Dashiell, a 29-year-old CPA, first came to see me after his self-described healthy sexual appetite went from fun to over-the-edge to addiction. In our initial assessment, Dash told me his sexual behavior had spiraled out of control, resulting in a string of reprimands at work (for downloading porn on company owned equipment) and eventually the loss of his job. Dash was also using adult friend finder apps, primarily Ashley Madison and Tinder, to seek out casual sexual encounters and prostitutes. Unsurprisingly, he was in deep denial about his sexual problems – justifying, minimizing, blaming, and deflecting like a seasoned addict. Nevertheless, his treatment motivation was high, even though he was hoping to not give up the escapist and highly compulsive sexual intensity that ruled his life. As part of his assessment and early treatment, I walked him through an extensive sexual, romantic, and relationship history, and from that it was clear that his patterns of problematic sexual behavior began relatively early, in his mid-teens, when he started viewing online porn and engaging in webcam sex. Over time, we discussed his family of origin, and what repeatedly stood out, as it does with many male sex addicts, was the often inappropriate, boundary-less, and covertly sexualized relationship Dash had with his mother.

When I was a kid my mom would pull me out of school some days, not for any reason other than she seemed to want my company. I would just get dragged along while she shopped, and then wed have lunch somewhere, with me listening to her talking about her life with my dad and how she was feeling about their relationship. Sometimes she would take me to the movies with her – not kid movies but grown-up stuff. My dad was always working or drinking, and she didnt have many women friends, so I was her fill-in. And in a way that wasnt so bad. I liked skipping school and eating out and getting see to movies that other kids didnt, but at the same time I always felt a little bit weird with her. She always seemed to sit a little too close to me, and she commented on my body all the time, especially when I was a teenager. Sometimes shed walk into the bathroom when I was in the shower to put away towels or some stupid thing that could easily have waited until I was done and dressed. Lots of stuff like that. I had no privacy at all. Even if I was in my room with the door locked she could be right outside, listening and asking me through the closed door what I was doing, was I OK, did I need her for anything. All I really wanted was for her to leave me alone. What makes me crazy even now is that she never actually touched me sexually. Still, by the time I was 15 or 16, just being in the same room with her made my skin crawl.

As is typical with covert incest survivors, Dash entered therapy relatively unaware of the long-term, adult-life effects of his mothers behavior – how her turning to him rather than her husband for emotional intimacy and sexualized closeness left him feeling icky and wrong even as an adult. (It is equally typical for covert incest survivors to enter therapy viewing their special relationship with a parent as a cherished privilege.) Though Dash initially resisted the notion that hed been abused by his mothers needfulness and emotional demands, over time, as he became more educated about family dynamics and looked more deeply into his adult problems, he came to reinterpret much of what he had believed about his mother. Eventually he was able to identify the parts of his maternal attachment that were damaging. Ultimately we identified and addressed the covert incest perpetrated by his mother as a key component underlying his sexual addiction.

What Is Covert Incest?

Covert incest, also known as emotional incest (and sometimes as psychic incest), is the surreptitious, indirect, sexualized emotional use/abuse of a child by a parent, step-parent, or any other long-term caregiver. In contrast to overt sexual abuse, which involves hands-on sexual contact, covert abuse involves less direct forms of sexuality – sexuality that is emotionally implied or suggested rather than overtly acted out. In this way, a child is used for emotional fulfillment, forced to support the adult by serving as a trusted confidante and/or an emotional spouse. Though there may be little to no direct sexual activity, these overly enmeshed relationships have a sexualized undertone, with the parent expressing overly graphic verbal interest in the childs physical development and sexual characteristics and/or betraying the childs boundaries via voyeurism, exhibitionism, sexualized conversations, and inappropriate sharing of intimate stories and/or images.

Covert incest often occurs when the parents have distanced themselves from one another both physically and emotionally, and/or when one or both of the parents are addicted to a substance or behavior. In Dashs case, his father was a high-functioning alcoholic while his mother struggled with life-long poor body image and eating disorders. When such dysfunctional parent couples distance themselves from each other, one of the parents may focus on the child – seeking adult emotional fulfillment by using the child as a surrogate partner – or the parent may tie his/her self-esteem to the success of the child. When this occurs, the childs developmental needs tend to be ignored, and his or her emotional growth (especially in the area of healthy sexual and romantic attachment) can be profoundly stunted. And the perpetrating adult is usually completely unaware of the emotional damage he or she is creating.

