Differentiating incest survivors who self-mutilate

Abstract

Objective: This study was an exploratory analysis of the variables which differentiated incest survivors who self-mutilate from those who do not. Method: A sample of women incest survivors (N ϭ 84) were divided into two groups based on the presence or absence of self-mutilation. Participants included both community and clinical populations. A packet consisting of a demographic questionnaire, Sexual Attitudes Survey, Diagnostic Inventory of Personality and Symptoms, Dissociative Events Scale and the Beck Depression Inventory was completed by each participant. Results: Demographic, incest, and family of origin variables distinguished the self-mutilating women from those who did not. These include ethnicity and educational experiences; duration, frequency, and perpetrator characteristics regarding the incest; and multiple abuses, instability, birth order, and loss of mother in one's family of origin. Psychological and physical health concerns also differentiated between the two groups. Conclusions: Many variables may differentiate between women incest survivors who self-mutilate from those who do not. A rudimentary checklist to describe the lives of incest survivors who self-mutilate resulted from these findings. The importance of the concept of embodiment is also discussed.

Deliberate Self-Harm in a Nonclinical Population: Prevalence and Psychological Correlates

“…There were stronger associations Author Manuscript between self-harm and both depression and anxiety for men than for women. Although many studies of psychiatric patients have found higher levels of depression in self-harmers (3,13,14,34), two studies that included only female subjects did not find self-harmers to be more depressed than comparison subjects (28,35). Similarly, a study in which 79% of the participants were women did not find an association between anxiety and self-harm (33).…”

“…Findings linking deliberate self-harm and borderline personality traits (11,31,32), suicidality (3,18,28,33,34), dissociation (4,10,14,17,29,31,32,34,35), and anxiety (12)(13)(14)34) (but see reference 33) have been replicated frequently. Posttraumatic stress disorder also appears to occur more frequently in patients who harm themselves (17).…”

“…Several studies have reported associations between substance abuse and deliberate self-harm (10,28,34), but other studies have not confirmed this relationship (18,33). Mixed results have also been found for depression.…”

Consejos en la psicoterapia de mujeres víctimas de incesto: Revisión de 59 casos

“…Dos casos eliminaron a la esposa que les causaba molestia, uno echándola del hogar (Oscar) y el otro asesinándola (Claudio) y así se quedaron con su hija como pareja y dueña de casa. Turell y Armsworth 19 señalan que las niñas abusadas por incesto y que después sufren con auto-mutilaciones provienen de hogares que han mantenido su familia intacta, pero que son abusivos y disfuncionales, viéndose un caos familiar que dura años 13,17 , con escaladas de violencia sexual, física y fisiológica desde la niñez a la adolescencia, incluyendo la madre, y que un niño en estas circunstancias no tiene alivio del horror. Turell y Armsworth 19 agregan: "la escala de violencia en estas familia puede llegar hasta el homicidio", como sucedió en el caso de Claudio de nuestra casuística.…”

“…Un aspecto que nos parece especialmente relevante en la psicoterapia de estos casos son los sentimientos y actitudes contratransferenciales del equipo que atiende estas pacientes aunque en una revisión de la literatura llama la atención que rara vez se menciona en las publicaciones como explícitamente lo señalan Joseph Shay 16 y Patricia Reynolds-Mejía 15 . Así es como, aunque existen interesantes y valiosos aportes nacionales 8,17 y extranjeros 18,19 en su mayoría se refieren a casuísticas, estudios clínicos y poblacionales de incesto o de abuso sexual intrafamiliar, pero no hacen referencia explícita a los diversos problemas de la contratransferencia (CT) con que se enfrenta el equipo de salud y que permite entender mejor, y muchas veces confirmar el abuso, como así mismo responder con mejor adecuación a la oferta transferencial que nos llega a veces inesperadamente 1 . Una excepción lo constituye el aporte de Ramón Ganzarain 20 quien informa acerca una psicoterapia de grupo experimental con adultos con antecedente de incesto cuyos interesantes comentarios serán parte de la discusión.…”