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[To begin to believe. Working notes on a mother-daughter incest case and its implications on the formation of the pre-transitional object].

Most psychoanalytic literature dealing with incest holds the premise that the act took place between a parent and a child of opposite sex. Incidentally, most of these cases involve a father-daughter incest (e.g. research by Julien Bigras). However, this is only one of four mathematically possible combinations. For instance, we tend to underestimate the occurrences and, consequently, the repercussions of mother-daughter incest relationships. The biological and psychological importance of the mother in the child's development radically influences the mother-daughter incest. In the reactualizing of transference, analysts, especially if they are female, often find themselves confronted with some of the most fundamental choices in the life of an infant, such as to live or to die, to grow or to cease to grow. It then becomes crucial to understand the most primitive components of the infant's early life. In such a case, an analyst must consult some of the most complex theoretical work covering the subject. The author, for her part, has greatly referred to the experiences of Renatta Gaddini, who insists on the importance of developing a pretransitional space during the analysis. This pretransitional space, however, is useless if the analyst is unable to follow it up by becoming a transformational object in the eyes of the patient, in the way described by Christopher Bollas: an object suggesting that the patient relive the steps leading from pre-thought to thought, from real to symbolic. Indeed, Bollas' research has allowed the author to develop a more accurate vision of what is at stake. At the same time, she was able to assess the amount of work still needed in that area of study, an area which, up to this day, offers only very little research to support the author's exploration.

Attitude of Health Personnel↗

Sibling incest: a consequence of individual and family dysfunction.

Sibling incest has seldom been researched and thus remains poorly understood. The authors review a case and discuss it in the context of the recent literature on incest. The case report they present demonstrates the complexity of individual and family dynamics leading to incest and illustrates the need for caution in making generalizations about incestuous families. The authors recommend that evaluators and treaters of incestuous families pay close attention to the specific dynamics of any given case and avoid assuming that common scenarios or traits of participants alone can adequately explain the incest.

Adolescent↗

Family pathology and father-daughter incest: restricted psychopathy.

Father-daughter incest can be found in dysfunctional families of many types. The concept of restricted psychopathy is discussed and examples of this concept in relation ot incest behavior are given. Three cases of father-daughter incest are presented. Ramifications of the concept of restricted psychopathy as it applies to father-daughter incest are discussed.

Adolescent↗

Demographic consequences of incest avoidance in the cooperatively breeding acorn woodpecker.

The avoidance of breeding with close relatives is an adaptation to inbreeding depression. Unfortunately, inbreeding depression has proved difficult to document or measure in the wild, despite being frequently observed among animals in captivity. We address this problem indirectly by determining the demographic cost of incest avoidance in the cooperatively breeding, polygynandrous acorn woodpecker, Melanerpes formicivorus, following the death or disappearance of all breeders of one sex within a group (a reproductive vacancy). Groups undergoing female vacancies that also contained female nonbreeding helpers experienced significantly lower reproductive success in each of the subsequent 3 years than those in which either no nonbreeding helpers or only male nonbreeding helpers were present, a decrease attributable to incest avoidance between the helper females and the related breeder males in the group. Using a computer simulation combined with a life-table analysis, we estimated that incest avoidance costs the population 9.2-12.1% in overall reproductive potential (measured in fledglings/female) and decreases the population rate of increase by 1.78-2.33%/year. These results suggest the presence, on average, of at least 1.2-1.8 lethal equivalents per individual, a value of the same magnitude as estimated for several other taxa, including humans. Incest avoidance may compound random demographic and environmental events and significantly facilitate the decline of threatened populations even prior to any detrimental effects of inbreeding depression per se. Copyright 1999 The Association for the Study of Animal Behaviour.

Journal Article↗

Endogamic incest and the victim-perpetrator model.

Traditionally incest has been seen as the aggressive act of a deranged adult perpetrator against a child victim. While this conceptualization is true for some cases of incest, it ignores the family dynamics and the underlying affectional neglect and deprivation that the child has experienced in the home environment. It can lead to interventions such as immediate incarceration of the perpetrator in all cases, which may cause more harm than good; furthermore, it may permit the state to provide no therapeutic services to the child. By using a more realistic conceptualization of prolonged endogamic incest, useful interventions and therapeutic plans can be designed.

Adult↗

Grandfather - granddaughter incest: a trigenerational view.

Grandfather-granddaughter incest accounts for about 10% of all reported cases of intrafamilial childhood sexual abuse. In a sample of 10 such cases, all referrals came from mothers of the child victims; six of these mothers had themselves been abused in childhood by the perpetrator. For eight of the 10 perpetrators, multiple child sexual victims were identified in a pattern that suggests facultative pedophilia. Only two of the 18 grandchildren sexually abused by the 10 grandfathers were asymptomatic at the time of report. Grandchild victims from chaotic families showed educational and behavioral symptoms; those from stable families exhibited fears and phobias. Eight of the 18 grandchildren were victimized by multiple perpetrators. The results cast doubt on the assumption that grandparent incest is a benign form of abuse and indicate that there is some justification for the fears expressed by adult incest victims about visitation between their children and the father-perpetrator.

