High on Arrival is the bombshell book published last September in which actress Mackenzie Phillips revealed that her childhood of hippie freedom and heroin cool also included a consensual sexual relationship with her rock-and-roll star father, John Phillips of the group The Mamas & the Papas.

Phillips, now 49, is best known for her role as teen Julie Cooper on the television sitcom One Day at a Time – a role she lost when cocaine addiction interfered with her performance. In her tell-all book, Mackenzie describes a prim and proper childhood by weekday at her mother’s home, followed by weekends that ‘veered down a psycopharma rabbit hole’ when her father’s limo would arrive to whisk her to one of John’s mansions. But what took the media, and Mackenzie’s family, by most surprise was Mackenzie’s account of the relationship she had with her father.

“On the eve of my wedding, my father showed up, determined to stop it,” writes Phillips, who was 19 and a heavy drug user at the time. “I had tons of pills, and Dad had tons of everything too. Eventually I passed out on Dad’s bed.”

“My father was not a man with boundaries. He was full of love, and he was sick with drugs. I woke up that night from a blackout to find myself having sex with my own father.”

“Had this happened before? I didn’t know. All I can say is it was the first time I was aware of it.”

Shortly after the release of High on Arrival, Mackenzie appeared on “Oprah” to discuss the secret she had harbored for 31 years.  Mackenzie said: “I’ve always known I would write this book. As the famous daughter of a famous rock star there are plenty tales of trashed hotel rooms, a 301-foot empty swimming pool, drugs (if you hadn’t heard), and off-the-charts hedonism. But ultimately, it’s about the shadow that fell over my life when I was young and full of hope and promise, and how I survived, got clean, and found that the person underneath that gray cloud of drugs and (let’s admit it) bad parenting was pretty okay.”

But could a father really convince his child that a consensual sexual relationship was a act of love, and could a victim of incest truly be in a consensual relationship? And what could happen to others who go through life with such an experience and beliefs without receiving therapy? To find answers to these questions, Behavioral Health Central turned to sex addiction expert Robert Weiss of the Sexual Recovery Institute in California.

BHC: Rob in our past talks, we really haven’t covered the issue of incest with regard to sexual recovery, and that issue has been brought to the forefront in the media with actress Mackenzie Phillips and her book that was released recently about her relationship with her father, John Philips. I wanted to speak with you because on a couple of levels it has some unique issues, not only incest, but the idea that it was consensual incest. I read in her book that Mackenzie thought it [the sex with father] was wrong, but yet it was still consensual. I wanted to get your opinion on what deeper issues are really going on here, and how do you treat a family and a patient who is going through something like this?

Robert Weiss: When you work with an adult child of an abused family, if they haven’t really worked on themselves in any particular way, one of the first things they’re going to say is, “I had a lovely childhood,” and then they go on to describe it in flat terms (every therapist knows this story) and we have to figure out a way to help them reinterpret that experience in a way that would connect to the feelings that they might have had about it then.

Any social worker knows that if you’re working with an abused child who has a file an inch thick of physical abuse and they come into the clinic with bruises, they’re going to say they fell down. Part of our development in childhood narcissism is the protection of our parents; we have to protect our caretakers emotionally, that’s part of our survival. We don’t survive as a species if we believe and live in the fear at 6 or 5 that our parents are unavailable or they might harm us. We don’t have the ability to think that way. So that’s part of our development is the ability to see others as good even in the worst of circumstances because we need to see them as good.

But unfortunately when the circumstances are bad, what do children do? They take responsibility for the badness. I often say when I’m speaking, a 5-year-old doesn’t look around and say, “Oh, I understand why they’re not treating me well. Dad’s an alcoholic and mom’s a compulsive overeater and that’s why there isn’t dinner on the table at 6 o’clock.” Five-year-olds don’t do that. Five-year-olds say, ‘What’s wrong with me that nobody is here to take care of me?’

And I think in like fashion, when an adult who is always going to be dealing with the trauma that they went through and always has a need to idealize a parent has an abusive situation that went on, it makes perfect sense to me that they would say, “Well, that was consensual” or “I had a part in that”. Because that’s what we do; we protect out caretakers.

