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The title encompasses the central dilemma; the perpetrator-youngster is a perpetrator,
but views himself as victim. This is elaborated in the first chapter, which gives a clear overview of the subject. Compulsion, rigidity and the presence of aggression in sexuality are described as pathognomonic of perversion. Woods argues that the subjective meaning of abuse determines whether the abused child becomes abusive. The complex reactions elicited in the therapist by the abuser/abused are highlighted, as well as the challenges of using countertransference constructively, while walking the technical tightrope of combining the duality of victim and perpetrator.
Chapter 2 discusses psychotherapy in a systemic context. This is a candid and comprehensive appraisal of factors - including professional rivalries and anxieties - that divide mental health professionals, ultimately diminishing their effectiveness. Woods believes that cooperation amongst professionals - who maintain differentiated roles - maximizes the possibility for a successful treatment. Apart from making use of transference and countertransference, the therapist offers a different emotional experience to the youngster by being a real and ‘new object’ (A Freud, 1966, p. 38). The author refers to Bentovim's paper ‘Trauma Organised Systems’ which emphasises the network of factors, including fear, dependence, blame and denial, that interact reciprocally to facilitate and perpetuate abuse. While this conceptual framework seems illuminating to understanding the internal world of the abused/abuser, the schematic diagram included is rather confusing. It was unclear to me whether the lines with arrowheads were to be understood as vectors (having magnitude, direction and causality) or whether they indicated characteristics of an element in the diagram.
Chapter 3 uses illustrative vignettes to highlight some common themes in therapeutic work with abused/abusers. The clear discussion enables the reader to gain insight into