INCEST is such a traumatic violation that its victims often forget that it even occurred. But the emotional scars live on, confusing in their seeming meaninglessness. Ongoing problems with relationships, sex, trust, touch, addictions, paralyzing depression and guilt can, when the cause is unknown, feel crazy and out of control. This checklist can be used as a guide to help adult survivors identify themselves and know that there are real reasons for their unrelenting difficulties—that, in fact, these “problems” are actually healthy attempts to cope with an impossible situation.

Incest has traditionally been defined as sex and/or marriage between close relatives. But incest, the most common form of child sexual abuse, is, above all, child abuse—abuse of the child's personal and sexual boundaries by the very person(s) entrusted with her care. And sexual violation can occur through the way a child is talked to or looked at, even when there is no touching at all. Incest, then, is any use of a minor child to meet the sexual or sexual/emotional needs of one or more persons whose authority is derived through ongoing emotional bonding with that child (parents, step-parents, babysitter, sibling, mother's boyfriend, teacher, priest, family doctor). Note that incest is an abuse of a power relationship, not a blood relationship; it is the violation of trust that damages the child.

Incest is especially common in alcoholic families. On the alcoholic's part this is due to damaged judgment, a need to control others (momentarily satisfied through playing out dominant/submissive gender roles), and inability to identify with other human beings (to care about the damage he does to others). Often the alcoholic does not remember the experience(s), or, applying the same defenses that surround alcoholic drinking and other alcoholic behaviors, he denies, minimizes, projects  blame. But these defenses are not exclusive to perpetrators who are alcoholic—and not all alcohol-related incest is attributable to the disease of alcoholism. Also, families where there is incest, like alcoholic families, have denial systems, and both experience total confusion of boundaries and disregard for the legitimately dependent developing child. As you will see from this list, children of alcoholics and incest survivors share many other characteristics, along with other adults who endured such childhood trauma as battering, etc.

Do you find that you have the majority of items on this list? If so, you could be a survivor of incest. However separate from people that might make you feel, you are not alone. Healing is possible; with help, you can break from self-blame, isolation, and the entrapment of Post-Incest Syndrome.

This list is based on observation and interviews with incest survivors as well as work done by New York Women Against Rape. To all those who contributed to this fact sheet, thank you; your generous sharing of your pain and experiences is a gift to all survivors.

1. Fear of being alone in the dark, of sleeping alone; nightmares (especially of rape, pursuit, threat, entrapment, blood), night terrors

2. Swallowing and gagging sensitivity; repugnance to water on face when bathing or swimming (suffocation feelings)

3. Alienation from body—not at home in own body; failure to heed signals of body or take care of it; poor body image; manipulating body size to avoid sexual attention; compulsive cleanliness, incl. bathing in scalding water; or, total inattention to personal appearance or hygiene

4. Gastrointestinal problems; GYN disorders (including spontaneous vaginal infections); vaginal/internal scarring; headaches; arthritis or joint pain; aversion to doctors (esp. gynecologists, dentists)

5. Wearing a lot of clothing, even in summer; baggy clothes; failure to remove clothing even when appropriate to do so (while swimming, bathing, sleeping); extreme requirement for privacy when using bathroom

6. Eating disorders, drug/alcohol abuse (or total abstinence); other addictions; compulsive behaviors (including compulsive busyness)

7. Self-injury (cutting, burning, etc.) (physical pain is manageable) (this is an addictive pattern); self-destructiveness

8. Phobias, panic

9. Need to be invisible, perfect, or perfectly bad

10. Suicidal thoughts, attempts, obsession (including “passive suicide”)

11. Depression (sometimes paralyzing); seemingly baseless crying

12. Anger issues: inability to recognize, own or express anger; fear of actual or imagined rage; constant anger; intense hostility toward entire gender or ethnic group (“race”) of the perpetrator

13. Dissociation (“splitting”), depersonalization; going into shock, shutdown in crisis (stressful situation always is crisis); psychic numbing; physical pain or numbness associated with particular memory, emotion (e.g. anger) or situation (e.g. sex)

14. Rigid control of thought process; humorlessness or extreme solemnity

15. Childhood hiding, hanging on, cowering in corners (security-seeking behaviors); adult nervousness over being watched or surprised; feeling watched; startle response; hypervigilance

16. Trust issues: inability to trust (trust is not safe); absolute trust that turns to rage when disappointed; trusting indiscriminately

