Interrupting the reenactment cycle: psychotherapy of a sexually traumatized boy

This case study describes the course in psychotherapy of an eight-year-old boy who had been sexually traumatized at an early age by his biological father. He was seen for 35 individual sessions during a three-month hospitalization. Many of the problems evidenced at admission were conceptualized as ineffective attempts to reenact and master the original trauma. Hospitalization provided an environment in which acting-out behaviors could be controlled in a manner sufficient to allow anxiety to be utilized in psychodynamically oriented therapy. A key element in psychotherapeutic work was the recognition that the boy struggled with positive as well as negative feelings toward his abusing father. Individual therapy provided a context in which these ambivalent feelings could be expressed, which ultimately allowed for developmental progression.