Conjoint family therapy and resumption of the bond in child sexual abuse

Reading Isabel Boschi’s article and a few exchanges with colleagues prompted me to put in writing some reflections that had been going around in my head for some time. It is common knowledge that, in our milieu, a controversy is under way about the treatment of cases of child sexual abuse, the emphasis being placed on the question of whether or not it is appropriate to re-establish the bond between parent and child and to conduct conjoint family therapy.

In the first place, I wish to make clear that I work by articulating various theoretical frameworks. Systemic theory, the new paradigms, complexity thinking and the narrative model, among others, help me in my daily clinical work to better understand human behavior, allowing me more respectful, more creative and more effective psychotherapeutic approaches. The concept of resilience, for its part, despite its debatable aspects, is useful to me in that it reminds me that human beings have the possibility – which does not necessarily come about – of recovering from devastating experiences.

That said, when it comes to the abuse of children, I would like to make a few points. To begin with, I believe that child sexual abuse, too, must be written in the plural, given that cases differ according to many factors, such as:

• the age and gender of the victim;
• the kinship relationship between the abuser and the child;
• the type of relationship established between the abuser and the abused (violence with seduction or violence pure and simple);
• the characteristics of the parents’ marital bond;
• the characteristics of the non-abusing adult;
• the degree of economic dependence, etc.

These factors will weigh on the consequences of the abuse and should be taken into account when choosing how to approach each case therapeutically. There are, however, certain common factors, to which I will now refer.

Violated family…