Maltz W
J Sex Marital Ther. 1988 Summer;14(2):142-70. doi: 10.1080/00926238808403914.
Given the significant number of adults who were sexually victimized as children and the serious negative effects that sexual abuse can have on sexual functioning, clinicians need to be prepared to recognize and treat the intimacy concerns of adult incest survivors. Broadening the definition of incest to include nontouch sexual abuse, this paper describes types of sexual problems commonly expressed by survivors, such as sexual dysfunction, fear of sex, conditioned negative reactions to sex, flashbacks to the abuse, and mind-body dissociation. The intimate partner of the survivor is viewed as a secondary victim of the incest, who often displays a unique set of sexual and emotional concerns as well. A four-stage couples therapy approach is presented which includes identifying the problem, working together on incest resolution, changing old sexual intimacy patterns, and creating positive sexual experiences. This model is a dynamic combination of incest resolution therapy, sex therapy, and couples therapy. Therapeutic dilemmas and considerations are discussed and recommendations given for increasing the effectiveness of therapy. An argument is made as to why a couples therapy approach is the preferred method of treatment.
鉴于有相当数量的成年人在儿童时期遭受过性侵害，且性虐待会对性功能产生严重的负面影响，临床医生需要做好准备，识别并治疗成年乱伦幸存者的亲密关系问题。本文将乱伦的定义扩大到包括非接触性性虐待，描述了幸存者常见的性问题类型，如性功能障碍、对性的恐惧、对性的条件性负面反应、对虐待的闪回以及身心解离。幸存者的亲密伴侣被视为乱伦的二级受害者，他们通常也表现出一系列独特的性和情感问题。本文介绍了一种四阶段夫妻治疗方法，包括识别问题、共同解决乱伦问题、改变旧有的性亲密模式以及创造积极的性体验。该模型是乱伦解决疗法、性治疗和夫妻治疗的动态结合。文中讨论了治疗困境和注意事项，并给出了提高治疗效果的建议。文中还阐述了为何夫妻治疗方法是首选治疗方式的理由。
