Researchers have found that incest has a negative impact on the later sexual functioning of survivors.  Difficulties with sexual self-image, promiscuity, sexual phobia/aversion, revictimization, orientation and preference, sexual dissatisfaction, painful intercourse and flashbacks can it impossible for the survivor to have a satisfying sexual life in adulthood.

As survivors move through the healing process and begin to reclaim rights over their bodies and their sexuality, therapists need to be aware of the issues regarding sexuality and the variety of ways incest affects adult sexual functioning.

Incest is defined by Blume (1990) as "the imposition of sexually inappropriate acts, or acts with sexual overtones, by - or any use of a minor child to meet the sexual or sexual/emotional needs of -- one or more persons who derive authority through ongoing emotional bonding to that child." Although incest is primarily the abuse of power and authority (Forward & Buck, 1978; Rush,1980), the sexual element of the abuse results in a variety of sexual problems in the adult-survivor (Gil, 1988; Jehu, 1987; Russell,1986).

Long-term effects

Researchers have found that survivors experience difficulties with: negative self-image (Blume, 1990;Lew,1988) promiscuity (de Young, 1982; Herman, :1981; Maltz & Holman, 1987), sexual phobia/aversion (Courtois, 1988; Jehu, 1987) revictimization (Arbuckle, 1988-89; Fromoth, 1983; Russell, 1986), orientation and preference (Courtois, 1988; Maltz & Holman, 1987), sexual dissatisfaction-impaired motivation/desire (Jehu, 1987), impaired arousal (Maltz & Holman, 1987),
impaired orgasm (Jehu, 1987; Maltz & Holman, 1987), painful intercourse, dyspareunia (Jehu, 1987; Sprei & Courtois, 1988), vaginisms (Jehu, 1987; Sprei & Courtois, 1988), flashbacks (Bass & Davis, 1988; Gil, 1988; Blume. 1990).

Blume maintains that the lengthy list of sexual difficulties experienced by survivors is due to the interruption of the normal sexual development of the victim.  She compares the normal sexual development of a child to the development of a child who is being sexually abused.  She states that normal development allows a child to integrate sexuality emotionally, physically and intellectually in a context of equality and comfort ... Even when children develop crushes on teachers or camp counsellors, their fantasies are not of sexual intercourse. but of cuddling and. kissing.  But before the child victim has had the chance to go through the stages of feeling and experience that would bring her to adult sexuality, adult sexuality is imposed on her.  Even though she has never held hands, someone is masturbating his frightening penis in front of her in an atmosphere of secretiveness and coercion.  She has never gently kissed someone who excites her, and now her body has been forced to experience the stimulation of an adult's hand. (p.210-211).

The child victim learns that sex is i) against her will/not in her control; ii) for another person's pleasure; iii) a price paid for warmth and affection; iv) passive-it is done to her; v) a betrayal by someone who is supposed to love and protect her; vi) a betrayal of her body-for experiencing pleasure; vii) a way to control others; viii) the only thing she is good for; ix) dirty, shameful; and x) painful.

Negative self-image
Since sex is introduced before the child's identity is fully developed, sex becomes "inextricably entwined with the training that she is a sexual object" (Blume, 1990).  The child victim also learns that "any expression of caring will lead to sex" (Lew, 1988).

A complicating factor of the incest is the lack of accurate information that the child victim has access to and the wealth of inaccurate information provided by the abuser.  Victims are frequently told that the abuse is their fault (i.e. "You're a tease",  "You like it",  "You're so sexy", "I can't control myself", "You turn me on", "You have to take care of me"). The abuser continually reinforces the idea that the child is responsible for the abuse and that the child somehow wanted it.

The abuser may go to elaborate lengths to prove to his victim that the victim wants or likes the sex.  One parent made an ‘arrangement' with his adolescent daughter that if she wanted him to come into her room after everyone was asleep, she should leave her bedroom light on.  The girl would go several nights without turning on the light but each day the father, would become more irritable with everyone in the family and eventually become aggressive.  Life would become unbearable for the entire family and to ease the tension the daughter would leave her light on.  The father would then declare that he knew the whole time that she could not resist him and really wanted the sex as much as he did.  As a result of this arrangement the abuser was able to remove the responsibility for the abuse off of his shoulders and place it on his victim.

