A Concept Becomes a Passion

Moral Commitments and the Affective Development

of the Survivors of Child Abuse

Ruth Miltenburg
Bunnik, the Netherlands
Elly Singer
University of Utrecht, University of Amsterdam

Abstract. The questions of resilience and discontinuity in the affective

development of survivors of child abuse are explored from the viewpoint of
Vygotsky’s cultural-historical theory and current social constructivist theo-
ries. Moral tools, commitments and higher-order skills play a crucial part in
the development of agency, personal empowerment and discontinuity. The
recurrence of affective problems in survivors may be connected to moral
confusion and insoluble moral dilemmas. This is seldom acknowledged in
theoretical discourse, for example in cognitive therapeutic theories. Conse-
quences for the treatment of survivors of abuse are discussed.
KEY WORDS: agency, moral development, social constructivism, survivors
of child abuse, treatment

In Borderliners, Peter Høeg (1996) tells the haunting story of Katarina,

August and Peter, three orphans in an experimental Danish boarding school
in the 1970s. The orderliness and precision of this school were to form the
firm, secure structure to elevate mentally defective and delinquent children.
But soon it becomes clear that August is in danger of being crushed by the
school’s regime. Peter tries to rescue him, and enlists the help of Katarina.
He steals into her room one night. She wakes, frightened to find him there.
However, he is able to convince her that he is not seeking sex: he shows her
a psychological report from his file in which it is written that he is incapable
of a relationship, or of having feelings, because of having spent his life since
birth in four different institutions and having failed to attach to any
particular adult. August has killed both his parents after years of being
abused and beaten by them. In the event, Peter and Katarina fail to prevent
August from committing suicide, but they do succeed in saving themselves
through their joint efforts to fathom the logic of the dehumanizing and
sickening regime operated by the boarding school, and through their

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504 THEORY & PSYCHOLOGY 10(4)

commitment to take on responsibility for August. In their attempt to escape,

August becomes their child and Peter experiences for the first time what he
had only imagined a family to be. Their flight comes to a fatal end, but from
being an outsider Peter finds he has been ‘initiated’. For the first time in his
life, he can connect his idea of ‘the good’ with directly experienced
reciprocal care and responsibility. This is his chance. ‘I knew I would
remember it for ever and ever and that they could not take it away from me,
not ever—come what may. And so that moment became one of utter
fearlessness’ (p. 138).
In Borderliners Høeg not only analyses children’s fears in contrast to the
overwhelming power of adults, but also the way children, despite ‘expert’
predictions of their incapacity to form attachments, can nevertheless enter
into commitments to each other through which they experience ‘good’ and
construct images of ‘the good’ that serve to keep them going. This is also
true even where these relationships of commitment, such as that between
Peter and Katarina, are brief. Høeg analyses a phenomenon which we, in the
literature of contemporary pyschology on child abuse, find difficult to
account for: despite horrific experiences, many people nevertheless succeed
in constructing a satisfactory life for themselves. Mainstream psychology,
according to Magai and McFadden (1995), is based on the ‘doctrine of
continuity’: if you have a history of child abuse, your adult life will be
continuous with your early life, that is, defined and marked by affective-
behavioural disturbances, re-enactment of abusive forms of interaction, and
so on. Consequently, at the level of theory, discontinuity in development is
scarcely admissible. This question of discontinuity is the central issue here,
and in particular the discontinuity in affective development that arises
through people realizing their capacity to engage with each other and to hold
on to their own conception of the ‘good’ through periods of disaster. We
shall demonstrate that children who have been abused can draw the strength
to survive from moral precepts and social commitments, and that the moral
development of survivors deserves to be an important focus of attention in
therapies. Sorting out moral issues in a therapeutic context can help adults to
maintain a distance between themselves and the violence of their childhood.
These considerations lead to theoretical reflection on the role of social
commitments and moral precepts on affective (both emotional and moral)
development. We take as a starting point Vygotsky’s cultural-historical
theory and constructivist theories of affective development (see also
Miltenburg & Singer, 1999a).

Research on Personality Change and Resilience of Survivors

Peter Høeg in Borderliners is no exceptional case. Research on resilience

factors shows that discontinuity in the development of survivors often goes
MILTENBURG & SINGER: A CONCEPT BECOMES A PASSION 505

hand in hand with new commitments: with friends or a partner, at school,

work or in a religious or social movement (Anthony & Cohler, 1987; Rubin,
1996; Rutter, Quinton, & Hill, 1990; Valentine & Feinhauer, 1993). Chil-
dren get the better of despair by picturing to themselves a good place, for
example a space where quiet and rest prevail (Rubin, 1996; Zimrin, 1986).
The hope that one day they will have good parents—either that their own
parents will change or that they will find new (adoptive) parents—helps
children to survive spiritually (Eagle, 1994; Lorrimer, 1987). Abused
children can also maintain contact with the good by assuming responsibility
for the protection of younger siblings (Driver, 1989; Zimrin, 1986). Some
child and adult survivors draw strength from a belief in a God who will save
them and help them endure even the greatest difficulties (Artenstein, 1990;
Valentine & Feinhauer, 1993). And if trust in others at both emotional and
cognitive levels has been destroyed, a system of commitments at the moral
level can restore connections with other people (Udo, 1991).
Similar conclusions can be drawn from research on personality change.
Discontinuity in later life often goes with the embracing of a new ideology
(religious, political, secular) or a new lifestyle following a marriage or career
change: ‘ “Human icons” (Lenin, Christ, Buddha) typically serve as models
to emulate; the community of “ideologues” (comrades, members of the faith)
provides a nurturing peer culture’ (Magai & McFadden, 1995, p. 318).
Ullman (1989), for instance, studied people who had undergone religious
conversion. Half of them described their childhood as extremely unhappy,
and prior to their conversion they were introverted, isolated and totally
preoccupied by their own emotional problems. The religious conversion
provided a way out. They committed themselves to a father-figure, a peer
group or transcendental object, and in these relationships converts experi-
enced strong feelings of love, of unconditional acceptance, support and/or
protection. According to Sampson (1993), collective movements such as the
women’s movement, the African-American movement, third world move-
ments and the gay and lesbian movements can also help people to develop a
new identity, to escape from (self-)repression and distance themselves from
their past. These movements give people a ‘voice’. Shared meanings are
constructed at both a conceptual level (of values, goals, explanations) and in
behavior (collective actions, rituals, lifestyles).
Building a good life after a bad childhood often proceeds through small
steps and with great difficulty (Rubin, 1996). Survivors who succeed in
constructing a good life acknowledge having had, or perhaps still having,
periods when they are afflicted by loneliness or guilt feelings or experience
difficulty in controlling their aggression and anxiety (Rubin, 1996; Valentine
& Feinauer, 1993; Zimrin, 1986). They might need a lasting ‘pain regulatory
system’ and special psychological tools to control overwhelming emotions
related to their traumatic past experience (see Miltenburg & Singer, 1997,
1999a, 1999b; Rubin, 1996). In a sense, aspects of their past might continue
506 THEORY & PSYCHOLOGY 10(4)

