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Smith, P.V. (1997). Secret Friends: Borderline Symptomatology and Post-Traumatic Stress Disorder in A Case of Reported Sexual Abuse. Brit. J. Psychother., 14(1):18-32.
  

(1997). British Journal of Psychotherapy, 14(1):18-32

Secret Friends: Borderline Symptomatology and Post-Traumatic Stress Disorder in A Case of Reported Sexual Abuse

Paola Valerio Smith, M.A.

Introduction

The title of this paper was suggested to me when my patient, Chris, told me about a television film by Dennis Potter. The film, Secret Friends, which reflected Chris's own preoccupations, was about a married man who lived a fairly respectable life on the surface but who had a darker side, a secret life both in fantasy and in reality where he explored the underworld.

Chris and I have also explored her own personal underworld where we have met many characters: an evil witch, a perverted old man, a prostitute and a young boy (among others). As we have got to know these inner figures we have come to see them, despite her negative associations, not only as enemies but also as friends, the secret friends who have helped us with Chris's individuation process, her path to wholeness, integration and a deeper understanding of who she is and whom she might become.

In this paper I also consider the process of working with patients who have a history of sexual abuse and who, from a diagnostic perspective, are often classified as borderline personalities. In particular, I focus upon the parallels and discrepancies between borderline symptomatology, familiar to analysts, and post-traumatic stress disorder (PTSD), which perhaps receives less attention. I think that an interplay between the two approaches in the mind of the analyst helps to illuminate an understanding of the transference/countertransference constellation.

Background

Chris is a petite, attractive woman of 33. She is the second youngest of five, in a lowermiddle-class Catholic family.

[This is a summary excerpt from the full text of the journal article. The full text of the document is available to journal subscribers on the publisher's website here.]

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