The reconstruction of early childhood trauma: fantasy, reality, and verification.

The contrasting perspectives of historical (actual, material) truth as opposed to narrative (intrapsychic) truth in psychoanalytic reconstruction parallel the controversial shift in Freud's thinking from a traumatic theory of neurosogenesis to a greater emphasis on fantasy and psychic reality. Freud and analysts since have sought to tease apart psychic and material reality as they dovetail in the transference. However, published cases in which a patient's memory of a childhood trauma turned out to be a verifiable fantasy or false belief and not an actuality appear to be remarkably scarce. This paper describes a case in which the patient indicated that in early childhood she had been subjected to antimasturbatory measures and finally to clitoridectomy that had ongoing traumatic effects. The case strikingly illustrates how a false memory of shock trauma may represent effects of strain traumatization interacting with fantasy and the state of drives and ego development in early childhood. It also highlights issues in the areas of trauma and memory, historical and intrapsychic truth, and the theory and technique of psychoanalytic reconstruction. Although it may not always be possible in the psychoanalytic situation to differentiate actual and plausible past events, in some cases the distinction between these perspectives on truth has clinical relevance that is more than academic.