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The treatment of incest victims is often painful and difficult. With patience, the vast majority of those who have experienced incest can experience considerable improvement and enjoy an enhanced quality of life without succumbing to repeated victimization. The study of incest as an actual phenomenon rather than as a fantasy is a relatively recent event. Inan authoritative text proclaimed that the incidence of father-daughter incest in the United States was 1 in a million families. By the early s, feminists, traumatologists, and contributors from the emerging study of dissociative disorders were engaged in a vigorous study of incest and the treatment of incest victims.
However, during this time, there emerged a trend of calling into question the recollections of those who incest girls incestuous abuse, mounting militant defenses of accused perpetrators. Certain books and media were incest girls of encouraging false reports. As a result, for over a decade and a half the study and treatment of incest has been under a cloud of suspicion that has impeded the advancement of knowledge about this devastating form of abuse. Scholars have backed away from even using the word, to the point that it has become difficult to research unless one searches under more bland and innocuous terms.
Incest girls is not the format in which to review 2 decades of acrimonious and polarized debate. I will proceed on the basis of what, in my view, are the best data and knowledge now available. That data and knowledge strongly affirm that abusive incest is common, that its consequences are detrimental, and that it usually leaves its victims with considerable psychiatric damage and distress. The contemporary study of incest and the contemporary treatment of incest victims proceed in the face of profound pressures to dissociate them from the mainstream of psychiatric concern.
Defining incest is further complicated by the fact that the term is often used in connection with a set of values and assumptions associated with a classic 2-parent nuclear family. In fact, in a society with a high incidence of divorce, blended families are not uncommon. Closely related and similar in their dynamics, although not formally deemed incestuous, are transgressions perpetrated within the context of the relationships of teachers, coaches, clergy, and psychotherapists with those who look to them as safe and positive presences in their lives.
Incest is considered abusive when the individuals involved are discrepant in age, power, and experience. The argument that a younger person may have desired, sought, or given consent is irrelevant. It has often been argued that incest between age peers with neither partner more than 5 years older than the other is nonabusive, mutually desired, and often consists of nothing more than experimentation. It is dubious whether this generalization will stand up to more detailed scrutiny. While such instances occur, proximity in age need not bring with it equality of power, knowledge, and sophistication.
In fact, implied or actual coercion and intimidation play a role in many such situations. Many instances of sibling incest, rationalized as youthful experimentation, are profoundly exploitive. And, there are more frequent reports of older sisters who take the initiative in sexualizing younger brothers.
The close relationship between perpetrator and victim complicates the incest girls of the incestuous act or acts with both relational trauma and betrayal trauma. The threat to attachment needs is so profound that the victim may be impelled to disavow the betrayal that he or she has experienced. Furthermore, incest often le to traumatic bonding, a form of relatedness in which one person mistreats the other with abuse, threats, intimidation, beatings, humiliations, and harassment but also provides attention, some form of affection, and connectedness.
Attempts have been made to describe motivational of incest. Maddock and Larson 13 have categorized incest into the following:.
There is an emphasis on the specialness of the relationship, within which otherwise unavailable caring is given and received. Its norm is the erotization of relationships. The perpetrator vents his or her frustration and conflicts on a vulnerable individual, and physical mistreatment is often involved. There may be great danger to the victim. It is not unusual for mixtures of these components to be encountered.
Many do not think that interactions without actual sexual events should be called incest. Sgroi and colleagues 15 have described a 5-stage process in the sexual mistreatment of children. In stage 1, engagement, the child is brought into a more intense relationship with the perpetrator. Some perpetrators use violence or threats to coerce sexual engagement.
In stage 2, the sexual interaction phase, the perpetrator builds on the preliminary grooming of the victim, and the initial sexual involvements escalate, often progressing from exposure and touching to the penetration of one or more orifices. The child is made to feel responsible and to understand that revelation would have incest girls bad consequences.
Threats include loss of attachment because the child will be seen as bad by others or would lose incest girls affection of the perpetrator and others ; being told that the child would not be believed; being assured that the child really wanted what was done; being told the child will be rejected by God for not honoring his father, etc.
