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Résumé :
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This paper is a journey into a relatively uncharted clinical landscape. The terrain in question is located at the intersection of three factors: early and cumulative trauma (where it exsits), societal and familial stigma and oppression (an inescapable reality), and the normal developmental process of coming out as a bisexual female. In the bisexual or lesbian client, moreover, the clinical aftermath of early trauma resonates with and is exacerbated by the painful impingement of societal and familial stigma and oppression encountered in childhood and throughout adult life. Consequently, the coming out process, even in the best case, will be radically affected by both factors. In the worst case, the coming out process will be derailed completely, leading to the foreclosure of the possibility of a fluid bisexual or lesbian identity. This paper offers a client snapshot with sufficient biographical and diagnostic detail in order to provide a context for discussion of two pieces of psychotherapeutic process that will follow. Rendered first will be a dream reported at the end of the first year of treatment. The dream highlights the client's struggles around coming out as a lesbian in a family and society that fears and stigmatizes homosexuality. The second example of process is a vivid visualization spun live in the moment in session at the end of the second year of treatment. It embodies a Fairbairnian "shirt" or freeze-frame which depicts this client's abiding, tortured endopsychic structure, i.e., her internal self and object world. It poignantly depicts her primitive agonies over her bisexual conflicts, and her relentless perfectionism, manifested as excruciating self criticism. For she attacks her vulnerable self to gain some measure of control over her pain, and to hold out hope that she will, in the end, be loved as a person in her own right.
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