Sibling Violence, Trauma, and Reality: A Clinical Report

In a recent session a patient began with an account of a distressing interaction with her husband during the previous weekend. In the near future she will make a presentation at an important business conference. Typically, before such events, my patient suffers considerable anxiety, accompanied by intense feelings of inadequacy. She imagines that her work will be attacked mercilessly. Silenced by these imaginary attacks, she will be publicly humiliated in front of her colleagues. Reality consistently contradicts these frequently evoked imaginary scenarios; her work has been for the most part well received by her fellow executives. Furthermore, my impression throughout the analysis is that she is well respected by the company hierarchy.

Faced once again with her tormenting fantasies, she sought reassurance and comfort from her husband. He had been usually sympathetic and supportive of her pre-conference doubts, but on this occasion she experienced him as somewhat impatient and preoccupied. In the session she said, “I felt as though someone had kicked me violently in the chest when he reacted like this.” Surprised at the intensity of her reaction at what seemed a mild rebuff from her husband, I commented that her distress and her choice of words seemed to come from somewhere else, perhaps involving memories of the persistent, often violent, physical and verbal abuse that she had suffered at the hands of her brother throughout her childhood.

Without hesitation she agreed and described yet another hitherto untold incident involving her oldest brother. When she was about 12 she