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The use of Rorschach data for research purposes is growing and careful attention to accuracy needs to be maintained. A comment on a recent article's use of the lack of reflection responses to indicate poor self-esteem for incest victims is offered.
The controversy in the mental health community over recovered memory has been heated. The devastation to families falsely accused of incest has been profound. A fortunate consequence, however, has been the vigorous pursuit of answers to a variety of mind-behavior questions raised by the controversy. In this article I raise some of the important questions and in reply I review and summarize some of the data. Some questions deal with the nature of memory and of unconscious processes, especially the role of implicit memory; the techniques of recovered memory therapy and the evolution of pseudomemories and its relevance to clinical practice; the effects, real and alleged, of trauma; the place of dreams, flashbacks, and repetitive patterns of behavior in the understanding of memory and behavior; and finally, questions dealing with the definition of reality. All of these are important issues for the psychoanalyst.
Twenty-five gynecologic patients with chronic pelvic pain were evaluated in a multidisciplinary study. Gynecologic evaluation revealed most patients had normal pelvic exams. Psychiatric evaluation showed all of the patients to have significant psychopathology, with Borderline Syndrome, and Hysterical Character Disorder the most frequent diagnoses. A significant incidence of early childhood family dysfunction and incest were found. Psychological testing corroborated the high incidence of severe psychopathology.
A convenience sample of 94 members of an agoraphobia self-help group responded to an anonymous survey on their possible histories of childhood incest. 12 (13%) respondents reported such a history. These results are discussed in terms of hypothesized etiologies of panic disorder and agoraphobia.
54 inmates were subdivided into four groups and classified according to their index offense. The groups included Rapists (n = 14), Incest Offenders (n = 9), Child Molesters (n = 11), General Offenders (n = 20). Nonoffenders (n = 20) were included as a control group. Psychometric tests including the Test of Nonverbal Intelligence, the Defining Issues Test, Survey of Interpersonal Values, Porteus Maze, and Minnesota Multiphasic Personality Inventory were administered to all inmate and control groups. Analysis showed the rapists and child molesters scored higher on moral reasoning on the Defining Issues Test; also rapists' scores were more elevated on the Psychopathic Deviate and Paranoia scales of the Minnesota Multiphasic Personality Inventory than those of other offender and control groups. These results imply that rapists and child molesters have the ability to understand moral issues; however, given their personality orientation, they ignore these interpersonal social values.
1. Yalom's "curative factors" provide a helpful "here and now" model for inpatient group therapy with incest survivors. 2. Psychiatric nurses are in an excellent position to identify female patients who have been sexually abused and to establish and conduct therapy groups for these women. 3. Preparation of women for the group by the therapist is an essential prerequisite for successful integration into the group. 4. During hospitalization, some of the women may experience brief psychotic episodes, suicidal ideation, self-mutilation, and increased depression, which may preclude group attendance for brief periods. However, these experiences will provide ongoing opportunities for exploration of group feelings of anger, helplessness, despair, and alienation.
1. Adult women who are survivors of incest can work on healing issues during long-term group therapy sessions. 2. Group therapy sessions can assist survivors to deal with unresolved family issues. 3. Group therapy sessions can be facilitated by psychiatric nurses who are college faculty when a nursing center is affiliated with a college of nursing.
Fatal diabetic coma was observed in a small-for-gestational-age newborn of brother-sister incest. Post mortem examinations revealed congenital absence of the pancreas and gall-bladder.
A case of a 16-year-old male who committed a sexual matricide following years of mother-son incest is reported. After murdering his mother by strangulation, which itself was sexually arousing, the youngster engaged in both vaginal and anal necrophilia. The homicide occurred while the perpetrator was in a dissociative state and experiencing what has been referred to as a catathymic crisis: the sudden release of emotionally charged psychic conflict and tension, resulting in extreme violence within an interpersonal bond. Discussion of maternal image and maternal sexual conduct in relationship to the psychosexual development of adolescent males offers insight into the motivation in this extremely rare case.
OBJECTIVE: Incest is one of the most difficult issues to be talked over and studied. Experience of sexual harassment is not only hard for the victim, but also for the rest of the family. Sexual harassment experienced in a family especially in father-daughter relationship is an enormously difficult and traumatic event. In this situation, the fundamental needs of trust and protection of the child is violated by the parent who is supposed to be responsible for establishing them and this is true for all the family. It is essential for the therapy of the victim to receive immediate professional help, to be able to disclose his/her experiences, and to receive support from his/her environment. It is apparent that intensive intervention immediately after trauma is vital in decreasing the possible effects of the trauma. This report presents a 16 years old female, applied to Crisis Intervention Center of Ankara University, who was sexually abused by her father. The patient and other family members, except father, were treated by an intense crisis intervention technique and all family members benefited from the treatment. Unfortunately, the father who didn't join the treatment process, committed suicide. This paper presents how effective and functional it can be to utilize crisis intervention, with a multidisciplinary group using multiple approaches, when sufficient social support is available. Negative consequences of neglecting the abuser due to counter-transference are also discussed.
