There are many young people who have suffered sexual assault or incest who never reveal it. Yet it may cast a dark shadow over their entire lives. One cannot overestimate of the impact the intense shame the young person experiences, and how disruptive this can be. The very fabric of the family environment that operates before the incest occurs, and how this moulds the internal life of the subsequent victim can affect profoundly how these events are psychically managed.

In any therapy there is no getting away from realities and these affect the relationship between therapist and patient. If the analyst is an older man and the analysand is a younger woman, this will affect how the therapeutic relationship develops, how trust develops, and with someone who as a child has been sexually assaulted by a parent, whether or not disclosure is at all possible. How one manages it as a male therapist can be even more problematical. This account tries to address some of these issues.