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I find so much fault with this essay that I want to begin with some praise. This is a serious study of a most important subject. The authors, in their clinical material (if not in their theoretical and technical formulations), show they are aware both of the tragic, painful, contradictory, conflict-ridden burdens that the victims of child abuse have to bear and of how much is demanded of the therapist who is brave enough to undertake the challenge of trying to help these people whose bodies and souls have been violated—people whose experience makes them intensely distrustful and even terrified of change and of help. The authors certainly mean well. They can empathize with and are trying to understand their patients; they know therapists of the soul-murdered have to be tough-minded and not sentimental purveyors of compensatory “love.” These attitudes will go a long way therapeutically.
But, but—I found myself sputtering with “buts” as I encountered many of the authors' opinions, generalizations, and ideas. Above all, I feel alienated by their tone of (sometimes militantly righteous) certainty. For over 30 years I have been treating adult patients who were abused and neglected as children, and I find myself constantly surprised by the unexpected as well as filled with so many doubts and with a sense of how much remains to be discovered about the effects of what I have called