Abusers use their adult knowledge of sexual response to confuse the child into thinking that the child wanted the sex.  After performing oral sex on the child or masturbating the child to orgasm the abuser will declare "See, you liked it.  That proves you wanted it!"  In the absence of other information the child believes what is said.  These beliefs have a direct impact on the way a victim sees herself and on her later sexual behavior.  If the sex is disgusting then the child assumes she is disgusting.  If she is ashamed of how her body responds to sexual touching -- she feels she is shameful.

Promiscuity
Child victims learn that the only way to get affection is through sex.  As adults, who have been deprived emotionally, survivors may continue to offer sex as a way to get affection.  Unsatisfied by each sexual encounter, (which offers little emotionally), the survivor may become frustrated and seek out new partners, hoping to find the emotional fulfilment missed as a child.  Survivors may believe that sex in the only good thing they have to offer or that sex is the only thing they are good for (Courtois, 1988).

Sexual phobia/aversion
On the other hand, some survivors may have been so traumatized by the sexual abuse that they reject any closeness (either physical, emotional or sexual) that might make them feel threatened sexually.  They may deny their need for emotional security. becoming isolated from friends and family.  Courtois, 1988; Maltz & Holman, 1987).  The best way to avoid being hurt is to avoid relationships.

Revictimization
Child victims are not taught how to protect themselves from potential abusers.  They are taught to do what is expected.  They are sometimes taught that to say "NO" results in physical violence.  As adults many survivors cannot recognize potentially dangerous people or situations.  They may believe that giving in sexually will be rewarded with the love they seek.  They may also believe they have no right to say "NO".  Some survivors dissociate (space out) whenever sex becomes an issue and then unable to protect themselves from a sexual assault.  Some survivors believe it is their responsibility to take care of anyone who approaches them sexually (Arbuckle et al. 1988-89; Fromoth, 1983; Russell, 1986).

Orientation and preference
Research to date has been unclear about the role of incestuous abuse on sexual orientation and preference.  Some studies, however, have found that for some people incest does effect these areas of sexuality.

For some women, (mostly abused by men), choosing a lesbian partner may be a way to avoid sexual contact with a male  who would be too strong a reminder of the childhood sexual abuse (Blume, 1990).  Male survivors my find (also abused mostly by males), sexual abuse results in his questioning his orientation (i.e. "What is it about me that made him think I am gay" and preference (i.e.  "My body responded, so maybe I'm gay") (Lew, 1988).

Sexual dissatisfaction
Almost all researchers have found that survivors have difficulties enjoying sex (Blume, 1990; Courtois, 1988; Finkelhor, 1986; Gil, 1988: Jehu, 1987; Lew, 1988; Maltz & Holmn, 1987; Sprei & Courtois, 1988).  Three areas in particular are noted: impaired motivation/desire, impaired arousal, and impaired orgasm.

I Impaired motivation/desire Survivors tend to associate arousal to the negative feelings that they experienced while they were helpless victims-disgust, anger, guilt and hatred (Maltz & Holman, 1987).  Connecting to those feelings in an adult sexual encounter inhibits the desire to be sexual.

II Impaired arousal For many survivors the ability to maintain sexual desire is inhibited.  Being touched in a sexual way can be an intense reminder of the abuse and can trigger flashbacks and nightmares (Maltz & Holman, 1987).  Since survivors have been taught that sex is for others and not for themselves, many survivors focus on the sexual pleasure of their partners and totally ignore the possibility that sex can (and should) be enjoyable for both partners.

III Impaired orgasm As child victims, many survivors learned to deaden painful feelings in their genitals.  This ability, to dissociate from physical sensations can interfere not only in the ability to experience pain but also in the ability to experience pleasure (Courtois, 1988; Gil, 1988).

