English Abstract

Love and Survival: On Infantile Sexuality and Sexual Abuse

How can the therapeutic work which starts with psychoanalytic theory be communicated beyond its own context? It is essential that psychoanalysis does not simply revolve around its own closed truths, but also that it takes an active part in the exchange and development of knowledge taking place outside the analytical community. It is precisely by opening the analytical room and making its practice accessible and visible that psychoanalysis can learn from an objectivity-seeking scientific enterprise, not with the same aim of seeking objectivity, but in order to explicate the criteria that are the foundation of scientific work (Stengers 2001).

It is not required of psychoanalytic theory and practice - not least the exchange that takes place between the theoretical and clinical work – that it live up to a positivistic or objectivistic definition of reality and knowledge. It is, however, critical that psychoanalytic work explicates the premises for its statement that the object of its scientific investigation is precisely the breaks, gaps, conflicts and paradoxes in relationships between people, not least the absence of meaning in these relationships. Scientific work is thus about making open propositions, that is to say, that that which establishes the premises for the scientific enterprise is open and accessible to others to examine and thus participate in.

When the concept of the unconscious, of drives and fantasies become black boxes, when the pivotal point for the psychoanalytic work becomes indisputable, then we can no longer think of this work as scientific. It is essential that the premises upon which the psychoanalytic work is based are presented, as it is these very premises that create the object of examination. The premises must be organized, and not until then can the object find expression within the framework in which it is produced (Stengers 2001).

To practise psychoanalytic theory is to close the gaps and the breaks with new hypotheses and to question the answers concerning the formation and the development of the psyche that have been given so far. Clinical research with its interaction between theory and experience which both takes place and is created in the therapeutic relation, can further develop the theory and thus its object too. We must examine why we pose the questions we do to our object. And we must examine why the subject asks the specific questions it does in its approaches to us as objects. Why does the child ask the adult the specific questions it does? Why does the child approach us in that specific way? What does it enunciate about the child’s sexual trauma, and what does it say about sexual trauma in general and in the development in which the trauma resides?

In my therapeutic work with Jesper, Line, and Anton I was struck by the insistence with which their fantasies expressed themselves in their play. Something was at work in these fantasies. Both in the individual therapeutic sessions where the children worked hard to create coherence in the world they expressed in their relation to me, but also from session to session, where the same theme was repeated and worked through in the children’s indefatigable and at times seemingly unending attempts to create coherence and understand. The fantasies could both be moving, violent, funny, horrifying, strange and sometimes have a hallucinatory character; nevertheless these fantasies expressed a reality, which could seem almost too real to require explication and analysis and to be the object of research.

This work calls attention to a conflict about ethics and confidentiality; a conflict that is also concerned with issues of reliability and confidence. If we are to be reliable in our work, our work must be accessible to others. But if we are to maintain the confidence of our clients, what takes place between us and them has to be kept confidential. But no matter how intimate and private the unconscious fantasies may seem, I believe nevertheless that it is extremely important to open the analytical room. Psychoanalysis’ participation in the scientific community demands the opening up of clinical psychoanalytic practice as an object of research. This is important if psychoanalysis is not to live up to its reputation of being secluded and closed around its own and inaccessible truths. However, it is also important to demonstrate what in actual fact takes place in the therapeutic room, and the point that what takes place is reality for those subjects that express themselves here. Psychoanalysis should, therefore, not only be accessible to the scientific community, but also the communities of practice that exist around the problems which psychoanalysis deals with - in this case the practice community around children exposed to sexual abuse.

It requires something of psychoanalytic theory and practice simultaneously to be able to maintain and communicate the significance of the symbolic room where the unconscious expresses itself. In my work in the area of children and sexual abuse, I have often met expectations that the symbolic is equal to what is real or the actual. I have been expected to explain the symbolic reality which the children’s fantasies express in the therapeutic room and to relate to how the fantasies might directly reflect the abuse the children have been subjected to. It is very tempting to step into this reality and to remove all doubt once and for all, so that eventually we can discover the truth about what these children have been subjected to and let justice be done. Unfortunately there is no such direct connection between fantasy and reality. But nevertheless there is a connection which must be examined and analysed on the terms in which this connection is explicated, that is to say in the meeting between the child’s wish to understand what the adult’s approach means and in the child’s limited possibilities for doing this. What the children express is, and always will be, an expression of the children’s reality. We must remember this when we assess what is to be done with these complex cases and with the children, who are not only victims of sexual violation but also of a society which cannot contain the ambivalence and uncertainty which these children carry within.

