ABSTRACT
This chapter focuses on incest. Incest often presents an extreme of suffering and illness. The issue for the therapist is the inability of the family to mobilize appropriate coalitions to defend the child. Incest is one clinical problem where the family therapist must address the issue immediately, for it is almost always extremely destructive. In dealing with incest the family therapist treats not only the family but the larger system. One of the key principles in treating incestuous families involves what Carl Whitaker calls the "battle for initiative" in which the therapist struggles against the family's inclination to let the therapist change them. In treating incestuous families some individual work must be done to help the victimized self rework the sense of trauma. The therapist must examine the mother's contemporary context to see what relationships are giving her the sense of incompetence or powerlessness. The concept of boundaries is a key approach to incest.