in the present. But what is characteristic is their rejection of the victim

position. They were victimized during their childhood and often want
acknowledgement of their (enduring) pain and condemnation of child abuse.
But they don’t want to be passive victims all their life. Therefore they fight
for the mastery of their own lives.

Discontinuity and Moral Development

What conclusions can be drawn from this research on the resilience of

survivors and personality change? Our main conclusion is that discontinuity
in development is related to experiences and developments in the moral
domain. Factors identified in these studies belong to the domain of morality
as defined in the social contructivist approach to moral development (Haste,
Helkema, & Markoulis, 1998; Killen & Hart, 1995). In this approach,
morality is more than moral debate and judgements about right and wrong,
as it was in Kohlberg’s cognitive theory (Kohlberg, 1976). It entails a move
away from a paradigm of cognitive representations and internally held
principles, in which the self is regarded as a disembodied, epistemic subject,
toward a paradigm of social construction and intersubjectively possible
forms of discourse, in which selves are assumed to be fundamentally
relational (Day & Tappan, 1996). According to Walker, Pitts, Hennig and
Matsuba (1995), morality is related to
. . .voluntary actions that (at least potentially) have social or interpersonal
implications and that are governed by some intrapsychic mechanism
(cognitive and/or emotive). . . . It prescribes people’s activities, regulates
their social interactions, and arbitrates conflicts. (p. 372)
Social constructivist theories of affective (emotional and moral) develop-
ment emphasize the role of cultural practices and social processes, such as
narratives and discourse, in the construction of shared values and valued
ways of life, and in the development of the individual’s skills in meeting
cultural expectations (Day & Tappan, 1996; Tappan, 1997). Social dialogues
and commitments are seen as the basis for autonomy and empowerment of
the individual (Colby & Damon, 1995; Tappan, 1997; Taylor, 1989). The
development of children’s shared commitments to honesty, justice, charity
or religious faith are studied (Haste et al., 1998) and attention is drawn to the
moral dimension in concepts of ‘trust’, ‘love’, ‘(self-)esteem’ or ‘attach-
ment’. This is a theoretical innovation. In the therapeutic literature, for
instance, ‘trust’ is construed as a feeling the client has toward his or her
therapist. In attachment theory, trust is a matter of procedures and working
models for organizing emotional security in the parent–child relationship
without this reflecting on underlying moral rules (Singer, 1993). Cognitive
psychologists, on the other hand, define ‘self-trust’ as a ‘cognition’ that can
be either ‘adaptive’ or ‘distorted’ rather than a moral judgement of one’s
MILTENBURG & SINGER: A CONCEPT BECOMES A PASSION 507

own person (Sampson, 1993). But according to social constructivists, a bond

of love between partners, for example, is not simply a ‘feeling’; it also
indicates that people have a shared (procedural and declarative) conception
of ‘the good’. Moreover, a love bond is a mutual contract and thus a moral
obligation that people enter into, and they therefore expect to be treated on
the basis of shared conceptions of ‘the good’. In reply to their question ‘Can
you recall a recent real-life moral dilemma that you have yourself experi-
enced?’ Walker et al. (1995) found that people frequently cited dilemmas
involving trust, mistrust, (dis)honesty, caring, (self-)esteem in relation to
their partner, their children, friends or colleagues at work.
Before presenting below the theoretical account of discontinuity sug-
gested by this social constructivist approach, however, we first need to make
two observations.
First, it is unusual to link the moral development of survivors with the
prospect of building a satisfactory life despite traumatic childhood experi-
ences. In mainstream psychology the emphasis is placed on survivors’
problems in the moral sphere, that is, on continuity. For example, research is
directed to the anti-social behaviour of survivors (Gibbs, 1991), or the
incapacity for empathy and ‘pathological’ feelings of guilt (Lamb, 1996); or
toward the way that subsequently, as adults, the abusive behaviour of their
parents is repeated in relation to their own children (Belsky, 1993; Kaufman
& Zigler, 1989). These problems in the moral sphere are taken up as
affective problems, cognitive problems or personality disorders. Tradition-
ally, psychologizing and pathologizing formulations are used rather than
moral frameworks to understand these issues. Only in the feminist literature
are links drawn between survivors’ own experience of (sexual) violence and
moral commitments to fellow-sufferers or participation in movements that
oppose violence against women and children and promote empowerment of
the person (Driver, 1989).
Second, our own approach also calls for comment. The moral dimension
of the lives of survivors is not always paramount. Survivors might need
special psychological tools all their life to be able to live with the intolerable
experience and pain related to their original traumas. In a sense their past
might never be over and done with. In line with Vygotsky (1936/1993b), we
oppose the idea that the objective of treatment should always be a cure, or
elimination of the original cause of a psychological problem, especially with
clients whose original problem concerned the lower mental functions that
are largely determined by biological factors. This seems to us the case with
clients who have suffered serious, long-term abuse as children, in whom the
primary psychological processes with which to cope with their experiences
are automatic ones. Vygotsky held that treatment must connect with people’s
natural inclinations in order to compensate for biological limitations by
helping them develop at the cultural level. This is where people have the
capacity to learn and to develop. Therefore treatment should be geared to
508 THEORY & PSYCHOLOGY 10(4)

giving the client more insight into and control over his or her own
psychological system by developing the higher mental functions, steadily
reducing the influence of the original damage on the client’s whole psychic
functioning. Because we have elsewhere extensively discussed our thera-
peutic approach and the special psychological tools developed by clients in
order to be able to live with intolerable experiences, we shall for the most
part not consider these aspects here (Miltenburg & Singer, 1997, 1999a,
1999b).

