Introduction
The subject of today's event is a topic that would be very attractive to television, namely the entertainment market.
The cameras and reporters:
• complain
• show exclusive reports
• make observations and comments:
– "We uncover the veil of silence that covered the anthropomorphic monster"
– "The Ruthless Bully"
– "The Inhuman Father"
and for the needs of the show, they show and re-show the scene where the abuser hides his face.
They will hunt to find exclusive comments from the child himself, which will cover his face, but will expose his soul.
• They will enjoy themselves as they complain
• They will talk about the responsibilities of the State
• They will request the intervention of the prosecutor
• They will make bitter comments about modern society and then move on to the next new scandal.

The work of the therapist, however, is not to uncover, judge and denounce, but to lift, to lift this huge burden of dysfunction.
Incest. Generally
Prohibition of incest is the basic concept of sex education.
(Fr. Dolto)
The prohibition of incest is perhaps the most important prohibition (taboo) on which our family and society are fixed. The prohibition of incest is a law of life, which in the context of traditional society was expressed as a religious term and surrounded with the power of the sacred, in order to protect the continuation of life.

While love expresses life, incest is the blow against the life of the child victim. The act of incest involves the child in a way that cancels the possibility of developing a normal love life. The child is involved and used, becomes complicit and loses the possibility of having the innocence of trusting his parent.

Incest is:

• antierotic
• deprivation
• misery
• closing
• crime

After the incest
* ...is used by the child
* …makes it complicit
* ...cancels the possibility of future love.
Family dynamics
The isolation of the family is mentioned in the literature as a determining factor in the development of incest. The systemic approach emphasizes the role of this "symptom" in maintaining the homeostasis of the specific family. In structural terms, the isolation of the "mixed family" is interpreted in relation to boundaries. They are described as families whose internal boundaries are diffuse but whose external boundaries are rigid.

Parents do not have significant contact with adults outside the home. The father appears to be seeking sexual experience outside of the marital relationship. Mothers appear withdrawn and weak. It is characteristic of most families that daughters have more authority at home than mothers.

The emotional climate of the family is characterized by resignation, abandonment, misery, fatalism, bitterness and anger.

In the literature, there is a notable absence of articles on the broader family system and the possibility of other broader support systems.

T. Gutheil and M. Avery (1977) also refer to a rigid external boundary, stating that "the line between the inside and outside of the family unit was seen by the Joneses as a chasm separating two different levels of existence, two different worlds." .

P.Alexander (1985) comments that the apparent isolation of the family explains the existence of inbreeding. He states that: "The family was clearly cut off from the environment" and "incest can be considered to be caused or at least favored by the lack of social relations".

Of course, important objections are raised as to whether the isolation is a choice of the whole family or the result of intimidation by the father, who imposes his rules on the other family members.
The Specialist against incest
The specialist child psychiatrist aims to protect the child's soul, so that a normal development is allowed. He must know the depth of the involvement, but choose, according to the interest of the particular case, how far he will penetrate. To wait for the reactions of acting out from the parents, so that he does not react with panic.

The expert is overwhelmed by strong emotions, as he becomes a participant in the child's injury, during the revelation of the incestuous act. It is important that he can keep alive his positive feeling towards the child, but without being drawn into feelings of pity, because this will become a reason for involvement. He risks identifying with the injured child and attacking, with the power he has, the abuser. In addition, it risks making the child guilty for the punishment suffered by the parent. But then, it risks causing the child feelings of uncertainty and insecurity, since he will either be removed from his family, or he will remain in it, but unprotected...

If the therapist again identifies with the weak side of the child and fears his involvement in the incident, he risks feeling intense guilt for his own participation in the neglect. He will then use intellectualization to assuage his guilt, claiming that various "objective" reasons prevent him from taking on the incident.

So the expert is faced with his own value system, with his own experiences and with his own feelings.

Some experts will take care to avoid getting involved with incest due to their own feelings. They choose to refer cases of child sexual abuse elsewhere, recognizing that they cannot provide the help they feel is needed. Some others will find that their own therapeutic frameworks are not suitable for dealing with such cases. Others, while recognizing the problem, respond inadequately. Finally, some other experts will be the ones to take over. Because they;

The expert's feelings about the fact of incest are strong and wide-ranging.

• pressure from the weight of the event
• curiosity towards a situation that is out of the ordinary
• sadness, pain, tightness, freezing, for the consequences of the act on the child and the humiliation of the human condition
• anger initially against the perpetrator and then possibly towards other members involved
• anger at the frequent attempt to cover up the act
• fear of the severity of the psychopathology, but also sometimes of the perpetrator's threats
• weakness, tendency to run away, immobility, indifference from lack of motivation and request on the part of those involved or from fatigue from previous failed attempts
• despair at the constant attempts to cancel every contract
• tenderness, sympathy, concern, interest, love for the child - victim.
• confusion, ambivalence, contradiction towards parents.
• guilt from the feeling of inadequacy and the tendency to abandon the incident.
• commitment and hope by taking responsibility for the incident.
Therapeutic intervention in childhood sexual abuse
The therapist, faced with the incident of incest he will be called upon to deal with, faces the question of his role in this specific case.

