Re:Therapist/Client safety

I second the recommendation to Linehan's work. I've worked extensively with borderlines, cutters, what have you, and have had some success with helping clients gain control over their flashbacks or dissociative episodes.

I use insight oriented therapy as well as gestalt approaches. I work to help clients 1)increase their awareness of what triggers their flashbacks and cutting behaviors and 2) strengthen their abilty to stay grounded when they feel pulled in. If you can catch your client at the onset of a flashback, give them a mint candy to suck on or ice cubes to hold in their hands. Strong stimulus helps them stay in the present.

Your client was almost certainly sexually abused. But rather than inject any possible false memories, you would do best to focus on the effects of the abuse. Any memory work should be led by the client, responding directly to what they bring up for discussion. Helping clients integrate their memories (be able to talk about the abuse without dissociating or getting upset and cutting) goes a long way toward helping them manage their emotions and normalize their experiences and reactions.

Also, consider starting a therapy group for survivors of childhood abuse. I run one and one of the most frequent comments is that they appreciate having a forum to talk about their abuse experiences with other survivors who understand first hand what they're feeling.

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