ABSTRACT
Psychoanalytic clinicians tend to aim beyond simple reductions in symptom counts, towards more abstract, and harder to measure, goals such as resolution of conflict, insight, self-understanding, self-acceptance, personality change, integration, psychic maturity. In one of the few randomized studies of psychoanalytic psychotherapy for sexually abused children, seventy-five sexually abused girls were randomized to receive either combined psychotherapeutic and psycho-educational group therapy complemented by supportive work with the carers, or individual psychoanalytic psychotherapy complemented by supportive work with carers. Patients in psychoanalytic psychotherapy and psychoanalysis who have experienced incestuous abuse might find silences particularly discomforting, interpretations might be experienced as intrusive, and exploration of the patients’ thoughts and fantasies might be felt to be seductive. The psychoanalytic psychotherapist might need to help the patient to put these experiences into words as soon as possible to avoid the patient being overwhelmed with claustrophobic anxiety and panic.
