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We often say in a diagnostic meeting that a child is ‘traumatized’. We are usually talking about some quality of behaviour—ranging from excessive anxiety to withdrawal, against the background of what we objectively consider to be a potentially traumatic event, e.g. hospitalization, seduction or parental pathology. At the same time, we are all aware that psychic trauma cannot be defined objectively, only intra-psychically. Only the child himself can tell us whether he experienced a particular event as traumatic, or what aspects of a situation were the traumatic ones, material which is often not available at the diagnostic stage.
We make use, therefore, of the child's reactions: such signs as severe fixation and compulsive repetitious behaviour, marked distortion or defect in some area of ego functioning, serious regression or developmental delay in object relationships, or persistent high anxiety. But such signs in themselves do not differentiate trauma from other sorts of psychic stress and strain; in any case we can only know the specific psychic significance of the trauma from the individual himself.
Sydney Furst's (1967a) book clarified the issues and problems in the concept of trauma, and Jules Glenn (1984a) has tackled some theoretical issues. We have selected cases which illustrate clinical problems of identifying and understanding trauma, and technical problems of helping the child to deal with the trauma by analytic means; and we hope these cases will facilitate discussion of theoretical issues.
Limitation of time forces us to exclude many interesting issues including the various forms of child abuse which raise delicate problems of practical intervention as well as problems of analytic technique. We have, moreover, illustrated only pathological reactions, not those where trauma is followed by a developmental spurt, precocious ego development or character formation within the range of normality. Our cases include examples of classical traumatic situations, and