Healing the Incest Wound: Adult Survivors in Therapy

Adolescence, Winter, 1993

Increasing numbers of women who were abused incestuously as children are now seeking therapy for problems related to their abuse. This book provides the special knowledge and clinical guidelines that therapists need to help these women. Unfortunately, as documented here not only by statistics but also by the survivors' own voices, incest is not a rare aberrant happening but a common childhood experience of a substantial minority of all children.

Since incest is generally hidden and denied, the victims are left to cope with their reactions in an atmosphere which contradicts the reality of their experience. All incest is not the same. In the first section, Courtois provides a general introduction to incest by category, type, characteristics, and family and individual dynamics. Such knowledge is essential for therapists hoping to understand the unique aspects of their clients' incest experiences. In the next section the symptoms, short-term aftereffects, and long-term secondary elaborations of incest are examined from four perspectives: traumatic stress or victimization theory, developmental theory, feminist theory, and loss theory. Courtois's sensitive discussion of the diagnostic process shows how multiple presenting concerns may alert the clinician to incest in the client's past. The final section describes the salient issues and strategies of incest therapy, which may involve a combination of individual, group, couples, and possibly, family therapy. Courtois covers basic philosophy and goals, general stages and specific techniques for therapy, and special populations, problems, and family issues. Here, as elsewhere in the book, case vignettes illustrate the therapeutic process. Using these insights and therapeutic strategies, therapists can help their clients heal the incest wound, become survivors rather than victims, and develop a core of self-respect and dignity.