Strategies for addressing the public health problem of depressive symptoms in mid-pregnancy will benefit from a life course perspective.

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An obstacle to recovery in therapy with survivors of incest and domestic violence is described. Inner conflict over whether to allow the psychic wound to heal is based on the client's unconscious belief that full recovery from the trauma would exonerate the perpetrator and be disloyal to other victims. Treatment implications are discussed.People who have been subjected to unusual psychic stress, such as survivors of the Nazi Holocaust, Vietnam veterans, and those who have been kidnapped, physically assaulted, or raped, often suffer from a constellation of psychological symptoms which have been termed the post-traumatic stress disorder (American Psychiatric Association, 1987). Recognizing this syndrome as one which results from extreme psychological stress, without postulating pre-existing psychopathology, has freed therapists from cumbersome assumptions and allowed therapeutic work to be focused on recovery from the trauma. The therapeutic goal is to assist the client in moving from victim to survivor status and in resuming normal life tasks (Ochberg, 1988). In the course of therapeutic work with victims of domestic violence (child abuse, incest, wife battering and marital rape), we have repeatedly encountered a phenomenon presenting an obstacle to recovery which we have come to call "the wound that must not heal.