Working in the Space between Psychoanalytic and Trauma Oriented Approaches to Stories of Abuse

A psychoanalytic practitioner who is sensitive to the special needs of trauma survivors must come to terms with two potentially conflicting modes of listening to and responding to stories of childhood sexual abuse, the psychoanalytic and the trauma oriented mode. To neglect psychoanalytic listening risks foreclosing the space for analytic work. To neglect trauma oriented listening risks minimizing the actuality of trauma and oppression, rupturing the empathic tie to the survivor, and foreclosing the full intensity of traumatic memory from the therapeutic situation. Several concepts from contemporary psychoanalytic theory can help a therapist to tolerate the contradictions between these perspectives. The ideas that flexible movement among the Kleinian psychic positions is preferable to “valorizing” the depressive position alone, and that engagement in enactment is universal and inevitable, can help the therapist to accept the need for temporary excursions out of the symbolic realm and into the realm of concreteness and action. Relational redefinitions of analytic abstinence and neutrality also allow the psychoanalytic therapist to reconcile validation of a trauma story with loyalty to these classic concepts. Contemporary psychoanalytic thinking, in synchrony with similar trends in current feminist thinking, allows a psychoanalytic therapist to vary her technique without sacrificing her sense of theoretical coherence.