CHAPTER 17

Adult Survivors of Incest

LEARNING OBJECTIVES:
Define incest and explain its dynamics.
Identify the physical, mental, and emotional patterns that survivors of incest
develop to cope with the assault.
Describe how rape crisis counselors can help survivors heal from incest.
Incest is a tragedy of enormous proportions, with repercussions that are often far-reaching.
Children who are sexually abused by a family member rely on creating coping mechanisms
in order to survive; as adults, these coping patterns can get in the way of having a full and
healthy life. A rape crisis counselor can become part of a support system that enables adult
survivors of incest to overcome painful feelings, heal from their abuse, and develop new
ways of coping that include a sense of power, dignity, joy, and wholeness.
What Is Incest and What are Its Dynamics?
Incest is a form of child sexual abuse perpetrated by someone in the childs family system.
Offenders may be anyone within that system, but typically they are adults or older children
with authority or power over the child victim. Force is sometimes used, but more often the
offender manipulates or tricks the child into sexual activity that may include exposure,
fondling and molestation, kissing, uncomfortable or sexual touching, and mutual
masturbation, as well as vaginal, oral, or anal intercourse. Incest may be a one-time isolated
event, or it may occur regularly over a period of time.
Incest may be overt or covert. Overt incest involves physical acts described above, while
covert incest involves the suggestion or threat of sexual activity. An example of covert
incest is when an older relative continually talks to a young child about sexual acts, beyond
the point of explaining facts and answering questions. In this case, the child may become
confused and afraid that the adult will want to perform the acts described.
Incest, like other forms of sexual violence, is about control and occurs within a cultural
context. Perpetrators use their power as adults (or older children) to control children who are
dependent on them. Children have limited physical power due to their smaller size; limited
mental power due to their earlier stages of development; and limited social power due to
social attitudes and laws. Perpetrators use this power imbalance to coerce or force children
to participate in sexual acts that the perpetrators control.

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Behavior Patterns and Healing Issues

Incest often results in long-lasting, deep emotional pain regardless of how long the incest
lasted, or what form of sexual abuse was involved. Intercourse does not need to occur for
survivors to have serious reactions.
Adult incest survivors who did not benefit from adequate (or any) help when the abuse
occurred often develop certain patterns of behavior, thoughts, and emotions as ways of
coping. These vary by individual; without help, they could even be life-long. (See Chapter
22: Coping Patterns of Sexual Assault Survivors.) Susan Lees, cofounder of Incest
Resources, Inc., of Cambridge, Massachusetts, describes a coping pattern as a behavior or
thought which is rigid and habitualized and which develops as a result of a persons being
hurt emotionally or physically. It is these patterns which get in the way of persons
functioning to their full abilities.1
The chief coping patterns and healing issues associated with incest are described below.
Most patterns have corresponding polar opposites. For example, trust patterns may be
played out as not trusting anyone at all, or as trusting too easily. Incest survivors may exhibit
characteristics of one pole or another, or may go back and forth. Not all survivors struggle
with every possible pattern or experience the coping mechanisms with the same intensity.
Developmental, personality, and cultural differences affect the emergence of the patterns and
how they are acted out. Moreover, the presence of these patterns alone does not necessarily
mean that someone was sexually abused as a child; many are common coping strategies for a
range of traumatic experiences.

Difficulty with Trust

Incest survivors typically have issues with trust. When children are sexually abused,
they experience an intense violation of basic trust that their environment is safe and
that those in authority will care for and protect them. This results in trust being a
difficult issue in all types of future relationships. Just as the inability to trust is a
common reaction, so is its polar opposite trusting too easily, without paying
attention to interpersonal warning signs. Incest survivors who are in denial of the
violation of trust perpetrated by their offenders may continue to trust untrustworthy
people because they have learned to ignore their internal sense of personal danger.
This may partly explain the high incidence of repeat victimization of incest survivors.
Survivors may need to relearn how to make judgments about whom and when to
trust. Survivors also must come to understand that developing trust is a process, and
that trust can be revoked at any time if it is betrayed.

Isolation
Incest survivors have been severely hurt by people close to them. For many, the
lesson learned was, closeness hurts. In adulthood, these individuals may seek
isolation as a way to feel safe. Survivors may also feel alone even when surrounded
by friendly people. They often feel that the incest has changed them and made them
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different and separate from others. They may distance themselves because it is difficult
to believe that anyone could understand their intense pain as a result of the incest.
Support and therapy groups are often useful in breaking this sense of isolation. Many
survivors are not aware that incest is as common as it is, and groups often result in
survivors saying with relief, It helps to know Im not the only one this has ever
happened to.