As is well known, in order to carry out a treatment, a therapeutic contract is required which stipulates that the client-patient asks to be helped by the therapist, whom he has chosen and trusts. Therapists also have the right to choose their client, to the same extent that clients have the right to choose their therapist.

The right of double choice allows the creation of the client-therapist interpersonal relationship and the development of a positive emotional climate, where the patient-client will confide in the therapist his thoughts and problems and the therapist will feel a genuine sensitivity for him. personal pain experienced by the client and will trust the words of his patient, since they will be united by the common goal which is treatment.
The circumvention of the therapeutic contract by the patient also means the end of the therapeutic relationship.

However, in cases of incest, the therapist is called upon to deal with chaotic relationships and intense extreme psychopathologies, not only without the trust, but with the reservation and perhaps the rivalry of the treated person.
In cases of incest, who is the client? Is the parent the perpetrator? Is the child the victim? Is it the family (what kind of family)? Is it the referrer (prosecutor, welfare, teacher, priest, neighbor, etc.)? Is it the community?
The therapist has to realize the nature and content of the request and the requester. He has to decide whether he is sufficient to respond to what is being asked of him. It has an end, to establish the intervention plan and the ways of its implementation.

It is clear that the therapist is clothed by the treatment seeker, (not of course by the perpetrator), with a cloak of omnipotence for the resolution of such an intense situation. If the therapist uncritically accepts such a savior role, then he will prove himself naked and weak.

The therapist for the offender is a link in a conviction. It does not express the hope for a better life, but the threat of intrusion into his guilty secrets, the disclosure of which will mean his condemnation.
The planning of therapeutic intervention is a complex and laborious process. Moreover, this question, the therapeutic goal, does not have an easy answer. Is the cessation of incest the therapeutic goal? Is that enough? When and by what criteria will it be considered that the risk of relapse has been overcome?

Clinicians working in the field of child sexual abuse are often overwhelmed by the complexity and depth of the problem. Some perpetrators were victims of abuse and their victims may become perpetrators.
Therapists have to deal with this complexity by developing equally complex therapeutic systems. To make use of all possible forms' from disclosure groups, as long-term therapeutic interventions: individual, group, family as well as larger systems.

The documentation of the serious psychological consequences, which persist throughout the life of sexually abused children, makes the need for therapeutic intervention dramatic.

The immediate goal of treatment is to modify the abusive environment so that the child is safe from additional abuse. There is no rule as to the duration of treatment, which cannot be short. The authors propose their therapeutic methods as a way of creating more options for therapists rather than as the be-all and end-all.

More studies are needed to assess therapeutic interventions according to their outcome. The literature on therapeutic intervention is deficient in the existence of retrospective studies (follow-up). There are reports of successful group therapy intervention. Some clinicians have described an improvement in self-esteem and a reduction in behavior problems in sexually abused children and adolescents who attended time-limited group therapy (Carozza and Heirsteiner, 1983; Furniss et al, 1988; Verleur et al, 1986).

Properly designed clinical research and intervention will lead to more effective intervention and treatment strategies.
The treatment approach should be, as much as possible, a solution-focused approach. The solution-focused model is preferred because it leads us to look for possibilities in even the most daunting situations, thereby overcoming our own biases.

The experienced therapist actively seeks to focus the interview on co-creating patterns of solutions, rather than trying to stop problem patterns. To do this, the therapist uses solution-oriented language that creates an expectation of change, solution-oriented questions, and the future.

Since the closedness of the family has been blamed for creating the problem of incest, the next therapeutic intervention is to seek and maintain the openness of the family to the community.
This opening, to be effective, must include a different separate proposal for each member. It should be an offer and not a punishment, so as not to cause resistance on the part of the family.

Additionally, this orientation helps to assuage the righteous indignation with which incest is viewed, which only serves to further isolate the family from social resources (Alexander, 1985).
It appears that multiaxial intervention directed at the child victim, the non-culpable parent (usually the mother) and the perpetrator has the best chance of reversing dysfunctional patterns of family interaction in cases of domestic sexual abuse.

If the non-culpable parent denies the abuse or is unable to protect the victim from further abuse, the child must be placed with a relative or foster family. In the face of refusal to cooperate, the expert should take a clear position. If he hides the fact, if he appears weak, then he becomes an accomplice. Of course, all measures should be taken to protect the child from further abuse, in the context of an evidentiary judicial process.
Mental Health Specialists and Legal Process
The judicial process is a difficult and painful process that can be further complicated by the lack of direct evidence, the absence of witnesses, the sensitive age of the child, the relationship of the child to the accused, the time since the alleged abuse and the alteration of evidence. from the multiple assessments and treatments.

Expert witnesses must resist the pull of identification with the side they support.

Furthermore, the field of mental health itself should protect itself and not be intolerant of some unworthy members of it, who are willing, for some monetary remuneration, to appear as witnesses, to support any position.

