Object Relations Therapy of Physical and Sexual Trauma

Rising above the polemics surrounding sexual and physical abuse, David and Jill Savege Scharff bring a relational perspective to the integration of psychoanalytic and trauma theories in order to understand the effects of overwhelming physical and psychological trauma, including sexual abuse, injury, and birth defect. The Scharffs draw from their object relations therapy with individuals, families, and couples recovering from trauma and abundance of relevant clinical examples described in their characteristically personal and vivid style. Their treatment approach, influenced by Fairbairn, Klein, and Winnicott, is respectful of the patient's experience. They advise avoiding premature interpretations that impose their own reality on patients because this traumatizes them just as their abuser did. In order to work well with these traumatized people, the clinician must be able to tolerate ambiguity and sustain long term therapy, for it takes the patience of waiting and wondering to recover deeply repressed memories, explore them thoroughly, and evaluate their meaning and importance for the patient. The Scharffs' demonstration of clinical processes helps therapists contain their own countertransference to trauma so as to be fully present with their clients and consistently able to confront abuse patterns in society. The object relations approach not only deals with trauma's impact on the individual but views it in its cultural and interpersonal context as well. Society alternately emphasizes and ignores trauma so that an encapsulated traumatic experience festers until the next eruption, just as dissociative defenses segmentally protect and exaggerate traumatic experience in the individual case. The Scharffs review Kramer's Mahlerian approach, McDougall's insights into the silence of the psyche and the words of the soma, and Anzieu's elaboration of the body ego. They resuscitate Freud's seduction hypothesis and the traumatic basis of the repetition compulsion. They compare and contrast the concepts of re

By Jill Savege Scharff and David E. Scharff

A comprehensive synthesis of past and present theory with pragmatic clinical approaches to traumatized patients. Integrating an historical perspective on the conceptual and political issues of sexual and physical abuse, together with a very candid, self-observing commentary on their own reactions, the authors richly contextualize their therapeutic interventions and countertransference. Salient treatment dilemmas and contentious sociopolitical issues such as "false memories" are examined in an open and thoughtful fashion. An important source of ideas and inspiration for psychotherapists working in this area. -- Frank W. Putnam, M.D., Chief, Dissociative Disorders Group, National Institute of Mental Health Object Relations Therapy of Physical and Sexual Trauma is a timely and impressive examination of the causes, effects, and therapeutic solutions to trauma. The Scharffs examine the psychoanalytic literature on trauma with meticulous attention and present the psychanalytic view in a lucid and fair-minded manner, all the more impressive given the emotionally intoxicating effect of the subject matter in contemporary America. Their own understanding of trauma and its treatment is presented through the moving accounts of the patients they have treated, giving this book a unique quality: somewhere between Havelock Ellis and Dickens. Not all will agree with their point of view, but if one book could embrace a topic as complex as that of trauma, it is hard to imagine a more lucid, moving, and generous presentation. -- Christopher Bollas, Ph.D., British Psycho-Analytical Society