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This book presents an object-relations theory of childhood sexual traumatisation based on the author's clinical experience with sexually abused and neglected boys. He takes issue with the traditional psychoanalytic approach to borderline patients and individuals with severe personality disorders for failing to acknowledge the importance of traumatic childhood experiences of abuse and neglect in generating their psychopathology. Prior traces the contributions of various analysts working with borderline children and adults. He credits Mahler for introducing the concept of trauma caused by aberrant mothering during the rapprochement period as a precursor of borderline psychopathology. He also cites the work of Rinsley in describing the impact of this early trauma on the dynamics of disturbed children, e.g. lack of object constancy, excessive splitting, inadequate defensive structures, stunted ego development, confusion between self and others and the presence of unmetabolised part-object representations and unintegrated, primitive affects. Prior suggests, however, that the major focus on the rapprochement period as the source of traumatogenesis is unnecessarily limiting.
In reviewing the contributions of traditional object-relations theory to the understanding of adult borderlines, Prior criticises Kernberg and Pine for overemphasising the importance of innate constitutional factors contributing to an intensification of drive activity and ego deficits in the genesis of borderline psychopathology, while overlooking the role of external trauma.
The author perceives a recent shift in the reconceptualising of psychopathology in the light of an increased understanding of childhood trauma occurring in abused children. The role of child maltreatment has become increasingly recognised as a factor contributing to borderline personality disorder and PTSD by clinicians working directly with abused children (Terr, Goodwin, Finkelhor) and with adult survivors of parental physical and