Treating the sequelae of chronic childhood emotional abandonment

Chronic emotional abandonment is traumatic for children, and often leads them to identify with the aggressor (IWA)-in order to hold onto their needed attachment to their parents, they feel, think, and do what their parents require, blame themselves for being abused and for their family's unhappiness, and feel ashamed. IWA often persists as a general tendency. Treatment requires therapists' dependability, attunement, empathy, interest, humility, and perhaps playfulness. Patients' history of abandonment should be explored in detail, though patients may be protective of their parents. Therapists should explore their own behavior if necessary, and acknowledge lapses; normalize and explore patients' shame; and avoid trying to "rescue" patients. Patients must be helped to re-find authority and agency over their own lives, and mourn their early loss of feeling "the right to a life." The treatment of "Claire," a 40-something child of two depressed parents, illustrates some of these points.