Whereas some children act out their distress, others distort their concept of self in an effort to find psychological hiding places. Unlike the acting-out children, these depressed, apathetic, overly compliant children are unlikely to be seen by therapists because their symptoms are not noticed. These severely abused children try to survive the reality of their situations by becoming invisible, because safety is a primary issue. These children may also try to overcome their neglect and emotional deprivation by 'feeding' those around them and fasting emotionally. Both of these adaptations are relational expressions. The child achieves a false sense of security and safety by becoming invisible or unworthy relative to others. The child's sense of self has been profoundly damaged. Psychotherapy with the adult victims of child abuse is challenging but also potentially rewarding, often requiring a long-term commitment from both client and therapist. 24 footnotes.