I. Introduction

Those attempting to come to grips with the issue of child abuse in the context of determination of contact and residency issues are not operating in a social vacuum.

When I began psychiatry 35 year ago, sexual abuse was not on the agenda. Wives did not get battered - and if they did, they deserved it. Physical abuse of children had only just been recognized in 1962 and Kempe was shouted down when he presented his first paper.

My awakening with regard to the sexual abuse of children came as late as 1985 when I was the family therapy consultant to an inpatient unit. Three girls came in with parasuicidal behaviour.

Over the weeks they were in hospital, each disclosed that her father was having sex with her - the word abuse in this regard was not regular currency.

I remember shock and disbelief. How could I have missed this for so many years. Why hadn’t patients told me? Did they give me clues I’d missed? And more importantly why aren’t our professional organisations shouting from the rooftops that this is happening?

Firstly, psychiatry has never admitted it has missed anything.

Secondly, the profession still minimises sexual abuse and other traumas in its engagement with its clients’ symptoms. For instance a glance at the annual report of the Beyond Blue project, headed by Jeff Kennett, government funded to deal with the burgeoning incidence of depression and suicide in the Australian community, reveals little attention being paid to child abuse, poverty, racism and unemployment as antecedents to psychiatric problem.

Thirdly as Thomas Szasz once said, if Freud had stuck to his guns, there would have needed to be a social revolution, not the invention of psychoanalysis. The same can be said of the recent fin desiecle.

In a recent publication, Finkelhor observed the decrease in CSA reports in the last ten years and postulated that some may have been frightened out of reporting because of the unlikelihood of being believed.3 He also countenanced other possibilities - for example that CSA was less common and that early intervention had been more successful.

Advocates for children who have been sexually abused have been on the ropes under this onslaught, which has not just come from the psychology and psychiatry professions, but also from academics like Elaine Showalter 4 and Ian Hacking5, who talk of mass hysteria perpetrated by social workers and women’s advocates and juxtapose this with the studied thoughtfulness of the distinguished grey eminences of the psy-professions. And for a while it looked like we might be heading for a new Dark Ages in trauma studies.

In family courts, the ramifications of recognising abuse as a reason for supervising or aborting contact have led to laws which are ambiguous, expert opinions which are not based in science and outcries from parents of both sexes about the unfairness of the system. The concept of alienation has gained ascendancy in family courts around the world particularly over the last five years. While most professionals familiar with the courts’ workings recognise that children can and do side with one or other parent, especially in the early stages of separation, little was done to research this. Indeed most of the papers written address Parent Alienation Syndrome, not parent alienation, and distinguished researchers in the field have only just turned their attention to the problem.

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