ORIGINAL PAPER
Art in Group Work as an Anchor for Integrating the Micro and Macro Levels of Intervention with Incest Survivors
Ephrat Huss • Einat Elhozayel • Ester Marcus
Published online: 6 May 2012
� Springer Science+Business Media, LLC 2012
Abstract This paper outlines a theoretical model for
combining art and group work to integrate the personal and
the social levels of incest trauma, as advocated in feminist
therapy. Incest survivors must deal with deep, present-day
defenses that result from both the trauma and from the lack
of social support. The paper demonstrates how art work
within a group context can be used to simultaneously
confront defenses, change interactive behaviors, and create
social change. This integrates the dynamic and diagnostic
underpinnings of art and group therapy with a socially
contextualized and empowerment perspective.
Keywords Incest survivors � Group work � Social change � Art interventions
Introduction
The victims of sexual abuse and incest experience a trauma
with both personal and social reverberations. Added to the
difficulties in exposing the abuse, obtaining justice, and
dealing with misogynic social messages—such as the ten-
dency to blame the victim—is the deep erosion of the most
basic trust. Sexual abuse is experienced as chasms within
the psyche that often demand intensive and long-term
interventions to heal, while still reverberating in the present
social life of the victim (Tillman 1995). The healing pro-
cess often includes exposing the incest and taking legal
action while attempting to heal internal scars (Ellis et al.
1990; Gibelman 1999). Because of this, working with
female victims of incest demands the integration of group
work and trauma work. These perspectives are held toge-
ther through an overall feminist social perspective that
focuses on the experience of the lack of gender equality
that enables sexual abuse to occur and to be lightly pun-
ished (this is true, of course, also for the sexual abuse of
male children and adults). To elaborate, group work helps
to address the social reverberations of sexual assault in the
here-and-now of the group interactions. Understanding the
trauma enables the victim to address the resulting symp-
toms or defenses that are behind these interactions. The
overall feminist approach enables defining the problem as
based on social gender roles and power relationships rather
than on personal pathology. A feminist stand, by definition,
integrates both micro and macro levels of experience from
a gendered perspective, and thus synergistically connects
the personal, group, and social perspectives of the trauma
of incest (Brody 1987; Ellis et al. 1990; Hogan 2002;
Parsons et al. 1994). While this may sound like a mix of too
many theories, this paper claims that the integration of
these different perspectives, anchored through art work,
enables a multi-pronged approach. This will be demon-
strated through a multiple-case study of victims of incest
within a group context. The focus will be on the use of art,
with the additional theories of feminist and group work as a
backdrop or guide for the direction of the art activity and
the way that the art is understood. This enables us to
identify both social and personal levels of incest trauma as
expressed within a single art work. The art work is, in turn,
contained within the group work. The group work is also
embedded in, but reaches beyond the symbolic level. Thus,
both the art and the group will be shown to integrate
symbolic spaces with concrete social support and social
change. This creates a model that is based within but that
E. Huss (&) � E. Elhozayel � E. Marcus Charlotte B. and Jack J. Spitzer Department of Social Work,
Ben-Gurion University of the Negev, P.O.B 653,
84105 Beer-Sheva, Israel
e-mail: ehuss@bgu.ac.il
123
Clin Soc Work J (2012) 40:401–411
DOI 10.1007/s10615-012-0393-2
also challenges dynamic theories that are decontextualized
from social concepts.
Literature Survey
Incest is defined as sexual contact between an adult and a
child who is controlled or enforced by the adult and who,
by definition, is not physically or emotionally ready to be
involved in sexual contact (Zeligman and Solomon 2004).
Incest is initiated by a family member and can occur in or
out of the child’s home and can take place on one occasion
or over time (Tillman 1995). While incest has presumably
occurred throughout history, it was only defined with the
rise of social movements expounding the rights of children
and women. With the ensuing research into these areas
over the last century, the silence around this issue was
broken (Herman 1994). Factors affecting the occurrence of
incest are those that weaken the overall sense of control,
meaning, and connection within a family, and can include
traumatic past experiences, family dynamics, social isola-
tion, lack of social support and extreme stress situations,
including drug use, norms about bringing up children, and
overall family violence (Zeligman and Solomon 2004).
A specific characteristic of incest is the secrecy that is
intensified through the need of both sides of the incest to
deny the social and psychological reality of the sexual
contact (Bentovim 2002). The trauma of incest creates an
erosion of a basic trust, towards the aggressor, and towards
