R ecently, I was teaching a course on trauma and psychoanalysis to advanced candidates at an analytic institute. I asked the candidates if they could offer examples from their own practices to illustrate cases of adults who had been traumatized in childhood and cases of adults who had been traumatized as adults. Each of them readily volunteered examples of adult patients who had suffered physical, sexual, or emotional abuse as children. Much of the time, the abuse in question was cumulative and consistent. There were also examples of sudden and horrifying violations of the trust between a caretaker and child. Others offered cases of striking emotional neglect, rather than active abuse. These are the painful and familiar narratives that we construct with pa-
tients daily, if not hourly, in the course of our professional lives. But, when I asked about examples of catastrophic stress in adulthood, there was silence. No one even asked me what I meant.