Theoretical Insights into Moral Development and

Discontinuity

Social constructivist insights into moral development suggest the following

three possible explanations for discontinuity in the development of in-
dividuals who have been abused as children:
1. Dissociation of cognitive-affective schemes. Cognitive-affective schemes
are characteristically relational and situation-bound. Individuals can de-
velop negative as well as positive schemes and selves in relation to a
person, and actively dissociate experiences with abusive or non-abusive
persons (Fischer & Ayoub, 1994; Harris, 1995). At a young age these
processes of dissociation are involuntary and automatic. But a germ of
knowing of the good is preserved.
2. The development of the higher mental functions. With the development of
higher mental functions, the individual develops the capacity to retain
experiences of the good at a conceptual level, independent of the
frequency or duration of those experiences; to develop ‘a concept which
has become a passion’ (Vygotsky, 1978b, p. 99). As a result, a distance
can be consciously set from negative experiences in primary relation-
ships, including the relevant, associated schemes and selves, and the
positive embraced. The individual is also able to develop skills for self-
determination.
3. Access to cultural sources—procedures, rituals, moral concepts, ideolo-
gies, religion—beyond the family of origin. In engaging with an in-
dividual, group or transcendent object, ‘tools’ can be internalized and
shared understandings of ‘the good’ constructed.
We shall elucidate some of these insights in the following.

Dissociation of Cognitive-Affective Schemes

Contemporary theoreticians emphasize that affective development involves
an interplay between social interactions, thought and emotions (Emde,
Biringer, Clyman, & Oppenheim, 1991; Magai & McFadden, 1995; Walker
MILTENBURG & SINGER: A CONCEPT BECOMES A PASSION 509

et al., 1995). Emotions are conceptualized as functional action tendencies

(Fischer, Shaver, & Carnochan, 1990; Frijda, 1986; Greenberg, Rice, &
Elliott, 1993; Magai & McFadden, 1995). In his or her relation to others, the
child learns ‘scripts’ for emotions (Fischer et al., 1990) or ‘cognitive-
affective schemes’ (Greenberg et al., 1993), by which is meant complex
synthesizing structures integrating cognition (in the form of appraisals,
expectations and beliefs), motivation (in the form of needs, interests, goals,
action tendencies), affect (in the shape of physiological arousal and sensory
and bodily feeling) and actions (in the form of motor responses and
procedures and methods for acting) (Miltenburg & Singer, 1999a).
The same tendency is evident in various theories of moral development.
Emde et al. (1991), for instance, propose that babies’ important affective
experiences are registered as procedural knowledge. As a result of care-
giving experiences, infants learn rules for reciprocity, for give and take,
together with the motive for using these rules, because ‘together’ is so
pleasurable. This non-verbal procedural knowledge is a basic form of
morality. ‘All systems of morality have a sense of reciprocity at their center
with a version of the Golden Rule: “Do unto others as you would have them
do unto you” ’ (Emde et al., 1991, p. 261).
Procedural schemes or cognitive-affective schemes are thus based on
social relations and on a past history of experience with particular in-
dividuals in particular contexts. However, social contexts for interactions—
even for infants—vary considerably (Emde et al., 1991). In relation to their
father, young children can develop procedures classified by attachment
theorists as ‘insecurely attached’, whilst being classified as ‘securely at-
tached’ in relation to the mother (Goossens & Van IJzendoorn, 1990). How
do children and adults coordinate multiple ‘procedural schemes’ for dealing
with self and other? That is the question addressed by Fischer and his co-
workers, according to whom, the mind naturally comprises distinct control
systems that are only weakly connected to each other (Fischer & Ayoub,
1994; Fischer et al., 1990). Generalizing relation-specific or domain-specific
procedural knowledge to other relations and domains is not an automatic
process. Young children lack the representational skills (e.g. linguistic
representational skills) needed to coordinate the schemes derived from
negative experiences of their parents with schemes based on positive
experiences. They judge their parents either ‘good’ or ‘bad’ according to the
situation. The development of higher mental functions enhances the possibil-
ities for integrating situation-specific schemes, and for reaching more
general and more stable judgements about self and others. But the propensity
for failure to integrate schemes remains even in adults. According to Fischer
and Ayoub (1994), this relates to people’s natural tendency to dissociate,
that is, to separate negative experiences relating to persons and situations
from positive experiences. In powerfully emotional situations (under threat
or intense love), such black-and-white thinking and feeling has survival
510 THEORY & PSYCHOLOGY 10(4)

value in enabling the individual to act rapidly and directedly without long
deliberation or qualification.
In children who are abused, the need to dissociate is often particularly
urgent. Maltreated children are confronted at a young age with powerfully
emotional experiences that are scarcely compatible. These children develop
procedural and cognitive-affective schemes around their abusive experi-
ences, and around a secluded area where their relationship with a loving
parent, peer or caregiver is kept intact (Fischer & Ayoub, 1994). Sometimes
they develop separate schemes for their private abusive world and the public
world. To keep these diverse schemes apart, which is necessary for survival,
they ‘actively dissociate’, that is, they develop cognitive skills for actively
separating schemes associated with specific events or situations. With the
development of higher-order skills (representational and abstract thinking),
survivors can develop extraordinary forms of coordination between dis-
sociated schemes; agencies related to separated schemes can act on each
other. This capacity for dissociation of cognitive-affective schemes provides
the first explanation of discontinuity in the development of abused children.
Because of processes of dissociation, images or germs of knowing of the
good are preserved. In this context, for example, survivors speak of a bolt-
hole or a shelter within themselves where they preserve good experiences
with their parental figures or friends; or of a domestic animal, a cuddly toy
or musical instrument from which they derived comfort and which they
protected from the destructive contact with their parents (Rubin, 1996).

