This book appears at a time when public discussion of the common atrocities of sexual and domestic life has been made possible by the women’s movement, and when public discussion of the common atrocities of political life has been made possible by the movement for human rights. I expect the book to be controversial—first, because it is written from a feminist perspective; second, because it challenges established diagnostic concepts; but third and perhaps most importantly, because it speaks about horrible things, things that no one really wants to hear about.

As recently as 1975, a basic American psychiatry textbook estimated that the frequency of all forms of incest as one case per million. [James Henderson, "Incest", in A. M. Freedman, H.I. Kaplan and B.J. Sadock, eds., Comprehensive Textbook of Psychiatry, 2nd ed. 1975 p. 1532.]

I have tried to communicate my ideas in a language that preserves connections, a language that is faithful both to the dispassionate, reasoned traditions of my profession and to the passionate claims of people who have been violated and outraged. I have tried to find a language that can withstand the imperatives of doublethink and allows all of us to come a little closer to facing the unspeakable.

Many survivors struggle to believe the abuse happened. They don’t want to believe it. It’s too painful to think about. They don’t want to accuse family members or face the terrible loss involved in realizing “a loved one” hurt them; they don’t want to rock the boat.

A refusal on the part of psychiatrists and therapists to validate the horrors of their patients' tortured past implies a refusal to take seriously the unconscious psychological mechanisms that individuals need to use to protect themselves from the unspeakable. Such a denial is, however, no longer ethical, for it is in the human capacity to dissociate that lies part of the secret of both childhood abuse and the horrors of the Nazi genocide, both forms of human violence so often carried out by 'respectable' men and women.

- Child is abused, perpetrator threatens to hurt mother. Child feels protective of mother.
- Struggle to escape perp reinforces feelings of mutual protection. It's Mom and I against the world.
- Something necessary at the time later creates "enmeshment." Child doesn't see her actions as separate from mother. Even during normal adolescent individuation. But--
- Normal individuation doesn't happen in abuse survivors. They don't feel normal, so they--
- Act out in unhealthy or self-destructive ways, which creates--
- Fear and pain for mother, which creates--
- Guilt for child who still feels responsible for mother's emotional health.
- Child seeks release from the guilt and from not feeling normal, which leads to--
- Escape to the world of other not normal people, where mother can't see her child self-destruct, which leads to--
"The bad news.