The Consequences

Although covertly incestuous relationships do not involve overt sexual abuse, they are sexualized relationships where profound inequity does nonetheless exist, and, as such, victims often and unsurprisingly respond in many of the same ways as survivors of overt incest. Essentially, a child in these circumstances is deprived of healthy attachment bonds, stable emotional growth, and many other basics of childhood development. Instead, the child is taught that his or her worth is based not on who he or she is as a person, but on how much he or she can please, amuse, and/or bond with the caretaker. As a result, covert incest survivors often experience the following symptoms and consequences later in life:

  • Addiction and compulsivity: In general, addicts dont use to feel better, they use to escape and dissociate from stress, emotional discomfort, and the pain of underlying psychological disorders, including depression, anxiety, attachment deficit issues, and more. All of these issues are symptomatic of both covert and overt incest. It is therefore not surprising that a very high percentage of incest survivors also deal with adult addiction – substance abuse, compulsive gambling, sexual and/or romantic addiction, compulsive spending, eating disorders, etc. Sex addiction is especially common among both covert and overt incest survivors.
  • Difficulty developing and maintaining adult long-term intimacy: Covert incest leads to a wide variety of intimacy disorders. Many covert incest survivors feel smothered or trapped when they enter into adult romances, even if the person they are seeing is incredibly emotionally healthy. The unhealthy attachment bonds these survivors formed in childhood are just too deep, and they can surface any time an intimate attachment presents later in life. Sometimes covert incest survivors avoid intimate adult relationships altogether; other times they seek these relationships but sabotage or flee them when the anxiety they associate with emotional closeness kicks in. As a result, many survivors of covert incest report feelings of social isolation and social dissatisfaction.
  • Codependency: Many covert incest survivors develop a pattern, usually during childhood, of placing the needs of others ahead of their own. In covertly incestuous relationships this sort of behavior is rewarded by the perpetrator, which reinforces it. In Dashs case, he got fancy lunches and adult-oriented movies when he complied with his mothers desires.
  • Shame and feelings of inadequacy: Shame is the inherent, deeply rooted belief that one is defective, not good enough, and unworthy of love. Most often adult shame is rooted in various forms of childhood neglect and abuse, including (but not even remotely limited to) covert and/or overt incest.
  • Dissociation: Depending on the individual, the age at which he or she experienced the abuse, the nature of the abuse, and how it was (or was not) handled in the family, covert incest survivors can learn to dissociate or space-out when experiencing a stressful emotional moment or a trigger to past abuse. Some may develop a full-fledged identity disorder, though most simply struggle to remain present at work and in their interpersonal relationships.
  • Difficulties with self-care (emotional and physical): Like most early-life complex trauma survivors, many covert incest survivors do not feel that they deserve to be happy or to get their needs met in healthy ways. One way this sense of unworthiness can manifest is through inadequate self-care – poor eating habits, lack of exercise, underemployment, seeking out and/or staying in abusive relationships, procrastination, not completing important work or school projects, etc.
  • Love/hate relationships, especially with the offending parent but also with others: Unhealthy attachment bonds that form in childhood, such as the bonding that occurs with covert incest, tend to repeat later in life, not just with the person who helped form that unhealthy attachment, but with romantic partners, employers, and even friends.
  • Inappropriate bonding with their own child (intergenerational abuse): Sadly, bonding styles learned in childhood tend to repeat later in life. As such, victims of incest, both covert and overt, tend to perpetrate the same abuse on their own children.

Identifying and Treating Covert Incest

As pervasive and damaging as covert incest is, it frequently goes unrecognized in treatment settings. As my colleague Debra Kaplan says, The obvious signs are obscured from plain view. It is like the air in the room – its here, but you cant see it. This confusion affects survivors and therapists alike. In general, the thinking seems to be that if theres no actual physical sexual contact, then no harm has been done. It is only when we dig beneath the surface that we see the connections between covertly incestuous behaviors and adult intimacy and addiction issues.

When covert incest is identified as an underlying issue with a particular client, as it was with Dash in the opening example, effective treatment typically addresses the following issues:

  • Fully examining the clients family of origin, attachment styles, and interpersonal dynamics
  • Identifying and naming the nature and pervasiveness of the covert incest that was perpetrated upon the client
  • Acknowledging and processing feelings of shame, anger, abandonment, and the like
  • Helping the client set healthy boundaries with the offending parent (and therefore others). If the perpetrating parent is deceased, this work can be done experientially through role-play, gestalt, art therapy, and other modalities.
  • Developing an understanding of how the damage caused by covert incest is affecting the client in the present, processing the pain of that covert incest, and helping the client move forward toward healthier, more fulfilling adult relationships

This is difficult and sometimes painful work. If, as a clinician, you do not feel comfortable or qualified to handle it (even if its only because you are going though a temporary stressor yourself), you should absolutely refer your client to one or more clinicians experienced in early complex trauma. In all cases you must recognize that recovery from covert incest does not happen alone or only in the confines of an individual therapeutic relationship. The more supportive and empathetic people there are in a covert incest survivors life, the better. This means that incest-focused group therapy, 12-step groups like Survivors of Incest Anonymous, and other early-life trauma support groups can be essential. Much of the time, simply knowing that they are not the only person who was abused and damaged in this way will go a long way toward reducing the shame that incest survivors experience. Books discussing covert incest, most notably Silently Seduced by Kenneth Adams and The Emotional Incest Syndrome by Patricia Love, are useful not only for covert incest survivors, but for the clinicians who may be treating them. I highly recommend both works. It can also be useful to incorporate body-work and mindfulness techniques into both the exploration/abreaction and the recovery/containment elements of trauma treatment. In such cases, somatic experiencing, EMDR, shame resilience (a la Bren Browns Daring Way curriculum), meditation, visualization, art therapy, DBT, and other established protocol-based forms of experiential work can be extremely useful – so long as the provider is well-trained in the overall treatment of early complex trauma

.