Current Treatment Strategies for Dissociative Identity Disorders in Adult Sexual Abuse Survivors

SUMMARY

During the past decade, increasing numbers of clinicians and researchers have suggested that the dissociative disorders, including dissociative identity disorder (DID), may be more prevalent than previously hypothesized. The “rediscovery” of DID is due, in part, to the recognition that early childhood trauma in conjunction with the propensity to dissociate, are etiologic factors for the development of DID. The purpose of this article is to raise clinical consciousness regarding DID, discuss the definition and etiology of the dissociative disorders, their assessment, and an approach to treatment of the sexual abuse survivor who has DID. This treatment program, while integrating some of the techniques recommended by others, is unique in its step-by-step flexible organization as well as its multifaceted format. The author's experience to date suggests that the sooner that a dissociative disorder can be identified in the adult sexual abuse survivor client, the more rapid the therapeutic progress.     

When ignorance is no excuse: Different roles for intent across moral domains

A key factor in legal and moral judgments is intent. Intent differentiates, for instance, murder from manslaughter. Is this true for all moral judgments? People deliver moral judgments of many kinds of actions, including harmful actions (e.g., assault) and purity violations (e.g., incest, consuming taboo substances). We show that intent is a key factor for moral judgments of harm, but less of a factor for purity violations. Based on the agent’s innocent intent, participants judged accidental harms less morally wrong than accidental incest; based on the agent’s guilty intent, participants judged failed attempts to harm more morally wrong than failed attempts to commit incest. These patterns were specific to moral judgments versus judgments of the agent’s control, knowledge, or intent, the action’s overall emotional salience, or participants’ ratings of disgust. The current results therefore reveal distinct cognitive signatures of distinct moral domains, and may inform the distinct functional roles of moral norms.     

Possible olfaction-based mechanisms in human kin recognition and inbreeding avoidance

Three studies explored kin recognition through olfaction. In Study I, adults (N=22) were tested for ability to identify the odors of themselves; their mother; their father; a sister; a brother; a familiar, unrelated individual; and a stranger. Acquaintances were identified as accurately as biological kin, implicating an association mechanism. However, biological kin were often confused, implicating phenotypic matching. Same-sex kin were confused more than opposite-sex kin, but mainly when same-sex kin had odors of similar intensity. Study II implicated phenotypic matching. Mothers (N=18) could identify their biological children but not their stepchildren. The preadolescent children (N=37) identified their full siblings but not half-siblings or stepsiblings. Thus, olfactory cues may help mediate favoritism of blood relatives. In Study III, mutual olfactory aversion occurred only in the father-daughter and brother-sister nuclear family relationships. Recognition occurred between opposite-sex siblings but not same-sex siblings. Thus, olfaction may help mediate the development of incest avoidance during childhood (the Westermarck effect).     

Boundaries and intimacies: Ethics and the (re)performance of “The Law” in psychoanalysis

The notion of a boundary as it pertains to psychoanalysis is explored, and the distinctiveness of psychoanalysis as a healing science that is ethical and amoral is discussed. The difference between such a science and psychotherapies, which are committed to ideological ideals of maturation and adaptation, is elucidated. Five characteristics of psychological boundaries are discussed, and the significance of each individual's “encounter” with the incest taboo is elaborated, in terms of the dynamic formation of the repression barrier. In this context, the strict ethicality and moral neutrality of psychoanalytic practice is understood in terms of the emancipative way in which free-associative discourse works and plays along the repression barrier.     

Counseling Women with Histories of Incest

No abstract available for this article.     

Current Treatment Strategies for Sexually Abused Children

SUMMARY

Given the disturbingly high prevalence of child sexual abuse, the expertise of medical and mental health professionals in treating child sexual abuse victims is essential. Relevant issues in treating these children include the mindfulness of developmental considerations, incorporation of a multi-modal therapeutic evaluation approach, clarification of treatment goals, appropriate use of and integration of various treatment modalities, and effective treatment termination. This article provides an introduction aid overview of treatment of sexually abused children of all ages, from preschoolers to adolescents, with special emphasis on the importance of developmentally linked evaluation and treatment strategies. Treatment is discussed in terms of goals, stages from evaluation to termination, and formats and modalities including individual psychotherapy, family psychotherapy, group psychotherapy and hypnotherapy, to provide a comprehensive overview of current treatment strategies for sexually abused children.     

“You make me sick”: Moral dyspepsia as a reaction to third-party sibling incest

A pilot study and two main studies lent support to the hypothesis that appraisals of consensual sibling incest as immoral may directly engender the phenomenological state of oral inhibition (OI), comprised of nausea, gagging, and diminished appetite. More specifically, the findings indicate that (a) OI is a central component of a third-party reaction to sibling incest (significantly more so than anger or fear), (b) that it is produced specifically by the morally proscribed aspect of the incestuous relationship (sex between two individuals with common ancestry), and that (c) it is produced so directly rather than as a by-product of a more immediate emotional response (say, intense anger or fear). Furthermore, Study 2 found equal levels of OI for individuals with and without opposite-sex siblings, indicating that third-party aversion to consensual incest is, most likely, a function of the culturally transmitted information regarding the inherent wrongness of such acts. John Sabini is deceased.     

Incest,Inbreeding, and Intrafamilial Conflict: Analyzing the Boundaries of Sexual Permissiveness in Modern North America

Our ability to critically analyze the effect of incestuous activity on society is complicated by the fact that such activity may take place in several different types of relationships, each of which play somewhat different roles within the family and community. Thus, if we are to analyze this effect in any meaningful manner, we must first take care to differentiate the various forms of incest from one another, and to study their consequences separately so that any effects due to relationship status, rather than to incest per se, can be taken into account. We must also ensure that we separate our definition of incest from that of non-consensual sex—that is, incest that occurs in couples in which one partner is too young to legally consent should be distinguished from incest that occurs between two consenting adults (i.e. incest per se), and the effects of these two variants of incest should as well be assessed separately. Using these careful definitions, it can be logically argued that incest on its own should not be prohibited in modern North American society, as the damage to our freedom that such a prohibition would entail cannot be justified by what little unambiguous evidence there is to support its case.

Remembering Herb

Abstract

This paper discusses treatment of an incest survivor who suffered a crippling sense of guilt. The work of discovering and understanding the unconscious fantasies that accompanied the patient's early traumatic experiences led to the alleviation of her misplaced guilt and to more adaptive compromise formations. It is necessary to understand and address the unconscious fantasies attached to the incest, as intellectual awareness of inappropriate guilt does not suffice to diminish it.     

The plural taboo

The human incest taboo is here conceptualized as a plural, gender-related psychological reality whose major strands are (1) an instinctual female incest inhibition and (2) a cultural father incest prohibition. These strands are experienced in a plural phenomenology - as a mother taboo, father taboo, daughter taboo, son taboo, and brother-sister taboo. The instinctual inhibition can be demonstrated in a wide range of plant and animal life, not just humans. The cultural prohibition would appear to have originated out of the instinctual inhibition after humans realized the existence of the previously unrecognized father-daughter relationship. The individual ontology of the taboos is explained in terms of object relations theory; the inhibition and prohibition are seen as psychodynamically unique and their differences are compared. It is proposed that the fuller realization of the plural nature of the incest taboo will not only maximize human ability to prevent actual incest but also lead to greater effectiveness for both males and females in the arena of sexual politics. Finally, the notion of the plural taboo is a clinical standpoint from which to explore sexual transference and countertransference in psychotherapy.