The Development of the Higher Mental Functions

Research on the development of self-regulation often harks back to the
cultural-historical theory of Vygotsky (Dı́az, Neal, & Amaya-Williams,
1990; Haste, 1993; Tappan, 1997), who also starts out from the assumption
that affects, thought and (social) activities form an indivisible whole in
human behaviour. Only cognitions do not motivate.
Thought has its origins in the motivating sphere of consciousness, a sphere
that includes our inclinations and needs, our interests and impulses, and our
affect and emotion. The affective and volitional tendency stands behind
thought. Only here do we find the answer to the final ‘why’ in the analysis
of thinking. (Vygotsky, 1934/1987, p. 282)
But the relation between affective and cognitive processes changes during
development, specifically under the influence of the developing higher
mental functions (Vygotsky, 1935/1993a, 1936/1993b). The affective pro-
cesses of young children are determined by their physical needs and
impulses which are stimulated by whatever they observe in their immediate
environment (Vygotsky, 1978b, p. 93). With the development of the higher
psychological functions, the child is able to disregard a situational incentive
and to regulate his or her emotions. The child develops the capacity to be
MILTENBURG & SINGER: A CONCEPT BECOMES A PASSION 511

affected by the will to achieve a goal and to realize moral values; he or she
can act on purpose.
According to Vygotsky, the development of the higher mental functions
(i.e. voluntary action and memory, abstract thought, inner speech, imagina-
tion) is culturally mediated; they develop historically, and they consist of
practical, collective activities (Van der Veer & Valsiner, 1991; Wertsch,
1985). He attributes a central role to cultural resources like speech, rules,
(moral) concepts, belief systems in the development of ‘mastering’ at the
individual level.
Every function in the child’s cultural development appears twice, on two
levels. First, on the social, and later, on the psychological level; first
between people (interpsychological), and then inside the child (intra-
psychological). This applies equally to voluntary attention, to logical
memory, and to the formation of concepts. All the higher functions
originate as actual relations between human individuals. (Vygotsky, 1978a,
p. 57)
The capacity for self-control and self-determination does not have its
source ‘within’ the individual but is of social-cultural origin. Vygotsky’s
concept of the individual can be represented schematically as in Figure 1.
Vygotsky’s theory leads to the following insights into the way dis-
continuity arises in development. The first insight is related to what
Vygotsky called ‘a concept which has become a passion’ (Vygotsky, 1978b,
p. 99). Thanks to the higher mental functions, children can hold on to
experiences of the good at a conceptual level, as a result of which the
influence of good experiences is relatively independent of their frequency
and duration. Peter Høeg, for example, writes in his novel that Peter’s
relationship with Katarina lasted no more than a few months. Nonetheless, it
was an experience that exerted enormous determinative influence because he
was able to hold on to it and as a result had an image of what he longed for.
‘When once you have encountered it [love], you will never sink again. Then
you will always yearn for the light and the surface’ (Høeg, 1996, p. 225).
The second insight lies in Vygotsky’s remark: ‘To carry out the rule is a
source of pleasure’ (Vygotsky, 1978b, pp. 99–100). What he meant by this
observation is that shared rules and social commitments function as power-
ful, affectively charged psychological tools for overcoming one’s own

activities in the socio-cultural environment

affective processes cognitive processes

Figure 1. The Vygotsky triangle of the human individual

512 THEORY & PSYCHOLOGY 10(4)

primary impulses. According to Vygotsky, this phenomenon is first ex-

pressed in pretend play. Children renounce direct impulses in order to act as
they think doctors, mothers and fathers act. It is precisely during play that
the child takes pleasure in voluntarily subjecting him- or herself to rules
(Elbers, 1996). The work of Emde et al. (1991) has shown that even babies
derive pleasure from shared procedural rules, and use these rules as
psychological ‘tools’ for self-monitoring. We again encounter self-
determination based on rules in those autobiographies where survivors
discuss their responsibility for the care of children or adults who are weak
and helpless (Colby & Damon, 1995; Rubin, 1996). In Høeg’s novel Peter
discovered in this way that the ‘law of reciprocation’ does not always obtain.
In caring for August, he was following the precept of helping without
thought for anything in return while he was putting himself at risk of being
transferred to a psychiatric institution, which is, according to Peter, a dustbin
for abandoned children.
And yet you did get something in return. I had descended and then
ascended to help and protect him. Now it was as though he were helping
me. As though you could set yourself free by helping others.
I cannot put it any better. (Høeg, 1996, p. 118)
According to Vygotsky (1978b), social rules and laws provide the founda-
tion for the freedom and conduct of the individual.
A third insight concerns the importance of mental skills to think through
one’s own situation and to make choices. Resilient survivors of child abuse
relate in retrospective research how, by the age of 5 or 6, they had already
consciously rejected their parents’ morality and way of life (Rubin, 1996).
They made the distinction between ‘them’ (those people they did not want to
belong with) and themselves, and between what they were and were not
responsible for. Resilient children relate that they reject their parents’
negative view of themselves; they reject the idea that it is all their own fault
(Zimrin, 1986). It is thanks to their own abstract mental skills that children
acquire new skills to enable them actively to dissociate and coordinate
positive and negative cognitive-affective schemes (see point 1, p. 552
above).

Access to Cultural Sources

A final insight provided by Vygotsky and contemporary constructivists into
the psychological processes that make discontinuity possible refers to
cultural sources—procedures, rituals, moral concepts, ideologies, religion—
beyond the family of origin. Both children and adult survivors can recognize
their image of the good in contact with an individual or group. This might be
a music teacher in lower grade school who recognizes and encourages the
child’s musical talent. Rubin (1996) cites the case of a man, the child of two
heavily alcoholic parents, for whom music was his entry card to the world
MILTENBURG & SINGER: A CONCEPT BECOMES A PASSION 513

beyond his family and his whole environment. But it could also be other
children, as in the case of Peter, in Høeg’s novel, or a religious movement,
as in the converts investigated by Ullman (1989). People beyond the family
can serve as ‘interpersonal scaffolds’ for all children (Magai & McFadden,
1995). They provide access to ‘psychological tools’ to operationalize their
concept of ‘the good’. Such important others can also function as a moral
forum to whom the child or adult can feel answerable, and with whom to
negotiate shared rules and meanings in everyday intercourse (Day &
Tappan, 1996; Haste, 1993; Rizzo & Corsaro, 1988). Again, this lays the
basis for internal dialogue and self-determination.

