Sexual abuse, or a delusional structure? From adolescent to young adult.

The treatment of an adolescent patient who recalled having been sexually abused in childhood by her father is described. In the course of treatment, various doubts were raised in the analyst's mind about the truth of this memory. As the analysis progressed, the analyst felt that the patient's responses to interpretations were signs of the presence of a delusional structure. When the patient felt that the analyst doubted her memory, or was not on her side, she angrily and vengefully broke off her treatment. She remains a very vulnerable young woman. The delusional structure contained the patient's sexual need to destroy the male's potency as a defense against her longing for the oedipal mother who, in reality, had left the patient for a new husband.