Descending the Therapeutic Slopes—Slippery, Slipperier, Slipperiest: Commentary on Papers by Barbara Pizer and by Glen O. Gabbard

Over the past 10 years, i have spent a good deal of my professional life writing and speaking about the long-term effects of childhood sexual abuse; what constitutes psychological trauma; and which part of the experience so pervades and controts future psychological functioning and so undermines the development of positive, nurturing interpersonal relationships. In the course of this work, I have become convinced that the most devastating aspect of childhood abuse, particularly parental abuse, is not the physical overstimulation or the fantasied elaborations of these actual events (though these are of great significance). I have come to believe that the most singularly devastating aspect of childhood abuse is the violent penetration and coopting of mind that occurs when one is emotionally and physically dependent on another who violates and exploits—when, due to the simultaneously dependent and exploitive aspects, one person in a dyad is granted the authority to control and define the other's reality, even when that definition of reality exists in stark contrast to the person's actual lived experience. This severing of