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Identifying psychological abuse

By Avery Neal February 7, 2023

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Two people sitting facing away from each other with upset looks on their face

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In their 2019 meta-analysis on psychological abuse and mental health (published in Systematic Reviews), Sarah Dokkedahl and colleagues found that psychological violence is estimated to be the most prevalent form of intimate partner violence, yet there is very little research on the individual impact of psychological abuse on mental health.

Historically, psychological abuse has been widely overlooked, despite the staggering statistics. In the National Intimate Partner and Sexual Violence Survey: 2010 Summary Report, Michele Black and colleagues reported that approximately half of Americans had experienced emotional abuse by a partner in their lifetime. In addition, they found that psychological abuse causes long-term damage to a victim’s mental health and that subtle psychological abuse is more harmful than overt psychological abuse or direct aggression. These findings indicate the urgency to educate clinicians on how to accurately identify psychological abuse and power imbalances in a relationship, particularly when the more overt forms of abuse are not present.

Furthermore, victims of psychological abuse often do not know that they are experiencing abuse, even though research has repeatedly shown that there is a strong link between psychological abuse alone and a range of mental health disorders and physical conditions such as posttraumatic stress disorder, anxiety, depression, suicidal thoughts, irritable bowel syndrome, gynecological problems, chronic pain, substance use, physical injury and sleep disturbances. In fact, Mary Ann Dutton and colleagues’ article published in the Journal of Interpersonal Violence in 2006 and Mindy Mechanic and colleagues’ article published in Violence Against Women in 2008 both found that psychological abuse is a stronger predictor of posttraumatic stress disorder than physical abuse among women. If clinicians are not sufficiently trained in psychological abuse, then this population will lack adequate support, or even worse, abuse victims may be further victimized by the untrained therapist, particularly in couples therapy.

Misconceptions about abuse

Many misconceptions about abuse have created certain social stigmas and prevent those experiencing abuse from accurately identifying what is occurring in their relationship and seeking help. Some of the most common misconceptions include that abuse only occurs among poor individuals and minorities, that abuse is only physical or sexual, that abuse is the fault of both parties, and that victims of abuse have grown up in abusive homes and are just returning to something familiar (which does happen but is also frequently not the case).

A prevalent misconception involves incorrectly profiling victims of abuse. Many have a preconceived notion that victims of abuse present as meek or timid and are therefore easy to identify. But this is not true at all. In fact, many victims of abuse are strong, well-educated, financially successful and independent. Many are top employees or leaders in their field. The outside world would never guess that behind closed doors, the person is being criticized unrelentingly, monitored by their partner, threatened if they try to leave and guilted for having other support systems. Counselors must be aware of their own beliefs around abuse so as not to overlook what may be occurring for their clients.

A common example of this is the tendency to overlook men as victims of psychological abuse when the reality is that nearly half of women and men in the United States have experienced psychological aggression by an intimate partner. This results in many men not recognizing that they are being abused, so a large percentage of this population doesn’t seek help because they feel confused, ashamed or embarrassed or they believe that it is their fault. In addition, there is a cultural expectation that men are supposed to be “strong” and assertive and know how to stand up for themselves. Compounding the issue, boys and men who have been raised to be respectful of women may take this to mean that they shouldn’t set boundaries even if they are being mistreated by their partner. And traits such as being highly empathetic, emotionally sensitive, overly responsible and conscientious may not only put men at greater risk for being mistreated by their partner but also increase the likelihood that they will stay in an unhealthy dynamic.

For victims of psychological abuse, the term “abuse” may be hard to accept if physical violence is not occurring. Once counselors identify that physiological abuse is occurring, they can begin to support their clients to accept this reality. If the client is not ready to accept or use the term abuse, counselors can explain the dynamic using the concept of bullying in their relationship. This can help victims of abuse digest the information until they are ready to fully accept what is happening to them. Victims of abuse often carry a substantial amount of shame around not seeing or ignoring early warning signs, not leaving sooner, or falsely believing that they have done something to cause the abuse to occur. Most victims of abuse have engaged in ways that they would not have otherwise behaved if they had not been coerced, forced or scared. Supporting these clients through abuse education and trauma recovery, helping them develop other support systems and fostering their sense of worth and self-esteem are all vital to intervention.

Signs of psychological abuse

Psychological abuse is insidious, and often there are no overt signs of violence. It is imperative, therefore, that counselors know warning signs that indicate abuse is occurring. Here are some important factors to look for when working with clients who may be in an abusive relationship:

  • A person who seems insincere or overly friendly
  • A person who exhibits grandiose displays of attention during the courting phase of the relationship
  • A person who withholds affection, attention, love, sex, money or children
  • A person who speaks disrespectfully about their partner, to their partner or in front of others
  • A person who puts their partner down through humor or is overly critical
  • A person who isolates their partner by sabotaging their support systems
  • A person who speaks disrespectfully about their former partners
  • A person who has a history of not cooperating with others professionally or personally
  • A person who has more power in the relationship
  • A person who has a pattern of possessive, controlling or jealous behavior
  • A person who has a pattern of not taking responsibility, dishonesty or infidelity
  • A person who intimidates their partner when they’re angry
  • A person who has negative views toward women or double standards
  • A person who consistently takes the opposing stance from their partner
  • A person who lacks empathy for their partner

Keep in mind that it is unlikely that all of these patterns will occur within the relationship. A combination of symptoms is typically present, and inquiring about the couple’s history and the beginning of the relationship can provide valuable insight for clinicians. For example, frequent calling or texting with seemingly “loving” messages may actually be an attempt to keep tabs on a partner. The partner may not make this connection but might report feeling anxious without knowing why. A client may also report engaging in excessive exercise, and with further inquiry, the clinician may learn that the client’s partner is critical of her family and friends and claims that they are not good influences, which causes the partner to worry about her mental health. Thus, the client becomes isolated from their support system and instead turns to excessive exercise as a coping mechanism. On the surface, these criticisms may seem to come from a place of love or concern, but they could be signs of an unhealthy dynamic at play.

