Tag Archives: domestic violence

Identifying psychological abuse

By Avery Neal February 7, 2023

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


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.


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

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.

Tough love: Supporting parents of children in unhealthy relationships

By Katie Bascuas December 7, 2022

Most parents would do anything to protect their children from pain. So watching a child struggle with an addiction, whether to a substance, behavior or even a relationship, can be an excruciating experience and bring up feelings of guilt, grief, self-doubt, worry and isolation. This situation becomes trickier when the child becomes an adult because parents can no longer intervene or make decisions on behalf of their loved one. 

Most people understand the challenges that surround having a child who struggles with a substance addition, but having an adult child in an unhealthy romantic relationship or a relationship in which there may be emotional abuse, such as inappropriate use of control, disrespect or dishonesty, is often considered less “taboo” or more acceptable than a substance addiction. Most people desire the feeling of being loved and accepted, including in romantic relationships. Therefore, parents can sometimes feel helpless when they think their child may be in a toxic and painful relationship.

“I’ve got half a dozen people I’m working with right now who are dealing with this, and my encouragement to someone who has a loved one in an unhealthy relationship is that it’s going to be difficult to talk them out of it because it’s just not rational,” says Ronald Laney, a licensed professional counselor (LPC) at Change Inc. in St. Louis. “The other person is going to feel that that relationship, whatever it is, is filling a void that started long, long ago.

For counselors, supporting these parents can look similar to working with clients who have loved ones struggling with an addiction. There may be questions around how much to get involved, whether to distance themselves from their child or if they’re doing the right thing. 

And depending on the parent-child relationship, helping parents to understand and accept the situation could be challenging. For example, there may be years of unhealthy patterns of co-dependent and enabling behaviors that inadvertently perpetuate and reinforce the child’s addictive patterns, says Laura Whitcomb, an LPC who owns and operates NoCo Counseling in Fort Collins, Colorado.

“Parents are willing to do and give everything for their kids,” Whitcomb says. But “they’re often trying to control someone else’s behavior and ensure someone else’s well-being, and that person is not making those same choices.” 

Counselors can play a key role in helping parents better understand what their child may be experiencing as well as normalizing the parents’ feelings and experiences and helping them reach a place of acceptance of the situation so as to ensure their emotional and mental well-being. 

Meeting clients where they are

While it might seem like a no-brainer, Whitcomb says one of the most important things to remember when working with parents seeking support around an adult child’s unhealthy relationship is to meet those clients where they are, but she admits this can be challenging. 

“I care so much that sometimes I get ahead of myself,” Whitcomb says, noting that she has to sometimes stop herself from giving advice or providing feedback that clients may not yet be ready to hear. “I really want [the clients] to be OK. I want them to get some joy back in their lives, and I want them not to be taken advantage of and have all this responsibility that isn’t really theirs. Some of these parents should be looking toward retirement or traveling, and they’re just sacrificing everything.”  

Because counselors are trained to examine the big picture, they may recognize things that may benefit the client before the client does, notes Robin Witt, an LPC and director of relationship dynamics at the Better Institute in Pittsburgh. “My biggest piece of advice is meeting the client where they’re at and working at the pace that they feel comfortable because, especially in these trickier situations, we can see the solutions but they’re not always willing or ready to see it, and if we push it, we can lose the client,” she says. “They could get scared or intimidated, and the biggest thing that we can do for them is to be a validating, supportive resource. We might be the only person that they’re talking to about this, and … what’s most important is keeping that professional relationship safe.” 

Witt focuses on client goals and knows that change can be gradual because clients do not have control over their loved ones. And truly accepting the fact that they may not be able to change the situation to the degree that they would like often takes time. “This is not a four-sessions-and-they’re-done thing,” she explains. “So keeping a slow pace and being mindful that the client is the driver is important.” 

Whitcomb says she has to remind herself as much as her clients that she may be getting ahead of them and that the process of learning how to support and engage with a loved one in an unhealthy relationship — similar to someone with an addiction is often long and complicated. She uses frequent check-ins and asks clients what changes seem manageable to them and what they are thinking and feeling in order to gauge where they are and what they want to accomplish as well as to help them set reasonable expectations. 

Some clients, for example, may take quick or impulsive action to try and fix or ameliorate the situation, such as giving ultimatums to their loved ones, but Whitcomb says those types of actions often just push the child away and have the potential to hurt the relationship. “A lot of people seem to want to do that. They want the problem to be solved. Most of us do,” she says. “So really try and shift their focus back to themselves, less on the unhealthy person and more on them.”

