Chapter 19 Restoring Complexity To the Subjective Worlds of Profound Abuse Survivors

When persons are profoundly abused, aspects of their inner ability to experience and develop become hidden. Sometimes these abilities are irretrievably lost, and no amount of therapy can recover them. Other times fragments remain, protected from further abuse. This chapter outlines a therapeutic method that searches for and recovers these hidden abilities, thus reclaiming aspects of relatedness and growth for those who have been profoundly abused.

Central to the therapeutic method developed here is the concept of detailing. Detailing in this chapter is a description of an aspect of therapist activity suggested by Stolorow and Atwood's (1992) self-delineating selfobject function, by Kohut's (1971) mirroring selfobject function, and by Stern's (1985) infant research. Detailing is a form of therapeutic attunement that helps to “lift the patient's affective experience to higher levels of organization by facilitating its articulation in verbal symbols—an example of what we have termed the self-delineating self object function” (Stolorow and Atwood, 1992, p. 49). The purpose of detailing is to increase the patient's “sense of the real primarily … through the validating attunement of the caregiving surround, an attunement provided across a whole spectrum of affectively intense, positive and negative experiences” (Stolorow and Atwood, 1992, p. 27). An attempt is made to exemplify what attunement might sound like where patients have been traumatically silenced. Detailing builds on concepts from