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In 1933 Sandor Ferenczi wrote the article, “Confusion of Tongues Between Adults and the Child: The Language of Tenderness and Passion.” In this article he challenged Freud and the existing notions regarding neurosis and childhood. He clearly stated his belief in the widespread occurrence of abuse and incest in families, even those of the middle and upper classes. He wrote that traumatic factors in the pathogenesis of neurosis have been unjustly neglected in the recent years. “I obtained corroborative evidence for my supposition that the trauma, especially the sexual trauma, as the pathogenic factor in neurosis cannot be valued highly enough” (Ferenczi, 1933). He went on to describe and outline the various symptoms exhibited in adult patients who have undergone this form of abuse. In this paper he ceased his support of Freud's shift in focus from trauma to fantasy, and established his belief in the effects of real childhood experiences on development.
Karen Horney did not write directly about childhood sexual abuse. Her theory, though, clearly reflects her belief that childhood experiences have a major impact on the development of the personality, character structure, and potential neurosis. In The Neurotic Personality of Our Time, (1937), she departed from the drive defense theory to a point of view that placed primary emphasis on early interpersonal relationships. She outlined characteristics in childhood that contribute to the development of neurosis. These characteristics include the parents' lack of genuine warmth and affection for the child and insufficient attention to the child's needs. According to Horney, neurosis arises not from any particular frustration of pleasure seeking or sexual desire, but rather from failures in the empathic matrix of the child's early development. With this profound and powerful statement,