[Psychoanalytic therapy of sexually abused adolescents]

Abstract

Sexual abuse as an extreme childhood trauma produces distorted object-images, introjects of violence which reproduce the trauma permanently through symptoms and acting-out. Although the traumatic power should be relived in transference, psychoanalytic therapy does not always mean permanent interpretation of transference, rather supporting, confirming, valuing activity is indicated. The following scopes can be differentiated: idealization, changing the therapeutic object into a triangulating one; negative transference of an archaic destructive mother imago, nevertheless also of the traumatic object, setting free hidden aggressive affects; emerging of the specific sexual trauma in transference and counter-transference. In the whole course of therapy, especially at the end, working through of guilt-feelings, shame and mourning permits the separation from the traumatic objects, although the danger of returning to them, often represented by the real actual objects, does not guarantee a full success in all cases.