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Since this book was first published in 1983, awareness of the reality of child abuse has increased dramatically, together with recognition of the help that professionals can offer its victims. The Tavistock Clinic workshop on which the book was based has continued to flourish, with increasing numbers of workers making referrals, encouraged perhaps by the attempts recorded here to make sense of the kind of experience that normally engenders rage, despair or numbness. It is sometimes difficult, when reading the book, to keep in mind just how much of a pioneering venture it was: that it was widely argued, on theoretical as well as on practical grounds, that severely deprived children in care could not be ‘suitable cases for treatment’.
The case studies collected here make it very understandable that this should have been so. The children concerned had suffered from every conceivable permutation of calamitous circumstances - single parent families, mental illness in the parents, abandonment from birth, multiple changes of children's home or foster parents - though actual abuse was not particularly prominent among these. Often a referral was made when a placement for fostering or adoption had broken down, after previous high hopes. The authors make the point that there may well have been something atypical about this sample of children in that all of them had inspired at least one worker with concern or affection or the feeling that something must be done. This did not stop the experience of their therapists from being one of virtually intolerable painful bombardment: always mental, often physical. Again and again the therapists were made to feel unwanted, useless, insignificant, left out, helpless against the manifestations of evil; or again, the repository of a seemingly two-dimensional child's capacity to feel pain. Three examples remain particularly in the mind. A little girl of four, who had been abruptly removed from her home because of sexual abuse by the father, s