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The underreporting of childhood traumatic etiology of the later onset chronic posttraumatic stress disorder (PTSD) of our present day Diagnostic and Statistical Manual of Mental Disorders (DSM IV: APA 1994) has complex societal-cultural, as well as unconscious, reasons, complexities of which are written already into the original Ferenczi’s concept of Identification with the Aggressor, as corroborated by the contemporary dynamic developmental neuroscience. Ferenczi’s is the pathogenic sequence (unlike Anna Freud’s later concept of the same name) resulting in the Identification with the Aggressor including the Confusion of Tongues between the adult abuser and the abused child, which results in a layered configuration of posttraumatic identifications of the Wise Child and the Identification with the Aggressor. The clinical vignette illustrates the dynamic complexity of the overall Identification with the Aggressor, with the Confusion of Tongues acquiring additional internalized form through perceptual–affective cross-modal (con)fusion: while looking in the mirror, the patient saw part of his face missing. The technical armamentarium of a flexible interpsychic/intropsychic model of psychoanalytic work with enactments is employed and illustrated in detail as a contemporary equivalent of Ferenczi’s active elastic psychoanalytic technique.