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Trauma has long been considered to be important in the instigation of neurosis and other mental disorders, and the maltreatment of children offers some of the clearest examples of the damaging effects of traumatic events occurring in the earliest, formative years of life. Trauma is described as the flooding of the psychic apparatus by stimuli in excess of its ability to cope. Thus there are always two elements and the balance between them to be considered. On the one hand, there is the amount of stimulation and on the other the protection against the excessive stimulation. Freud (1920, pp. 27-31) described the latter as a “protective shield,” and described as “traumatic any excitations from outside which are powerful enough to break through the protective shield.” More recently, this protective function in infancy has been described as a “stimulus barrier,” and in older children and adults we have tended to consider it an ego function, an expression of “ego strength,” which has been acquired during development through interactions with protective care givers.
In physical abuse, there is obviously an increase in the amount of stimulation coming from the body's surface and impinging on the psychic apparatus, although the intensity, duration, and frequency of the abuse can be extremely varied, and the type of abuse can range from bruises, lacerations, and burns to fractures (we are