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PubMed1980

Problems in the psychotherapy of children with histories of incest.

Therapists must be cognizant of the meaning of the patients' presentation and the extreme need for therapeutic safety. The therapists must be keenly aware of the deprivation issues for these patients and not be seduced by the sexual "red herring." At the same time, the therapist must be careful that his own discomfort does not make him run away from the sexual material. Thus the therapist must strike a difficult balance between the two. The therapist must avoid allying with the child solely as a victim, an alliance which would hinder an understanding of the child's motivation and subsequent guilt, and thus foster further difficulties. The therapist must work through his own outrage that a child has been molested so that he may avoid blame seeking. By attending to these issues, the individual psychotherapist will pass the patients' "test" and take the first step in helping patients and their families in forming a therapeutic working alliance.

Adolescent↗
PubMed1987

Self-mutilation and self-blame in incest victims.

A case is made for self-blame as the psychic link between children's experiences of incestuous sexual abuse and their self-mutilating behavior later in life. Representative case histories and the results of a small pilot study are presented to illustrate the author's theoretical formulation.

Adolescent↗
PubMed1997

Healing the incest wound: a treatment update with attention to recovered-memory issues.

This article provides an updated treatment model for adults who report having experienced incestuous abuse in childhood. It integrates psychodynamic, traumatic stress, developmental and feminist formulations, accords greater emphasis to object relations and self-psychology perspectives, includes more attention to dissociative reactions, and utilizes more cognitive-behavioral interventions. It is also responsive to issues raised in the recovered/false memory controversy. This holistic model is sequenced, paced, and titrated according to the patient's characterological structure, ego strength, and needs as well as the range and severity of presenting problems and life difficulties. Special consideration is given to issues pertaining to memory and the maintenance of a neutral stance by the therapist, especially in the case of recovered rather than continuous memories and/or suspicions rather than actual knowledge of abuse. Contemporary perspectives regarding some of the unique transference, countertransference, and vicarious traumatization issues with this population and their potential impact on treatment are also discussed.

Adolescent↗