ABSTRACT
The clinical material reported in the three preceding chapters shows clearly that the psychotic disturbances suffered by the three patients were linked to traumatic experiences to which they had been subjected. The three patients had either been sexually abused or had witnessed such abuse. In the present notes we will consider how sexual abuse was reflected in the patients’ inner world and how it profoundly affected their mental functioning. We will see that these traumatic experiences led to the internalisation of extremely bad figures and to the domination of their mental world by sadomasochistic phantasies, and in particular by phantasies of intrusion. Their defences against mental pain had developed to an extreme degree, leading to psychotic states. A further pathogenic factor in these girls’ development was that before the abuse they had received little emotional containment.