Affective Problems and Moral Confusion

So far we have been discussing the relations between development in the

moral sphere and discontinuity in the development of survivors. But the world
does not just consist of individuals like Peter; there are also the Augusts.
August is overwhelmed, despite the efforts of Peter and Katarina to save him.
According to Peter, August’s strategy was to hate: hatred of the parents who
had abused and maltreated him; hatred of the authorities who allowed all this
to happen. And he repeated the violence by killing his parents and hating
himself. Does this make August amoral? According to Peter, his hatred
comes from his sense of justice, without which his life would be unbearable.
He has to hate. ‘And those you hated had to be the ones who were
responsible. Well, I mean otherwise they, personally, would not be guilty’
(Høeg, 1996, p. 177). At the dramatic climax of the book, August is at the
point of committing another murder, this time of the director of the boarding
school. But instead he breaks the chain of repetition and kills himself, thus
redeeming himself as a moral person.
August was impaled on the horns of an almost insoluble moral dilemma.
He could not go on living without justice being restored; nor could he live
once having taken that justice into his own hands by killing his parents. We
shall look more closely below at this moral dilemma and the confusion of
survivors, and also at the continuation of affective and behavioural problems
that are often correlated with it.

The Moral Dimension in Affective Problems

Many demands for help from survivors are essentially moral, or at least have
a moral dimension. Lebowitz and Newman (1996) and Jehu (1992) found
that the most common themes in the therapeutic sessions of survivors relate
to self-blame and shame; feelings of helplessness and a global absence of
agency; fear, rage and loss; feeling that one’s emotional responses are not
legitimate; loneliness and isolation; negative beliefs about the self, other
514 THEORY & PSYCHOLOGY 10(4)

people and the world; culturally given meanings associated with race, class,
gender and sexual orientation. That self-blame and shame refer to morality is
quite clear (Lamb, 1996). But constructivist research on the moral develop-
ment shows that others’ themes are also either directly or indirectly
concerned with values and norms (Walker et al., 1995). A feeling of general
lack of a sense of agency, for example, can be related to an insufficiently
explicit or inadequately worked-out set of norms and values; or with an
inability to form one’s own moral convictions in daily transactions. Anger
that is difficult to control can cause the survivor to doubt his or her own
moral trustworthiness: he or she could perpetrate some kind of assault on his
or her own children. Negative beliefs about the self and other presuppose a
moral judgement. For instance, breaking out of loneliness by embarking on
an intimate relationship is not only based on the ‘feeling’ that the other
person can be trusted. It also has to do with constructing shared norms over
what constitutes the good in a particular context, and with knowing that
nothing wrong is done, and therefore with a shared conception of what
‘wrong’ is.

A History of Abuse and Moral Confusion

The development of a personal moral framework can be very difficult for
survivors. In the first place, they have often been set insoluble moral
problems as children, which subsequently leave them trapped in moral
dilemmas later in life. The history of August is not unique. Take, for
example, a case cited by Lebowitz and Newman (1996). Sandra is a 35-year-
old woman who was sexually abused by her father. She is full of anger
against her mother, whom she describes as a critical and rejecting woman.
Her main problem, presented during an intake session, is her self-hatred,
deriving from her feeling that she ‘betrayed her mother on her deathbed’
(p. 203). Sandra feels bad because she didn’t take care of her sick mother,
and because of her ‘strong sex drive’ and her current sexual behaviour,
which includes masturbation in public places and a sado-masochistic rela-
tionship. She condemns herself, but is she really guilty? ‘Who among us can
apportion blame correctly?’, asks Lamb (1996, p. 118). Survivors are
confronted with dilemmas for which there scarcely exists any moral forum at
the social-cultural level. Even a feminist ideology is inadequate to deal with
this. Feminist authors such as Croghan and Miell (1995) and Sen and
Daniluk (1995), for instance, exonerate all mothers of incest survivors,
whatever they did or didn’t do, on the grounds of their social impotence in a
patriarchal world. Will their judgement be of any help to Sandra in resolving
her moral problem and anger against her mother? It is doubtful. Survivors
might be caught between conflicting moral forums or ‘voices’. On the one
hand, the recognition of victimhood might be situationally necessary to
promote an understanding and acceptance of the functionality of their
MILTENBURG & SINGER: A CONCEPT BECOMES A PASSION 515

special psychological tools and lasting pain regulatory system. But, on the
other hand, they might reject an identity of victimhood and fight for
acknowledgement of their human agency.
Second, developing one’s own moral framework is made much more
difficult for survivors by the moral chaos that the parents/perpetrators
bequeath their children. As authority figures, they legitimate something
which the child knows at the same time to be wrong. According to Emily
Driver (1989), this can often lead to the following kind of reasoning in
children:
What is happening is wrong, yet who is doing it to me is right. Therefore I
must be wrong. It is ‘dirty’, therefore I must be dirty. Good children are
rewarded and bad children are punished. Therefore I must be a bad child.
What did I do wrong? I must have done something wrong without even
knowing. Therefore I am not a good judge of whether I am right or wrong.
(p. 109)
The child’s confidence in his or her own feelings about right and wrong is
undermined, which in turn can be an impediment to the development of
higher-order skills for making judgements in (personal) relations. The
developmental delay may be confined to specific domains, since skills and
schemes are specific to situations and relationships, for instance in relation
to an individual’s partner or his or her own children.
Even if a child remains convinced of the guilt of the parent/perpetrator
and is determined to live blamelessly, problems can nevertheless arise later
in life, for survivors often do not always command the range of knowledge
and skills needed to put their moral values into practice. Owing to their
experience of abuse or neglect, survivors often have lively and concrete
images about what they don’t want (Fischer & Ayoub, 1994), while their
concept of the good remains too abstract and stereotypic to be used as a
guiding principle for their daily behaviour. Not every survivor succeeds in
entering into new positive social commitments with individuals or groups
outside the family. A classic example is the girl who is sexually abused, who
runs away, marries at a young age, and is re-victimized by her partner(s).
Survivors are much more likely to be victimized than are non-abused people
(Beitchman et al., 1992; Summit, 1983).
Finally, dissociated schemes based on positive and negative experiences
can lead to problems of coordination later in life which make it difficult for
survivors to control and direct their own lives (Miltenburg & Singer, 1999a,
1999b). August, in Peter Høeg’s book, is an extreme example of this. He
was ‘either the one person or the other, there was no connection’ (Høeg,
1996, p. 140). The one person was a totally frightened and helpless child
who could not control the destructive force of the other person. In the
terminology of Fischer and Ayoub (1994), August had developed no higher-
order coordinating schemes to facilitate any sort of communication between
dissociated schemes or to direct them. Most people suffering from a
516 THEORY & PSYCHOLOGY 10(4)