Assessing for psychological abuse

In my clinical practice, I have observed some patterns that appear to be prevalent in abusive relationships. Clinicians need to be aware that these patterns exist in both physically abusive relationships and partnerships with psychological abuse alone. At the heart of an abusive relationship lies the abuser’s core desire for power and control. Abusers’ styles may vary somewhat, but the underlying mechanisms they often use to gain power and control include the following.

Lack of empathy. Empathy and conscience are directly correlated. The higher one’s level of empathy, the greater likelihood their conscience can clearly differentiate between right and wrong. An abusive person has diminished empathy for others and a reduced capacity for distinguishing between right and wrong. This directly affects the abuser’s value system, making the abuser less responsive to the needs of their partner and/or children.

Sense of entitlement. Abusers have a high need for control. One presentation of this can be seen in an abuser’s sense of entitlement or belief that they know best and/or that their partner owes them. At the core, an abuser is insecure and compensates for this insecurity by undermining their partner. An abuser sees their partner’s autonomy as a threat. In an effort to reduce this threat, an abuser will try to diminish their partner’s character, accomplishments and other relationships. The presentation of this pattern is often more covert and can even play into an abuser’s charm. The abuser, for example, may use humor to put their partner down, have double standards or play devil’s advocate, all of which enhance the power differentiation.

Defensiveness and manipulation. Clinicians may have a difficult time recognizing an abuser’s manipulative tactics. Abusers often present themselves with charisma. They may impress clinicians with their “psychological awareness.” In couples therapy, they may seem like the “good” one, while their partner seems to be more emotionally reactive, hysterical, or physically or mentally unwell. Counselors are often unaware of abusive relationship patterns and will unconsciously support the seemingly balanced and logical abuser, which gives the abuser more leverage against their partner and furthers the abuse. Clinicians must pay attention to each person’s account of behavior at home and keep the possibility of a power differentiation in mind. Furthermore, counselors should pay attention to their own feelings in response to each client. Often a clinician may feel uneasy or intimidated by a client, but they may not be able to identify why. Examples of this include a client who is overly flattering to the therapist or a client who causes the therapist to question themselves. It may be hard for the clinician to pinpoint what is occurring, which is a telltale indication of a good manipulator.

Lack of responsibility. Abusers typically do not take responsibility for their behaviors or actions. This can be seen in interactions with their partner and often in their professional interactions. They often blame others or external events for their actions, rather than holding themselves personally accountable. This frequently presents as being a victim, so clinicians must pay careful attention to the person’s overall pattern of limited accountability. Typically, an abusive client will quit therapy once they realize that they are unable to manipulate the therapist. When this occurs, therapists must realize that this is not a failure on their part, but rather an indication that the abuser does not want to take responsibility for or change their hurtful behavior. When this happens, therapists can focus their work on supporting the abused partner.

Playing the victim. Playing the role of the victim is likely the abuser’s most powerful manipulation. They can cleverly disguise their aggressive behavior by appearing to be the injured party; for example, the abuser may blame their partner for the exact hurtful behaviors that they are actually doing. The partner then blames themselves and believes the abuser’s story of victimhood. An abuser is highly skilled at making others, including their partner, feel sorry for them; they know exactly which buttons to push to evoke sympathy. This makes the partner blame themselves and often prevents them from identifying the bigger issue because they take more than their fair share of the blame and responsibility. Clinicians can often be led astray and fall for the abuser’s manipulation.

The push/pull pattern. An abuser is not mean and cruel all of the time. If they were, then their partner would be more likely to leave the relationship. An abuser pushes boundaries, escalating mistreatment. And when the abuser gets away with the abuse, the severity of the abuse escalates. This represents a win for an abuser because they gain more power in the relationship and their partner is increasingly rendered powerless, which in turn makes them easier to control. The abuser then displays “loving” gestures to keep their partner off balance and questioning themselves. This is often seen in the “honeymoon phase” of the abuse cycle when the abuser is attempting to atone for misconduct. The abuser might do something for their partner that they know their partner has always wanted. This demonstration fills the partner with positive feelings for the abuser and with the hopeful, but false, belief that the relationship can be the way that it was in the beginning.

Abuse is gradual and cyclical. Abuse is not obvious at first, but it escalates over time. The more committed the relationship becomes, the more the abuser escalates the abuse because they know that their partner is less likely to leave if there is a strong commitment (e.g., shared finances, children). The severity of abuse increases as the victim tolerates the mistreatment and does not leave the relationship. More overtly abusive episodes are followed by a honeymoon phase, where the abuser may act remorseful and appears to have changed. This leads into the buildup phase where an abuser’s partner begins to feel tension and anticipates the next overtly abusive episode. During this phase, the abuser’s partner is likely to either tread lightly to avoid conflict or initiate conflict in hope that the abusive episode will not be as severe if the buildup phase has not lasted as long. Both behaviors are an effort to manage the abuser’s reaction and an attempt to give the victim some sense of control over the severity of the abuse.

If a counselor suspects psychologically abusive behaviors in the relationship after identifying the presence of some of these patterns, it is important to address it. Clinicians need to ascertain the level of the abuse and whether any physical or sexual abuse has ever occurred. It can be quite helpful to work with both parties individually in addition to couples therapy. Working individually with the victim can allow a safe environment for full disclosure, and counselors can support the client through abuse education and help them to recover their confidence and self-esteem. Best practices include trauma work and building on the client’s strengths and available resources. Working individually with the perpetrator allows the clinician to explore past trauma, their need to control and anger management.