In addition to that, when someone has sexual abuse, if it is pleasurable, the body responds. And this is what’s part of what’s difficult for people with sexual abuse is they may physically at times enjoy what’s happening to them because if they’re not being violently or forcibly sexualized, physical responses to sex are pleasant. It’s very confusing having your body respond in a positive way when, in your head, you’re saying something doesn’t feel right about this.

So when I put those two things together in narcissism of children is the need For them to protect their families, and the fact that sexual abuse, even if it is abuse, at times for some people can feel pleasurable in the moment, which they say people who have been sexually abused and who have experienced it at times as pleasurable say, ‘My body betrayed me.’ They’ll say, ‘I responded when my thought was this is a bad thing.’ So all of those factors really feel a lot like what you’re talking about when she says, “It was consensual with my father”.

BHC: Now let’s talk about the point of view from the father. Mackenzie wrote in her book that she had been drinking and she woke up and found this act going on with her father. Afterward she asked him, “Why did you rape me”? And he said he wasn’t, that he was making love to her. Do the abusers actually believe that, or is that just how they rationalize what they know is wrong?

RW: Well, let’s also put the time in context. I mean this is the early 1970’s when there was such a lack of boundaries around people’s sexual behavior and an exploration, not to mention the drugs and the alcohol that were flowing so freely at the time. So that kind of rationalization doesn’t surprise me. Remember, this is way before we really had child abuse laws in place. This is really before we had reporting; there wasn’t really the reporting that we have now. Social work wasn’t evolved in a way that we would respond to families like this; we didn’t know how.

Now remember all of that happened in the 80’s. So at this time, I can completely understand this man having using the culture that he was living in and his relationship with his daughter to rationalize and justify what anyone one even then would have said is wrong. So to say, “I’m teaching you how to make love”, I mean that is a classic sex offender strategy. In fact, I think it’s number one if you go through the list of offender strategies to say, “I was teaching that child how to be an adult.”

BHC: What about the whole issue of her writing the book and the public announcements on ‘Oprah’ and so forth when the family was so against it? Is that cathartic for the patient or was this a cry out for help?

RW: I don’t know her; I don’t know this woman, so I can’t say what her motivations were. We live in a world where, let’s face it, people will put their kids up in balloons to get them on TV, or say they did, so if that’s the criteria, ‘I slept with Tiger Woods’ in order to get myself on television, if that’s their criteria to get into public rather then earning it through some skill in the public mind, then it’s hard for me to say whether she’s someone who needed to up the sales of her book. I mean, it could be a very personal issue about success and Hollywood; it could also be something very personal. Maybe one too many people had idealized her parents to her and she had to tell the truth in a public way so that this illusion of who her parents were in the public eye would change.

There any many reasons why someone would choose to do that at some point. Does going public with your most personal violations help you? I don’t know how that would help anyone. In some ways, it creates a public conversation, but I cannot imagine that could be healing for anyone. I don’t know that being so public with such private and such hurtful matters really can help anyone.

BHC: When someone has buried a secret like this for such a long time and then goes public with it, do they likely still need treatment, and if they don’t get treatment, what sorts of repercussions could happen down the road?

RW: Well, I think we saw some of that. There was during the process of her talking about this book and talking about her experience, she went back and forth several times about how she depicted the event in public. So either she wanted to restate it in a way that made other people more comfortable or she saw what she had to see in print and people said to her, “What, are you kidding? That was a loving act on the part of your father?,” or whatever, and then she said, “Oh, I have to rethink this. I guess I needed to do more work on this.” I don’t know which one of those it is, but regarding sexual abuse, a couple things. One of my favorite statements, and I’m going to misquote it I’m sure, is by a man by the name of John Briere. John is a psychologists at UFC and he does a tremendous about of research about childhood abuse and childhood trauma. He said that it isn’t really any specific trauma that causes the long term outcome of a child’s adult life, it isn’t whether they were rapped or violated or snatched or whatever happened to them. The real long-term outcome of how that child is going to develop into an adult has to do with how that trauma was handled. If someone is abused or violated in an environment where they can then stand up and talk about it and get help at that time, and they can be believed and accepted and supported and what they’re going through normalized, not what happened to them but their emotional life, then they’re going to have a lot better opportunity to be able to deal with what happened to them as an adult.

