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Factors involved in domestic sexual abuse of children and adolescents related to parental psychodynamics are approached. By seeing incest as an essentially narcissistic issue rather than a sexual one, the author deals with perversion and narcissistic perversion in their relationship with paranoia and links them to the psychological pattern and relational model, to which the child or adolescent victim is subjected. Because of perverse aspects in the transference-countertransference, the consequences of this situation for his psyche and the particular constraints in the psychoanalytical treatment of these persons and their families are addressed.