It is important to note that there is a spectrum of abuse, ranging from being overly critical and controlling to pointing a gun or battery. Individuals who fall on the lower end of the spectrum are a lot more likely to respond positively to interventions versus those who display more aggressive signs of violence. There is also a correlation between the perpetrator’s level of accountability and empathy for others and the likelihood that therapy will be successful. As previously mentioned, most perpetrators of abuse (both overt and covert) are unwilling to take responsibility for their behavior, meaning that once confronted by the counselor, they typically quit coming to therapy. There is very little that counselors can do to avoid the discontinuation of treatment if the perpetrator of abuse does not want to participate in therapy.

For therapy to be effective, counselors must address the abusive behavior. If the individual is unwilling to confront their behavior, counselors must not take this as a failure on their part but understand that it is a symptom of the abuser’s personality structure. Clinicians must continually evaluate the level of risk to their clients and to themselves when working with individuals who abuse and refer to available resources when necessary. If there are concerns about the physical safety of the victim or the counselor, appropriate steps must be taken to ensure everyone’s safety.

Conclusions and recommendations

My primary recommendation to the counseling field is a call for more research in the area of psychological abuse. Despite the prevalence of psychological abuse worldwide, numerous studies confirm that it still remains a severely neglected area of study. Because research drives clinical practice recommendations, it is imperative that we start here.

Psychological abuse is a complex issue, and identification and intervention are difficult at best. Because covert forms of psychological abuse may be harder to identify, clinicians need to pay particular attention to how both people feel in their relationship. When counselors are aware of the characteristics and patterns of an abusive relationship, they can use intervention strategies to adequately support their clients in clinical practice.

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Read more in Avery Neal’s online exclusive “Does your personality make you more vulnerable to abuse?”

headshot of Avery Neal

 

Avery Neal holds a doctorate in psychology and is a licensed professional counselor, a practicing psychotherapist, and an international author and speaker. In 2012, she opened the Women’s Therapy Clinic, which offers psychiatric and counseling support to women. She is also the author of If He’s So Great, Why Do I Feel So Bad?: Recognizing and Overcoming Subtle Abuse, which has been translated and published in 12 languages. Contact her through her website at averyneal.com.

Counseling Today reviews unsolicited articles written by American Counseling Association members. To access writing guidelines and tips for having an article accepted for publication, visit ct.counseling.org/feedback.

Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

Does your personality make you more vulnerable to abuse?

By Avery Neal January 26, 2023

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Katherine (pseudonym) sits before me, meticulously dressed and exuding confidence. She makes great eye contact, and within minutes of our meeting, she has informed me of her high-powered position at one of the top law firms in the city. She is assertive in her responses, and I am left without any question that this woman is brilliant.

As our session unfolds, I find out that Katherine has come to see me after having left her husband following years of abuse and deceitful manipulations. As she described the last incident — how he pinned her against the wall, almost choking her, and then threw her across the room — I can hardly believe that this self-assured, outspoken and composed woman in front of me has been the victim of abuse.

After years of listening to clients share their stories about how they have endured aggressive and controlling relationships, it occurred to me that we’ve got to throw out our misconceptions of abuse and start paying attention to the reality of abusive patterns.

Most important, abuse is not just physical violence. Although physical and verbal abuse are usually the easiest to recognize, psychological and emotional abuse are more destructive to a person’s psyche, physical health and mental health. Psychological and emotional abuse mostly go unrecognized because the person is left without visible bruises. There are many abused people who have never been harmed physically, which leaves them to question themselves rather than identifying the abusive dynamic in their relationship.

And it’s not simply the insecure, meek woman who finds herself in the throes of an abusive relationship. It’s the woman who graduates with distinction from her Ivy League school or the selfless housewife who dedicates her life to her children. It’s the male executive who is ashamed to admit that his wife physically attacks him.

There is no way of telling if the person sitting next to you is being severely mistreated and manipulated by their partner. There are, however, some defining characteristics that make a person more vulnerable to being abused. It is important for people to know what personality traits make them more susceptible to being manipulated and abused so that they can begin to protect themselves.

Are you naive or inexperienced in relationships?

People who have not dated much or who have not had many romantic partners are more likely to end up in a controlling relationship simply because they don’t have other relationships with which to compare. They believe that what they are experiencing in their relationship is normal even if it doesn’t feel right.

The widely believed notion that only people who grew up in abusive families seek what is familiar and tend to end up with abusive partners gives many a false sense of security. Those who have not grown up in an abusive home think they will be equipped to know what to look out for in a partner. Although people from abusive homes are more likely to overlook abusive behavior in their partners, this is only part of the story — a very small part that has left many people falling unsuspectingly into the hands of abusive partners.

Because abuse occurs gradually, many people find themselves committed to their partners before they even have an inkling that something is amiss. Therefore, it is critical not only to know the early warning signs of an aggressive or controlling relationship but also to know how to protect yourself if you find that you fit the profile of someone who is at a higher risk for being abused.

Are you overly responsible?

People who take on more than their fair share of responsibility — be it bearing the brunt of financial burden, investing more in the family or carrying the emotional weight in the relationship — tend to be more likely to end up with partners who exploit their sense of responsibility and work ethic. It is not uncommon for one person to find that they’re doing most of the heavy lifting in the relationship while their partner sits back and watches, completely unconcerned.

In addition, those who tend to apologize even when they haven’t done something out of line are, in fact, taking responsibility for whatever mishap has taken place. While it is admirable to have the humility to apologize and “own up” if you’ve done something wrong, it makes it easier for an abuser to take advantage of you if you constantly apologize when you haven’t done anything wrong. So if you tend to be the overly responsible type, both in practice and emotionally, be sure to find a partner who contributes equally to the relationship.

Are you highly empathetic?

