Identification and Treatment
of Incest Victims
DENISE J. GELINAS
The essential element in working with incest is recognizing that incest does, in fact, exist. There is a common misconception that incest occurs only as a relatively rare form of sexual deviance, in fantasy, or in cultures sufficiently removed from our own that they are best dealt with using anthropology or history. Prior to working with incest victims and their families, we thought the same way. 1.
In the course of our usual clinical work, however, each of us became interested in a certain peculiar pattern. There were several patients, all women, for whom we were having difficulty establishing a diagnosis and, therefore, a treatment approach and information regarding possible medications. Specifically, they all complained of depression, but their depressions were atypical and showed certain "borderline" features. These patients had received a variety of diagnoses, including depressive, hysterical, and dissociative neuroses; incipient psychosis; and latent schizophrenia. As we gathered more information from these patients to establish a more reliable diagnosis, we found that each had been sexually abused by a close family member as a child.
We use a working definition of incest based upon sexual contact and____________________