Adolescent↗

Drawings by child victims of incest.

Art is an expression of the child's inner reality. Drawings by child victims of incest might be expected to differ from drawings by other children presenting at a child psychiatry clinic. This study compares drawings by child victims of incest with drawings by children referred to the University of Arizona Child Psychiatry Clinic for nonsexual issues. Each drawing was rated on 15 dimensions, including sexualization of the figure, degree of dependency, quality of ego defenses, and adequacy of impulse control. Child victims of incest were judged to have more poorly developed impulse controls and a defensive structure which emphasized repression. These children were also significantly more variable than their counterparts in the degree to which they expressed sexual features in the drawings, but were less variable in their rated maturity and in the rated adequacy of their ability to use sublimation as a defense against anxiety.

Adaptation, Psychological↗

Survival responses to incest: adolescents in crisis.

Twenty-seven incest victims, aged 12-18, responded to their experiences with self-destructive behaviors such as substance abuse, suicide attempts, perfectionism, isolation, or depression in attempts to alleviate stress or assert some control over helplessness created by the incest. Therapy focused on the premise that such adolescent behaviors are logical and predictable survival responses rather than simply clues to sexual abuse. Treatment goals included establishing trust, helping the victim re-define his or her role in the incest, view destructive behaviors as predictable responses, and understand that present behaviors are a continuation of these past survival responses. Such self-awareness encourages the adolescent to better manage or discontinue now inappropriate behaviors.

Acting Out↗

Knowledge and management strategies in incest cases: a survey of physicians, psychologists and family counselors.

A questionnaire was mailed to all 255 psychologists, psychiatrists, pediatricians, and family counselors listed in the 1983 telephone directory. Of the 108 private practitioners who responded, over one-half had treated a child or adult incest victim in the past year; 86% requested more training in this area. Practitioners had a high level of general knowledge about intrafamilial child sexual abuse. Nevertheless, one-third stated they would not refer to protective services a child who had first made, but then retracted, an incest allegation. While most pediatricians would recommend physical examination of a child who had retracted, only half of other professionals would do so. Women practitioners were more realistic about the high frequency of actual father-daughter incest and were more likely to report the hypothetical case of the retracted allegation.

Attitude of Health Personnel↗

Attitudes of health professionals to child sexual abuse and incest.

While there has been increasing interest in the topic of child sexual abuse, few studies have focused on attitudes or the determinants of such attitudes held by professionals. To what extent concern is based on stereotyping or factual knowledge is not clear. The present study uses a combination of experimental and survey methodologies to address these issues. Sample case histories were issued to subjects who were then asked to complete a questionnaire on topics relating to the case and to incest in general. Results showed that the type of sexual activity involved influenced responses; type of relationship between adult and child, less so. Estimates of incest were low, but incest was considered, especially by female respondents, to be harmful to the victim.

Adolescent↗

Therapy of incest survivors: abuse or support?

A preliminary study examined the self-reports of 30 adult incest survivors related to professional help received for personal concerns and incest-related problems. Subjects rated the helpfulness of services received from 12 categories of professionals or groups commonly sought for counsel. Subjects utilized 113 professionals (53 male, 60 female) and spent an average of 36 sessions (9 months) in helping relationships. Chi-square analysis indicated a significant relation (p less than .001) between sex of professional or helper and rating of helpfulness of individual sessions. The trend indicated by this data suggests that male helpers were seen longer and rated lower than females. Additional information provided indicated that the most helpful categories of interventions included (1) validation; (2) advocacy; (3) empathic understanding; and (4) absence of derision or contempt. Practices or attitudes considered harmful were (1) blaming the victim; (2) lack of validation; (3) negative or rejecting responses; and (4) exploitation or victimization of the client. Sexual involvement with the person in the helping role was reported by 23% of the sample; an additional 23% reported other forms of exploitation or victimization. Results of the study are discussed using the conceptual framework of trauma-based disturbances. Reliving experiences, revictimization dynamics, and dissociative processes are speculated to be involved in the high incidence of exploitation of adult incest survivors by persons in helping roles.

Female↗

Psychological profile of the female adolescent incest victim.

This research describes the personality and self-concept of the female adolescent incest victim. Subjects were 40 female adolescent incest victims, ages 12 to 18. Each adolescent completed the High School Personality Questionnaire, the Piers-Harris Children's Self-Concept Scale, and a brief demographic questionnaire. These incest victims were shy, expedient, guilt-prone, aggressive, realistic, and withdrawn with low drive. Low overall self-concept with less happiness and satisfaction was characteristic. These adolescents also showed more confidence about physical appearance and intellectual and school status than other aspects of self-concept. The psychological profiles of these adolescents show they had accommodated to the abuse and suggest the beginning of an orientation of learned helplessness.

Adolescent↗

A qualitative analysis of adult incest survivors' responses to sexual involvement with therapists.

