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John Crewdson is a journalist who has brought his investigative skills to bear in the area of childhood sexual abuse. He presents facts and figures on the prevalence of this particular type of mistreatment of children that startle even the psychoanalyst. His case histories of both the victims and the abusers are interesting to read but are, of course, the case histories of a journalist and lack the sophistication of a psychiatric or psychoanalytic report. He tends to focus in great detail on the "acts" themselves, which is itself a type of exploitative journalism.
In trying to explain the motivation of the abuser, he has adopted the now popular diagnosis of narcissistic personality as a label to apply to this very large and heterogeneous group of individuals. Once having applied the term "narcissist," he generalizes about "narcissists," what they need and how they should be treated. This is quite misleading. The numbers of victims and of abusers involved are staggering. According to Crewdson, about twenty percent of the adult population has been sexually abused by an adult before the age of eighteen, the ratio of male to female victims is about one to two.
Of course, this number includes victims in many different situations. Some involve incest, and others involve more distant family relations, or strangers. It can be the act of an individual or the premeditated action of a group functioning over a long period of time. The latter may masquerade as a social institution, such as a day care center or a school. These statistics probably do not surprise psychoanalysts, who hear about such incidents from our adult and child patients. However, since we deal with small numbers and with a selective patient population, it is hard for us to generalize from our small sample about the extent of the problem.
The chapter derived from interviews with victims suffers from allowing the victims themselves to decide what the sequelae of their traumata were. This amounts to a