The child often emerges from this brainwashing with profound self-loathing, convinced that he or she is evil, and that any revelation would only confirm his or her badness, and guarantee rejection. In stage 4, disclosure, the secret gets out, either spontaneously, accidentally, or deliberately.
Families tend to be most protective of the child when the perpetrator is not a parent or a sibling. Not uncommonly, the family becomes protective and defensive in its anxiety and moves to disavow the severity of the offense and its sequelae and to blame the victim and any authorities or professionals who become involved.
Good becomes redefined as what is most likely to preserve the good name of the perpetrator and the family. Bad is redefined as what might acknowledge and shine an unfavorable light on what has transpired.
The loyalty conflicts in which the victim is placed are terrible and can prove more traumatic than the incest itself. The group does not want to deal with the consequences of the ugly truth and are eager to avoid the shame and inconvenience of dealing with agencies and professionals. Individuals may actively try to discredit the child or pressure him to recant accusations.
With painful irony, their adaptation to the abuse they cannot avoid le to behaviors that undermine their credibility if they later complain about their circumstances. The consequences involve both psychopathology and unhelpful patterns of adaptation.
Adaptations that allow one to survive amidst an incestuous family usually prove maladaptive in other areas of life. Efforts to link particular aspects of incestuous mistreatment with the severity of the symptoms suffered by the victim have often yielded inconsistent. However, a of factors generally thought to increase the severity of psychopathology were summarized by Courtois 6 Table 1.
Incomprehension, shame, loyalty conflicts, fear of retaliation, and the misperception that the child is to blame for what took place make revelation difficult. The remainder are revealed by eyewitnesses and are inferred from vague or ambiguous comments. This is especially true for those who attempted to reveal their situations earlier and suffered terrible consequences. Roesler and Wind 19 found that The take-home lesson is that there are so many disincentives incest girls revelation that many incest victims will undergo several rounds of psychiatric treatment before they risk revealing this aspect of their histories.
Incest victims present with a wide range of symptoms and comorbidities. The treatment of incest victims must be highly individualized. Victims of incest are found in all walks of life and from all socioeconomic circumstances. Some are alone in the world, some are surrounded by loving and concerned family and friends, and some have support systems that cannot or will not tolerate the burden of dealing with such matters.
Some can afford the luxury of regressing in their treatment sessions and taking hours to restabilize after a difficult session, and some must rush back to their jobs, studies, or families in a stable and functional state. With distance incest girls time, some are able to look at the past from a position of safety, while others remain dependent on those who mistreated them.
Appropriate treatment is individualized to each patient and is not focused around the problem, the relevant diagnoses, or a particular theo-retical model. In general, therapists adopt the overall framework of the 3-stage treatment of trauma 22 :. A common error is to assume that if there is a dissociative issue, it will declare itself readily. Such an assumption defies a massive body of information to the contrary.
Because dissociation is such a powerful coping tool for the person under sustained and repeated distress, it may well have been mobilized by an overwhelmed victim of incest. Such episodes can be disruptive and life-threatening to the patient. The treatment must be paced in a manner that does not consistently overwhelm the patient, and the trauma work must be understood to be only part of an overall therapeutic effort.
At times, other concerns predominate or the patient cannot tolerate dealing with the incest. The relationship that the therapist forms with the patient may prove more crucial than the theories and techniques used in treatment. Patients may bring and develop trans ferences based on relationships with persons who have hurt and betrayed them.
The expectation of sexualization and emotional harm from the therapist may be denied on a conscious level but is often revealed in numerous ways, and usually it incest girls finally acknowledged. Many therapists have difficulty with being perceived as someone who may exploit, betray, and reject the patient, but this must be tolerated and explored as treatment progresses.
The pervasiveness of shame, guilt, self-loathing, and self-directed disgust experienced by many incest victims cannot be overstated.
It is difficult for victims to accept the treatment as well-intended; even if it is, it is difficult for them to accept that it will likely continue to be well-intended as they reveal more deep-seated information. This is especially pronounced in incest victims who suffer dissociative identity disorder or closely related dissociative conditions. One of the major concerns during treatment of incest victims is their ongoing rumination over whether their accusations are accurate or whether what has happened is their own fault.Incest girls
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