Highly empathetic people are more likely to fall for someone who plays the role of the victim, a common personality trait in most abusers. A person with a great deal of empathy accepts when their partner tells them that past childhood trauma is the reason for the abuse and that they simply can’t help it. The highly empathetic person is also more likely to cave after standing up for themselves when an abuser cries, apologizes, begs them not to leave or promises that “it won’t happen again.”

A person’s greatest strength can also be their greatest weakness, and this is certainly the case with empathy. If you’re an empathetic person, be aware that abusers know they can appeal to your empathy and compassion to get what they want. You must learn to protect yourself from being manipulated by someone who does not have your best interest at heart. Focus on relationships with people who do not exploit your empathy or coerce you into tolerating behavior that you should not have to withstand.

Do you avoid conflict at all costs?

Those who suppress their feelings to prevent others from getting mad at them are more likely to end up being abused. People who avoid conflict experience extreme discomfort if they believe that someone is mad at them. Their fear of disapproval or discord leads them to give up their need so as to avoid confrontation at all costs. These people, who typically describe themselves as peacekeepers, are far more likely to end up with an abuser because they are an easy target.

The conflict-avoidant person takes pride and feels settled when harmony is restored, so they work harder and harder to keep the abuser happy. The problem is that no matter how hard they work in their relationship, they alone cannot change the dynamic. Far more likely, they will completely lose their sense of self in the process of trying to change the relationship, eventually succumbing to keep harmony in the relationship.

Although there are tremendous benefits to being a peacekeeper, the problem arises when you completely sacrifice yourself to keep your partner happy. It is important to practice asserting yourself and your needs and to have a partner who allows you to do so without punishment.

Trust your intuition

I encourage people to trust their intuition if something doesn’t feel right in their relationship. Far too many people suffer in silence because they are embarrassed to admit that they have ended up in an unhealthy relationship or that the cost of getting out of the relationship seems too great.

Remember, abuse is gradual, which makes it even more difficult to see objectively. People try to convince themselves that if they could just get the relationship back to what it was, everything would be all right. But it will not be because abuse escalates over time.

In the case of Katherine, her personal life now matches her professional one. It wasn’t an easy journey, but she has learned to recognize the early warning signs of an abuser, to speak up for herself and to not excuse bad behavior. Her life now is filled with people she respects and who respect her in return. And she has the freedom to make her own choices — without fear.

 

headshot of Avery Neal

 

Avery Neal holds a doctorate in psychology and is a licensed professional counselor, a practicing psychotherapist, and an international author and speaker. In 2012, she opened the Women’s Therapy Clinic, which offers psychiatric and counseling support to women. She is also the author of If He’s So Great, Why Do I Feel So Bad?: Recognizing and Overcoming Subtle Abuse, which has been translated and published in 12 languages. Contact her through her website at averyneal.com.

 

Read more about how counselors can recognize and treat psychological abuse in Avery Neal’s article “Identifying psychological abuse” in the February issue of Counseling Today.

Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

A survivor’s lens on counseling and intimate partner violence

By Leontyne Evans August 12, 2021

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Speaking as a survivor of domestic violence, I have found that society is not often kind or understanding about matters related to this particular form of abuse. Frequently, society seems to perceive it as something someone has chosen for their life instead of something someone was forced into. Grace and empathy are generally given when we talk about other forms of abuse, but mention domestic violence, and that same grace isn’t always extended. 

For years I wondered why — why is one type of abuse viewed differently in comparison with another? Just like any other victim, I never planned to be a victim, so why was I looked at differently? Why is it that victims of domestic violence have their pain invalidated by questions such as “Why didn’t you just leave?” 

That question alone — Why didn’t I just leave? — is what led me to the counseling profession. Given that I was a strong, independent woman who came from a good family, it was a question that plagued me. To transition from victim to survivor, I needed answers — answers that I just didn’t have. 

No easy answers

When I was an uneducated victim of domestic violence, the question of why didn’t I just leave felt complex. But after majoring in behavioral science/psychology and completing specialized courses in domestic violence intervention, trauma-informed care and, eventually, clinical counseling, I found that answering the question still wasn’t simple. In fact, as an educated grad student removed from her past situation, it became inherently clear to me that no amount of education would provide a clear-cut answer. 

I was in my last semester of graduate school and preparing to enter into the practicum portion of the degree when I enrolled in a class on family violence. Each week, we would watch videos and discuss our views and how we would help the client. In week four of the class,
that difficult question came up again. I was reading through the discussion post when I saw it: “Why don’t people just leave? If you want it to end, just leave.”

Being this far into my degree program, I was surprised to see other soon-to-be counselors asking this question and making that comment. I assumed other professionals had taken classes outside of this one to better understand a problem so prevalent in our society. If that wasn’t the case, were counselors really prepared to serve this population? 

In my own experience seeking counseling, I was asked, “Why do you think you chose not to leave?” I immediately felt like the counselor didn’t understand my position, and I decided to never see her again. I was hurt and angry, but I realized I still needed help. Luckily, I found another counselor and continued to educate myself on the cycle of abuse. 

Unfortunately, that is not the story for the majority of survivors with whom I have worked. If they feel misunderstood or invalidated, they don’t go back to counseling. In other words, asking the wrong question as counselors doesn’t just keep us from building a trusting relationship with these clients; it may actually deter them from ever seeking help again. 

It’s not that asking “Why do you think you chose not to leave?” is a horrible question. In relationships that do not involve abuse, it’s a perfectly acceptable question. When domestic violence is present, however, it crosses the line into victim blaming. Society constantly asks those who were victimized why they stayed instead of asking those who perpetrated abuse why they abused or why they created environments where leaving was not an option. According to Cynthia Hill, director of the 2014 documentary Private Violence (in an interview published in The Guardian), between 50% and 75% of homicides related to domestic violence happen at the point of separation or after the victim has left their abuser. We must be sensitive to the real danger involved in trying to escape intimate partner violence.

