Building Concern Free of Force in the Treatment of Adult Survivors of Childhood Incest

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Incest brutally extinguishes the instinctive concern of a parent towards his/her child, transforming the relationship into one of force and destruction. This mode of communication tends to be re-enacted in therapy. A main paradox embodied in the treatment of adult survivors of incest is, therefore, the paradox of force and concern. How can therapeutic relatedness sustain maternal concern when, at the same time, the therapeutic couple is unconsciously forced to re-enact elements of an unforgiving past? By presenting clinical material, I demonstrate how this conflicting paradox blinded me while working with a female patient, leading us to an impasse, while overlooking and then re-enacting an incestuous relationship. In the process of re-enacting, maintaining genuine human concern was annihilated, as we both became figures in her previously written story. Concern free of force becomes possible when the therapeutic process is released from the burden of resolving the tension between concern and force, thereby gradually facilitating the evolution of a dialectical space that enables a more comprehensive mode of experience and communication. The force of abusive re-enactment, then, does not negate the free choice of the patient and the therapist alike to react to force with concern.

Original languageAmerican English
Pages (from-to)175-186
Number of pages12
JournalBritish Journal of Psychotherapy
Issue number2
StatePublished - 1 May 2016


  • Adult Mental Health
  • Adult Psychotherapy
  • Case Study
  • Child Abuse
  • Incest

All Science Journal Classification (ASJC) codes

  • Psychiatry and Mental health
  • Clinical Psychology


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