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Stein, H.H. (1986). Meeting of the Psychoanalytic Association of New York. Psychoanal Q., 55:374-376.

(1986). Psychoanalytic Quarterly, 55:374-376

Meeting of the Psychoanalytic Association of New York

Herbert H. Stein

February 25, 1985. THE RECONSTRUCTION OF TRAUMA IN A CHILD WITH ACTUAL SEDUCTION AND PHYSICAL INJURY. (Melitta Sperling Memorial Lecture.) Robert D. Gillman, M.D.

Dr. Gillman presented material from the case of a boy who had suffered two major traumas by the time he came for analysis at six and a half years. He had been seduced into mutual fellatio by a teenage cousin at age four and a half and had been seriously burned while playing with fire at five and a half. Dr. Gillman stressed the importance of reconstruction in treating a traumatized child. Prominent fantasies from the developmental period in which the trauma occurred merge with the traumatic event and are reinforced by the reality of the trauma and the ego regression that accompanies it. Reconstruction is a valuable tool in integrating the trauma and its attendant fantasies into the maturing psyche. Attempts to master the trauma or to escape from the memory of it may lead to several pathological outcomes: object relationships that recreate or reverse the traumatic relationship; characterological defenses such as identification with the aggressor; or phobic avoidance of situations that might trigger recall of the trauma. Reconstruction, by bringing the trauma into focus, may help the child to relinquish these defenses so that healthier development can proceed.

Dr. Gillman's patient, M., was an adopted child whose mother showed some ambivalence about her ability to care for him. When he was three and a half, on an ocean voyage he became fearful that he would be thrown overboard because he was kept in a life jacket for picture-taking after a safety drill. Separation anxiety subsequently became a problem. He underwent a tonsillectomy at four years, and shortly afterward, the teenage cousin seduced him into mutual fellatio. A few days after he told his parents about the fellatio, they allowed him to take an overnight train ride with the cousin. At five and a half years he was severely burned in a fire he had started by playing with matches. He had begun playing with matches at four and a half, prompting his mother to teach him their proper use. In addition, M. had been

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