When catastrophic events overtake adult lives, they can often scar the psyche in ways that psychodynamic clinicians struggle to understand. The adult survivor of a catastrophe–whether a life-threatening assault, a serious accident, an act of terrorism, or a natural disaster- experiences a near fatal disruption of fundamental aspects of self experience. Many who have physically survived catastrophic trauma are uncertain that they have psychologically survived the ordeal. Integrating recent findings in the neurobiology of stress and developmental psychology with relational psychoanalytic concepts, Ghislaine Boulanger, PhD, shall describe the phenomenology of Adult Onset Trauma and suggest ways in which to work with it.