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Tips for building relationships with survivors

I understand that as counseling professionals, we can ask questions only of the individual we are working with, and we always want to make sure the client is focusing on their behavior and not that of a partner or anyone else. Accountability is important and key in the healing process. However, it is not the best idea for this to be the primary focus when working with this specific population. 

When working with individuals who are currently experiencing intimate partner violence or have recently left an emotionally, mentally or physically abusive situation, counselors can use the following six tips to build relationships with these clients. 

1) Start by understanding that if leaving were an option, domestic violence would not be a thing. Remember, up to 75% of deaths related to domestic violence occur while the victim is attempting to leave or afterward. Because domestic violence is rooted in power and control, perpetrators of abuse often lash out at the idea of losing the person they feel they control. 

In the movie What’s Love Got to Do With It, based on the life of singer Tina Turner, her husband, Ike, says at one point, “Tina, if you die on me, I swear I’ll kill you.” To most people, that sounds crazy, but in Ike’s mind, he wanted to maintain control over Tina, even in her death. For those who are not movie people, the Duluth model of domestic violence intervention also explains this concept. Leaving is dangerous and maybe even impossible for most victims. So, stop asking clients why they didn’t or don’t leave. If they could, they would.  

2) Always be on time and end on time. This might seem trivial to most, but if you are working with clients you suspect are actively experiencing intimate partner violence, being on time and ending on time is a must. You never know what the client had to tell their abuser so that they could meet with you. You don’t know if this is the time when the abuser is out of the house and the only time the client can meet. If the counselor is late, the session still needs to end on time. The client should always know they will be home when they are supposed to be home. Messing with the schedule could potentially mess with someone’s life. 

3) Talk about every other relationship rather than focusing on the abuse. Individuals involved in intimate partner violence are fully aware of the nature of their relationship. Trust me, they do not need a reminder of how dangerous or unhealthy the relationship is, even if they are not ready to leave. The cycle of grooming, gaslighting and manipulation can lead to victims feeling that they have to prove everyone wrong and show the world that their partner can still be the person they fell in love with. Most of the time, victims truly believe if they work very hard to adjust their behavior, their partner will treat them like they used to before the abuse started. Speaking directly about this relationship can cause the client to become defensive. It hurts the chances of building a trusting client-counselor relationship.

I have found that discussing other relationships in the client’s life can be helpful in shining a light on the behaviors of their current partner without making the client feel judged or attacked. You might say something along the lines of: “Oh, it sounds like you didn’t like your father when he drank because he became violent. How do you feel about XYZ’s behavior when they drink?” This allows the client to make the comparison on their own.

4) Realize that “Christ” and “counselor” are two different titles. Counselors are not saviors, nor should we try to be. In all situations and with all clients, the objective should be to meet them where they are. As with addiction, a client experiencing intimate partner violence may not understand the severity of the problem and may not want to leave. Perhaps instead of leaving the relationship, the client wants to learn to cope with certain behaviors. If that is what the client wants, it is also what the counselor should want. 

Go home resting in the fact that you are doing your job. Even though the client may be in an unhealthy situation, they are working with you, trusting you and listening to you. They hear you. When the time is right, they will make the best decision for their life. Your job is not to save anyone; it is to give clients the tools to save themselves. 

5) Accept that you are not the expert. Counselors work hard to become licensed professionals. That hard work is so appreciated. However, we are not the experts in this situation. No matter how many studies we have read, statistics we have memorized or theories we can apply, survivors are the experts when it comes to their experiences and their stories. 

Every survivor’s journey is different. There isn’t a one-size-fits-all approach when it comes to counseling survivors of intimate partner violence. Even if you’ve seen 10 clients in one day and they all have experienced intimate partner violence, ask questions of the next client rather than assuming that you know how the story will end. Because I promise you that you don’t.

6) Check your biases. We all have biases, but not everyone is aware of what theirs are and how they affect the lives of the individuals they work with. If you have certain views about intimate partner violence, if you believe it is a “choice” to stay, if you believe someone is able to “just leave,” please stay away from this population. It takes a lot for survivors to ask for help and to expose themselves enough to discuss the abuse. If this situation is handled incorrectly, they may never seek help again. Let’s be a part of the solution as professional counselors, not the reason that a survivor returns to the problem. 

As a survivor myself, these tips helped me build a long-lasting relationship with my counselor. Now, as I sit on the other side of the table, these tips have worked for me in counseling and coaching individuals who have experienced intimate partner violence. I hope you find these tips useful and join me on a journey to end the cycle of unhealthy relationships.

A Survivor’s story

During an internship, I worked with a young woman who had experienced physical abuse throughout her entire life. Every man from her father to the father of her children had abused her. At this point in her life, abuse was the expectation. The interesting part is that she wasn’t seeking help because of the abuse; she wanted help learning how to be better for her future husband. What I heard was: “What can I do to be who he wants me to be so he doesn’t hurt me?” I couldn’t immediately confirm my suspicions, so I continued to listen, ask questions and build trust.  

In about our fifth session, she opened up and revealed that she had been in the hospital the night before, put there at the hands of her fiancé. After I asked if she was OK and in the mental space to continue the session, she said, “This is probably the safest place for me to be today.”

As we continued talking, I asked if she still felt like marrying this man was the best option. To my surprise, she said, “Yes, he isn’t nearly as bad as what I’ve dealt with before, and I knew better. I shouldn’t have made him that upset.” I could continue with the story, but just this portion of it serves to paint a vivid picture of the mind of someone who is a victim of intimate partner violence. 

This is an extreme example of a person who had a long history of being abused, but many victims find themselves in the same predicament — asking themselves how they can change to “be better,” what they can do to be abused less, instead of asking what the abuser needs to change to stop abusing. Because survivors blame themselves enough, they do not need anyone else to do it for them. They don’t need someone to reinforce what they already believe. Imagine if I would have asked this client, “Why don’t you leave?” In that moment, I would have become the problem instead of the solution. She didn’t want to leave; she didn’t feel as if she needed to. 

