AGGRESSIVE ENACTMENTS: CONTAINING THE "NO" IN CLINICAL WORK WITH SURVIVORS OF ABUSE.

Identity development depends on the ability to say 'no.' Setting limits enables a relationship between two separate individuals to develop. Early trauma can leave the individual so vigilant to others' demands that internal prohibitions against intrusion remain silenced, which we conceptualize as a 'no' that could not be sufficiently articulated to keep the person safe. For those who have not been able to assert this fundamental limit, the consulting room provides a potential anchoring point to formulate and work through unconscious meanings. Being able to articulate and register the legitimacy of one's own no becomes an important challenge, as tensions regarding power and powerlessness, trust and distrust, are acted out within the consulting room. Case material illustrates how psychoanalytic ideas regarding transference, countertransference, and enactment help the clinician tolerate the intrusion of past into present, inviting the type of mentalization that moves towards repair rather than merely reenacting the trauma.