However, if they have to keep it a secret and they have to hide it and there’s no place to go that’s safe to talk about it, or if they talk about whatever the abuse is and they’re told not to talk about it, or it’s their fault, that’s a very different environment for someone to work through what’s happened to them. I think one of the goals of therapy and treatment of people who have abuse is to be able to set up an environment where they can work through things in a way that they couldn’t work through them when they were younger.

BHC: If you get to the point where she’s at, she’s an adult, her father’s been dead for a number of years now, maybe she feels safe that it’s okay to come out with that, but if she doesn’t seek treatment, or people in a similar position don’t seek treatment, what could the long-term repercussions be down the road if they don’t get help to uncover what emotions they might secretly be dealing with but not realize it?

RW: Well, I think your question is a really good one. I wish I had a definitive answer. Part of what any good therapist knows, I think, is that it isn’t just want happened to people, it’s also who they are in their own ego strength. So some people can go through horrendous experiences and find a way to find peace and a way to come to terms with it, while other people will continue to live it out their whole lives, and other people may never deal with it but find someway of adapting that isn’t pathological.

So I really think it depends on who this individual is and what kind of support she had going through what she went through growing up. If someone does not have the opportunity to work through or talk about what happened to them, it’s going to effect their adult life and there’s no question about that. So the typical scenario I think that most trauma therapists see are things like people who are chronically depressed, underemployed, extremely low self esteem, either hyper-sexual or hypo-sexual, either they’re having a lot of sex or there not having any, or people who are acting out other kinds of relationship and intimacy disorders in their lives in a way that’s really problematic. The problem is going to show up, it’s just a matter of how and who that person is and what strength they have to deal with it.

BHC: Rob are there any statistics about the number of children that this happens to? I guess the reason I’m asking is because is it something that pediatricians should be screening for when a child reaches a certain age to ask questions or that educators should be on the look out for or is it not that prevalent?

RW: Well I think the prevalence of child abuse is pretty readily attained through the missing exploited children’s services through the US government. There’s that information we have, we have it state by state county by county. Now what is never reported is what we don’t know about, and the truth is that most sexual abuse is not reported and never uncovered because it’s often a family member or a teacher or someone who’s abuse just simply goes by.

I don’t know this because most of my work is with adults, but I would think and hope that pediatricians and family physicians are asking, are saying to children, ‘I need to examine you here but you know no one else gets to touch you here but mom or dad,’ and kind of giving those basic lessons about what abuse is just through the course of a medical exam or just through the course of a conversation with a child. I would hope, and I don’t have the exact answer to that, but that would be included in a standard medical education if you’re working with children – which is not anything extremely explicit but just things like, ‘has anyone ever taught you about what’s okay for an adult to do with you or not’, or ‘I’m going to examine you here; has anyone else ever touched you here?’, or just things like that. Children are very willing to talk about their experiences if they are just asked very simple and honest questions.

BHC: What about from the adult point of view who might have read her book and be thinking that maybe they need to get help for issues that they’re doing with children inappropriately. Let’s say, for example, someone approaches you and said, ‘Look I need help for this, this is happening with my son or daughter or a minor,’ are there any legal ramifications for you to have to report that as a crime or are you able to treat that in a private way so that they can get help?

RW: So your question is if an adult comes in over the age of 20 and they say, ‘I was abused as a child sexually and I was physically touched inappropriately etcetera and I want to work on that and I have to deal with what happened to me’, or we figure that out over the course of therapy, not figure it out but they really come to some understanding that that is true, then is there something that’s reportable. Is that your question?

BHC: That and also from the perpetrator’s point of view. Let’s say that John Phillips was alive and before this he self reported that he wanted to go and seek help. If he came to you and said, ‘I had this relationship with my daughter that was inappropriate I need counseling,’ do you have an obligation to report that crime?

RW: I do not have an obligation to report what he did to his daughter 30 years ago or 25 years ago, that is not my obligation. But I do have an obligation to be aware of any children that might currently be at risk for example if that man came forward and said, ‘I did this to my daughter when I was 35 and now I’m 60 and I want to come to terms with it,’ one of my thoughts and questions would be, ‘Do you teach school, do you have grandchildren around?’ Because once someone is an offender the possibility of offending remains. That doesn’t mean they’re going to do it, but it remains. So my responsibility is to the protection of children. So if someone was sexual with a child 25 years ago and they’re coming into me for help and they’re surrounded by children, I would feel like there might be reasonable suspicion, I certainly would be asking myself that. But no, I don’t think and I’m pretty sure I don’t have any accountability to what happened that many years ago, if the person is no longer a child.

