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At least 343 records · Page 19Linked to original sources
PubMed1991

Long-term medical consequences of incest, rape, and molestation.

One hundred thirty-one patients who gave a history of childhood sexual abuse were seen in a general medical practice decades after the event and were compared with a control group. The subject patients were found to be distinct for chronic depression, morbid obesity, marital instability, high utilization of medical care, and certain psychosomatic symptoms, particularly chronic gastrointestinal distress and recurrent headaches. It is clear that these remote events can underlie difficult chronic medical problems. Questions about childhood sexual abuse must become part of the practitioner's review of systems in these difficult cases, if not routinely.

Child↗
PubMed1995

Trauma and symbol. Instinct and reality perception in therapeutic work with victims of incest.

With the help of the conceptualizations of Amati and Bleger, and of Jung, the loss of instinctual experience and reality sense in the victims of incestuous abuse is described as an extreme regression to a primary undifferentiated stage of development: that of 'ambiguity' and 'identity'. At this stage the identity of the victim is taken over by that of the aggressor and becomes petrified in a form of mimicry. Differentiation processes are partially blocked. Through the therapeutic work with a woman who was sexually abused as a child, and whose daughter was also being incestuously traumatized, it is demonstrated how, through the use of fantasy, the instinctive reaction of thanatosis can be given up, together with the attempt to find meaning through self-sacrifice, which continually places the victim in renewed danger. By means of activating the transcendent function, the positive pole of the archetype can be set up as a counterforce in the internal world which was once feared like an abuser, and thus as a balance to the images of actual historical violation. The positive pole of the archetype then allows the inner world to loosen itself from the tangled aggressive and auto-aggressive layers of identity. This leads to a revival of protective instinctual reactions and to an improvement in reality functioning. It is emphasized that it is not the recall of actual abuse that promotes therapeutic progress but the evolving symbolizations. The analysis of the symbolic experience leads to the following conclusion: the hypothesis that, on the grounds of positive feelings, the children 'have also wanted' the incestuous activity, cannot be upheld.

Adolescent↗
PubMed1995

Forming a consortium: a design for interagency collaboration in the delivery of service following the disclosure of incest.

A central issue in the treatment of intrafamilial sexual abuse is the "secondary trauma" experienced by both the victimized child and her family when the wider system of regulatory and treatment agencies present redundant, incongruent, or conflicting perspectives and demands. This article describes an attempt to effect second-order change through formation of a consortium of regulatory and treatment agencies to develop a consistent and coordinated response to the disclosure of sexual abuse. Feminist, social constructionist, and organizational development ideas are used to develop principles of intersubjectivity, collaboration and a "both-and" stance, which have guided both the clinical and wider systems work.

Child↗