Childhood sexual abuse and multiple personality disorder: emotional sequelae of caretakers.

Occupational therapists are often among the first members of the health care team to be trusted by the patient with information and questions thought to be taboo, especially those of a sexual nature (Evans & Asrael, 1990) Several articles in this issue of the American Journal of Occupational Therapy (AjOT) suggest that occupational therapy provides the patient with a forum in which to disclose secrets such as those associated with childhood sexual abuse and multiple personality disorder. Although it is not within the domain of occupational therapy to diagnose mental health conditions, the experienced, welleducated, observant therapist can provide important information that will contribute to a proper diagnosis. In the case of multiple personality dis order, the earlier a correct diagnosis is made, the sooner an appropriate course of treatment will begin. The purpose of this issue of AJOTis to increase our clinical awareness and understanding of multiple personality disorder and its associated phenomena. We also need to be aware, however, of the possible emotional consequences of working with this popUlation. Acknowledgment of the prevalence of childhood sexual abuse has been relatively recent Browne (1990) presented a succinct and enlightening account of Freud's initial identification of the problem of incest in 1896. Freud's baffling recanting of his discovery of Childhood sexual abuse in 1914 led to his ill· conceived theories of infant seductiveness and childhood sexual fantasies. For nearly 50 years, these theories led the psychiatric community to discount patients' reports of sexual abuse as imaginary. Only in the past two decades have M. Laurita Fike