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Abstract: The clinic of patients, victims of incest in childhood, invites us to question the fate of such psychical trauma and working-through issues offered by psychoanalytical treatments. Differentiation and articulation between the registers of the act and the factual reality, and those of fantasies and psychical reality, are at the heart of the psychoanalytical approach of incest. But, despite the theoretical contributions of Ferenczi on early trauma and because of a misunderstanding of the “abandonment of Neurotica” by Freud, psychoanalysis, until recently, has been accused of ignoring the specific sexual trauma by favouring only the psychical reality. A reassessment of this theory precedes a reflection on various figures of incest worked through in psychoanalytic literature: if the father-daughter incest is considered relatively often, mother-child incest, which is more rare in its genital forms, is nevertheless common on the form of perverted care, and is just as psychologically harmful. The difficulties of counter-transference work under intense transference reactivation show that the psychotherapist is attacked in his mental capacity to contain and associate. The particular destructiveness of incest trauma lies in its attack of the œdipal organization and its structuring value. [Copyright &y& Elsevier]