A Preliminary Report of a Case of Consummated Mother-Son Incest

A case of consummated mother-son incest has been described after nine years of psychotherapy. The reasons for the apparent increase in such cases as well as the paucity of reports were discussed in terms of the reluctance of those involved in mother-son incest to present themselves for treatment, the countertransference aspects, and changing sexual mores. Specific aspects of the therapeutic handling of such cases were reviewed. The therapeutic necessity to handle the homicidal and suicidal impulses of such patients was stressed. Moreover, the frequent necessity of the therapist to serve as an alter ego at times of stress in order to halt precipitous decompensation of ego defenses was noted. Possible etiologic factors in the genesis of such a condition, particularly in the patient's conception of himself as an “exception,” were discussed. The overriding role of sadism toward a rejecting mother and the consequent need to punish oneself for such motives have been presented as the clinical core of this phenomenon. The ego of the patient presented here is so deformed that he will probably remain a very dependent, impulse-ridden, and vulnerable individual throughout his life. The availability of supportive treatment on a continuous basis would seem to be indicated, due to the gross defects in his ego attendant upon his incestuous history in particular and his early deprivation in general.