feminist therapy


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


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


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