Six women who had histories of incest and had been sexually involved with therapists participated in qualitative research employing semi-structured, open-ended interviews. Transcribed interviews were content analyzed for recurrent regularities in topics, themes, events, and dynamics. Following content and cluster analyses of interviews, three overall themes emerged that appeared most salient in attempting to understand the development and maintenance of therapeutic relationships in which incest survivors experienced additional abuse. The themes were (1) early environment that prohibited the development of a sense of "personhood" in incest survivors, (2) repeated experiences of depersonalization inside and outside of therapy that reinforced a state of non-personhood, and (3) adoption of a "surrender pattern" to cope with violations, including therapist violations.

Adolescent↗

Stress, coping, and adjustment in female adolescent incest victims.

Although previous literature on incest has dealt extensively with the nature, parameters, and effects of such abuse, it has not focused on the role of coping in the psychological adjustment of victims. Forty-five female adolescent incest victims in treatment completed questionnaires regarding their current adjustment, characteristics of their molest, their perceptions of the stressful aspects of the molestations, how they appraised the molestations, and how they coped with the fact that it occurred. The majority of the girls in this study had been sexually abused by a father figure (82%). The coping strategies of wishful thinking and tension reduction, the lack of maternal support at the time of reporting, and appraisals of threat and "holding self back" accounted for 70% of the variance in self-reported distress. The coping strategies of detachment, seeking social support and appraisal of hold self back accounted for 38% of the variance in adolescent's global psychopathology as rated by their therapists. In light of these findings, the implications of the need to address appraisals and coping efforts in research and therapy with incest victims was emphasized.

Adaptation, Psychological↗

An incest survivors' therapy group.

A weekly therapy group for women who have been incest victims and are residents of Odyssey House, a therapeutic community for drug abusers, is described. Women participating in the group have a significantly greater retention and graduation rate than other women in the program. The group reduces isolation; helps in dealing with denial; clarifies relations with children, other family members, and significant others; and facilitates dealing with incest-related guilt and shame. The impressive therapeutic progress of the incest survivors, which is attributable to the group, suggests the possible utility of such a group for other therapeutic communities and treatment programs.

Adolescent↗

Paternal and sibling incest: a case report.

A case is reported of a female victim of paternal incest, who had also been raped repeatedly by her elder brother for two years. A survey of the literature showed no other report of such a case from Turkey. This does not necessarily mean that the incidence of paternal and sibling incest does not happen, but may indicate that incestuous abuse is not reported or handled without making it known to legal authorities. The victim was first raped by her 16 year-old brother when she was 9 years old. He raped her repeatedly over a period of two years, until he left home. Her father began raping the victim when she was 13 year-old, leaving her pregnant at age 15. He took her to a doctor for a termination of pregnancy. The father continued abuse after the termination. The victim left home to marry a man. The father filed a lawsuit against the man for taking the victim away from home. More openness and awareness of incest in Turkey may encourage the victims to seek help from medical and legal authorities.

Adolescent↗

Adult attachment and long-term effects in survivors of incest.

OBJECTIVE: The aim of the study was to test the hypothesis that adult attachment is related to distress and personality disorders in incest survivors. METHOD: Adult female incest survivors recruited from the community participated in a structured interview (Family Attachment Interview; Bartholomew & Horowitz, 1991) and completed measures of current functioning (Impact of Event Scale, SCL-10, Beck Depression Inventory) and personality (MCMI-II). Complete data from 92 cases out of the total sample of 112 were analyzed. RESULTS: Analyses of variance suggested that attachment (as represented by a category) was significantly related to personality structure, with fearful individuals showing more avoidant, self-defeating, and borderline tendencies and preoccupied individuals showing more dependent, self-defeating, and borderline tendencies than secure or dismissing individuals. Results of hierarchical regression analyses suggested that attachment (as represented by four dimensions) was significantly associated with personality structure, depression and distress, and abuse severity with post traumatic stress disorder (PTSD) symptoms (intrusive thoughts and avoidance of memories) and depression. CONCLUSIONS: The findings demonstrated the propensity for insecure attachment among incest survivors. Sexual abuse severity and attachment have significant but distinct effects on longterm outcome; abuse characteristics predict classic PTSD symptoms and attachment insecurity predicts distress, depression, and personality disorders above and beyond any effects of abuse severity.

Adult↗

No more mother blaming: a feminist nursing perspective on the mother's role in father-daughter incest.

Historically, nursing literature has been heavily laden with "mother blaming" messages, particularly for mothers of incest victims. The author was interested to discover the origin of this "mother blaming" ideology. Because nursing has frequently adopted the beliefs and practices of medicine, a review of selected literature on incest from psychiatry and psychiatric nursing was conducted in an effort to identify the epistemics and ontology of nursing knowledge pertaining to an underlying "mother blaming" philosophy. The potential negative implications these allegations of maternal culpability have on female clients will be explored. Finally, nurses will be encouraged to adopt a feminist nursing perspective in formulating and providing care to mothers of incest survivors.

Adolescent↗