My internship ended shortly after this session. I offered for this client to continue having sessions with the therapist on staff, but she was not interested. She never went back. I later found out that she did in fact get married to her abuser, and they lived happily ever after — until he killed her a little over a year later. 

This story sticks with me because it reminds me to be intentional about my time with clients and how I end things. It’s so much more than ending an agreement with a client; it’s the end of a relationship. I wish I had known then what I know now. I would have been more intentional about including a long-term therapist in our sessions. I wouldn’t have ended things the way I did. My only hope is that someone else can learn from me and we can all be better when it comes to dealing with clients who have been or are currently experiencing intimate partner violence. 

 

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Leontyne Evans works as the survivor engagement specialist for Survivors Rising, where she helps to empower and uplift survivors by providing education and resources that encourage survivor voice and self-sufficiency. She is a published author of two books, Princeton Pike Road and Relationships, Friendships and Situationships: 90 Days of Inspiration to Keep Your Ships From Sinking, both of which support her mission of ending the cycle of unhealthy relationships. Contact her at leontynesurvivorsrising@gmail.com.

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

Using apps to promote client safety

By Marissa Gray and Victoria Kress August 12, 2020

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Daily, professional counselors work with clients who live in unsafe situations involving exposure to violent and exploitative relationships. These unsafe situations might include experiencing partner violence or being the victim of child abuse or human/sex trafficking.

Especially now, during the coronavirus pandemic, partner violence and child abuse are on the rise. Clients are at a heightened risk of violence during the pandemic because of increased stress (which can exacerbate violence), isolation from support systems, and more time spent in close quarters with potentially abusive family members.

When working with clients who are being victimized, counselors have an obligation to promote these individuals’ safety. While perpetrators often use technology against clients to control and further victimize them, recent technology apps have been developed that can help counselors facilitate client safety. We will discuss several of these apps in this article.

Harnessing technology to empower clients

Many client safety concerns must be considered in counseling. First, technology is often used by perpetrators as an additional vehicle for abuse. Technology outlets provide perpetrators with opportunities to antagonize, stalk and ultimately continue abusing and exploiting their victims. Technology that can be used to perpetuate abuse includes tracking devices, location-enabled applications on cellphones, cameras, microphones, social media apps and even simplistic communication methods such as abusive text messages, emails and phone calls.

Clients are often forced to surrender their devices completely, especially if their technology use is being monitored by their abuser or if their number is in any way known by their abuser. Clients might consider changing their phone numbers and presence on social media, but this can be difficult, expensive and time-consuming.

Although taking steps to maintain digital — and, thus, physical — safety involves placing thick boundaries around technology use, it is important to realize the role that technology can also play in supporting survivors’ safety, autonomy and empowerment, all of which are crucial factors in a trauma-informed counseling approach. Counselors can work with clients to maintain their desired level of digital connection while also encouraging them to take measures to be safe. 

Overview of apps for client safety

Several apps exist that can offer crucial support and assistance to clients. These apps are free and are compatible with iOS and Android devices, meaning they are widely accessible regardless of the devices clients use. These apps can be powerful and empowering resources. They are particularly helpful for those in violent relationships and for trafficking survivors seeking to extricate themselves from unsafe relationships. They can also empower clients who have been sexually abused or assaulted, as well as those looking to enhance their safety “just in case.”

All of these apps can be easily incorporated into clinical practice. For example, counselors can support survivors in setting up and configuring these apps and talk with clients about how best to use these apps to promote their safety. For many survivors, these apps can be a small step on the long road toward rehabilitating a sense of personal safety. Thus, counselors can play a crucial role in supporting survivors as they process the tangled emotions that accompany the steps of starting to feel safe again.

In this way, the use of technology via apps is an interactive and engaging intervention that can help empower survivors. By incorporating these safety apps into counseling, clinicians can help survivors begin to feel, perhaps for the first time, that they are worthy of protection and deserve to feel safe.

myPlan

Safety plans are an important part of counseling when working with clients in unsafe relationships. Historically, counselors have developed written safety plans on paper with clients, but these can be dangerous because abusers can discover them, and this may invite violence.

One app that can be useful in developing electronic safety plans is myPlan. This app allows clients to craft safety plans and keep them stored in the cloud of their devices. Plans are saved in the app itself, which is then backed up in the cloud, making it difficult for perpetrators/abusers to access.

On this app, individual survivors respond to several brief questions (automatically generated by the app) regarding their relationship and situation. The app then produces a safety plan tailored to the specific needs of the survivor, based on the responses the person provided to the questions.

Use of this app puts a more secure and technologically advanced spin on safety planning. Keeping safety plans in the cloud allows clients to have immediate access to their plans. In addition, this app connects survivors with local resources, live chats with advocates (trained volunteer advocates working with loveisrespect.org) and even emergency medical/shelter options. The live chat option provides real-time support for survivors that can complement and enhance the safety plan.

Noonlight (formerly SafeTrek)

Noonlight allows individuals to call emergency services without having to dial 911 or make any sudden motions that could alert the abuser that the person is seeking help. In actively unsafe situations, this app can save lives. The app can be especially useful for clients who remain in harm’s way or continue to have contact with their abusers.

Noonlight allows users to simply hold the phone in their pocket, purse or another location that is not suspicious. The app comes equipped with a large safety button that, when gently touched, gives real-time notification to local emergency services to send help. The app is location enabled and holds an individual’s data to pass along to law enforcement in the event that the individual is unable to speak, text or otherwise seek help.