Whitcomb says she draws from her experience growing up with parents who had substance use issues to help clients learn to redirect their focus to themselves. It took her several Al-Anon Family Group meetings before she realized that focusing on herself, not her parents, was one of the first steps toward healing.

“It took me four meetings before I realized, ‘Oh, these people are no longer consumed with what their addict is doing. They are focused on their own lives and rebuilding their own lives,’” she recalls. “It took me a while to get it because people are holding so much intense emotion. We’ve been hurt a lot. That lightbulb doesn’t go on just overnight.” Whitcomb says that she uses this insight to prevent herself from getting ahead of clients as well as to help explain to clients the common tendency to focus on the other person.

The importance of psychoeducation

Another helpful component of supporting parents whose adult children are in unhealthy relationships is psychoeducation, which can include accurately labeling unhealthy or abusive relationships and modeling empathy and understanding.

Witt admits there can sometimes be a fine line between educating clients and validating and supporting them. The clinician, for example, wants to acknowledge the client’s experience and how painful it may be, but they also want to help the client understand the reality of the situation, which may involve exploring uncomfortable truths such as the fact that their child is likely unaware of or unwilling to accept that they are in an unhealthy relationship and subsequently are likely in denial about the effects that the relationship is having on other family members. 

Witt finds that naming and defining abusive relationships can help clients better understand what a loved one might be experiencing. Depending on where the client is at, this can be incredibly validating in the moment, or it might be information that clients come back to in the future. “Giving them the vocabulary can be important because we might only get that client for a short time,” Witt notes. “We’re planting seeds. Someone else is watering them, and we also might be watering seeds that therapists or others have been planting and watering.” Then, if the child becomes more open to discussing their relationship or relationship dynamics down the road, the parent will be more prepared to help their child see and understand some of the unhealthy patterns taking place, she adds.

Clinicians can also teach parents the importance of meeting their child where they are, while also modeling this behavior within the therapeutic relationship, says Laura Copley, an LPC who owns and operates Aurora Counseling & Well-Being in Harrisonburg, Virginia. 

“If I was seeing a mother whose son or daughter was coming home from college and all of a sudden in this toxic or manipulative relationship, I would first need to help teach her how to slow down enough to recognize where her child is at,” she says. To do this, Copley may use open-ended questioning to encourage the mother’s exploration into her child’s mindset. For example, she may ask the client questions such as “What do you think your child is experiencing right now? How do you know your child is experiencing that? What are some of the things they’re showing you that is making you feel like this is how they’re connecting to this relationship? And if that’s the case, what might be something your child needs to hear first from you?”

Copley also advises clients to show an interest in their child’s partner by asking how that person is doing and demonstrating concern for the partner’s well-being. Clients “don’t like this part, but it works,” Copley admits, because it’s a way to show genuine concern and hopefully create a safe space where the child can open up about their own well-being without getting defensive or reactive. “The son or the daughter then starts to trust, starts to feel safe, starts to express what they’re experiencing,” she explains. Then parents can reassure their child that if something bad happens in the relationship, they can stay with them, no questions asked.

Copley says that it can also be helpful to teach parents about the positive and negative personality characteristics that are often present in someone engaging in an unhealthy relationship. For example, a person may identify as being a “savior,” so they are loyal, committed, loving and courageous. On the other hand, saviors are also prone to attracting others who “need” saving, so they may also have a fear of asking for their needs to be met or a fear of being vulnerable or getting hurt, she notes. 

“This is all part of the conversation that we could have with parents to help them understand how to bridge the mindset of where their child might be,” says Copley, who adds that she would also role-play and model various ways to approach the loved one. “How we approach another human being, even somebody like our child, around something like this will deeply influence how they receive the message.”

Setting healthy boundaries

Working with clients to set healthy boundaries is another important aspect, but it can be incredibly challenging. 

To overcome difficulties with boundary setting, Laney encourages clients to think of it as setting a boundary not only for themselves but also for their loved ones. For example, he says that parents could tell their child, “Out of my care for you, I’m going to set this boundary because it’s not doing you any good to allow you to continue to treat me in that manner.” Framing the boundary as a means of protecting the child has helped many of Laney’s clients overcome their hesitancy to set boundaries. 

Another challenge with setting boundaries, especially in the beginning, can be finding the right balance. Clients sometimes move from having no boundaries to the extreme, Laney notes. For example, a parent may go from talking to their child every day to cutting off communication completely, rather than just communicating less. “We have to find that sweet spot,” Laney says.

Therefore, it’s important for counselors to help clients understand the nuance of boundary setting as well as the feelings of guilt and anxiety that can come along with setting limits with loved ones. Witt says that she encourages clients to make values-based decisions around things such as finances, faith, career and physical well-being when setting boundaries to ensure greater success.