Painful Intercourse
Many survivors experience pain when attempting intercourse.  Two major problem areas have been noted by researchers; dyspareunia and vaginismus.

I Dyspareunia results when intercourse is attempted before the woman is sufficiently aroused. If the survivor has difficulty getting aroused to begin with it may be impossible to become aroused enough to lubricate the vaginal walls so that intercourse does not hurt (Maltz and Holman, 1987).

II Vaginismus results when the fear of penetration (which may have been extremely painful as a child) causes the vagina to spasm.  Any attempt at penetration will be painful and cause  greater tension in the vaginal muscles (Maltz and Holman, 1987).

Flashbacks
For many survivors, engaging in sexual interactions can trigger flashbacks vivid recreations of abusive experiences from childhood.  These memories can be terrifyingly real to the survivor who may experience the flashback as happening NOW.  The survivor may or may not lose touch with where she is and who she is with (Bass & Davis, 1988; Blume, 1990; Courtois, 1988; Gil, 1988).  These flashbacks understandably make it impossible for the survivor to continue in the present sexual interaction.

Conclusion

It is common for incest survivors to experience a wide variety of problems in their sexual functioning as adults.  As a counsellor to incest survivors it is essential that I am aware of these difficulties and am prepared to deal with each issue as it arises.  Until now, most of the women I work with have been focusing on the other long-term effects of incest and have begun to understand how the incest has affected every part of their lives.  This paper has been timely for me (and my clients) who are beginning to take a look at the effect that the incest has had on their sexuality.
It is encouraging for me to watch survivors go from:

• "I have to do it or my partner will leave me" to
• "I won't do it unless I want to do it" to
• "I don't ever want to do it again as long as I live" to
• "I would like sex to be a part of my life.  Now   what?

They all seem to go through the same stages. Hopefully I can provide them with the information and support necessary to help them define-who they are sexually and to be able to enjoy all aspects of their lives.

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Bibliography

• Arbuckle, T.Y., Brender.  W. & Gagnon, R. (1988-89). Long-term sequelae and traumagenic factors in childhood sexual abuse . Montreal, QC: Concordia University. unpublished.
• Bass, E. & Davis, L. (1988).  Courage to Heal.  New York: Perennial.
• Blume, S.E. (1990).  Secret Survivors .  New York: John Wiley & Sons.
• Courtois, C.A. (1988).  Healing the Incest Wound.  New York: W.W. Norton.
• de Young.  M. (1982).  The Sexual victimization of Children.  Jefferson, NC: McFarland.
• Finkelhor, D. (1986).  Sourcebook on Child Sexual Abuse.  Beverly Hills, CA: Sage.
• Forward, S. & Buck, C. (1978).  Betrayal of Innocence.  Los Angeles, CA: J.P.Tarcher.
• Fromoth, M.E. (1983)j The long-term Psychological impact of childhood sexual abuse./Unpublished doctoral dissertation.  Auburn, AL: Auburn University.
• Gil, E. (1988).  Treatment of Adult Survivors of Childhood Abuse.  Walnut Creek, CA: Launch Press.
• Herman, J.L. (1981).  Father-Daughter Incest .  Cambridge, MA: Harvard University.
• Jehu, D. (1987).  An intervention program for women who were sexually victimized in childhood or adolescence. Ottawa, ON: Ministry of National Health and Welfare, Canada.
• Lew, M. (1988).  Victims No Longer .  New York: Perennial.
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• Rush, F. (1980).  Best Kept Secret .  Englewood Cliff, NJ: Prentice-Hall.
• Russell, D6E.H. (1986).  Secret Trauma .  New York: Basic.
• Sprei, J. & Courtois, C. (1988).  Treatment of women's sexual dysfunctions arising from sexual assault.  In J.R. Field & R.A. Brown (Eds.) Advances in the understanding and treatment of sexual problems.  N.Y: Spectrum.