dissociative disorder develop a high-level dissociative capacity with agen-

cies that can act on each other (Fischer & Ayoub, 1994); but even in the
latter type of case coordination and directive problems can arise at certain
points (Miltenburg & Singer, 1999a, 1999b). In the moral sphere, this can
become visible in ‘problems of loyalty’ vis-à-vis the maltreating parents. On
the one hand, the child or, subsequently, the adult can swing back and forth
between longing to break out, desire for revenge, or at least to stop the
abuse; while, on the other hand, the contrary longing is equally strong—for
good experiences with the parents, to forgive and forget. This problem will
return in the therapeutic example with which we conclude this article.
In summary, we can conclude that a strong desire for justice and for the
good, combined with insoluble moral dilemmas and a lack of higher-order
skills and moral tools, can lead to major emotional, relational and moral
problems. As Emily Driver (1989) has written: (sexual) abuse ‘may have a
profound influence on the child’s system of morality, and the whole ethical
approach to later life’ (p. 112).

Moral Issues in Therapeutic Practice

In the final parts of this article we shall examine the implications of the
above for the theory and practice of therapy and discuss a clinical ex-
ample.

Denial of Morality
The tendency to view psychotherapy as applied psychological science has
produced a huge body of conceptual and empirical work which tries to
explain the way counselling works through the social and cognitive dimen-
sions of psychotherapeutic conversation (Sugerman & Martin, 1995). By
contrast, the moral dimension of those problems for which clients seek help
has received relatively scant attention from psychologists (Lamb, 1996;
Sugerman & Martin, 1995). Rather, the so-called ‘healing discourse’ pre-
dominates in the therapeutic literature on survivors of childhood abuse.
According to Davies (1995), this healing discourse is mainly about ‘working
through’ and ‘healing’, while moral issues are psychologized and patholo-
gized.
On the one hand, a lack of self-confidence, helplessness or self-blame are
construed in the literature as emotional problems that survivors suffer from,
such as those resulting from insecure relations of attachment and lack of a
‘basic security’ (Alexander, 1992; Crittenden & Ainsworth, 1989; Steele,
1986). On the other hand, these same problems are also construed as
cognitive problems that have arisen because survivors have assumed the
‘distorted cognitions’ of the perpetrators, or even rely on such ‘distorted
MILTENBURG & SINGER: A CONCEPT BECOMES A PASSION 517

cognitions’ to fend off intolerable emotions (Briere, 1992; Janoff-Bulman,

1992; Lamb, 1996; Salter, 1995). Sampson (1993) points out that the term
‘distorted cognition’ is an authoritarian one, based on the legacy of a realist
perspective in the positivist social sciences. According to him, the concept of
distorted cognitions blocks insight into the discursive framework in which
judgements are construed about ‘real’ vs ‘false’ statements concerning
socio-cultural reality. In line with Sampson, we think that scientific state-
ments about abused people often rest on the discursive frameworks of non-
abused people. Take, for example, the statement that an abused client’s lack
of trust in the therapist or people in general is a distortion of reality. This
statement is based on the generalization of the experiences of non-abused
people: that the world is benevolent and the self worthy (Janoff-Bulman,
1992). But abused people have also drawn appropriate conclusions from
their experiences; in fact many of them have had negative experiences with
the helping profession during their life. To doubt their ability to think is to
doubt the way they have managed to survive, and is therefore not only
authoritarian but also undermining.
There is another objection against the term ‘distorted cognition’: when it
is applied to judgements about ‘right’ and ‘wrong’. The term assumes that
the therapist, on the basis of objective professional knowledge, can dis-
tinguish between correct cognitions and ‘real’ guilt, on the one hand, and
distorted cognitions and ‘self-destructive guilt’, on the other. A therapist
cannot do this. With the help of attribution theory, we can analyse the
process of acknowledging guilt; and in the terms of psychoanalysis, the self-
blame of a survivor can be interpreted as resistance to anger directed against
the self; but neither attribution theory nor psychoanalysis nor any other
psychological theory can establish what is a correct moral judgement. This is
a question that belongs not in a psychological, but rather in the moral,
domain. Naturally, a therapist has his or her own moral framework, and in
our western society there are shared basic values and laws. But you don’t
have to embrace a relativist position on morality to acknowledge that, when
it comes to dealing with answers to the complex moral problems of
survivors, the therapist’s moral framework is by definition no better than the
client’s.
This has the consequence that although moral themes may perhaps be
raised in practice, no systematic work is devoted to the development of the
client’s own moral framework; or that the therapist imposes his or her norms
because moral problems are confused with notions of ‘health’. An extreme
example of the latter is the discussion among therapists as to whether
survivors should forgive the perpetrators of their violation. According to
some, hatreds that have not been worked through stand in the way of the
client’s cure and lead to continuation of the cycle of violence into the
following generation (Davies, 1995).
518 THEORY & PSYCHOLOGY 10(4)

Lamb (1996) and Davies (1995) point out the strong tendency in the
literature to exculpate both survivors and perpetrators as victims of their own
unassimilated traumas. According to them, perpetrators as well as their
victims have the right to a moral judgement of their deeds. For ‘blame-
worthiness requires personhood, the belief in persons as vehicles and
representatives of moral values’ (Lamb, 1996, p. 185). In our view, Lamb’s
proposition could be extended to all affective problems that have a moral
dimension: the denial of the moral is but a subtle form of dehumanization.

