Source: Supplied by Dr. Adams. Used with permission

Over the years, my psychotherapeutic work has been heavily influenced by several groundbreaking clinicians, one of whom is Dr. Kenneth Adams. Specifically, his books Silently Seduced: When Parents Make Their Children Partners and When He’s Married to Mom: How to Help Mother-Enmeshed Men Open Their Hearts to True Love and Commitment have furthered my understanding of intimacy disorders, particularly the ways in which early-life covert incest often creates a later-life inability to intimately attach in healthy ways. Shockingly, this is a phenomenon I’ve witnessed in a large percentage of my impulsively and/or compulsively sexual clients.

I recently had an opportunity to speak with Dr. Adams about his pioneering work, and I am happy to share excerpts of our conversation with you here.

In the simplest terms, what is covert incest?

Covert incest describes a relationship between a parent and child in which the child feels more like a romantic partner. Typically the parent is motivated by the and emptiness of a troubled , so he or she turns the child into a surrogate partner. There is not necessarily any kind of overt sexual touching, but the relationship feels too close for comfort to the child. The boundaries are such that there is an incestuous feeling. The child feels used and trapped, the same as with overt incest.

In Silently Seduced, you use the word “icky” to describe how covert incest feels. When I first read that, may years ago, I said, “Oh my God, he totally gets this.”

Yes, it just feels like it’s too close. The child thinks, “I shouldn’t be sitting here watching soap operas with you, mom, while you tell me about your sexual frustration with dad,” and so forth. Or there is sexualized commenting on the child’s physical development. Or mom takes her son to the movies and tells him she has the handsomest date there. However it unfolds, it feels icky.

Later on, covert incest victims tend to continue functioning in the role of a surrogate partner where they’re overly enmeshed with the parent [or] over-involved as a caretaker, even though they may have long forgotten the icky part that was present early on — usually during . As adults, instead of feeling icky, they might just feel frustrated, angry, obligated, and way too involved. This type of enmeshment is very common in terms of the adult-life characteristics. Basically, enmeshment describes the nature of the ongoing relationship; covert incest defines the earlier sexual inappropriateness.

Beyond enmeshment, what other later-life manifestations do you see? For instance, in the foreword to Silently Seduced, Pat Carnes writes, “Loving a person but not being able to be sexual with that partner is a great irony when is easy with anonymous or unavailable partners.”

Basically, what I see with men, and women too, as a result of covert incest is that they never quite feel free to be who they are. Because a parent has caused them to feel obligated, burdened, and overly responsible — with a sexual element underneath that — their relationships elsewhere are affected. They meet someone and they think, “I don’t want to be with you if you burden me.”

Sometimes they become sexually shut down with their long-term partner because the relationship feels so burdensome. They can’t enjoy it or be spontaneous with it anymore. It starts to feel icky to them, just like their unhealthy, overly enmeshed relationship with mom or dad. So they’re drawn to sex where there’s no commitment and there’s no obligation. Sometimes they don’t even want to know the other person’s name. The more anonymous it is, the less they know about the other person, the better. For example, guys who experienced covert incest with mom might struggle to maintain an erection with their wife or a serious girlfriend, but with a stranger they don’t have that problem because they don’t feel burdened and the sex doesn’t feel icky.

I’ll never forget one client I worked with. He talked about all the women in his life and he said that there were at least a few ships that he let pass by because he felt like he had to take care of his mother instead, and he started crying when he was talking about that. He desperately wanted to connect with those women in an intimate way but he couldn’t. Here he was, a 40- or 50-year-old man, handsome and successful, but he couldn’t commit to a no matter what. He just wasn’t able to take advantage of situations that were in his best interest.

Do things improve when the covert incest victim moves far away or the parent passes away?

No, because you still have the emotional and psychological conflict, even though there may be some immediate relief of not having to be responsive to the parent so frequently. Separation doesn’t remove you from the bondage of your template. You still enter a relationship and almost immediately feel burdened and overly responsible.

I also want to point out that the earlier the covert incest, the earlier the enmeshment, the earlier the role of surrogate partner, the more deeply rooted this template becomes. The covert incest victim’s developmental and schema is ever more heavily layered with , , obligation, and so forth. So a guy can move across the country and get involved with someone romantically and he still wants to leave that relationship very quickly because it’s just too much for him. He gets involved, he feels responsible and burdened, and he wants out.

I see a lot of covert incest survivors who just don’t regulate themselves very well when it comes to romance. They move in too quickly, or they’re ambivalent right from the start, or they go quickly and then become ambivalent, or whatever. It’s not uncommon for covert incest survivors to become serial monogamists, one relationship after another, because in the early stages of romance, when the neurochemicals are surging and making it seem like everything is great, they’re able to bypass their sensation of feeling burdened. They’re able to connect and be sexual with another person. But when the neurochemical rush of early romance dies down, the old feelings return and they’re out of there. They’re toast.

