ABSTRACT
In the late 1970s and early 1980s, the occurrence of childhood sexual abuse began to be widely recognised. Childhood sexual abuse can be seen as the abusing adult's "madness" being forced into the mind of the child, and it penetrates deep into the unconscious: the child's mind is "raped". The abusive experience was extensive and early childhood experiences were not good enough, then the split-off, denied abusive experiences seem almost to take over the whole person, leaving very little mental or emotional energy available for current life. Post-traumatic stress disorder can follow abuse; it is partly a means of managing the unbearable thoughts and feelings but also, if there is frequent re-experiencing, seems to fixate the experience. Understanding the intra-psychic phantasies and ways of dealing with the overwhelming experiences with current psychoanalytic ideas enable the individual to be helped with psychoanalytic psychotherapy and psychoanalytically informed case management.