BHC: What if they were to read this and thing, “Oh God, I’m doing this and I need to get help”, what if it’s a current situation? I guess what I’m getting at is is there a recommendation for those who may read Mackenzie’s book and think, “Alright I’ve got to put an end to this, but I need help because I know I can’t do it myself”. Do they have any protections about getting help?

RW: Reporting laws are what are. First of all, they all know what we all think of their behavior. It’s not surprising to anybody that’s an offender what everyone believes about offending behavior, so they already know what we think. I don’t think there are many offenders out there who don’t know what happens if they talk about it.

Now I don’t know that every offender knows the child reporting laws necessarily, but there reality is they’re there and they exists and all of us should have them in our office waiting room paperwork. If I have a client who’s coming in and they start something that’s reportable, I will stop them and say, ‘I just want you to know that if you continue with the information you’re giving me, that is something that might be reportable, so I think we should stop now and talk about what that means and both to you and the situation in your life.’ That’s about the best I can do. But the laws are what they are, and I have the responsibilities I have, and if I have a suspicion that a child is at harm, I’m going to report it.

Just because an offender might be fearful of being reported or arrested or turned in by disclosing the details that they’re acting out in therapy, or their history of sexual behavior therapy, that doesn’t mean that they can’t be in a 12-step program where that responsibility doesn’t exists.

So I might be able to tell my sponsor or one of the people in my 12-step meeting, not in the meeting, but outside of the meeting, “This is something I did and I need to talk about it in order to make sure I never do it again and I want assume accountability and I want to work through it through my program.” I mean that is one of the miracles of recovery is that you can go somewhere and have at that level of anonymity. There are places people can go and absolutely talk about this and a client can come to me and say, “Listen, I did some things that I have tremendous shame about, they’re of a sexual nature, they involved people who were underage when I was much younger and I can’t give you the details now”, or “There’s something that’s going on that is sexual that is problematic in my life and I can’t give you the details right know but I would like to talk about how to get help.”

There are a lot of online resources that sex offenders and people who engage in inappropriate sexual behavior can use to stop offending. There are websites, accountability sites, 12-step support groups, books, materials, there are a lot of places that someone who is afraid of getting turned in and needs to learn more about his because they don’t want to hurt another person, there are a lot of resources for that person online and that would be my first place to go.

BHC: Do you have any sites in particular to recommend?

RW: Sure, one really good site just to start is www.safersociety.org. It provides information and support and print materials both for survivors and perpetrators. They look at both ends of it and they’re non profit. I think they would be particularly good; it really it’s a fairly neutral organization.

It’s very strange because part of the treatment of offenders is you have to help them work through the shame of what they’ve done, even though what they’ve done is really shameful. If they just see their act as confirming how horrible they are, they can only look at their behavior as being a confirmation of them being bad people. That is not helpful because it’s their own self hatred in part that they act out over, so there has to be a way to help someone, as we say in the biz, hate the behavior not the person.

So if I can get a sex offender or a sex addict to say, “I hate my behavior, I don’t hate myself. I’m not a bad person but I do bad things and I need to work on them.” That’s a very different stance because self hatred is just a form of self obsession. But once we’re past that, then there’s room for things like empathy because, “I’m a horrible person, I should be killed, I did these terrible things, I can’t believe I hurt kids.” That kind of stance doesn’t help the person stop and it also doesn’t provide empathy because in the statement, “I hate myself, I’m horrible, how could I do that?” There’s nothing about the other person. It’s all about themselves, and what I want an offender to say is,’ I feel so badly for that child, I don’t even imagine what they went through’, not, ‘I’m so terrible for what I did.’ So these are human beings and it’s hard. We’d like to say, ‘look how terrible you are and you did these terrible things and don’t you feel sorry?” But unfortunately treatment is not that simple.

Happy Mothers Day to all the mothers in my life – today is your special day and I am thankful for each of you. I miss my mother – Dr. Carrie Due.