Adult Psychic Trauma: The Question of Early Predisposition and Some Detailed Mechanisms

I propose to examine whether—contrary to what is believed by many—there is evidence for the existence of predispositions and vulnerabilities for an acute traumatic neurosis of the adult that lead back to childhood experiences and patterns. I see these mainly as stemming from the nature of early object relationships, which has concise and perhaps irreversible repercussions on the feelings about the self. To illustrate this I shall use my experience—direct and indirect—with persons suffering from different types of adult traumatic neuroses, and will draw on the literature concerned with adult reactions to a variety of traumata. In addition, I would like to suggest that we view the adult traumatic neuroses on a continuum with other psychic disturbances, so that they can serve as a paradigm for understanding similar aspects and processes in other psychological events, both of the adult and of the child.

As happens so often, my own concern with this topic has to do with my personal life experience. Yet I feel it is important to state that I have not personally experienced a shock trauma; nor have I been a victim of the Nazi holocaust of World War II, nor reacted to battle situations or to disaster with traumatic reactions. I have, however, been a partner to the denial of the impact of both such traumata; the psychological influence of the holocaust was not seen by me, as by others, until many years later. Similarly, though I treated combat reactions in the Israel War of Independence in 1948–49, all of us at that time succeeded in maintaining much professional distance from our soldier patients, and thus shared their experiences only very partially. On the other hand, I have lived for 40 years in a country beset with wars and with sporadic violence. I have learnt to make less use of the mechanism of denial over the years, and have therefore been able to concern myself gradually more with the psychological effects of a possible