My interest in the area of child sexual abuse has been borne by indignation that discussions about this subject often focus on children’s ability to tell the truth and on children’s ability to object. What truth one might ask? Object to what? In order to be able to tell the truth, the child must know what is right and what is wrong. In order to be able to object, the child must know what it is subjected to, let alone that it is subjected to something. In other words, the child must be able to make these distinctions, and the child must learn this from the adult or adults that take care of the child and see to its survival. It is the adult who must present the world to the child at a pace that is consistent with the child’s possibility of grasping this world and making it its own, in the same way that it is the adult who can prevent this development from taking place on the child’s terms. It is my wish in the work I have presented here to establish this assumption in the scientific and practice-orientated field around children subjected to sexual abuse, so that this premise can become an integral starting point in our work with these children. The child is at the mercy of adults because it cannot survive in the world without adults regardless of how the adults manage their powerful position in relation to the child.

In connection with my association with the Team for Sexually Abused Children at the Danish Teaching Hospital (“Rigshospitalet”), it became evident to me how difficult it is to clarify child sexual abuse cases by reference to a reality which we have defined based on sharp dualities between true and false, between objective “uncovering” and the subjective interpretation. When I followed and took part in the team’s work in assessing these cases, where the agenda often contained the expectation of establishing whether sexual abuse had taken place or not, I became aware of the difficulty of understanding such cases with reference to a rhetoric that merely distinguishes between whether something has or has not happened.

The area of child sexual abuse is extremely difficult to work with because it deals with children who have been exposed to something that they cannot comprehend. Most frequently it is the child that, as the only witness, has given occasion for suspicion through its behaviour or its verbal expression. In other words, the area of child sexual abuse is characterized by the fact that what we are asked to examine as a possible criminal act, where an adult has offended a child sexually, does not exist as such in the child’s universe. At the same time, we expect the child’s assistance in finding out what has happened. The adults around the child can find this extremely difficult to cope with because we badly want to help the child and to be certain that our actions are based on the correct premises.

This is obviously relevant for the adults that are closest to the child. But it can also be difficult to manage for professionals that are employed to safeguard the interests of the child as we are expected to distil the truth in our work with these children. I experienced this when I was giving a lecture to a staff group at a school where they had experienced first hand how difficult it was to relate to these issues in connection with the suspicion that some of the older children repeatedly had offended a younger child. When I had finished my lecture a teacher got up saying that he hoped I would find some other employment, as I could not give him an answer book for how to ascertain whether sexual assault had taken place or not. This man was angry that I could not produce a world where things could be separated and assessed beyond doubt for what they were. This thesis does not provide such a list of answers to casual connections between concrete incidents and the expression of these incidents in the mind. Nor does the thesis present a developmental psychology which step by step describes the normal and natural development of child sexuality. This is simply not possible.

But this does not imply that we should not come to a decision as to what is right and what is wrong in relations between children and adults (or between younger and older children), and that it is not our responsibility to assess whether a child has been subjected to a sexually offensive experience. The point is merely that there are no unambiguous and simple answers and that exactly this premise must be the starting point for our work. By way of an interplay of theoretical development and case analysis, my thesis demonstrates how the child’s development and the sexual trauma are associated cumulatively with one other and are intertwined in the development of infantile sexuality. This is the case because the child’s development invariably takes place in the relation between a specific child and a specific adult. The adult does not only facilitate the child’s development by feeding and caring for the child. The generation of meaning is consequent upon care-giving in the sense that the fact that the adult sees to the child’s survival is not without significance. And exactly because this significance is only partially accessible to the child, the child can gradually participate in giving the adult’s care meaning on its own developmental terms, starting, however, with the reality which is intrinsic to the specific relationship.

