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The consequences of child abuse have profoundly and adversely affected the lives of many women. That women are more commonly the victims of child sex abuse would seem to be a truism, but their ability to deal with trauma and to lead normal lives as is sometimes supposed seems questionable. The authors, by using current research and comparing it to the salient features of a particular case history, contest that this survival comes at the price of living a fantasy and colluding with perpetrators in a life of continuing abuse. We suggest that such women are often the targets of inadequate men who deflect their own deficiencies on to these emotionally damaged women, and this destructive dynamic is also inflicted on their children. Moreover, when psychiatric breakdown does occur, abused women are often the victims of glib and demeaning psychiatric misdiagnosis.