Men and Abuse

Dear Sir

I would like to comment on the recent paper by David Mann entitled ‘Incest: The Father and The Male Therapist’ (British Journal of Psychotherapy, Vol. 6(2)). Firstly, with regard to a specific point; the author refers to my paper (British Journal of Psychiatry, ) and interprets my comments about the therapist's gender as evidence to support his contention that there are positive therapeutic indications for male therapists to work with female incest survivors. I wish to make it clear that I do not agree with Mann concerning this issue. Although the reasons that none of the women in my study first disclosed a history of sexual abuse during the assessment interview could not be specifically correlated with the gender of the therapist (and it was a fairly small sample), I did suggest that the nature of the procedure in itself mitigated against disclosure. Mann clearly does not understand that this must be contextualised within the existing structure of patriarchal NHS institutions which have always medicalised women's psychological distress, thereby maintaining existing power relations and invalidating the reality of incest survivors' experiences. It would seem to me that male therapists can hardly offer an alternative role model to female survivors, whilst continuing to uphold, and act within, the very structures which have not allowed a woman to be the subject of her own story.

Secondly, in focusing on the Oedipal issues facing father and daughter Mann minimises the significance of the basic underlying dynamic operating in childhood sexual abuse, clearly identified by Frosh whose ideas are discussed and then discarded by Mann. Central to this dynamic is the gratification of the perpetrator's need to feel powerful, to feel loved and to release the hostility and frustration for which he has been unable to find appropriate outlets. Although Mann admits to being drawn into this dynamic in his description of his interaction with a group member, he seems to have rema