Blitz rape and confidence rape: implications for clinical intervention

Article Abstract:

The notion of a Rape Trauma Syndrome was developed following the establishment of the Rape Crisis Intervention Program in 1974 at Beth Israel Hospital in Boston. This syndrome describes the situations and psychological manifestations resulting from two distinct patterns of rape, blitz rape and confidence rape. The clinical implications for treating the two types of victims are discussed. In blitz rape, the attack is a surprise by an unknown assailant. In confidence rape, sometimes referred to as 'date rape,' the victim is generally acquainted with her assailant, and has probably spent time with him prior to the rape. From a review of the cases of 1,000 rape victims, it appears that the victims of blitz rape are more likely to be or have been married, to work in a professional position, and to be living alone at the time of the rape. Confidence rape victims, on the other hand, are more likely to have consumed alcohol or drugs prior to the rape, and to have made some attempt at resistance. Because of the different circumstances surrounding each type of attack, different emotional consequences should be expected, and various approaches to treatment are warranted. The most significant consequence of blitz rape is that the victim's sense of safety in the world is shattered; sleep disturbances, flashbacks and anxiety are common repercussions. Therapy for these individuals should focus upon reassuring the victim that nothing could have been done to stop the attack and that repeated blitz rape is extremely rare. In addition, the victim's sense of personal safety should be redeveloped. For victims of confidence rape, restoring a sense of trust is of utmost importance. These victims often blame themselves, asking themselves ''How could I have trusted this person?'' They may isolate themselves, and avoid treatment for a long time, feeling doubtful that they are entitled to help. These victims need to be reassured they are deserving of help, and their lack of trust needs to be acknowledged and discussed. (Consumer Summary produced by Reliance Medical Information, Inc.)

Psychological aspects, Care and treatment, Evaluation, Rape, Rape victim services, Acquaintance rape, Rape trauma syndrome

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Projective identification as a self-psychological change agent in the psychotherapy of a child

Article Abstract:

Projective identification is usually conceived as a defense mechanism, in which an individual projects negative feelings about him- or herself onto another person, usually in an attempt to gain control of the feelings. However, this process may also be seen as a healthy developmental strategy, in that it allows the individual to get rid of frightening feelings and helps the individual to communicate and relate. It may also provide a path for psychological change by permitting the reintrojection of the projected feelings once they have been ''metabolized'' by the person onto whom they are projected. A case is presented of a 10-year-old boy who was seen because of suicide attempts and serious interpersonal difficulties. The boy had been the object of both neglect and physical abuse, and was witness to the sexual abuse of his stepsister by his father. Within the framework of self psychology, where the primary task of the therapist is to help restore the patient's lost or incoherent sense of self by mirroring back to the patient an idealized self image, projective identification can be used by the therapist to contain the patient's rage and other threatening feelings until the patient is able to accept them as his own. The boy in this case initially projected onto the therapist strong feelings of anxiety, which the therapist had to identify as coming from the boy and not herself, in order to be able to reflect back to the boy an idealization. Eventually, the frightened child began to feel safe, and to develop a stronger sense of self, as he became able to reintroduce the feelings handled by the therapist into his own repertoire. The stages of projective identification for use as a therapeutic technique within a self psychological framework are outlined. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Methods, Self psychology, Self psychology (Psychoanalytic theory), Child psychotherapy

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The concept of projective identification and its clinical relevance

Article Abstract:

Borderline personality disorder is associated with two defense mechanisms: splitting, in which people who are regarded ambivalently are treated by the patient as if they were either saviors or malefactors; and projective identification. While the psychological phenomena associated with splitting can be fairly well characterized, the manifestations of projective identification are less easy to identify. Projective identification involves locating the source of internal feelings such as anxiety and anger in another person, with whom the patient then empathizes. Projective identification is further delineated according to three clinical manifestations: redirection and disownment, whereby the patient attempts to cope with an intolerable experience by redirecting the cause onto another person, for whom he develops a hatred; manipulation, in which the patient then unconsciously manipulates the real relationship in order to confirm the intrapsychic struggle which exists in the fantasied relationship; and induction, whereby the object of the patient's projections (e.g., the therapist) actually begins to participate in the patient's fantasy and to identify with what the patient thinks of himself. Two case studies illustrate how this defense can lead to the development of a complex clinical picture and how it may develop in a therapeutic relationship. Also discussed are strategies for dealing with projective identification and its role in various syndromes.

Diagnosis, Complications and side effects, Identification and classification, Defense mechanisms (Psychology), Borderline personality disorder, Schizoid personality disorder

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