Sexual trauma is characterized by the fact that it is completely inaccessible. The child cannot participate in giving the sexual abuse meaning, but nevertheless, and put somewhat paradoxically, it exists in the relation between the child and the adult as a specific absence. The adult approaches the child, but the child has no possibility of giving this approach meaning. The trauma exists as an absence of meaning, which has been linked to the specific offending adult. Thus the abuse ties the child to the person who interferes with the child - centred round the absence of meaning.

This thesis has unfolded and developed a theory about what it means for the development of infantile sexuality that the child relies on the adult in order to learn to differentiate between dualities such as the inner and the outer world, pleasure and pain, active and passive, need and satisfaction, subject and object. I have discussed the implications of this, both when the child’s development takes place in relationships that attend to the child’s needs, and when the child’s development takes place in relationships that involve the adult’s perverted needs. By using the French psychoanalyst Jean Laplanche’s theory of general seduction, I have wanted to demonstrate that the child is seduced by the adult since the child has no other options, and I have focused on the fact that this premise depicts both the Achilles' heel of the development and its flexibility. I maintain that it is the specific adults that have responsibility for the child who can establish a relationship which either contains the possibility of or excludes the child from participating in giving its own development meaning.

Thus I argue for the fact that the theory of general seduction implies that in clinical work with sexually traumatised children we have the opportunity to enter into a relation with these children in a way that can transform the traumatic development in to a development where the child becomes an active participant in giving meaning to its experiences based on its own premises. Through analyses of three therapeutic play sessions with sexually traumatised children I have demonstrated that infantile fantasies can recover their character of being fantasies of an adult and mysterious world, which has not been filled up by the adult’s offensive presence. This requires, however, that in our work with these children we are prepared to move through the specific absence of significance, which the offensive approach has left within the child without yielding to the temptation of filling the absence with a specific meaning. With this I mean without yielding to the temptation either to name what we believe to be the specific offensive incident or to reject the fantasies that are played out in the therapeutic room. By expressing the trauma as a concrete sexual assault or by rejecting the child’s fantasies, the reality of the trauma is repeated, but in a concrete way which cannot be symbolically represented. The child’s fantasy remains solely populated by the adult’s reality. The child is held in what Lacan would call the real (Muller 1996), which in this case is the inaccessible reality of the sexual assault.

I have described the inaccessible absence of the sexual trauma as a centrifugal force, which retains the child in motion around the specific other person given that the child will always choose to avoid losing the coherence in its mind which presupposes the child’s link with the world. It is our job in the therapy to establish a relation which allows the child’s development to centre on the child.

I have demonstrated that the therapeutic relation can reinstitute the general seduction because the psychologist does not answer the questions that are implicit in the child’s approach to the psychologist, but on the other hand together with the child he/she examines how the child’s questions reflect the child’s attempt to create coherence in a world that through the sexual trauma is characterised by an inaccessible and specific absence of meaning. In its relation to the psychologist, the child has the opportunity to ask him or her other questions, and thus to have another expectation of the adult than the one which the sexual trauma has established in the child’s mind. The psychologist does not fill out the gap with a new answer, but tries to create this gap and to maintain it as a developmental room, which allows for the child’s own participation. One can say that the psychologist thus establishes an accessible absence of meaning in the relation between the child and the adult. An absence is established, which is general and associated with development as a starting point and incentive; a development which moves between the original absence of meaning and an attempt to overcome this absence.

The relation between the general seduction’s absence of meaning and the perverted seduction’s absence of meaning can be illustrated with two examples from Jesper and Anton’s therapies respectively. In both cases the situation was about receiving a present. In Anton’s case, the point was that he wanted to have some of the toys from the therapy room, to which I answered that he could wish for this. Anton became very angry with me because of this answer. What he became angry at was not that he could not take the toys home. He became angry because I, albeit hypothetically, gratified his wish without together with him examining the significance of his wish. Even though it was only hypothetical, my suggestion that he could wish for the thing met his wish at a specific level without reflecting together with him on the general and symbolic meaning of the present. There was no “gap” in my reply to Anton’s question. It corresponds to giving a crying child an ice cream. The child may stop crying, but the adult satisfies a need before the need has been defined.