“Making values-based decisions leads to those boundaries that actually stick,” Witt explains. For example, a parent may value attending church every Sunday, so if their child asks them to watch their grandkids one Sunday so that they can spend time with their partner, the parent may feel more empowered to say no because it will be a values-based decision. 

“If it’s values based, [the client] is more likely to uphold the boundary versus something they feel they ‘should’ do,” Witt says. “And setting a boundary that’s not going to stick is not going to be helpful to anybody.”

Dealing with guilt, grief and shame

There’s also the possibility that parents will feel a sense of guilt while watching a child in an unhealthy relationship dynamic and wondering how their parenting style or the child’s upbringing might have contributed to the situation. 

“The reality is that … our early attachment styles can absolutely set the stage for what we expect in romantic relationships, how we expect to get treated, how we get our needs met and if that’s replicated,” Copley says. So she likes to keep clients who may be experiencing these feelings of guilt focused on the present and what they can do now as opposed to exploring past events, at least when it comes to their goal of helping their child. 

Copley refers to having clients focus on what they can do in the present as a corrective experience, one in which behaviors and dynamics from the past can be corrected in the present by making another choice and behaving differently. For example, if a parent avoided tough conversations with their child in the past because of their own discomfort around confrontation, they could decide that moving forward they will be more open to having difficult conversations with their child. 

“If there’s shame and guilt for something the [parent’s] recognizing, we can either spiral into that shame and guilt and once again make it about us,” Copley explains, “or we can say it’s a signal that another opportunity is present for you to do something different and get redemption over anything that happened in the past.” 

Copley also teaches clients how to better manage the uncomfortable feelings that their child’s relationship may be bringing up in them by using somatic techniques to decrease the chances of reacting out of fear and trying to control the situation. Often, “the storm of emotions that are more than likely in them is because they’re so afraid of what their child is going through and the pain that they must be going through,” she explains. “And if we project that fear onto someone who thinks they are in love, that’s going to push them away and make them protect the toxic person more.” 

Sometimes parents feel guilty because they were also in an unhealthy relationship when their child was growing up. Witt advises clients who are worried their child may have witnessed unhealthy relationship patterns from them to have an honest and transparent conversation with their child about it. “We can’t go backwards, but we can be mindful of what we can do today to move forward,” she notes. “Whether that’s an apology or having an age-appropriate conversation to explain ‘This is why I handled things the way I did,’ [it] can enhance the relationship that you now have with that adult child.”

To help clients work through some of the shame and guilt that they might feel in these situations, Laney says that he likes to reinforce self-compassion and will often work with clients to explore how they can accept both difficult emotions and realities. For example, he might work with clients on how to hold the sense of sadness that their child might be in an unhealthy situation with possible feelings of guilt as well as possible disappointment around the dynamics of the relationship they have with their children. 

Accepting what you can’t change 

Although it’s not easy to come to terms with potentially challenging realities, such as a child’s unhealthy relationship and its effects on the wider family, embracing a certain amount of acceptance and equanimity can be one of the healthiest solutions for these clients, Laney says. 

“At some point there’s almost a surrender,” Laney says. “We exhaust ourselves trying to change things that we really can’t change. There’s something of a letting go there.”

Whitcomb also emphasizes acceptance, especially self-acceptance, in these types of situations that often involve an element of codependence or a preoccupation over the child and the child’s relationship at the expense of parent and their well-being. “Codependence feeds on avoidance of one’s own needs and difficult emotions because by being consumed by the problems of another, we are better able to ignore and avoid encountering our own,” she explains. “As I encourage parents and family members to shift their focus from the person they are enmeshed (overinvolved) with, I also try to guide clients to identify their own strengths as well as parts of themselves they perceive as flawed.” In recognizing their strengths and taking time for self-care, clients can start to develop not only a healthier sense of confidence and independence but also more self-compassion, she says, which in turn can cultivate more compassion for others.



Contact the counselors interviewed in this article: 



Katie Bascuas is a licensed graduate professional counselor and a writer in Washington, D.C. She has written for news outlets, universities and associations.


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.

Counseling From a Survivor’s Perspective: Understanding the cycle of abuse

By Leontyne Evans March 18, 2022

Recently, I was facilitating a conversation around supporting survivors of intimate partner violence (IPV) in the workplace, and a clinician approached me afterward and said, “Hey, this was a great presentation. I now know how to better support survivors in the workplace and signs to pay attention to, but I’m not sure I understand intimate partner violence as a whole.” This was an eye-opening moment for me. I consistently go out and speak on this topic, but I never start at the beginning.

