COUPLES TREATMENT FOR INCEST SURVIVORS

This article will explore one common manifestation of the incest survivor's difficulties with sexuality, the phenomenon of the sexless marriage between a female incest survivor and her heterosexual partner. It is based on work with three couples who presented themselves to the authors with a nearly complete breakdown in emotional and sexual intimacy which threatened to dissolve the relationship. Each couple was unwittingly engaged in a elaborate mutual reenactment of the survivor's incestuous relationships. In the reenactment the survivor experienced her spouse simultaneously as the perpetrator, and as her mother, who did not know of the abuse and whom she felt she could not tell. Grounded in both object relations theory and trauma theory, our treatment strategy rests on interpreting the central role of reenactment in the couple's relationship difficulties.