Taping Together Broken Bones: Treatment of the Trauma of Infant Physical and Sexual Abuse

To explore the ways in which the particular traumas of infant physical and sexual abuse affect early development, this paper presents the long-term treatment of a child physically and sexually abused at age 4 months.

Clinical and empirical literatures are outlined and synthesized in order to elucidate the particular nature of preverbal trauma. Three specific orienting concepts from the literature that were particularly useful in the treatment of preverbal abuse are discussed: 1) Neurobiological sequelae of physical and sexual abuse in infancy and the implication of specific trauma for emotional and relational development, 2) Trauma symptoms and conceptualizations of PTSD specific to early childhood, and 3) Somatic expression and representations of trauma in child behavior and play.

Clinical conceptualization of the nature of early play, and the meaning of repetitive play observed in children who have undergone early abuse, are briefly discussed and applied to the case material. The symptoms expressed by the child and the course of the play therapy treatment are considered as ways in which to understand the somatic, behavioral, and emotional, expression of the abuse.