Letter: Child sexual abuse

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Sir: Your two articles on child sexual abuse (1 October) pose something of a conundrum. Psychiatrists argue about the validity of recovered memories of childhood sexual abuse ("Abuse claims may be false memories") whilst thousands of paedophiles are apparently advertising on the Internet.

Psychiatrists have a long history of failing to come to terms with the reality of child sexual abuse. In 1895, Freud published a paper suggesting that much adult neurosis had its roots in childhood sexual trauma. The next year he radically revised this view, arguing that the histories he was receiving were fantasies. In doing so, many of us would argue that he put back the cause of the sexually abused by almost a century.

In my own very ordinary general practice using no special techniques, hypnosis or leading questions, many adult patients have told me harrowing stories about their own childhood sexual abuse.

They are usually disclosing this for the first time many years after the event with no intention of punishing the abuser - who is often dead anyway - but are wishing to begin to come to terms with the misery, shame and pain they have lived with all their lives.

They do not expect to be believed, sensing that society reacts with horror to the notion that apparently normal parents or relatives could ever assault their children in such a devastating way.

Some studies have shown that as many as 50 per cent of psychiatric in- patients have a history of childhood sexual abuse, but many psychiatrists refute this and when such a history is offered they either ignore it or, worse still, deny its reality.

As doctors we must let those who have been sexually abused know that we believe their experiences are rooted in reality and do not simply exist in cyberspace.

Dr KEVIN ILSLEY

Bromyard, Hertfordshire

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