Treating Sexual Abuse

Some readers might have misinterpreted a phrase in the article on childhood sexual abuse {Focus, Dec. 4}. It is important to clarify the statement that "invasive and intrusive" psychotherapeutic methods must often be employed to effect healing. This should not be taken to mean that a therapist may violate physical or sexual boundaries, as this behavior would clearly be unethical and would constitute the re-abuse of an individual already made vulnerable by similar inappropriate behavior. This caveat is true not only for sexual abuse survivors but also for anyone in therapy. Maureen Kearney, PhD Bethesda

As a psychotherapist, I felt that the statement, "In therapy, methods that are 'invasive or intrusive' must often be employed to get beyond a patient's evasiveness," without further explanation or elaboration may well frighten many victims away from getting the help they need. Such methods are by no means invariably employed; a responsible therapist arrives at the decision to use such techniques very carefully. Indeed, their use is a matter of some controversy among therapists. Many of us believe that, in order not to re-victimize the patient, whose original traumas were very invasive and intrusive, long-term resolution of the pain, guilt and shame requires a therapy that is non-invasive and non-intrusive.

Victims considering therapy need to know there are various forms available and that they can make choices. The hurting adult does not need to submit unquestioningly to the "experts," as the frightened child did to the all-powerful adult in the original trauma. Susan F. Glaser, PhD Arlington The Truth About Who Speeds

I seriously question the honesty of the percentages of people who never exceed the speed limit {Vital Statistics, Dec. 11}. If you have ever traveled on the Beltway at the speed limit of 55, as I have, you will note that 99 percent of the drivers behind you will quickly pass. In fact, if you drive 55, you had better be in the right lane, which is the wrong lane since all merging traffic comes into the right lane. But if you move over a lane, you become a traffic hazard for those trying to pass. Richard S. Morgan McLean Drug-Induced Euphoria

The interesting account of tobacco and cocaine {Medical History, Dec. 11} begins with the observation that "tobacco is bad, so is cocaine." I have listened to the debate that humans have an innate requirement for substances that create euphoria, pleasant sedation or stimulation, and that since they occur in nature they must be intended for use by people.

Will pharmacologists develop a euphoric substance that does no harm? Chemical happiness without a psychological price? I hope not. In the short run, such a drug could eliminate misery or bring happiness to the individual, but it would undermine society completely. Susanne J. Pierson, R. Ph. Rockville

Letters intended for publication must be signed and include the writer's home address and home and business telephone numbers. Letters may be edited. Although we are unable to acknowledge all letters, we appreciate the time and value the viewpoints of those who write. Send letters to Health Section, The Washington Post, 1150 15th St. NW, Washington, D.C. 20071.