Smiling, swallowing, sickening and stupefying: The effect of sexual abuse on the child

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Abstract
Referrals for child sexual abuse have increased dramatically in the UK, Europe and America. As assessment skills improve we find earlier ages at onset of abuse. Referrals of mentally and multiply handicapped children who have been abused are also increasing. This paper tries to understand the meaning of abuse and its effect on the child by examining the process of small everyday abuse in a loving home. This is done by means of extracts from a baby observation. The infantile processes of smiling, swallowing, being sick and becoming stupid are then traced in the twice-weekly psychoanalytical psychotherapy of two children, a boy and a girl. The trauma of sexual abuse played a part in the mental handicap of the boy who is seen here moving from tragic victim of abuse to adolescent struggling against abusing. The girl is 5 and abuse has led to her emotional and learning difficulties.

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