(2013). Attachment: New Directions in Psychotherapy and Relational Psychoanalysis, 7(2):125-147
victims of sexual abuse face in the of discovery. Their attempts to reconcile their private experiences with the realities of the outer world are assaulted by the disbelief, blame, and rejection they experience from adults. The normal coping behaviour of the contradicts the entrenched beliefs and expectations typically held by adults, stigmatising the with charges of lying, manipulating, or imagining from parents, courts, and clinicians. Such abandonment by the very adults most crucial to the 's protection and recovery drives the deeper into self-blame, self-hate, , and revictimisation. In contrast, the advocacy of an empathic clinician within a supportive treatment network can provide vital credibility and endorsement for the .
Evaluation of the responses of normal children to sexual assault provides clear evidence that societal definitions of “normal” victim behaviour are inappropriate and procrustean, serving adults as mythic insulators against the 's pain. Within this climate of prejudice, the sequential survival options available to the victim further alienate the from any hope of outside credibility or acceptance. Ironically, the 's inevitable choice of the “wrong” options reinforces and perpetuates the prejudicial myths.
The most typical reactions of children are classified in this paper as the sexual abuse accommodation syndrome. The syndrome is composed of five categories, of which two define basic vulnerability and three are sequentially contingent on sexual assault: (1) secrecy, (2) , (3) entrapment and accommodation, (4) delayed, unconvincing disclosure, and (5) retraction. The accommodation syndrome is proposed as a simple and logical model for use by clinicians to improve understanding and acceptance of the 's in the and controversial dynamics of sexual victimisation. Application of the syndrome tends to challenge entrenched myths and prejudice, providing credibility and advocacy for the within the home, the courts, and throughout the treatment process.
The paper also provides discussion of the 's coping strategies as analogues for subsequent behavioural and psychological problems, including implications for specific modalities of treatment.