We first have to understand the cycle of abuse, a concept that originated with psychologist Lenore Walker in the 1970s, to better support survivors of IPV. It’s not enough to be aware of the cycle or have a diagram printed out; there has to be an understanding of what it is and how someone may find themselves in the cycle. When we seek to understand, it creates an opportunity for empathy to grow and biases to shrink. So, let’s break this down so we can be more impactful when serving survivors.

The cycle of abuse, also known as the cycle of violence, refers to common patterns of abusive behaviors, which are often associated with high emotions and periods of reckoning or revenge. The pattern, or cycle, repeats itself and can occur multiple times during a relationship.

This cycle is broken up into different stages (discussed more in the next section). But these stages don’t all happen at once, and the cycle will look different for every person. In some instances, the complete cycle can happen within a couple of hours, while other times, it may take up to a year to complete.

In short, the cycle of abuse is unpredictable and follows no rules.

The best way to conceptualize it is to think about the first time you went on a roller coaster ride: You feel the rush of excitement while waiting in line, but, as you get closer, a little anxiety creeps in. Then suddenly, it’s your turn! Your excitement, anxiety and fear all come together creating a beautiful storm of emotions.

The person operating the ride locks the safety bar in place, signaling your last chance to change your mind. You could back out now, but you’ve been waiting for this moment for so long you have to see it through. As the ride starts, your anxiety lessens. Everything feels good as the roller coaster ascends to the peak position. Even though you’re nervous, it still feels safe.

Then, all of a sudden, it drops! It all happens so fast. The ride descends rapidly, along with your stomach. Your heart rate speeds up as you are jerked side to side and up and down, and no matter how scared you are, you can’t get off. You’re stuck. No one can see you crying; no matter how loud you scream, there isn’t anything you can do except wait until it’s over.

The next thing you know, you’re on the straightaway: The ride slows down and you think you’ve survived the worst part. You start to feel safe; you can breathe again. But as soon as you take a breath and get comfortable, the ride takes another dive and the cycle starts all over again.

Survivors of intimate partner violence also experience periods of happiness, thrill and excitement in their relationships, so it’s not as easy as one may think to “get off the ride.”

The five stages

In an abusive relationship, the abuse starts way before it ever becomes physical. It is well-known that the cycle of abuse includes four stages (tension, incident, reconciliation and calm), but from my experience, I argue there are actually five stages:

1) Trust building. This stage, similar to any other relationship, is where someone establishes an emotional connection, and may even fall in love. In unhealthy relationships, this typically happens extremely fast. Two people meet, create a trauma bond and become the center of one another’s lives within days or weeks. Like the first time someone rides a roller coaster, it’s new and exciting. Even though they may be nervous, the anticipation of seeing where things will go outweighs the concern. (The initial excitement of the ride.)

2) Tension building. This is when the impending victim begins to notice a change in their partner. Some abusers may become clingier, whereas others may be more distant. They may become angered or irritated with small things that typically wouldn’t upset them. This change isn’t connected to any particular life event. This is what causes the victim to feel confused. One minute things are going so well, causing the victim to wonder what they could have done to cause someone to go from being the nicest/sweetest person to being mean, cold or dismissive. (The ride ascends as tension builds.)

3) Incident of abuse. The abuser releases the tension and engages in abusive behaviors. These behaviors may not be physical; they can be emotional, mental, financial or even spiritual. This may show up as insults or irresponsible behaviors such as spending money that was designated for the household bills. Maybe the abuser stays out all night or hides the car keys. The victim may believe they are responsible for the abuser’s actions and that this abusive behavior stems from something they did to cause the tension or change. (The ride descends rapidly.)

4) Reconciliation. During this stage, the abuser expresses remorse and what appears to be genuine regret for their behavior. They may even make the victim feel guilty for “causing the behavior.” The victim, who is still questioning their emotions and processing what happened, may feel a sense of relief that things are going back to “normal.” (The straightaway.)

5) Calm. After reconciliation, there is usually a sense of calm after the storm. This period of time could last for several weeks or months, depending on the abuser. The extra love and kindness from the abusive partner trigger a reaction in the victim’s brain that releases feel-good and love hormones known as dopamine and oxytocin. This release of hormones makes them feel closer to their partner and as if things are back to normal. (The ride slows down.)

However, right when the victim starts to heal and believes it won’t happen again, the ride starts to ascend, tension begins to build, and the cycle starts again.

