Éclairages historiques, épidémiologiques et psychopathologiques concernant l’inceste : entre crime et pathologie ?

Abstract

There are many different specifications about incest and they do not refer to the same concept: each society gives it borders which are valid for a community in a specific time. Regulation about incest is constantly evolving as shown by the last act of February 8, 2010 that brings the term of “incest” in the penal French Code. Nowadays, about 2 millions French people are victims of incest. In France, incest cases constitute 20% of Assisi trials, they represent 75% of sexual assaults of minor cases and more than 57% of rape of minors. On the forensic accounting in 2007, sexual violence authors are the second largest contingent of subjects incarcerated, behind assault and battery authors. Senon and Manzanera estimate that only 1 to 5% of sexual offenders suffer from a mental disease. By a literature review, we found there is a significant variability in prevalence estimation about psychiatric comorbidities in sexual offenders’ population. In international classifications categories such as pedophilia are identified by the term of “sexual preference disorder” in ICD-10, or by the term of “paraphilia” in DSM-IV-TR. In both these classifications, the notion of incest is not clearly stated as a separate entity but finds itself inserted into the concept of pedophilia. Psychiatric classifications are not intended to study sexual offenses but they are useful, during forensic psychiatric assessment, to identify a mental illness causing transgressive sexual behavior or to identify a psychiatric comorbidity. However, statistically, very few sex offenders are recognized criminally irresponsible because of their mental illness, according to Article 122-1 paragraph 1 of the French Criminal Code. Psychiatric experts are “technicians” in the service of justice: they have to carry out the missions entrusted to them by the judges, based on their skills and knowledge in the subject concerned. The psychiatrist expert may be questioned before the judgment on the issue of criminal responsibility, and, if convicted, on the appropriateness of an injunction care. In a current context of media dramatization, we choose to question about links between crime and pathology in a population of incestuous fathers. Nowadays, irrespective of the chosen theorical frameworks, there is a consensus to denounce the shortcut by which a subject can be defined by its act. Despite the clinical polymorphism of deviant behavior, the infinite variety of psychopathological configurations in which these behaviors may appear, one point seems to have the experts agreement: the fact that these sexual behavior disorders are much less sexual disorders themselves than “defense solution” attempts versus major anxieties about feeling identity. Authors’ ethiopathogenic hypotheses that refer to psychodynamic theories are the following: in most cases, there is at the forefront a serious disturbance of narcissism, a fragile sense of continuity of identity, and the threat of collapse depression, linked to major anxiety about alteration or disappearance of self-representation. Incest, by its transgressive dimension, asks each of us. Major health problem, it cannot be answered only by punishment but requires a diverse precautionary approach where societal debate (and its educational decisions), and psychiatric theorizing are decisive.