A Vygotskian Approach
Our approach to the support of survivors of child abuse is based on
Vygotsky’s cultural-historical theory and current social constructivist theo-
ries. Among other characteristics of this approach, much importance is
attached to the development of the higher mental functions and the psycho-
logical tools that survivors may need to direct and control their own
functioning—tools that are both exceptional and have to be developed. For
the theoretical underpinning of our approach we refer to earlier articles
(Miltenburg & Singer, 1997, 1999a). We shall limit discussion here to the
role of moral tools and skills, or their lack, and of (conflicting) moral
commitments in the treatment of affective problems. We will illustrate our
position by discussing a clinical example.

‘The Mother Who is Good to Me, and the Deranged One’

1
Janna’s therapy revealed a woman oscillating between strong positive and
negative feelings for her mother, without the skills or psychological tools to
manage her desires in the relationship with her. Because of the violence of
her emotions, she was unable to distance herself and to develop higher-order
skills that would enable her to coordinate her conflicting cognitive-affective
schemes. She was also having difficulties in asserting herself in her work as
manager in a large store. During her therapy, it appeared that these problems
were connected with childhood neglect and parentification by her mother,
and with a huge moral problem: Janna’s parents had been Nazi collaborators
in the Netherlands during the Second World War.
Janna sought help when she was in her late thirties and the mother of two
children. She came for help because for years she had suffered from stress
and had been off work for several months. This turned out to be related to
her powerful urge to control, feeling burdened by responsibility and a lack of
trust in her subordinates; and to her strong feelings of guilt that prevented
her from dealing with the shortcomings of her subordinates. It was not long
before Janna’s problems in the private domain were also raised in therapy.
According to Janna, her problems at work were related to her past. After the
MILTENBURG & SINGER: A CONCEPT BECOMES A PASSION 519

collapse of Nazi Germany her parents had endured very hard times. Her
father served a prison sentence, and upon his release he had cut all ties with
his children. Janna’s mother was consumed by self-pity and anger against a
post-war world that had ruined her life. She had forced Janna into the role of
caregiver. When Janna was sexually approached by SS friends of her
mother, her mother called her a liar and refused to protect her. Janna felt
very lonely at home and at school, where she was bullied by the other
children. Later in life she kept her family past a secret hidden from all her
friends. Janna did not know how to deal with her (parents’) past, whether in
relationship with her mother, or in relation to herself, her friends and
colleagues.

Learning Goals in the Moral Domain

Throughout the entire therapy—in total 17 sessions with lengthy intervals
spread over a period of four years—Janna was involved in fierce conflict
with her mother. Janna wanted her mother to recognize that she had suffered
from the past. Her mother said: ‘These are ancient mistakes for which I have
paid the penalty, and I don’t want you to speak to me about them again.’
And: ‘It didn’t affect you.’ On the one hand, Janna wanted to avenge herself
by destroying her mother’s illusions and breaking with her. On the other
hand, she also wanted to learn to be able to look back without resentment,
and after each row with her mother she felt so guilty she did everything
possible to put things right between them again.
Although Janna got time and attention during each session to share her
emotions and thoughts about the continuing conflicts with her mother, this
was insufficient to overcome the turmoil of her feelings. The therapist
assumed that Janna lacked the necessary skills and that her morality was too
blurred to restore order to the emotional chaos of her relationship with her
mother. She explained this hypothesis to Janna and together they decided to
work at skills to deal with moral issues. For this the therapist chose a
relatively minor moral issue: her feelings of guilt and great reponsibility at
work.

Skills to Deal with Guilt

At first the therapist offered Janna tools and skills with which to make
judgements where guilt arose in her relationships with subordinates. The
first rule to be learned was not to ask why-questions. Janna, whenever a
conflict arose, was in the habit of endlessly thinking about the reasons why.
Did it go wrong because I am too impatient, because I can’t keep my end up,
or is it—the most painful explanation—because in the end I’m a fascist?
Even minor conflicts would provoke her to search her conscience to the
point of exhaustion. Her why-questions led to totalitarian answers to the
520 THEORY & PSYCHOLOGY 10(4)

question of whether or not she was bad, or whether it was the other who was
bad. She was becoming more introverted and more (self-)judgemental.
Instead of why-questions, Janna had to learn to ask how-questions. How
exactly did I act? How did others act? What were the consequences of this
action? How and on the basis of what values and norms do I judge this to be
good and that bad? These how-questions led Janna to recognize—to her
surprise—how little in fact she was doing ‘wrong’.
Janna also learned methods of dealing with guilt constructively. She
unlearned her old habit of reacting to guilt feelings by introverted self-
reproachful behaviour, and instead she learned to see the feeling of guilt as
an indication that perhaps she was guilty of something. Once you know what
you are guilty of, you can try to put matters right, after which the whole
business is finished and done with.

Clarification and Empowerment of Moral Commitments

Janna learned to make her own moral framework explicit by taking the
emotional cravings that had been directing her actions and making them
guiding values and norms. She learned to make explicit the moral implica-
tions of her desires. For example, in her work she desired of herself only that
she should deal with her subordinates in a positive, supportive manner.
Taking unpopular measures had been causing too many guilt feelings (‘I am
a nasty fascist’), and, because of this, she had for too long been putting up
with unhappy situations where everyone suffered, and for which she herself
had been trying to compensate to the point of burning herself out. Once the
moral implications of her longing to be ‘good’ had been clarified, she arrived
at a new moral norm: managers sometimes have to exert their authority
against the will of (some) subordinates. In conjunction with this realization,
she obtained information about management styles and practical manage-
ment advice.
Finally her moral confusion was also dispelled by a powerful moral
resolution: I have not been infected by my parents and I am not a fascist.
Making this resolution required more than moral self-examination and her
new skills to deal with guilt. Janna took a Jewish acquaintance into her
confidence over her past and this assured her that she had no guilt. For Janna
this person represented the highest authority; and this acknowledgement of
authority gave her the strength to take her resolution.

