Object Relations Therapy of Physical and Sexual Trauma by Jill S. Scharff and David E. Scharff. Published by  Jason Aronson, Northvale, NJ, 1994;  390 pages; $47.50. Remembering, Repeating and Working through Childhood Trauma: The Psychodynamics of Recovered Memories, Multiple Personality, Ritual Abuse, Incest, Molest, And Abduction by Lawrence E. Hedges. Published by  Jason Aronson, Northvale, NJ, 1994;  352 pages; $40.00. Adult Survivors of Childhood Emotional, Physical and Sexual Abuse: Dynamics and Treatment by Francisco G. Cruz and Laura Essen. Published by  Jason Aronson, Northvale, NJ, 1994;  230 pages; $30.00.

As the Scharffs comment in the concluding paragraph to their book, ‘100 years ago, patients whose impairment was due to sexual trauma were the inspiration for Freud's invention of psychoanalysis’ but, as his interests changed, the field moved from the study of trauma and dissociation to intrapsychic conflict, neurosis and repression. As a result, ‘in this long interval we did not advance our knowledge about actually traumatized patients and consequently had less to offer them than we might have’. Surely so! Indeed much of the recent understanding of the long-term consequences of childhood trauma has developed outside the main psychoanalytic traditions, having been inspired partly by the appreciation of post-traumatic stress disorder in veterans of the Vietnam war; in the late 1980s, clinicians began to realize that the symptoms of people with borderline and other severe personality disorders could in many ways be understood as manifestations of long-term PTSD. These books go some way to reclaiming the ground and restoring the balance that psychoanalysis had lost during most of this century.

Working with the effects of childhood trauma is deeply disturbing. Both therapist and writer become traumatized. The Scharffs comment in their introduction:

As writers we procrastinated, studied anything else and wrote other books first, because recording our countertransference reawakened the memory of our reception of the patient's trauma. As therapists, and then as writers, we have felt nauseated, anguished, frightened, guilty and helpless.

Having identified and overcome their resistance, the Scharffs have managed to write a truly excellent book, commendable particularly for its breadth and balance. Drawing on their extensive previously published work, the authors give particular emphasis to the relevance of Fairbairn whose thinking was always more attuned than most of his analytic colleagues to the impact of childhood trauma. If one book were to be chosen as a foundation text fo