The indiscriminate formulation of experts' positions on these issues risks leading in the future to the formation of the opinion that the field of mental health is unreliable.

Various scientists in the legal field in the U.S. have referred to the weaknesses of mental health professionals in court in relation to child sexual abuse cases (Cohen, 1985; Gass, 1976; Guyer, 1991; Levy, 1989; McCord, 1986, 1987). According to them, the use of experts in determining a person's guilt not only does not help the judicial decision, it erodes it, since the extreme divergences of expert opinion confuse the judges in their decision making.

Horner, Guyer, and Kalter (1992) find that mental health clinicians differ greatly in their assessments of sexual abuse in the context of a custody battle. They claim about the experts that: “They make assumptions that are not based on facts. They assume guilt at even the slightest hint and demand, without substantial evidence, that father-child contact be banned. They identify with the accusers and rarely only with the defense".

Contrary to the above authors, research by Morrison and Greene (1992) reports that a more select group of experienced and well-trained experts could provide important services to the court by educating less informed judges and juries with reliable opinions.

If this task is extremely difficult, then we need extremely well-trained experts to meet the challenge. To assess these complex cases, specialists are required to possess deep knowledge of child development and psychopathology, human sexuality, family dynamics, cultural background, biological background, the importance of transference and countertransference, research methodology , the legal issues, the logic and the rules of the court.

Furthermore, they must be able to navigate the jungle of sexual abuse research, plagued by issues of reliability and validity. Among the problems that exist are: the reliability of retrospective evidence, distinguishing the imaginary from the real event, the different definitions of abuse, the falsification of memory with the passage of time.

Psychotherapy is not always possible to apply to the members of the family involved, but understanding the dynamics of incest is essential for professionals to understand the situation and make appropriate therapeutic interventions.
The Healer
Ann Cattanach (1992) notes that when we commit as therapists to take on an abused child, we make a contract to share a difficult journey to help the child "make sense" of the world. This world may have been extremely raw, so that the emotional distance between the child and the therapist was initially required to be bridged in order to create a climate of trust.

Accompanying a child on their journey of self-discovery is a privilege and should be treated as such. The child involved in the incestuous relationship risks experiencing it as the only way to relate, either to find himself again in the position of the victim, or to pass to the opposite position of the aggressor. The main task of the therapist is to open new paths in the child's relationships with others, by giving him the possibility to experience new ways of relating.

It is a tough journey for the therapist to guide children from abuse to healing. Wounds may heal, but scars remain. How to make young children understand the inhumanity of abuse? How to stay human in such inhumanity? Some of the abuse stories shock, shock and disgust the therapist with their cruelty. Sometimes the therapist is abused by the child or the family.
The healer loses his innocence. Simple physical contact loses its simplicity, and memories of stories of child abuse infect his sex life. He may feel uncontrollable anxiety and fear of his children's vulnerability. In the worst moments, the healer feels insecure, powerless in the face of corruption.

The therapist during his intervention is anxious, hopeful, thwarted and must be aware that at some critical moments of his intervention, he will experience intense existential anxieties and feel that he is touching the threat of death. It is then that he realizes, that breaking the taboo really leads to the disorganization of life.

That is why experienced psychotherapists are required, who can understand their fantasies and emotions. To be able to control their spontaneous reactions, the way of relating, so that they do not constitute an obstacle to the therapeutic intervention.

That is why the therapist cannot be alone, but requires the existence of a therapeutic group and a therapeutic framework to support the intervention.

It is our belief that cases of incest cannot and should not be dealt with by a single therapist, no matter how experienced.

A stable therapeutic framework and an organized therapeutic team are required to enable a multi-level therapeutic intervention.

A therapeutic group is required, whose members are close-cooperative, with a positive emotional disposition among themselves. The dynamics they will be asked to face will be so intense that they should not put the relationships of the experts to the test. In addition, it is desirable to have an experienced therapist who will not directly participate in the therapeutic process, but will be responsible for the process and supervise the therapeutic team.

Such a therapeutic framework is required to offer: positive emotional climate, lack of attribution, understanding, support, strict structure, trust, recognition, stability, flexibility (in methods, times, working relationships), ability to process group dynamics.

The therapist needs to understand the emotional effects of his work on himself and also to recognize the wider factors of workplace organization, which can also reinforce the therapist's powerlessness. The difficulties of the work must be recognized by the directors of the agencies.

To keep the children safe the therapist must also be safe. He must ask for help and supervision, sharing and boundaries. Know when to stop and rest. To have a functional personal life and to enjoy it.
It is dangerous for the constant preoccupation with such incidents to lead to fear and panic, that is, to closure and pathology. If we are affected by these situations we are led to other pathologies, where love is identified with evil. If we set these situations as banners for the organization of our lives, we end up fatally, in other unsalvageable situations. The conscious healer knows, however, that if the erosion caused by the pathology is strong, overcoming the flattening and fixation is finally possible.
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Dimitris Karagiannis
Conference "The provision of psychosocial services in cases of incest", 1994