ABSTRACT
Florence’s progress in therapy completes the case studies of survivors of childhood sexual abuse I chose in order to illustrate the many facets of their troubled lives, and the implementation of an integrated working model in order to facilitate the resolution of the long-term effects of their experience. At initial presentation, Florence’s personal resources were at a level that did not enable her to cope with life’s daily demands, or to regulate her relationships in the general, family, and intimate domain in an adaptive manner. The parameters of my conceptualisation of her difficulties within an Axis II diagnosis of borderline personality disorder, underpinned by the experience of loss, sexual abuse, and disrupted family dynamics, acted as my own crucial guide towards establishing and maintaining our therapeutic relationship and remaining vigilant to the inevitable see-sawing between engagement and ruptures (Silk et al, 1997). A particular challenge was the need for careful integration and blending of a variety of techniques that would address Florence’s difficulties, while at the same time not losing sight of her need for validation, guidance, and the opportunity to learn to trust.
