Early trauma and its representation over the course of life from infancy to early adulthood: A case report.

Early traumatic experiences have long been considered by psychoanalysts to have significant carryover effects into adulthood, although the nature of these effects has been a subject of ongoing debate. Much is known about the immediate effects of a trauma in early childhood. However, longitudinal data delineating the development course of traumatic representations and symptoms over the time span from early childhood to adulthood has been notably lacking. This paper will report on a child who witnessed the death of her mother by a letter bomb at one year of age and who has been followed up to age twenty-four. There was strong evidence through reenactment play and verbal descriptions that the child retained explicit, consciously available representations of the traumatic event up to age six. As will be described, she also manifested symptoms characteristic of posttraumatic stress disorder and developmental disruption up to this same age, including recurring flashbacks and nightmares, distress to stimulus triggers associated with the trauma, avoidance of traumatic reminders, hyperarousal, disturbances in her attachments, and intense separation anxiety. The course of her symptoms and traumatic representations will then be traced through her later childhood, adolescence and early adulthood, documenting how they shaped, and were shaped by, the expectable range of stresses and vicissitudes of life that she experienced growing up in a stable, loving adoptive home. Although certain implicit representations and symptoms persisted into late adolescence, including two trauma-based generalized fears, the child's resilience and determination combined with the strong support of her adoptive parents enabled her to overcome her early traumatic loss to a remarkable degree.