The recorded incidence of child abuse is higher than many nurses might imagine, and adult incest survivors often suffer long-term psychological effects. An awareness of the characteristics marking families where abuse takes place can alert nurses to such cases--both past and present.
There seems to be a consensus today by which a child, who is a victim of incest or sexually abused, must be directed to therapy in order that he or she provides a factual account of the traumatism and, by the same token, exorcises it. The authors deplore the widespread use of this destabilizing method. They emphasize that, for many children, recovery is achieved more successfully through "repression" (in the psychoanalytical sense of the term). After having obtained disclosure from the child, the authors argue that it is preferable for the intervenor to create the appropriate therapeutic conditions allowing the child to positively bury the event and move on with his or her life.
Incest is a kind of sexual abuse that causes serious disorders during childhood and adulthood. In order to overcome the trauma, abuse victims frequently use dissociative defence mechanisms. Post traumatic stress disorder, dissociative disorders, major depression and borderline personality disorder can be seen in the victims of childhood sexual abuse. In this article we present an adolescent who was found and brought to our clinic by the Children's Police Department while she was wandering around aimlessly. She could not remember anything about her identity or personal history. She had no apparent physical disturbances, marks of beating or wounds which could be seen externally. Her physical and neurological examinations were both normal. In her laboratory tests, there was nothing abnormal. No sign of intoxication or infection was detected. EEG and CT were also normal. After the family was found, we learned about the sexual and physical abuse and the patient was diagnosed with dissociative amnesia. The psychometric evaluations also supported our diagnosis. When the dissociation began to disappear, post traumatic stress disorder symptoms became more apparent. After she described her traumatic memories, PTSD symptoms began to recede. Through this case presentation we would like to emphasize the relationship between childhood physical and sexual abuse and dissociative disorders.
A history intrafamilial sexual child abuse was dicited from 33 patients (20%), admitted to the Psychiatric Department (Psychosomatic Unit) of the University Clinics of Innsbruck in 1989. They exhibited quite different psychopathologies, with no typical incest syndrome, however, self-destructive behaviours of different kinds appeared to be characteristic of sexually abused patients. Experiences of separation and loss could be seen as the most frequent trigger for mental and psychosomatic disorders. The importance of child sexual abuse as a vulnerability factor, the necessity to consider the possibility of sexual abuse during childhood in all cases of mental disorder and the importance of the therapist's empathy as a precondition for the patient's ability to speak about the traumatic experience are discussed.
There are incest victims for whom the trauma is unknowable. It is held sequestered in their minds and not available to consciousness. The price to the victim is a group of recognizable signs, symptoms, behaviors, and deficits, some of which threaten the professionalism of the physician/patient relationship. They are described in detail here so that they can be recognized and the correct diagnosis can be made.
The psychological, legal and ethical considerations in treating victims and prosecuting offenders in the United States are described, and the dilemmas highlighted by the use of a detailed case study of an incest victim.
Group psychotherapy is a recommended part of treatment for victims of incest--male and female--in childhood or adulthood. Self-help groups, treatment groups, individual treatment, family therapy, and other modalities may be used concurrently or sequentially. Special techniques include art therapy, play therapy, psychodrama, bibliotherapy, wilderness encounters, and educational techniques.
A cross-sectional investigation on a day chosen at random i autumn 1987 in the Hospital for Neuroses, Montebello, Elsinore, revealed that a total of 25% of the female patients treated on that date had previously been the victims of incest (8.7%) or sexual abuse (17.3%). Of these, the great majority, 19 out of 23 (82%) had been abused prior to the age of 18 years. One out of 15 male patients (7%) had been the victim of previous sexual abuse. Approximately one third of the sexually abused women had been abused by more than one person. The incident had been reported to the police on one occasion only. In addition, previous incest/sexual abuse was presumed where further 10% of the female patients were concerned, on the basis of the opinions formed by the therapists from the clinical pictures and the case histories. In approximately half of the cases, the secrecy concerning the abuse was broken in the course of the psychotherapeutic process and it is concluded that frankness knowledge and courage on the part of the therapist are essential in order to establish sufficiently differentiated psychotherapeutic treatment and that increased knowledge about the problem in society will presumably exert a prophylactic effect.