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Why traumatized borderline patients relapse

A H Appelbaum1

  • 1Cornell Medical Center, New York, NY, USA.

Bulletin of the Menninger Clinic
|January 1, 1996
PubMed
Summary

Healing from childhood sexual abuse can be challenging, as recovery may evoke negative feelings and fears. Recognizing the psychological barriers to healing is crucial for patients and therapists.

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Area of Science:

  • Psychology
  • Trauma Studies
  • Mental Health

Background:

  • Childhood sexual abuse (CSA) survivors often experience complex psychological responses to recovery.
  • Painful symptoms and functional impairments can become intertwined with a patient's identity and coping mechanisms.

Observation:

  • Patients may consciously or unconsciously resist healing due to fears of unmet expectations, loss of care justification, and invalidation of trauma.
  • Relinquishing illness symptoms can feel like abandoning a familiar, albeit harmful, form of relationship or revenge.

Findings:

  • The prospect of recovery can trigger negative emotions, including disappointment, fear, and paranoia, as it challenges established psychological frameworks.
  • Progress toward health may be perceived as a loss, leading to resistance or destructive reactions.

Implications:

  • Therapeutic approaches must acknowledge and address the negative psychological meanings associated with recovery for CSA survivors.
  • Focusing on the patient's perception of progress is vital to mitigate destructive reactions and facilitate genuine healing.

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