Anton spends most of the time talking about dinosaurs. He told me that he and I had equally many dinosaurs, and they were almost the same. Nevertheless, I had one he wanted, and we had a little talk about that. After this I suggested that he could wish for one as a present. This made him very angry, and he hit me with the dinosaur. He told me not to talk about presents, and he called me a twerp. I told him I was pleased he told me because I did not know. Some times it was not nice to get presents perhaps. Anton said it was not and told me not to talk about it. I told him I was pleased he told me. Anton approached me to show me that he was not angry (11.3).

Of course I cannot exclude the possibility that presents had another and more specific significance to Anton that I did not know about. Presents may have been involved with the sexual assaults he has been exposed to. But regardless of whether it was this specific meaning he rejected or it was my proposal that he could wish for the things he did not have, I still think that the example expresses that it is the specific and concrete nature of my reply which he refused to participate in, and justly so. I did not examine what it was Anton actually wanted because I filled the gap between us with meaning. Perhaps Anton was beginning to accept that the therapy could offer him something he could not have at home, and perhaps Anton wanted to be allowed to hold on to this feeling, which at the same time might reflect an incipient insight and a beginning integration.

The example from Jesper’s therapy reflects a more diffuse and undifferentiated duality between needs and satisfaction, between giving and receiving. The example shows that for Jesper absence of meaning about getting something from another person implied an absence of meaning focused on desire and wishes:

Jesper pretended that he got presents from the nice father. After this he bashed his head hard up against the corner of the table. He began to cry and ran away, but came back in the room again. When I observed that he had hurt himself very badly he laughed on the verge of tears. He said “that tickled, and it was just in fun” (11.1).

Both examples demonstrate that the sexually abused child does not know what it wants, let alone how its wishes should be satisfied in the relation to an adult because the assault has met the child’s need with something that satisfies the specific adult. The assault has taken the place of the infantile fantasies and filled it with an adult and inaccessible meaning. The child has been prevented in using its infantile fantasies to create coherence between its inner and outer world, and thus from incorporating reality at a pace which maintains the coherence in the developing infant mind by linking the body and the mind through the adult’s approach in the general seduction. Coherence now exists as an absence of meaning attached to the specific and offending adult. Instead of it being the infantile fantasies that create coherence between the child’s inner world and outer world, it is now the adult’s perverted satisfaction of his/her own need that defines the starting point for the child’s attempt to create and maintain coherence in its mind.

In this thesis I have wanted to examine the premises that the development of child sexuality takes place in the relation between child and adult, and, more specifically, I have wanted to examine the significance for the child’s development if the relation is sexually abusive. As a premise for my examination, I have defined the unconscious as a place and a structure in the mind that comes from the outside, from the adult, and using Laplanche’s concept, I have called this place and this structure the inner foreign body. I have focused on the fact that the unconscious comes into being in the relation between the child and the adult in order to capture the double nature of the unconscious in the sense of being simultaneously inner and outer and at the same time being associated with the object and the subject.

I have demonstrated that the relation between child and adult starts from a folding of dualities in the process of the general seduction, where the adult’s satisfaction of the child’s needs defines the child’s instinct and with it the child’s desire and wishes. Thus it is in the relation between child and adult that the first coherence in the mind comes into being, and here the infantile fantasies express the child’s attempt to maintain this coherence between the inner and the outer world. The unconscious does not distinguish between fantasy and reality because the fantasies exist to create coherence in the child’s reality, a coherence which is prior to and establishes the premises for the child’s establishment of and distinction between dualities. Furthermore, I have through analyses of the three play therapies illustrated how the sexual trauma keeps the child from developing the ability to distinguish between dualities because the child is forced to maintain coherence in its mind; in this case, a coherence which via the abusive relation is tied to the absence of meaning associated with the sexual trauma.

The precondition for examining the child’s development as linked to the relations in which the child grows up, is the assumption that the specific adults who look after the child in its early childhood establish the fundamental premises for the child to experience itself as an individual in a world full of other individuals. This is not just an old song and dance about social inheritance, but the proposition that what is critical for the way the child relates to other people in its life is precisely the specific relations that foster the child’s survival, including the adults’ way of entering into this relation in the certain knowledge that the way they communicate the meaning of that relationship is vital. And it is precisely in our relations to others that we develop to become the people we are.