Chapter 7

The author describes an experiment he conducted at the Children’s Clinic in the Massachusetts Mental Health Center. He would show photographs cut from magazines to the abused children and ask them to tell stories based on the pictures. The children told frightening stories with gruesome endings based on neutral images. For instance, a picture of a man repairing his car watched by his two children became a narrative of the little girl in the photograph smashing in her father’s head with a hammer. A control group of children who had not been abused told more benign stories, with happy endings.

It is through the experience of being cared for by their parents that children learn to take care of themselves as they grow up. The psychiatrist John Bowlby describes childhood attachment as “the secure base from which a child moves out into the world.” When mothers care for their babies, the babies become attuned to the movements and speech of their mothers. The traumatized children in the clinic had not experienced this attachment or attunement, leaving them isolated and withdrawn.

Children who do not form secure bonds with their parents develop coping strategies, pretending not to care or drawing attention to themselves by continual crying and screaming. Abused or traumatized children, whose caregivers are themselves a source of distress, develop a pattern called “disorganized attachment,” in which they may become physically immobile, seek intimacy with strangers, or trust nobody. These children continue to have difficulties with their emotional responses as they grow to adulthood. Karlen Lyons-Ruth conducted studies at Harvard which showed that children who exhibited patterns of disorganized attachment were likely to behave in various self-destructive ways eighteen years later. These included substance abuse, binge eating, promiscuous sex, and suicidal behavior.

The author concludes with the observation that children who are not “in sync” with their parents grow up to be dissociated from themselves and those around them. This process can be reversed, and he has worked with his colleagues at the Trauma Center (which the author founded in 1982) to develop programs which build attachment and attunement.

Chapter 8

The author begins this chapter with the story of a patient named Marilyn. Marilyn seldom had relationships with men, and when she did begin such a relationship, she would soon find herself violently attacking and abusing her new partner without understanding why. She told the author that she often felt numb, as though she was merely going through the motions of her life. She remembered little of her childhood but said she thought it “must have” been happy.

The author believed that Marilyn was displaying the psychological symptoms of childhood incest. However, the symptoms were not only psychological but physical. Marilyn found that her eyesight was deteriorating, and she had several falls. Physicians at the Massachusetts Eye and Ear Infirmary diagnosed lupus erythematosus, an autoimmune disease affecting her retina. She was the third person that year in whom the author had suspected a history of incest and who had turned out to be suffering from an autoimmune disease.

Marilyn’s psychological and physical symptoms were typical of an abused and traumatized child. The foundations of self-worth are laid in childhood. Parents tell their children that they are beautiful, special, and valued, and the children internalize these views. If, later in life, they have abusive partners, they react to the abuse with anger and indignation, knowing that they do not deserve it. However, victims of childhood trauma and abuse are likely to believe that they deserve more abuse as adults. Merely telling them that they ought not to feel...