The author traces the structure, psychodynamics, and metapsychology of the traumatic reaction and illustrates these with facets of his study of longterm psychic damage caused by rape. He identifies the centrality of the traumatic introjection, which anchors certain aspects of the traumatic event as an “inner alien element” in the ego of the victim. This introjection, which cannot be assimilated, can alter the inner object world of the victim so basically that even fundamental psychic structures may subsequently be impaired or even destroyed. The consequences of these theoretical considerations for the therapeutic treatment of trauma victims are outlined and illustrated by a vignette of an analytic hour.