalytic technique. Journal of the American Psychoanalytic Association 1, 104-43.

Eissler, K.R. (1958). Variations in Classical Psycho-Analytic Tehnique. International Journal of Psychoanalysis 39, 200-242.

Etchegoyen, L. & Amati Mehler, J. (2004). Language and affects in the analytic practice. International Journal of Psychoanalysis 85, 1479-83.

Fonagy, P. (1999). Memory and therapeutic action. International Journal of Psychoanalysis 80, 215–23.

Fonagy, P. (2003). Rejoinder to Harold Blum. International Journal of Psychoanalysis 84, 503-509.

Freud, A. (1967). Comments on psychic trauma. In: The Writings of Anna Freud: Vol. 5 (pp. 221-241). New York: International Universities Press, 1969.

Freud, S. (1896). Letter from Freud to Fliess, December 6, 1896. In Masson, J.M. (1985) The Complete Letters of Sigmund Freud to Wilhelm Fliess, 1887-1904 (pp. 207-214). Cambridge, MA, and London, England: The Belknap Press of Harvard University Press.

Freud, S. (1915). The unconscious. In SE 14 (pp. 159–204). London: Hogarth Press

Freud, S. (1920). Beyond the pleasure principle. In SE 18 (pp. 1–64). London: Hogarth Press

Freud, S. (1925). Negation. In SE 19 (pp. 233-239). London: Hogarth Press.

Freud, S. (1933 [1932]), New introductory lectures on psycho-analysis. In SE 22 (pp. 1–182). London: Hogarth Press.

Freud, S. (1937). Analysis terminable and interminable. In SE 23 (pp. 209–253). London: Hogarth Press.

Gabbard, G.O. (1997). Challenges in the Analysis of Adult Patients With Histories of Childhood Sexual Abuse. Canadian Journal of Psychoanalysis, 5, 1-25.

Gabbard, G.O. & Westen, D. (2003). Rethinking Therapeutic Action. International Journal of Psychoanalysis 84, 823-41.

Gabbard, G.O., Horwitz, L., Allen, J.G., Frieswyk, S., Newsom, G., Colson, D. & Coyne, L. (1994). Transference interpretation in the psychotherapy of borderline patients A high-risk, high-gain phenomenon. Harvard Rev Psychiatry 2, 59-69.

Gaensbauer, T.J. (1995). Trauma in the Preverbal Period: Symptoms, Memories, and Developmental Impact. Psychoanalytic Study of the Child 50, 122-149.

Gaensbauer, T.J. (2004). Traumatized young children – Assessment and treatment processes. In Osofsky J. (Ed.) Young children and trauma – Intervention and treatment (pp. 194–216), New York: The Guilford Press.

Gerzi, S. (2005). Trauma, narcissism and the two attractors in trauma. International Journal of Psychoanalysis 86, 1033–50.

Giaconia, G. & Racalbuto, A. (1990). I percorsi del simbolo. [The symbol paths: theory and psychoanalytic clinic]. Milano: Raffaello Cortina Editore.

Greenspan, S.I. & Lieberman, A.F. (1994). Representational elaboration and dif- ferentiation: a clinical-quantitative approach to the assessment of 2- to 4-year-olds. In A. Slade, D. Wolff (Eds.) Children at Play (pp 3-32). New York: Oxford University Press.

Holinger, P.C. (1999). Noninterpretive Interventions in Psychoanalysis and Psychotherapy A Developmental Perspective. Psychoanalytic Psychology 16, 233-253.

Horwitz, L., Gabbard, G.O., Allen, J.G., Frieswyk, S.H., Colson, D.B., Newsom, G.E. & Coyne, L. (1996). Borderline Personality Disorder: Tailoring the Psychotherapy to the Pattient. Washington, DC: American Psychiatric Press.

Katan, A. (1961). Some thoughts about the role of verbalization in early childhood. Psychoanalytic Study of the Child 16, 184–188.

Killingmo, B. (1989). Conflict and deficit Implications for technique. International Journal of Psychoanalysis 70, 65-79.

Kirshner, L.A. (1994). Trauma, the good object, and the symbolic. A theoretical integration. International Journal of Psychoanalysis 75, 235-42.

