Although the history of psychoanalysis had its origins in the study of hysteria, as observed by Freud and its association with traumatic events in the women he was treating, its intrapsychic sequelae and behavioral manifestations remain elusive and often challenging to treat. In this article, I intend to present ways in which the effects of trauma in general, but more so the pervasive impacts of incestual trauma, could be understood from the point of view of a deficit in symbolizing capacity and the accompanying shifts in the economy of libidinal forces that perpetuate the reenactment of experiences for which the patient at a conscious level will seek help, but will unconsciously strive to refuse it. Some of the associated treatment difficulties will be mentioned, emphasizing sadomasochistic maneuvers employed by patients, with accompanying countertransferential responses by the analyst. Some examples of technical approaches to managing difficult clinical impasses from the author's clinical experience will be presented. I also offer the concept of the Fear Position as a psychic maneuver that some traumatized patients show, which represents a challenge to developing a symbolizing capacity without which healing from trauma is impossible.