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In this chapter I shall discuss Sandler’s concept of the background of safety and suggest its applicability to clinical theory and technique when practising psychoanalysis with patients who have experienced man-made disasters or extreme social violence, such as war. Freud began to be concerned about the effects of war during and after World War I. In 1915 he wrote:
It [war] tramples in blind fury on all that comes in its way, as though there were to be no future and no peace among men after it is over. It cuts all the common bonds between the contending peoples, and threatens to leave behind a legacy of embitterment that will make any renewal of those bonds impossible for a long time to come.
The fury and embitterment that Freud was concerned about have continued throughout this century; the power of these destructive forces has appeared repetitively and unequivocally both in the individual and in society.
It is difficult to speak about war from a purely theoretical point of view without relating to its concrete reality and manifestations. It is also difficult for psychoanalysis, which focuses primarily on the internal world, to function in a context of violence and war. The technical difficulties involved in continuing psychoanalysis during extreme external circumstances will also be discussed in this chapter.
Today more than ever before, we find ourselves treating more and more patients with disorders that turn out to be linked to a background of trauma due to social violence. Where and how does the social violence that occurs in reality show itself in the clinical material? This question is particularly relevant today when many treatments are taking place in countries where war and social violence are occurring at the same time. In fact, we are faced with a series of questions: how has social violence affected the mind? Can we apply the same theory of personality development in treating people who in childhood and adolescence experienced terrible tra