Kramer, S. (1983). Object-coercive doubting: A pathological defensive response to maternal incest. Journal of the American Psychoanalytic Association i/(Suppl.), 325-351.

Krimendahl Wolf, E. & Alpert, J.L.(1991). Psychoanalysis and Child Sexual Abuse: A Review of the Post-Freudian Literature. Psychoanalytic Psychology 8, 305-327.

Laplanche, J. & Pontalis, J.-B. (1973). The Language of Psycho- Analysis. London: Hogarth.

Levi, P. (1987). If This is a Man and The Truce. London: Abacus.

Loewenstein, R. (1958). Variations in Classical Psycho-Analytic Tehnique. International Journal of Psychoanalysis 39, 200-242.

Mancia, M. (2006). Implicit Memory and Unrepressed Unconscious: How They Surface in the Transference and in the Dream. In M. Mancia (Ed.) Psychoanalysis and Neuroscience. New York: Springer.

McQueen, D., Itzin, C., Kennedy, R. & Sinason, V. (2008). Psychoanalytic Psychotherapy After Child Abuse: The Treatment of Adults and Children Who Have Experienced Sexual Abuse, Violence, and Neglect in Childhood. London: Karnac.

Marcus, B.F. (1989), Incest and the borderline syndrome: The mediating role of identity. Psychoanalytic Psychology 6, 199-215.

Margolis, M. (1977). A preliminary report of a case of consummated mother-son incest. Annual of Psychoanalysis 5, 267-293.

Moore, Y. (2009). Thoughts on representation in therapy of Holocaust survivors. International Journal of Psychoanalysis 90, 1373–1391.

Person, E.S. & Klar, H. (1994). Establishing Trauma: The Difficulty Distinguishing Between Memories and Fantasies. Journal of the American Psychoanalytic Association 42, 1055-1081.

Rachman, A.W., Yard, M.A. and Kennedy, R.E. (2009), Noninterpretative measures in the analysis of trauma. Psychoanalytic Psychology 26, 259–273.

Raphling, D. (1990). Technical issues of the opening phase. In H. Levine (Ed.) Adult analysis and childhood sexual abuse (pp. 45-64). Hillsdale, NJ: The Analytic Press.

Rauch, S.L., van der Kolk, B.A., Fisler, R.E., Alpert, N.M., Orr, S.P., Savane, C.R., Fischman, A.J., Jenike, M.A., Pitman, R.K. (1996). A sympton provocation study of post-traumatic stress disorder using Positron Tomography and script-driven imagery. Behavioural Neuroscience 105, 817-825.

Rosenblum, R. (2009). Postponing trauma: The dangers of telling. International Journal of Psychoanalysis 90, 1319–1340.

Slade, A. (1994). Making meaning and making believe: their role in the clinical process. In Slade A, Wolff D (Eds.) Children at Play (pp. 81–107). New York, Oxford University Press.

Solms, M., Turnbull, O. (2002). The brain and the inner world. New York: Other Books.

Stern, D.N., Sander, L.W., Nahum, J.P., Harrison, A.M., Lyons-Ruth, K., Morgan, A.C., Bruschweilerstern, N. and Tronick, E.Z. (1998). Non-Interpretive Mechanisms in Psychoanalytic Therapy: The ‘Something More’ Than Interpretation. International Journal of Psychoanalysis 79, 903-921.

Terr, L.C. (1989). Treating psychic trauma in children: A preliminary discussion. Journal of Traumatic Stress 2, 3–20.

Trowell, J., Kolvin, I., Weeramanthri, T. et al. (2002). Psychotherapy for sexually abused girls: psychopathological outcome findings and patterns of findings change. British Journal of Psychiatry 180, 234 -247.

Winnicott, D.W. (1974). Fear of Breakdown. International Journal of Psychoanalysis 1, 103-107.

Yanof, J. (2005). Technique in Child Analysis. In E.S. Person, A.M. Cooper, G.O. Gabbard (Eds.) Textbook of Psychoanalysis. Washington, DC: American Psychiatric Publishing.




DOI: http://dx.doi.org/10.12869/TM2013-2-02

Refbacks

  • There are currently no refbacks.


ISSN 2282-0043 - Registered at the Court of Rome on Nov. 8, 2012, no. 305/2012

All articles are © Europa Ricerca Onlus