Obsessed by endless ruminations, demented by pain and the reactions to maltreatment - sleeplessness, malnutrition, and substance abuse - the victim regresses, shedding all but the most primitive defense mechanisms: splitting, narcissism, dissociation, Projective Identification, introjection, and cognitive dissonance. The victim constructs an alternative world, often suffering from depersonalization and derealization, hallucinations, ideas of reference, delusions, and psychotic episodes. Sometimes the victim comes to crave pain - very much as self-mutilators do - because it is a proof and a reminder of his individuated existence otherwise blurred by the incessant abuse. Pain shields the sufferer from disintegration and capitulation. It preserves the veracity of his unthinkable and unspeakable experiences. It reminds him that he can still feel and, therefore, that he is still human.

These dual processes of the victim's alienation and addiction to anguish complement the perpetrator's view of his quarry as "inhuman", or "subhuman". The abuser assumes the position of the sole authority, the exclusive fount of meaning and interpretation, the source of both evil and good.

Abuse is about reprogramming the victim to succumb to an alternative exegesis of the world, proffered by the abuser. It is an act of deep, indelible, traumatic indoctrination. The abused also swallows whole and assimilates the abuser's negative view of him and often, as a result, is rendered suicidal, self-destructive, or self-defeating.

Thus, abuse has no cut-off date. The sounds, the voices, the smells, the sensations reverberate long after the episode has ended - both in nightmares and in waking moments. The victim's ability to trust other people - i.e., to assume that their motives are at least rational, if not necessarily benign - has been irrevocably undermined. Social institutions - even the family itself - are perceived as precariously poised on the verge of an ominous, Kafkaesque mutation. Nothing is either safe, or credible anymore.

Victims typically react by undulating between emotional numbing and increased arousal: insomnia, irritability, restlessness, and attention deficits. Recollections of the traumatic events intrude in the form of dreams, night terrors, flashbacks, and distressing associations.

The abused develop compulsive rituals to fend off obsessive thoughts. Other psychological sequelae reported include cognitive impairment, reduced capacity to learn, memory disorders, sexual dysfunction, social withdrawal, inability to maintain long term relationships, or even mere intimacy, phobias, ideas of reference and superstitions, delusions, hallucinations, psychotic microepisodes, and emotional flatness. Depression and anxiety are very common. These are forms and manifestations of self-directed aggression. The sufferer rages at his own victimhood and resulting multiple dysfunctions.

He feels shamed by his new disabilities and responsible, or even guilty, somehow, for his predicament and the dire consequences borne by his nearest and dearest. His sense of self-worth and self-esteem are crippled. Suicide is perceived as both a relief and a solution.

In a nutshell, abuse victims suffer from a Post Traumatic Stress Disorder (PTSD). Their strong feelings of anxiety, guilt, and shame are also typical of victims of childhood abuse, domestic violence, and rape. They feel anxious because the perpetrator's behavior is seemingly arbitrary and unpredictable - or mechanically and inhumanly regular.

They feel guilty and disgraced because, to restore a semblance of order to their shattered world and a modicum of dominion over their chaotic life, they need to transform themselves into the cause of their own degradation and the accomplices of their tormentors.

Inevitably, in the aftermath of abuse, its victims feel helpless and powerless. This loss of control over one's life and body is manifested physically in impotence, attention deficits, and insomnia. This is often exacerbated by the disbelief many abuse victims encounter, especially if they are unable to produce scars, or other "objective" proof of their ordeal. Language cannot communicate such an intensely private experience as pain.

Bystanders resent the abused because they make them feel guilty and ashamed for having done nothing to prevent the atrocity. The victims threaten their sense of security and their much-needed belief in predictability, justice, and rule of law. The victims, on their part, do not believe that it is possible to effectively communicate to "outsiders" what they have been through. The abuse seems to have occurred on "another galaxy". This is how Auschwitz was described by the author K. Zetnik in his testimony in the Eichmann trial in Jerusalem in 1961.

Often, continued attempts to repress fearful memories result in psychosomatic illnesses (conversion). The victim wishes to forget the abuse, to avoid re-experiencing the often life threatening torment and to shield his human environment from the horrors. In conjunction with the victim's pervasive distrust, this is frequently interpreted as hypervigilance, or even paranoia. It seems that the victims can't win. Abuse is forever.

When the victim realizes that the abuse he suffered is now an integral part of his very being, a determinant of his self-identity, and that he is doomed to bear his pains and fears, shackled to his trauma, and tortured by it - suicide often appears to be a benign alternative.

next: The Narcissist - From Abuse to Suicide