In this paper I will present the case of Paul, who survived an assault as a young adult, resulting in a traumatic brain injury and post-traumatic epilepsy. Paul's reactions to this traumatic event in adulthood are considered in the context of his earlier traumatic experiences, his psychodynamic conflicts, and his characteristic defense patterns. Transference and countertransference will be considered from the viewpoint of psychodynamic therapy with a traumatized patient who has been in a complex, dependent relationship with one of the perpetrators. Paul's progress in therapy will be reviewed, including his realization of the profound impact of trauma on his life and his strong will to work through his issues.