Background: Although childhood endangerment often precedes adult posttraumatic stress disorder (PTSD), the mechanism from danger to disorder is unclear. We proposed a developmental process in which unprotected and uncomforted danger in childhood would be associated with ''shortcuts'' in information processing that, in adulthood, could result in PTSD if the adult experienced additional exposure to danger. Information processing was defined as the basic associative, dissociative, and integrative processes used by all humans. Individual differences in parents' (or primary caregivers') protective and comforting behavior were expected to force unprotected children to use psychological shortcuts that linked early trauma to later vulnerability for PTSD. Method: We compared 22 adults with chronic PTSD to (a) 22 adults with other psychiatric diagnoses and (b) 22 normative adults without any diagnosis, in terms of information processing around childhood danger. The Adult Attachment Interview was used to derive information processing variables, including self-protective strategies, childhood traumas, and depression. Results: The two patient groups differed from the normative group on all variables. Adults with chronic PTSD differed from other psychiatric patients in having more childhood traumas and using more transformations of associative and dissociative processes. Within the PTSD group, there were three psychologically different subgroups. Conclusion: Our findings suggest that (1) prediction of risk for adult PTSD may be possible, (2) treatment might be facilitated by provision of a protective and supportive therapist, (3) who included a focus on correction of information processing errors and use of more adaptive strategies, and (4) subgroups of adults with PTSD may require different forms of treatment.

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In this paper I explore the case of a woman, Miss M, whose twin died 'in embryo', employing as an extended metaphor Coleridge's Rime of the Ancient Mariner. Both the poem and Miss M's story describe 'internal world' dramas formed through very early object relationships. In Coleridge's allegorical poem we are told much about the poet's own inner world. The poem contains universal themes of destructiveness, loss and the quest for reparation; these themes illuminate the patient's story which was recounted by Miss M during assessment sessions for psychotherapy. The impact of her story, particularly its maritime images, formed many associative connections in my mind with the poem. The result for me was an enriched understanding of both the patient and the poem.Coleridge wrote his Rime during a fertile period between the years of 1797 to 1799 when the bulk of his most imaginative work was written. It tells the story of a wedding guest waylaid by an old mariner whose life task it is to recount a sea voyage of horrifying hardship to anyone he can persuade to listen to him.During the voyage a friendly albatross follows the ship-an event regarded by the mariner's fellow sailors as a good omen. However, the mariner, for reasons best known to his unconscious, shoots the bird with his crossbow, much to the consternation of his seamates who fear some terrible reprisal for this unlucky deed. When at first all continues to go well, the sailors withdraw their disapproval and agree it was right to kill the bird. Before long the ship is becalmed. The sailors change their minds and now judge the mariner responsible for this dreadful misfortune.The albatross, a reminder of the mariner's destructive act, is hung around his shoulders. A drought-induced hallucinatory state follows, in which Death and his Spectre-Woman partner dice for the mariner and his shipmates. The latter are won by Death; the mariner remains only barely alive in a state of living death. Eventually he finds himself able to pray. The albatross falls from his neck, a breeze begins to blow and the ship is at last brought near to land, where it sinks. The mariner is picked up by a pilot's boat and recounts his story to an old hermit who lives in the woods nearby.Having been a captive audience to the Ancient Mariner's tale, the wedding guest is now free to leave -'a sadder and a wiser man'.This gripping and profoundly moral narrative may be understood from a number of different perspectives. Firstly, as a theological parable about good and evil. The poem moves from an initial state of innocence to a 'fall' through sin for which all share responsibility, followed by a resurrection. The message of the poem is about the potential for redemption through suffering and penance.From an eco-political viewpoint, it is an allegory of man's wanton destructiveness of his environment; the appalling consequences unleashed by such violations of Nature's laws -and the heavy price paid by man for his mindless behaviour. A prophetic