QUOTE : Could a child in the comfort of her own home experience anything as overwhelming as the terror and stress of a soldier in combat? In fact, children who are chronically physically or sexually abused must endure precisely the kind of protracted and inescapable fear, unpredictability, and helplessness that results in posttraumatic stress disorder. What makes an experience traumatic, says van der Kolk, is not its objective reality but the subjective meaning the victim attaches to it. In general, the more terrified a victim feels and the more powerless she is over her fate, the more likely she is to develop PTSD. Factors that may compound the sense of trauma include the relationship between victim and perpetrator, feelings of shame or guilt over actions the victim did or did not take, lack of support after the trauma or blaming or rejecting the victim, and any symbolic or psychosexual interpretation overlaid onto the experience. All of these are factors that come into play in childhood abuse. In some ways, an abused child faces terror and uncertainty far worse than anything a soldier experiences on the field of battle. She lives in a world of continual and unpredictable danger and may, with good reason, fear for her life. Yet she has no gun to protect her, no squad to back her up, no training for her combat role. She is completely alone, completely powerless, completely at the mercy of her parents' will. She cannot fight back, cannot escape. She is trapped. Like Pavlov's dogs, she endures a punishment inescapable. Her experience may actually be more akin to that of a prisoner of war, but it is even more psychologically pernicious than that. Her captors are her own parents, the people who are supposed to love and nurture her, teach her right from wrong, and protect her from harm.