Difficulty with Sexuality

Difficulties with sexuality may appear in either asexual or hypersexual patterns.
Asexuality may represent fear of intimate contact that stimulates memories of the abuse.
The opposite polarity, hypersexuality, may be a result of the learned belief that the only
way to relate or get attention and nurturing is through sex. In addition, survivors may
struggle with sexual identity issues not only in terms of being heterosexual or
homosexual, but in very basic terms of questioning who they are as sexual beings.
Healing involves the survivor reclaiming her sexuality as her own, and realizing that
while sex can be a special way of expressing closeness and intimacy when she chooses,
her personal value is not dependent on shared sexuality. Survivors need an opportunity
to define their own sexuality in their own terms, rather than in reaction to the abuse, so
that they stop allowing their offenders to have power over them sexually.

Playing a Protector Role

Keeping the incest a secret so as to not disrupt or destroy the family is frequently a part
of incest. In such a situation, child victims learn at an early age to protect others (the
family), and to put others needs before their own. This results in a role reversal as these
children protect others (particularly adults) rather than have themselves protected.
Healing this pattern involves grieving for the lost childhood, learning to value ones own
needs, and reclaiming a part of oneself that can experience a sense of innocence and
playfulness. Assertiveness training is often helpful in survivors learning that they can
protect their own rights and assert their own needs while still respecting the rights and
needs of others.

Perfectionism, Over-Achievement
Incest often results in feelings of low self-esteem and a sense of being damaged.
Survivors often struggle for perfection and high achievement, to prove their worth and
goodness or to attempt to appear normal. They may also act on the false belief that if
they are good enough, the abuse will stop. The polar opposite of this pattern is selfsabotage. Sometimes survivors internalize the violence of incest in the form of self-hate
that manifests through sabotaging their own success. Survivors may feel they have to
prove their own badness to avoid facing the painful fact that someone hurt them
without reason. It often seems less threatening to blame oneself than to see the world as
a
place where violence occurs without cause. Healing on this issue involves repeatedly
affirming self-worth and increasing self-love.
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Compulsiveness, Inability to Rest

Incest survivors frequently have difficulty resting. They may engage in compulsive
behaviors that distract them from memories and painful feelings. Compulsive
behavior stems from fear of the feelings that arise when one stops the behavior.
Substance addictions (drugs, alcohol, food, etc.) and process addictions (gambling,
relationships, sex, etc.) are examples of compulsive behavior. (See 22B: Coping
Patterns of Sexual Assault Survivors Eating Disorders and Chapter 22C: Coping
Patterns of Sexual Assault Survivors Substance Abuse.) Healing or contradicting
such patterns requires addressing addictions, as well as setting aside planned rest time
for allowing feelings to come through and become integrated into ones life.

Difficulty Accepting Pleasure in Life

Survivors may feel so bad inside that they are resistant to letting anything good affect
them. They may have difficulty experiencing joy and pleasure. They may have a
hard time believing that they deserve this, or they may be so accustomed to living in
pain that they do not recognize good times when they occur. One specific block to
experiencing joy may be the belief that they must first work through all the pain. In
fact, pain and joy coexist in most peoples lives. Survivors can start claiming the
joyful parts while still healing the painful parts.

Power Issues
Abuse by someone in authority typically results in fear of power. This may be
expressed as fear of others who have power or ones own personal power. Incest
survivors may associate all power with abuse, and need to learn they can be both
powerful and good. Assertiveness training is very useful for teaching the concept of
personal power originating from within the self, rather than power that is gained by
overpowering someone else.

Shame
Perpetrators use shame to keep victims silent. In addition, young children have not
yet developed the capacity for complex thought processes, so they tend to internalize
and identify with anything bad that happens to them. Thus, instead of thinking that
something bad happened, children may be likely to believe that they themselves are
bad. Survivors need to work through and let go of shame. Safe places for them to
break silences and end isolation are essential, as are strategies to increase self-esteem.
Acknowledging that incest is more than a personal issue between two people is
crucial to healing shame patterns.

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Depression, Suicidal Inclinations

Depression and suicidal thoughts are common to incest survivors. Death may seem the
only potential escape from the extreme pain they feel. Also, if there was never a safe
place to express rage about the abuse, survivors may turn their anger inward, resulting in
deep depression and thoughts or acts of violence against themselves. Survivors can heal
this pattern by learning to directly release their emotions in safe ways and settings. In
particular, they must redirect their rage away from themselves and focus it on the abuse.
(See Chapter 24: Suicide Prevention.)

Family Conflicts
Survivors often struggle with long-term conflict about how to handle family
relationships, or they may feel tremendous loss and loneliness if they stop contact with
their families of origin. Survivors need to resolve family issues and find a peaceful
solution. If they continue contact with the families in which they were abused, they need
to learn how to avoid being pulled into dysfunctional family patterns that may be
continuing. Survivors who end all family of origin relationships may find that it helps to
create a new chosen family.