This app can prove especially useful for individuals who are being restrained or are unable to verbally communicate their distress. Furthermore, it helps to provide peace of mind and a sense of empowerment to clients. If an individual is at risk of ongoing abuse, this app can assist them in acquiring emergency assistance.

Aspire News

Another app helpful for clients affected by unsafe situations or ongoing abuse is Aspire News. In the event that a client’s phone is being monitored, this app appears as an ordinary news app with daily headlines, weather reports and so on. Embedded in the “Help” section of the app, however, are emergency contacts, resources, and information on shelters and other supportive services offered to those affected by abuse. The app is location enabled, meaning that it can tailor resources for wherever the client is at that particular moment.

Although this app is geared mainly toward clients affected by relationship violence, it can be equally useful when working with clients in other unsafe situations. It may be especially helpful to those being trafficked because these individuals are moved around frequently and may not be aware of local resources or shelters where they can go for assistance. Aspire News can connect these individuals with resources wherever they go, regardless of their familiarity with the area.

Many resources in the app target survivors of intimate partner violence and sex trafficking, but they also service those experiencing sexual abuse or exploitation. Aspire News connects clients with resources such as shelters, food and hygiene pantries, case management, law enforcement and even counseling. Aspire News may be a helpful app to provide to any client concerned about an abuser searching their phones or punishing them for seeking help.

bSafe

The relatively new bSafe personal safety app offers a variety of helpful tools and resources. It provides specific supports to clients who may be enduring ongoing abusive situations and wish to record or gather evidence against their abusers. The evidence can then be saved to the cloud so that it cannot be destroyed.

The bSafe app has both audio and video recording capabilities (the form used is selected by the app’s user) to capture whatever abusive act may be occurring. The app also offers the ability to livestream an abusive incident or assault as it is occurring. All of these evidentiary recordings can be saved to the cloud to ensure that they are not lost or destroyed by an abuser, even if the abuser destroys the device itself. The app also forwards the footage or recording to trusted people whom the client has previously identified and included on their emergency contact list.

For clients who choose not to report their abuse, it can still be empowering for them to know they have evidence to document the trauma they have survived. This leaves the door open for them to report their abuse in the future if they so choose. Accruing such evidence may also help clients feel heard and believed concerning their lived experiences within an abusive relationship. The evidence gathered by the bSafe app may also assist clients in obtaining protective orders against their abusers or perpetrators.

In addition, the app can automatically alert contacts to call 911. The app is location enabled, meaning that it equips trusted social supports with the individual’s location in the event that the individual is in distress and unable to call for help themselves. The app also offers an SOS button and a “fake call” service, further allowing survivors to reach out for support during an abusive situation without pinging the radar of a perpetrator who may notice or monitor cellphone usage. By simply pressing the button, individuals are able to notify emergency services to send help immediately through use of the app’s location-enabled technology.

National Human Trafficking Hotline

Safety planning is crucial when working with clients who have experienced sex trafficking. These clients may be at ongoing risk as various abusers and pimps attempt to wrangle these individuals back into a life of exploitation. As counselors, we can empower this specific population with knowledge of ways to maintain safety during the recovery process.

The National Human Trafficking Hotline has recently begun offering more advanced and accessible options for individuals to use. The hotline provides a plethora of resources and assistance to help clients keep themselves safe. One such resource is the BeFree Textline; individuals can reach out for assistance by texting “HELP” to 233733 in the event they cannot speak freely in the presence of their traffickers or johns. This text line is a powerful resource to share with clients because it offers a great deal of support.

Crisis Text Line

The Crisis Text Line (CTL) can be reached by texting 741741. Callers are then connected with a trained crisis counselor. The CTL is a valid resource for all clients but has immense value for those impacted by relationship violence, trafficking or sexual abuse.

Given that the CTL communication occurs over text, many clients may find it less threatening, or perhaps less noticeable to their perpetrator, to connect with an advocate. The CTL will then connect clients with appropriate referrals and resources that they can use to find support and maintain their personal safety.

Empowering survivors with technology

The aforementioned resources offer examples of apps and other tools that can support clients in their ongoing struggle to maintain safety. Technology can play a unique and emerging role when we work with these resilient clients as counselors. These apps and text tools demonstrate recent advancements in technology that can foster support, safety planning and healing for clients.

Use of these tools is one small way to remind clients that they are indeed worthy of protection, safety, peace and healing. As counselors, we have the privilege of walking alongside these clients in their brave and unique recovery journeys. These technological nuggets provide resources to empower clients while helping to preserve their safety, dignity and healing resilience.

 

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Marissa Gray is a licensed professional counselor working at Youth Intensive Services in Youngstown, Ohio. She provides trauma counseling to those who have been involved in the sex trafficking industry. Contact her at mgray@youthintensiveservices.com.

Victoria Kress is a professor at Youngstown State University. She is a licensed professional clinical counselor and supervisor, national certified counselor and certified clinical mental health counselor. She has published extensively on many topics related to counselor practice, particularly regarding work with abuse and trauma survivors. Contact her at victoriaEkress@gmail.com.

 

Counseling Today reviews unsolicited articles written by American Counseling Association members. To access writing guidelines and tips for having an article accepted for publication, go to ct.counseling.org/feedback.

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

How to help domestic violence clients during shelter-in-place situations

By Federico Carmona April 13, 2020

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It’s heartbreaking to read the variety of articles circulating about vulnerable people trapped at home with their abusers because of shelter-in-place mandates during the COVID-19 pandemic.

Unfortunately, experience reminds us of a concerning reality that is typical of these uncertain times: Adverse labor market conditions are positively related to domestic violence. Research conducted after the Great Depression of the 1930s, the farm crisis of the 1980s, and the Great Recession of 2008 found that economic crises have significant negative effects on the quality of intimate relationships and parenting in working families. Marital conflict, abuse (particularly violent controlling behavior), and a decline in parenting quality are among the harmful effects in families of a macroeconomic downturn.

