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Entering the tumultuous, dissociated world of the adult survivor of childhood sexual abuse presents an intimidating challenge for clinicians. But as the authors of this innovative book argue, therapists must be willing and able to work within the powerful and rapidly shifting relational paradigms of transference and countertransference commonly found in treatment of these patients. Such dual roles enacted in treatment include the unseeing, uninvolved parent and the unseen, neglected child; the sadistic abuser and the helpless, enraged victim; the idealized rescuer and the entitled child; and the seducer and the seduced.This is the first model for treatment of adult survivors of childhood sexual abuse that takes advantage of a relational approach and that integrates psychoanalytic thinking with the latest findings from the literature on psychological trauma and sexual abuse. Diverging from a more classical perspective, the authors view dissociation as the means by which a person adapts to and expresses traumatogenic material and by which such patients defend against traumatic memories, affects, and fantasy elaborations emerging into consciousness. The authors also detail how dissociation helps organize the patient's personality and presentation of self.Richly illustrated case examples bring to life the authors’ treatment model and show how clinicians can work through the relational paradigms between patient and therapist and, ultimately, reach the core of the patient’s deeply buried experiences of self and other.

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