Dissociation
Dissociation is the process by which we separate awareness from an experience. Some
level of this is normal, healthy, and routine. (See Chapter 22A: Coping Patterns of
Sexual Assault Survivors Dissociation.) To cope with the pain of incest, however,
many survivors use dissociation to separate their awareness from the abuse. The opposite
polarity of dissociation is hyper-awareness, or not dissociating at all. Because they grew
up in fear of the next time they might be abused, many survivors stay alert at all times,
unable to relax or focus on just one thing for fear of being caught off-guard and hurt.
Three different types of dissociation common to incest survivors are described in the
remainder of this section.

Mental Dissociation, Memories

Mental dissociation or blocking out mental pictures of the abuse from the conscious
memory may result in a lack of childhood memories, particularly of the period
when the abuse occurred. If and when memories unfold, it may be years later; the
memories may not unfold sequentially but in the order of that which is least
threatening first. Another form of mental dissociation incest survivors often
experience is having intrusive memories or flashbacks of the incest. This is a type of
dissociation even though it involves remembering, because it also involves having
ones awareness be separate from current circumstances. When experiencing
flashbacks, survivors often are not able to focus well on present circumstances as
their awareness is pulled back to the time of the incest in a way that may feel out of
control.

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Emotional Dissociation, Numbness

Emotional dissociation, which involves blocking emotional reactions to the abuse,
results in frozen feelings. The pain of incest may be so overwhelming that the only
way to survive is to shut off feelings, deny the pain, and adopt an Im okay or
everythings fine pattern. While numbing the pain, one freezes pleasurable feelings
as well, and the result is a general numbed-out existence. To heal this pattern,
survivors need to learn they can tolerate and release feelings. It is especially
important to deal with the emotions of rage and deep terror. Physical discharge
yelling, crying, hitting or pounding, kicking, and shaking of objects in a safe setting
is often helpful.

Physical Dissociation
Physical dissociation means blocking awareness of the abuse and losing touch with
ones body. This may be a result of blocking physical sensations during the abuse.
As adults, incest survivors may stay dissociated from their bodies to avoid body
memories, meaning the physically imprinted memories of the abuse that they may
feel when they focus more on their bodies. Therapeutic massage and bodywork, or
breathing and movement exercises with a sensitive, trained practitioner may assist
survivors in reclaiming their bodies. (See Chapter 26: Further Support for Healing.)

The Counselors Role in an Effective Healing Environment

The coping patterns and healing issues may paint a rather dismal picture for incest survivors.
However, it is important to remember that healing is always possible. These patterns are
simply survival mechanisms that helped when they were developed in childhood, but are
ineffective now that the survivor has become an adult. Incest survivors are often strong and
creative. By re-channeling their strength and creativity, survivors can heal their hurts and
interrupt or contradict their incest patterns. It is helpful for survivors to take pride in their
ability to survive by whatever means, and to know that they can use their creativity to
develop effective behaviors and thoughts that are more effective in present circumstances.
Essential elements of any healing environment for incest survivors should include: a sense of
safety, empowerment, creativity, and a holistic approach incorporating and respecting the
survivors personal values.
Rape crisis counselors can help establish safety by having clear, consistent boundaries with
incest survivors and allowing survivors to progress at their own pace. Keep in mind that
during the abuse, incest survivors boundaries were unclear while they were pushed past their
developmental pace. Counselors must be extremely careful not to symbolically repeat these
traumas during counseling.
Empowerment of survivors is encouraged by allowing them to be in charge of their own
healing processes. When children are sexually abused, they are helpless in the hands of
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abusive authority figures. They have no sense of control or power to make choices. Due to
the nature of the helping relationship, survivors often see counselors as authority figures.
Counselors can do much to help survivors regain their sense of personal power by reminding
them that survivors can make their own choices, even while interacting with someone in a
more authoritative role.
Creativity is important in healing work with survivors of incest because so much of healing
from abuse must happen on a nonverbal level. Many survivors were abused at pre-verbal
ages, and others express that there are no words to describe the pain they feel about the
incest. Creative methods of healing (art, movement, writing, etc.) allow expression of these
feelings that words may not communicate. Counselors can support survivors in exploring
these methods by helping them identify personal, self-help, and therapeutic resources
focusing on creative/expressive healing work.
Incest results in a physical crisis, an emotional crisis, and a spiritual crisis, as survivors often
describe feeling a threat to their entire existence during the abuse. A holistic approach to
healing, addressing all these levels of crisis, is the most effective. This approach allows the
body, mind, and spirit to integrate the incest as a painful experience that can be healed and
released. Counselors can support survivors full recovery by acknowledging reactions on all
these levels.
Counselors must be clear, however, about their role and the limits of their work. While all
rape crisis centers provide hotline and referral services for incest survivors, they have
varying policies about the type and extent of other support and intervention work they
provide around incest issues. Make sure you understand the scope of services your center
offers, and that you receive adequate supervision and get assistance when making referrals.

Susan Lees, Cues to Identifying Women with Histories of Incest, unpublished paper (Cambridge, MA,
1981).

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