The Effect of Childhood Sexual Abuse on Transference and Therapeutic Alliance: A Case Presentation

This case presentation is of a man whose transference reactions at every level from primordial to mature were obscured and made extremely difficult to analyze because of the strength gained by his negative oedipal reactions in response to extended sexual abuse by his father, beginning as far back as he could remember and extending into his late teen years. As these negative oedipal aspects were analyzed in the transference, it became possible for him to understand the tenacity of their hold over him, in preference to the reexperiencing in the transference of any maternal relationship, including Stone's primordial “symbolic reunion with the mother” (1967, p. 9). His resistance to maternal transferences was occasioned mostly by his trauma-induced intense negative oedipal transferences, but in addition there were traumas associated with his mother which came to light in analysis. Through a study of Stone's works (e.g., 1967) I took heart in my belief that I could infer the underlying presence of the primordial transference by his avoidance of all transference reactions toward me as his mother. But before this patient could experience such early maternal transferences, much work was necessary in order for him to understand his defensive substitutions. The situation resembled that described by Stone:

The striving, in short, is to establish at least symbolic bodily reunion with the mother. Further, the striving is to substitute this relationship for the kaleidoscopic system of relationships which have, in good part and inevitably, replaced it. To the extent that actual and concrete—later intrapsychic—barriers prohibit even part or derivative

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manifestations of this drive, in relation to the mother, requiring that in varying modes and degress, it be displaced to other individuals, sometimes even there undergoing secondary repression or otherwise warded off; this is a “transference” [1967, p. 9].

To be sure, maternal transferences were eventually engaged; they, too, became a