Psychic Trauma and Traumatic Neurosis

In the introduction to a clinical example of a young boy with a traumatic neurosis, this paper reviews the phenomena of psychic trauma. Freud's contribution to the initial description of the phenomena is discussed with consideration of such factors as the “stimulus barrier”, breaks in this “protective shield” and the development of a “traumatic neurosis”. The elaboration of these concepts is followed in their later development in the literature. The clinical example presented by the author is a description of the assessment and treatment of a four-year-old boy who had been mauled by a leopard in a suburban pet store. The presenting complaints at the time of assessment were numerous and of precise onset to the time of the mauling. The boy exhibited disturbance in sleep, clinging, fearful, apprehensive behaviour and marked separation anxiety. All such symptoms appeared as a marked regression in the boy's formerly normal development. The child's course in play therapy is detailed. This highlighted the existence of a number of intrapsychic conflicts involving anger, guilt and the fear of retaliation. The fact that such conflicts predated the traumatic event is postulated to be a determinant of the traumatic process.