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It is our experience that great diagnostic variability is found among women who are childhood victims of incest. Based on two case stories, illustrating two very different treatment processes, we give an in-depth discussion of the importance of basing treatment goals, treatment focus and therapeutic strategies on a diagnostic evaluation of personality organisation.
For some of these women, the incestuous experience was not the only pathogenic factor in childhood. Beyond being affected by the sexual acts they were subjected to, these women also suffered an early disturbance of personality that reflects itself in their difficulties in forming a therapeutic alliance. In the women characterised by borderline personality traits, the primary treatment goal is for the person to develop a more integrated experience of self and others. The working through of the incest trauma takes place later in the treatment process. We propose a differentiated incest therapy based on the personality structure and each individual woman.