ABSTRACT
As clinicians and researchers, most of their knowledge about the longer-term effects of sexual abuse comes from the testimony of people who have sought out help—that is, from people who do consider themselves to have been affected significantly and adversely. There is general agreement, among those professionals who work with adult survivors, that the effects of abuse might show themselves in the form of low self-esteem, lack of assertiveness, depression, and problems in sexual and maternal relationships. All therapists could usefully examine the degree to which their work, and their position within the socially sanctioned "mental health" field, constrains their freedom to think about the abuses and anomalies that are glossed over when the global term "the family" is used. Abuse survivors may receive excellent help from friends, family, and self-help groups run by other survivors, and many do so without ever approaching a professional therapist.