17. High risk taking (“daring the fates”); inability to take risks

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18. Boundary issues; control, power, territoriality issues; fear of losing control; obsessive/compulsive behaviors (attempts to control things that don't matter, just to control something!); power/sex confusion

19. Guilt/ shame/ low self-esteem/ feeling worthless/ high appreciation of small favors by others

20. Pattern of being a victim (victimizing oneself after being victimized by others), especially sexually; no sense of own power or right to set limits or say “no;” pattern of relationships with much older persons (onset in adolescence); OR exaggerated sense of entitlement; revictimization by others (adult sexual violence, including sexual exploitation by bosses and “helping” professionals)

21. Feeling demand to “produce and be loved;” instinctively knowing and doing what the other person needs or wants; relationships mean big tradeoffs (“love” was taken, not given)

22. Abandonment issues; desire for relationships with no separateness; avoidance/fear of intimacy

23. Blocking out some period of early years (especially 1–12 but may continue into adulthood), or a specific person or place

24. Feeling of carrying an awful secret; urge to tell/ fear of its being revealed; certainty that no-one would listen. Being generally secretive. Feeling “marked” (the “scarlet letter”)

25. Feeling crazy; feeling different; feeling oneself to be unreal and everyone else to be real, or vice versa; creating fantasy worlds, relationships, or identities (esp. for women: imagining/wishing self to be male, i.e. not a victim)

26. Denial: no awareness at all; repression of memories; pretending; minimizing (“it wasn't that bad”); having dreams or memories (“maybe it's my imagination”) (these are actually flashbacks, which is how recall begins); strong, deep, “inappropriate” negative reactions to a person, place or event; “sensory flashes” (a light, a place, a physical feeling) without any sense of their meaning; remembering surroundings but not the event. Memory may start with the least threatening event or perpetrator. Actual details of abuse may never be fully remembered; however, much recovery is possible without complete recall. Your inner guide will release memories at the pace you can handle.

27. Sexual issues: sex feels “dirty;” aversion to being touched, especially in GYN exam; strong aversion to (or need for) particular sex acts; feeling betrayed by one's body; trouble integrating sexuality and emotionality; confusion or overlapping of affection/ sex/ dominance/ aggression/ violence; having to pursue power in sexual arena which is actually sexual acting out (self-abuse, manipulation [esp. women]; abuse of others [esp. men]); compulsively “seductive,” or compulsively asexual; must be sexual aggressor, or cannot be; impersonal, “promiscuous” sex with strangers concurrent with inability to have sex in intimate relationship (conflict between sex and caring); prostitute, stripper, “sex symbol” (Marilyn Monroe), porn actress; sexual “acting out” to meet anger or revenge needs; sexual addiction; avoidance; shutdown; crying after orgasm; all pursuit feels like violation; sexualizing of all meaningful relationships; erotic response to abuse or anger, sexual fantasies of dominance/ real rape (results in guilt and confusion); teenage pregnancy. Note: Homosexuality is not an “aftereffect!”

28. Pattern of ambivalent or intensely conflictual relationships (in true intimacy, issues are more likely to surface; in problem relationships, focus can be shifted from real issue of incest). Note: Partner of survivor often suffers consequences of Post-Incest Syndrome also (especially sex and relationship issues).

29. Avoidance of mirrors (connected with invisibility, shame/self-esteem issues; distorted perceptions of face or body)

30. Desire to change one's name (to disassociate from the perpetrator or to take control through self-labeling)

31. Limited tolerance for happiness; active withdrawal from/ reluctance to trust happiness (“ice = thin”)

32. Aversion to noise-making (including during sex, crying, laughing, or other body functions); verbal hypervigilance (careful monitoring of one's words); quiet-voiced, especially when needing to be heard

33. Stealing (adults); fire-starting (children)

34. Multiple Personality “disorder” (often hidden)

35. Food sensitivities/avoidance based on texture (mayonnaise) or appearance (hot dogs), which remind the survivor of abuse, or smell/sound which remind survivor of perpetrator; aversion to meat, red foods.

36. Compulsive honesty or compulsive dishonesty (lying)

37. Hypervigilance regarding child abuse, or inability to see child abuse, or avoidance of any awareness or mention of child abuse; tendency to develop relationships with incest perpetrators

Note to therapists and others: Many of these “aftereffects” can be the consequence of other problems that occur in early life. There are, however, some items which nearly always indicate childhood sexual abuse, and when one experiences over 25 of the items on this checklist, incest should be strongly suspected.