In my role as a trauma therapist, I have seen dozens of domestic violence clients during clinical intakes and in counseling. I have also read a multitude of articles on the subject about studies and reports from different parts of the world. Shelter-in-place mandates aren’t a good thing for women and children who are the targets of abuse. The anticipatory anxiety and uncertainty of these times can cause negative emotions to churn, leading to behaviors that increase the already-concerning number of domestic violence and child abuse cases. There is no “how-to” manual to deal with the current situation, of course, but the safety of this vulnerable population demands us to do our best.

How can the counseling community help domestic violence clients who are trapped at home with their abusers? I offer a few suggestions:

Reach out between appointments/sessions. One of the critical signs of abuse is the isolation of victims of domestic violence from their networks of love and support. An occasional check-in from us can empower these clients to tell us more about their situations and perhaps even dissuade their abusers from further violence as we keep checking in.

Listen, just listen. People experiencing domestic violence need an empathic ear — someone who will allow them to vent their repressed emotions and feelings without judgment. We are not to offer advice, only listen and empathize. It’s just time to build trust.

Validate clients’ feelings, emotions and beliefs even when they don’t make sense. The best way to build trust with clients experiencing domestic violence is by being present with them. We’re present with them through our vicarious empathy, active listening and compassionate validation. Our empathy is vicarious because it takes an emotional toll to connect with someone’s anguish and suffering. Active listening requires us to be disciplined enough to fully concentrate on what the client is saying rather than on the answer that we might have in mind to their situation. Clients experiencing domestic violence require validation — compassionate validation — because many times, their decisions (or lack of them), circumstances and beliefs don’t make sense to us.

Introduce them to mindfulness exercises. Clients experiencing domestic violence live in a world of fear and anxiety because of the cycle of abuse. At first, they’re worried because of their confusion and inability to make sense of and control the incipient abuse. In time, as the abuse increases, worry turns into anxiety and fear.

Mindfulness can help these clients become aware of their emotions, thoughts and bodies to take control of them and find much-needed relaxation. Meditation exercises shouldn’t necessarily be long. There are plenty of sites online with short, simple exercises, from breathing to stretching, that can help clients gain the bodily and emotional awareness they need to function.

Remind clients of their strengths and qualities. One of the benefits of practicing active listening is the ability to notice in clients’ stories what they have forgotten about themselves: their own power, qualities and strengths. By doing this, we help clients not only to survive their circumstances but also to move toward a better future as survivors of domestic violence who deserve lives of meaning and purpose.

Help clients to start a project. Because of shelter-in-place mandates, more perpetrators of abuse are at home all of the time. This increases the emotional state of “walking on eggshells” for domestic violence clients. We can help distract these clients from that state by brainstorming with them or suggesting a project to them. It could be an individual project based on their abilities, strengths and qualities that we noticed in their stories, or it could be a project that involves their children.

Assist clients in making a safety plan. Making a safety plan is incredibly useful. It doesn’t need to be complicated or lengthy. The simplest way of doing this is by helping these clients become aware of their circumstances (call the problem what it is — domestic violence). The rest of the plan might involve:

  • Trying to avoid conflicts and arguments during the mandated confinement
  • Involving their children in most of their home activities
  • Reaching out to relatives and trusted friends (when possible)
  • Being prepared to leave at any moment (i.e., having money, documents, car keys, children’s backpacks filled with some clothes and snacks ready to go)
  • Calling 911 when they feel that they or their children are in danger (even in a shelter-in-place situation, law enforcement will issue an emergency protective order to separate victims from their abusers)

Involve others. We can help our clients experiencing domestic violence to think about the resources they possess to deal with their situation. One of these resources could be men who are part of the couple’s life in some way (e.g., clergy, friends, relatives, co-workers, classmates, teachers, bosses).

When families and friends get involved, perpetrators of abuse can sometimes be dissuaded from causing harm to their partners and children. The presence of fathers, brothers, neighbors and friends prompts accountability. Some of these individuals might be willing to offer their support and speak up against the ongoing abuse. Victims of domestic violence can only break their silence and become survivors if they feel supported. We need to be cautious, however, and see each client in their particular context, giving consideration to whether this type of intervention could put them in more danger than they already are.

Help clients build a network of support. Isolation is one of the most critical signs of abuse. It creates a hated dependency on the abuser. Imposed isolation robs victims of domestic violence of their personhood. It suppresses their voice and identity piece by piece as family members and friends are pushed away. Connections are the simplest way to beat domestic violence. It is critical that victims of domestic violence get reconnected with relationships they trust. It is also crucial to get these clients connected with other survivors of domestic violence (via online groups) so they can claim their victory and begin the journey of healing from the trauma caused by the abuse.

Inspire clients to pursue self-sufficiency. Studies show that when women’s wages are relative to those of men in dual-income couples, there is a significant reduction in domestic violence. To be self-sufficient is to have bargaining power. It’s to have the ability to exert influence in the relationship. There are public resources designated to help survivors of domestic violence pursue further training and education with the purpose of becoming self-sufficient. Check with social services agencies about these resources.

These recommendations aren’t intended to override the urgency of calling 911 when someone is facing a clear and present danger at home. Let law enforcement personnel figure out how they will bring individuals and families to safety during shelter-in-place situations. Emergency protective orders are being issued even with the courts closed.

 

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Federico Carmona is a trauma therapist for victims of domestic and sexual violence at Peace Over Violence in Los Angeles. He is also an ordained elder in the United Methodist Church. The experience of domestic abuse in his ministry and his own family motivated him to seek specialization in clinical counseling, specifically in trauma, to assist survivors of domestic and sexual abuse and violence to reclaim their identity, peace, and lives with dignity and purpose. Contact him at federico@peaceoverviolence.org.

 

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.