What first sparked your interest in covert incest? When and why did you first start looking at it?

Back in the 1980s I became involved personally with the Adult Children of Alcoholics movement, and then, professionally, I began to treat adult children of alcoholics. What I found was that a lot of these people had played the role of surrogate husband or wife to a distraught parent as a result of the other parent’s . I noticed that story unfolding repeatedly, and I began to write about it. I also noticed a strong connection between this early-life enmeshment and adult-life sexual acting out. I published the first article on this in 1987. And of course I started looking into this more deeply, creating surveys and doing some research to find the patterns and connections.

What was it like to be the first person to identify and write/talk about this issue? Did you initially experience a lot of resistance to your work? If so, has that changed over time?

Yeah, I got some flack, especially from colleagues who were treating sex abuse and didn’t like that I was calling this covert incest. I’d picked that term because the sexual part is hidden behind the good boy or good girl role. But I had colleagues in the field who didn’t like me using it. They argued that all sexual abuse is covert. I got pushback from laypeople, too. They just found the whole topic really difficult. Some of them even threw my book across the room when they started reading it.

I’ll never forget the first time I did a public presentation. It was in New York, on Long Island, and I was in front of an audience of 75 or 100 clinicians and I started out by giving the definition that I gave to you earlier. About 10 minutes into the talk, this woman raised her hand and I called on her. She stood up and said, very firmly, “This is preposterous.” She was very, very offended that I was calling out parents on this issue. The next time I gave the talk, a different woman stood up at the end and said, “Thank you very much. I’m going to go home right now and take my son to a therapist.” So I had a real mix of responses early on. Since that time, I’ve learned to talk about it in a more authoritative way. These days, you can’t get past me on this issue. I don’t flinch. But in the beginning, I found it difficult.

When you’re treating a client who suffered covert incest, do you sometimes have to break through the “I wasn’t abused” barrier because, say, mom didn’t touch his penis or dad didn’t fondle her breasts?

Yes, sometimes. In those cases, I try to not use the word "abuse," because clients will often defend against that. Instead, we’ll talk about enmeshment and feeling obligated to meet the needs of a parent when those needs should really be met by a spouse. I talk more about the role, and I stay away from talk about abuse. I get less resistance that way. So we just don’t talk about it as sexual abuse, even though it essentially is. And let’s not forget that even with overt sexual abuse survivors there can be resistance. Let’s say a boy was molested by a teenage babysitter. A lot of the time, he’ll say it wasn’t abuse because he wanted it and he enjoyed it.

Just to be clear, though, with covert incest there is a sexualized element.

Yes, with classic covert incest, a sexual element is present. Usually, the person will report something like, “I went to the movies with my mom a lot, stuff my father should have taken her to, and I felt icky. I didn’t want to be there, even though I liked the movies. She confided in me and I had to listen to her problems. She kept talking about how sexy I looked.” You know, things like that. In those cases, there is a sexualized, romanticized aspect to the role of surrogate partner. But it is possible to be enmeshed without that. That’s an important distinction to make.

Can you also differentiate a bit more about the difference between overt and covert incest?

Any time there is physical sexual contact, and that includes things like inappropriate kissing or touching, we’re talking about overt incest. Basically, you’ve moved past playing a role and into being an object. It can be both, of course. When that happens, usually the overt incest lasts a much shorter time than the longer-term surrogate partner role. I should also state that in cases of overt and covert combined, it isn’t uncommon to see the victims involved as adults with incestuous – mother and son or father and daughter stuff online, or power differential relationships where a boundary is crossed. Or their lovers tend to be much older or younger, so much so that the age difference raises some people’s eyebrows. So, the incestuous dynamic is played out in some way.

Frankly, I try not to draw too fine a distinction here because there is definitely a blurry line between things like sitting too close and making a child uncomfortable vs. kissing that child on the lips too long. Either way it feels icky. And the result might be that even though nobody touched my penis or breasts or vagina, when my lover tries to kiss me, I withdraw. That withdrawal is your evidence that something happened that was inappropriate and not welcome.

People should also know that healing is possible, and that covert incest isn’t a life sentence.

Healing is absolutely possible. People have to set healthy boundaries with the parent (if they’re still alive), and they have to work on reclaiming their sense of self, moving away from always signing up for the role of caretaker in their relationships. And that’s not easy. Learning to not become so enmeshed with your lover that you can’t function and you want to run away from the relationship is a difficult process. It’s a long-term issue where you always have to keep track of it, like an . But it doesn’t have to rule your life anymore.

If people are interested, I do enmeshment intensives a few times a year for both men and women. We just completed one in September. The next ones are in May of next year. I have people fly in from all over the world for these, and they leave with an emancipated sense of self, if I have anything to say about it, in ways that they never imagined. It’s really amazing to see their transformations.