Bringing Order to Chaos

Abstract

One out of three women in the United States has been sexually abused by the age of 18. The legacy of the trauma influences, for example, the survivor's ability to trust others, to recognize appropriate boundaries, and to form intimate relationships. The dynamics of the therapeutic relationship can engender intense responses and activate many of the feelings from the original trauma. This article presents a framework that describes and explains the connections between past sexual abuse, the survivor's present symptoms, and the ways that these influence the transference and countertransference. The frame-work can help clinicians conceptualize the interplay between the sexual abuse and the treatment process. The therapist will therefore be able to avoid some problems in the therapy and better manage those that do arise.