Survivors of atrocity of every age and every culture come to a point in their testimony where all questions are reduced to one, spoken more in bewilderment than in outrage: Why? The answer is beyond human understanding.

Father-daughter incest is not only the type of incest most frequently reported but also represents a paradigm of female sexual victimization. The relationship between father and daughter, adult male and female child, is one of the most unequal relationships imaginable. It is no accident that incest occurs most often precisely in the relationship where the female is most powerless. The actual sexual encounter may be brutal or tender, painful or pleasurable; but it is always, inevitably, destructive to the child. The father, in effect, forces the daughter to pay with her body for affection and care which should be freely given. p4

The guarantee of safety in a battering relationship can never be based upon a promise from the perpetrator, no matter how heartfelt. Rather, it must be based upon the self-protective capability of the victim. Until the victim has developed a detailed and realistic contingency plan and has demonstrated her ability to carry it out, she remains in danger of repeated abuse.

In this climate of profoundly disrupted relationships the child faces a formidable developmental task. She must find a way to form primary attachments to caretakers who are either dangerous or, from her perspective, negligent. She must find a way to develop a sense of basic trust and safely with caretakers who are untrustworthy and unsafe. She must develop a sense of self in relation to others who are helpless, uncaring or cruel. She must develop a capacity for bodily self-regulation in an environinent in which her body is at the disposal of others' needs as well as a capacity for self-soothing in an environment without solace. She must develop the capacity for initiative in an environment which demands that she bring her will into complete conformity with that of her abuser. And ultimately, she must develop a capacity for intimacy out of an environment where all intimate relationships are corrupt, and an identity out of an environment which defines her as a whore and a slave.

It has become clear that, as Janet observed one hundred years ago, dissociation lies at the heart of the traumatic stress disorders. Studies of survivors of disasters, terrorist attacks, and combat have demonstrated that people who enter a dissociative state at the time of the traumatic event are among most likely to develop long-lasting PTSD.

HYPERAROUSAL
After a traumatic experience, the human system of self-preservation seems to go onto permanent alert, as if the danger might return at any moment. Physiological arousal continues unabated. In this state of hyerarousal, which is the first cardinal symptom of post-traumatic stress disorder, the traumatized person startles easily, reacts irritably to small provocations, and sleeps poorly. Kardiner propsed that "the nucleus of the [traumatic] neurosis is physioneurosis."8 He believed that many of the symptoms observed in combat veterans of the First World War-startle reactions, hyperalertness, vigilance for the return of danger, nightmares, and psychosomatic complaints-could be understood as resulting from chronic arousal of the autonomic nervous system. He also interpreted the irritability and explosively aggressive behavior of traumatized men as disorganized fragments of a shattered "fight or flight" response to overwhelming danger.