Treating the Adult Survivor of Childhood Sexual Abuse: a psychoanalytic perspective by Jody Messier Davies and Mary Gail Frawley. Published by  Basic Books, New York, 1994;  259 pages; $35.00 (hardback).

Over the past two decades there has been an enormous growth in the interest and publication of literature on the subject of childhood sexual abuse. Using the American Psychological Association's abstracting service, Psychlit disc, with the key phrase sexual abuse I found a listing of 216 journal articles published between the years 1974 and 1986. Accessing the second file of this service, which covers the years between 1987 and 1994, the service shows a huge increase in publications to a total of 2166 articles on sexual abuse. Additionally it shows 736 books or chapters dedicated to the topic. Clearly clinicians and survivors alike are swimming in a sea of theory and advice. This growth seems to me not only indicative of a growing patient population, but also of the sense of bewilderment felt throughout the profession in reference to working sensitively and ethically with this patient population. When Davies and Frawley's book came to my attention, my first thought was to question what could they possibly offer that has not already been published? But their subtitle A Psychoanalytic Perspective held out the promise of something consolidating and new in the literature on this subject.

Within the introduction they draw their lines of theoretical influence. Beginning with a discussion of Freud's abandonment of the seduction theory, they move on to build their model clearly within a relational perspective. Their knowledge of theory is scholarly and encyclopaedic as they sweep through theoreticians making compatible use of an Anglo-American consortium as diverse as Kohut and Sullivan from the American schools, and Fairbairn and Winnicott from the British schools. Their model is impressive, well articulated and applicable, if at times running the risk of being overwhelmingly theoretical. (In one paragraph alone they cite twenty-four references!)

Central to their theory is an emphasis on the clinician's need to understand the process of dissociation when working with survivo