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within this area: Large scale traumas of the World War II; massive traumas of the Holocaust; and the new undisputable evidence of child abuse (e.g., Bergmann, Jucovy eds. 1982; Blum, 1986; Bohleber, 2000; Kempe, Silverman, Steele et al. 1962; Shengold, 2000). In an IPA Classic Books edited volume on “Reconstruction of Trauma”, Harold Blum (1986) wrote, “Massive extended trauma differs from the usual concept of trauma which is that of an incapacitating ego shock in a short period of time. The massive traumata of adult life may be comparable in its global effect in breaking down already formed structure to trauma in the infant which leads to damage or arrest in the formation of structure. The greater the vulnerability and the more massive the trauma, the more profound and pervasive the structural impairments. Developmentally, vulnerability is greater during preoedipal structural differentiation than during postoedipal structural consolidation.” (p. 26). In a book edited by Sidney Furst (1967a) a number of ego psychologists clarified the conceptualization of trauma, stressing its specificity and more narrow definition (A. Freud, 1967) as involving a massive overwhelming of the ego, and uncontrolled regression, to be distinguished from other situations of conflict or emotional upset. Furst (1967b, 1978) described the traumatic process as beginning at a ‘tipping point’, beyond which the ego seemed to slide uncontrollably into a deeper and deeper regression, involving loss of many basic functions. Anna Freud (1967) noted that the traumatic situation and process should be distinguished carefully from the sequelae of trauma. In keeping with the differentiations made by Anna Freud and others, a number of ego psychologists stressed the importance of understanding trauma on its own terms, as something that enters as an independent factor into interactions with other issues, such as mourning and drive conflicts (Blum, 2003), as well as stressing the importance of trauma in all stages and developmental levels, including adult trauma (Phillips, 1991). Joseph Fernando (2009) took the ego psychological conceptualization of the traumatic process as an independent factor in mental dynamics and used this differentiation to clarify and deepen the understanding of a number of issues. First, he reiterated a point that had been made by others (Yorke and Wiseberg, 1976): While trauma had been previously connected by Freud to the motive for primal repression, in fact, in trauma, the ego is enough out of commission that such complex and coordinated defenses as repression may be impossible. It is powerful, pervasive affect that is the motor for primal defenses. Freud (1926) had stated that the overwhelming of the ego from the “inside” by the drives, or from the “outside”, were equivalent and led to the traumatic situation that motivated primal repression. But everyday clinical observations disprove this: the sequelae of the breaching of the barrier against overwhelming internal sources (as in night terrors or temper tantrums) is quite different from the breaching of the external stimulus barrier. Freud (1920, 1939) had described the aftereffects of the second situation, in terms of the compulsion to repeat the trauma, and yet avoid anything connected to it, and thus knew very well that this difference existed, but he did not consistently maintain this view when speaking at the more general theoretical level.
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