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Clearly recognized by researchers in the field as one of the major long-term sequelae of childhood trauma, discussion of the process of dissociation remains embedded in the classical psychoanalytic literature and is not often referred to in contemporary psychoanalytic writing. This article attempts to update the definition of dissociation in accordance with contemporary research on traumatic stress and posttraumatic stress disorders and to demonstrate the manifestations and impact of dissociative phenomena in the psychoanalytic treatment of adult survivors of childhood sexual abuse. Several points are emphasized: (1) treatment of the adult survivor of childhood sexual abuse involves recognition of the simultaneous coexistence and alternation of multiple (at least two) levels of ego organization; (2) at least one level represents, in split-off form, the entire system of self- and object representation, including unavailable, affectively loaded memories and fantasied elaborations and distortions originating in the traumatogenic abusive situation; and (3) there is present a kaleidoscopic transference-countertransference
Dr. Davies is Adjunct Associate Professor of Psychology, Derner Institute, Adelphi University, and Adjunct Faculty, Teachers College, Columbia University. She is also a supervisor at the Center for the Study and Treatment of Abuse and Incest, Manhattan Institute for Psychoanalysis.
Dr. Frawley is Adjunct Assistant Professor of Psychology, Derner Institute, Adelphi University. She is also Clinical Psychologist, Incest and Sexual Abuse Recovery Affiliates.
© 1992 The Analytic Press
picture that shifts illusively but can often be understood as based on the projective-introjective volleying of a fantasized victim, abuser, and idealized, omnipotent savior.