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In the most basic of definitions, incest is a type of child sexual abuse that occurs within a familial context between those who are related by blood, marriage, family relationships, or close familiarity. Incest is distinguished from molestation, in that molestation is child sexual abuse that occurs between strangers or those who know each other at a distance. Sexual abuse in the form of incest may or may not include intercourse between members of the same family other than husband and wife.

Sexual acts that are considered incestuous may include making sexually harassing statements and/or anti-women jokes; treating the victim as a sexual object; insisting that one is dressed in a sexual way that is inappropriate; minimizing feelings about sexuality; criticizing the victim sexually; insisting on unwanted, inappropriate, or uncomfortable touching; withholding affection unless the victim is sexual; calling the victim sexual names, such as “whore” or “frigid;” forcing the victim to undress; forcing particular unwanted sexual acts; forcing sex when the victim is sick or when endangering his or her health; forcing sex for the purpose of hurting with objects or weapons; performing sadistic sexual acts or any form of intercourse; raping or coercing sexually; making oral-genital contact and/or anal penetration; kissing and hugging sexually; sexually staring at the victim; accidental or disguised touching of the victim's body by the perpetrator; making verbal invitations to engage in sexual activity; verbally ridiculing body parts; producing pornographic photography or video; reading sexually explicit material to children; and exposing the victim to inappropriate sexual activity. Observably, the list is quite extensive and covers all aspects of inappropriate sexual activity perpetrated by family members, usually against children.

The term victim in this context refers to a child victim of sexual abuse or sexual trauma and the term perpetrator refers to the individual who inflicts the sexual abuse on the child. When incest occurs within the family, the family is often a protective mechanism and attempts to hide the abuse from those within and outside of the family. What often develops for the victim is the need to maintain the secret, which is engendered out of shame and loyalty for and among family members. Secrecy, however, causes more stress for the child who is often blamed, not believed, and discouraged from reporting anything outside of the family. Because of the shame and loyalty, incest often remains unreported or reporting is delayed into adulthood.

Additionally, incest often occurs within the context of family problems, communication problems, power differentials, household violence, and in the presence of alcohol or other substances. As a result, children often find that they have to parent themselves, and the disruptive lifestyle is both chaotic and inconsistent, experiencing neglect, guilt, and a sense of shame because of the constant shifting moods of the parents. Those feelings often lead to anxiety, depression, attachment issues, and dependency. Children often hope for assistance or help, but because of keeping the secret, rescue and safe placement often elude them. Children may feel that any type of disclosure may lead to criticism, blame, and rejection. Because loyalty issues abound, children may be further confused and it may strengthen their sense of worthlessness and the belief that they deserve what they get. A child is left with an inability to trust, which in adult life causes problems particularly regarding intimacy, and the individual's developmental pattern is stunted because of not knowing what to expect from others, lack of consistency in the family and structure within the home, feelings of worthlessness and degradation, and lack of family security. When incest is ongoing, the child's defensive pattern may include dissociation as a way of protection or fragmentation of the personality, as in dissociative identity disorder.

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