Case # 2

Sylvia was a shy, quiet, 40-year-old teacher with chronic low self-esteem.  She was a middle child of a verbally abusive, rejecting, alcoholic father and a passive mother.  She was a shy, fearful, and lonely child who often felt different and inferior to her brother and sister who were much more outgoing and popular.  She coped with this by concentrating on her studies and trying to be perfect.

Sylvia had a very close and emotionally intimate relationship with a boyfriend who drowned when she was an adolescent.  His death devastated her and after that she backed off whenever she began to feel close to another adult.  She reported having lifelong problems with emotional alienation and isolation from others and a deep ambivalence about intimate, trusting relationships.

Sylvia met her husband in college and although she didn't love him, she married him because he was a "good catch."  They were never close and intimate and their sexual relationship had been nonexistent for several years.  Sylvia described herself as a good mother but said that her family did not really know her.  Her greatest source of personal satisfaction came from her career rather than from her family.

The couple had two daughters and a son, Josh, who was adopted as an older child.   Although the adoption initially went well, when Josh reached puberty, be began having problems and was placed in a group home in another state.  The family moved to a new community where Sylvia had no family or friends and was "incredibly lonely."  Sylvia's relationship with her husband became more troubled after the move because of disagreements over whether their adopted son should come home for Christmas and she became seriously depressed.

Shortly after the move, Sylvia met Brett, a 12-year-old neighbor boy, through her daughter, Debbie.  Brett was from a large family and was having behavior problems both at home and at school.  The two children became close friends and spent a lot of time together.  As Christmas approached, Sylvia became more depressed because Josh would not be spending Christmas with them.  By this time, Brett was spending a great deal of time at their house and she looked forward to his visits.  He began spending more time with her than with Debbie.  He started spending the night and stayed in Josh's vacant room.  Sylvia and Brett grew close, shared personal things about their lives, until Brett became "the most significant person in my life."

Brett sometimes had trouble falling asleep so Sylvia began cuddling with him in bed until he went to sleep.  After a while they started kissing.  Sylvia began to depend upon Brett for attention and affection.  They had long talks and she told him about John, her childhood boyfriend.  She had never talked about John to anyone before.  Brett apparently looked a lot like John and the hugs and affection brought back the good feelings she had had only with John.

The physical involvement developed into episodes of mutual fondling, oral sex and attempted intercourse over several months until Brett's sister became suspicious of the relationship and called child protection.  When first interviewed, Brett said that Sylvia was his "best friend."  He described his sexual involvement with Sylvia but made no claim of coercion.  However, after therapy, Brett began to perceive Sylvia as having taken advantage of him and became very angry with her.

When confronted, Sylvia admitted to being sexually involved with Brett, took full responsibility for the behavior, and voiced deep remorse and guilt for "betraying" him.  She denied that she had ever been sexually involved with a juvenile before this and felt that the sexual activity had occurred because they each needed some love in their lives and "the chemistry between them was just so strong."  She said that at the time she had not felt she was engaging in the sexual behaviors alone because Brett was a very aggressive child whose responses encouraged her.  She saw him as the dominant one in the relationship and reported becoming physically ill at the thought of losing him and his affection.  She said that she cared for him more than she had cared for anyone in her life since her childhood friend, John.  Although she periodically felt guilty over the sexual relationship, she felt unable to stop it.  After the abuse was disclosed, she reported feeling suicidal and despondent over her recent "losses" of both her her adopted son, Josh, and Brett.

Psychological test results were consistent with the psychological and emotional problems noted in Sylvia's history and indicated significant depression, anxiety, hopelessness, withdrawal, inadequacy, low self-worth, sensitivity to criticism, and a tendency to set extremely high standards of performance for herself.  She was diagnosed as a mixed personality disorder with avoidant, compulsive, and hysterical features along with major depression and dysthymic disorder.

The devastating loss of John when she was 16 left Sylvia in a state of unresolved grief which greatly reduced her capacity for intimacy.  This was compounded by the loss of Josh and the stress of moving to a new community.  These losses, along with her lifelong emotional isolation, low self-esteem, and lack of a satisfying relationship with her husband made her susceptible to reach out to Brett, with whom she felt safe and who reminded her of the one emotionally satisfying relationship in her life.  Her involvement with Brett developed out of her need for emotional intimacy and gratification from a special person rather than from sexual desire or lust.