Isolating the Insoluble Moral Conflict

Just before the end of her therapy, Janna learned to deal better with her
feelings of guilt in relation to her mother. She has learned to transfer the
skills and moral tools that she has developed in relation to her work to the
domain of the relationship with her mother. She still feels a certain bitterness
MILTENBURG & SINGER: A CONCEPT BECOMES A PASSION 521

toward her mother, who continues to behave as a victim who has a right to
Janna’s care. According to Janna, she has two mothers: ‘the mother who is
good to me, and the deranged one’. In the end, Janna decided not to break
with her mother but to accept that the contact between them will remain
limited. For her, having a family is more important. Commitments to her
children also play a role: she does not want to deprive them of a grand-
mother. Thus, Janna has learned to live with an insoluble moral problem: she
loves a mother whom, in essential aspects, she also condemns, and who will
never acknowledge guilt on her account. The difference is that this dilemma
no longer impinges on her behaviour at work or in her private life. Her
feeling of guilt no longer affects her other relations. It is now several years
since she suffered from stress.

The Therapist’s Role in Learning Processes in the Moral Domain

Earlier we emphasized the role of social commitments and processes, such
as narratives and discourse, in the construction of shared values and a
personal moral framework. Elsewhere we have argued that the therapeutic
situation should be interpreted as a joint problem-solving setting where both
the client and the ‘more experienced social other’ (the therapist) pursue a
common goal (Miltenburg & Singer, 1999a). What are the implications of
these theoreretical assumptions for the therapist’s contribution to the con-
struction of ‘the good’? In the case of Janna, the therapist was an important
other; and just as in any therapeutic approach, empathic listening and
confirmation of feelings by the therapist played an important role. But this
doesn’t mean that the therapy resulted in a shared moral framework; some
moral choices were shared and others not. The goal of the therapy was the
development of skills to deal with moral issues and the explication of
Janna’s own moral framework, that is, of her commitments to moral values
and important others (her mother, children, friends, colleagues, anti-fascist
organizations, Jews). To counteract the therapist’s influence, two techniques
were very important. The first was socratic questioning about Janna’s
commitments and the moral implications of her emotional cravings. For
instance, ‘What would you answer to Peter’s questions at the gate of heaven
about the good things you have tried to accomplish in your life?’ Janna was
not religious and she enjoyed these kind of questions. Socratic questions
foster the development of meta-cognitive skills and the development of
desires into moral commitments and norms; and they support an emotional
distance toward the therapist. The second technique to assist Janna to solve
her moral problems in her own way was teaching her thinking methods or
tools with which to analyse her moral conflicts: for instance, learning to ask
how-questions instead of why-questions; methods of dealing with guilt;
information about management styles and practical management advice.
522 THEORY & PSYCHOLOGY 10(4)

Janna’s solution of her moral dilemma in relationship to her mother was

definitely hers.

Conclusions

Many people who have been abused as children manage to construct a good
life despite their unfortunate childhood. How can this discontinuity in their
development be explained? We have shown in this article that Vygotsky and
social constructivist theories can bring new insights to bear on this question,
crucially the renewed thinking-through of the relations between affects
(emotions and morals), cognitions and social conduct, and the insight that
cognitive-affective schemes are bound to particular relations and situations.
The human capacity to direct one’s own behaviour is correlated with the
development of the higher mental functions. Concepts of the good and social
commitments (rules, laws, norms and values) are important psychological
tools for self-determination. They are important in the creation of dis-
continuity; they enable the individudal to take a distance from cognitive-
affective schemes that are tied to experiences of violence.
In the second half of the article we looked at recurrent problems in the
lives of survivors. These can also be related to developments in the moral
sphere. Guilt feelings, hate, lack of self-confidence or a general feeling of
lack of control and direction can all lay the basis for moral dilemmas and
confusions. For this reason, in the therapeutic context careful consideration
needs to be given to just how the client can be supported in the moral sphere.
In the contemporary therapeutic literature this is unusual; the moral dimen-
sions of affective problems frequently go unrecognized. Two questions are
important in the therapeutic context. First, how can clients be helped to
strengthen their contact with their own moral sources, with personal images
of ‘the good’ and with (earlier or new) commitments with other persons and/
or a higher authority? Second, how can clients be put in contact with cultural
sources and psychological tools to develop skills that will enable them to
operationalize their abstract, stereotypic concepts of the good and to learn to
live with moral dilemmas? For we have learned from resilient survivors that
developing one’s own moral framework and mental skills does help one to
gain a grip on one’s own life.

Note
1. ‘Janna’ is a pseudonym.

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Acknowledgements. We would like to thank the anonynous reviewers.

Owing to their thorough work, we could clarify further our own conceptual
framework.

Ruth Miltenburg is a therapist and management consultant. She special-

izes in psychotherapy for survivors of child abuse with problems at work
and has developed a model for short-term therapy based on (Vygotsky’s)
activity theory. With Elly Singer she has published in Human Develop-
ment, Feminism and Psychology and Theory & Psychology on issues
concerning basic assumptions in psychotherapeutic theories and learning
and developmental processes in therapeutic settings. Address: Hoenderko-
pershoek 9, 3981 TD Bunnik, The Netherlands.

Elly Singer lectures at the University of Utrecht (Department of Devel-

opmental Psychology) and the University of Amsterdam (Department of
Education). She has written on the history of child care and its relationships
to values and theoretical fashions in developmental psychology, and on the
social development of young children in day care centres. She is doing
research on the development of foster-children and survivors of child abuse
based on constructivist approaches to emotional and moral development.
Her publications include Child Care and the Psychology of Development
(Routledge, 1992). Address: Department of Developmental Psycho-
logy, PO Box 80140, 3508 TC Utrecht, The Netherlands. [email:
E.Singer@FSS.UU.NL]