Incest and Psychoanalysis: Are We Ready to Fully Acknowledge, Bear, and Understand

AS ELVIN SEMRAD noted in a clinical aphorism, much of individual clinical work has to do with acknowledging, bearing, and putting into perspective intolerable affects. Our profession as a whole is philosophically and clinically at the point of acknowledging the role of incest and sexual abuse in the lives of many patients, but is perhaps not yet clear about how to bear and how to put into perspective this knowledge. "Putting into perspective" includes, in our view, biological-evolutionary, cultural, and political perspectives, perhaps entailing social and political action—areas where we as a profession have rarely tred. Viewing the books reviewed in this essay collectively, we can specify dialectics presented in them and move the field beyond obstructing disagreements.

Each of these books makes a specific contribution to understanding the larger problem of incest, and thereby brings us closer to the ideal stated in Semrad's aphorism. At the same time, what each book omits tells something about the conflict between knowing and not knowing which is often at the heart of both the patient's and the clinician's experience. Collectively, they represent a substantive expansion of our professional commitment and skill. We have here an opportunity to review the current state of our growing understanding—its possibilities and its limitations.