The victim-to-patient process: the disconfirmation and transformation of abuse.

The victim-to-patient process is reconceptualized as an interplay among abuse events, family relationships, and other life contexts, emphasizing the fragmented identity deriving from accommodations to the judgments of others about the abuse. Original defenses are seen to form the later core of the survivor's psychopathology. This schema helps clinicians to understand obstacles to treatment and recovery and to recognize the behavior reflecting disconfirmation and transformation of abuse.