Therapy with a Sexually Abused Woman

Ms A presented some three years ago for psychoanalysis having been referred by a colleague. A somewhat overweight woman, she referred to herself as 'fat' having put on forty-five pounds, she said, in the last five years. The history she gave at this time, which over the course of the next three years she corrected, was that she was born and grew up in America. Her father was a very severe alcoholic with a lot of very violent behaviour and abusive, sexual acting out towards the other children in the family, particularly her elder sister who had died in a mental institution, as well as a younger sister. There was also a strong history of epilepsy in the family, an elder sister having died of epilepsy and another child, a brother who was handicapped and being looked after by her mother, who has now moved to the southern United States. She says she has very little contact with her mother now and virtually none with her brother and sister, who are still living.

She could not give very much history of her childhood apart from the violence and the fact that she lived in a poor area of town with Puerto Ricans and blacks. She was not allowed to play with them though she saw them at school all the time. She said her father also had a longstanding affair with another woman, and, as her mother worked every night on night duty as a nurse, this woman was frequently around the home. Father controlled the children from seeing anything by forbidding them to come out of their rooms at night. After high school she left America and went to western Canada and took a degree where she met her husband who was in a PhD. programme. They married, and when he had finished his degree they went to his country of origin for a period of three or four years. However, when she wanted to return to America he did not want to come back. She came back with a son, who is now 15. Her husband came to Canada for a short period of time but they felt they could not be reconciled with their fundame