What counselors must understand

When I host workshops on IPV, I often say, “Put yourself in their shoes; meet the survivor where they are.” And without fail, there is always a professional in the room who responds, “I couldn’t even imagine.” But the truth is we have all been abused and misused by individuals to some degree — maybe not to the same extent as IPV — but the emotional dilemma that weighs on you is similar. We’ve all been on our own emotional roller coaster.

Maybe you had a friend whose behavior made you question whether you were really friends. Some days they were really nice, but other days they made you wonder if they liked you at all. Maybe there was a family member that you just wanted to feel loved by, but no matter how hard you tried, you never got the love you desired. What about that person you wanted to make proud, but they always made you feel like your efforts weren’t good enough?  Maybe you have experienced the heartbreak of having a family member or friend only want you around when it benefited them.

When I tell people this, they say, “But I wasn’t in an intimate relationship with the person who mistreated me.” I would like to challenge that as well. Intimacy is defined as a feeling of closeness. Because intimacy is involved in all relationships (even work relationships), we have all had an experience of being mistreated — to some degree — by someone we have been intimate with or felt close to. When working with survivors, remember what it felt like for you to have this experience with someone you loved.

I am sure you are wondering, “As professionals working with this population, how do we help clients get off this roller coaster ride?” I am so glad you asked! As mentioned earlier in this article, the first step is understanding the cycle. If someone is on this roller coaster ride, they can’t just get off. It’s too dangerous.

But we can help them prepare for the ride until they are ready to get off. Safety planning is essential. We can help the client to identify signs of each phase and ways they can remain as safe as possible. Introducing the client to the cycle, helping them understand the current stage they are in and identifying strategies to stay safe during every phase lessens the shock and helps the client feel more prepared. Similar to how counselor help clients manage their anxiety triggers, we can help the client prepare for what’s coming, so it doesn’t pose as much of a threat. The more they know, the more prepared they will be to exit the cycle when it is safe for them to do so. 

How to be a supportive ally

Become knowledgeable about the cycle of abuse so you can identify which stage the client is in. Then you are in a better position to help them to become more aware of this cycle so they can learn to identify the stages on their own.

And continue to educate yourself. Remember the more you seek to understand, the more helpful you can be.

Stephen Hateley/Unsplash.com


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. Her monthly Counseling From a Survivor’s Perspective column for CT Online aims to help clinicians better understand and serve people who have experienced interpersonal violence. She is also 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.



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.

Counseling From a Survivor’s Perspective: The unrecognized grief of IPV survivors

By Leontyne Evans February 3, 2022


This is the debut article of a monthly online column about working with survivors of intimate partner violence written by a counselor who is also a survivor of domestic violence.


In August 2021, I wrote an article for Counseling Today challenging counseling professionals to not ask survivors of intimate partner violence (IPV) “Why didn’t you leave?” or to give the perceived notion that leaving would solve the problem. Doing so often causes confusion because most people believe that once someone leaves an abusive relationship, the problem is resolved.

So, let’s go with that for a second. Playing devil’s advocate to my own article, let’s say the protocol for assisting clients who have experienced IPV is to encourage them to leave. If they do leave, then what? What are the next steps? Where do they go from there? Is the problem solved? Will they no longer need the intervention of a professional?

As mental health professionals, we often believe we have all the solutions. We think our degrees, research, theoretical knowledge and certifications give us superpowers to fix people. But we often lack the real-life experience to understand the complicated layers of the situations our clients face.

If a client leaves their abuser, are you prepared to help them along their journey to recovery? Do you understand the journey? Do you understand the new set of problems that will arise after a survivor leaves?

Every counselor should not only be prepared to support their client in deciding how to safely exit an unhealthy situation (if that’s what the client wants to do) but also be adequately equipped to help the survivor prepare for what’s next.

You may be asking, “Well, if someone has removed themselves from an unhealthy environment, shouldn’t that be good enough?” Survivors often receive little to no support once the threat of abuse is gone because so many counseling professionals and organizations believe this very thing. It sounds easy enough: Leave your abuser and get back to living your life. Then all will be well, right? Wrong!

A survivor may experience unexpected issues after they leave their abuser that a clinician can help them to process and understand. As professionals, however, we must understand these issues first.

Each article of my column, “Counseling From a Survivor’s Perspective,” will focus on one specific issue survivors may face post-crisis. In this first column, I explore how counselors can help survivors work through their grief and loss.

Experiencing grief and loss

One of the most overlooked side-effects of leaving an abusive relationship is grief. It may be hard to believe, and maybe even hard for some to understand, but there can be a lot of grief associated with ending an abusive relationship. Even if it was unhealthy, it was still a relationship.

Grief happens after people experience loss. A survivor who leaves an abusive situation may grieve:

  • Loss of self
  • Loss of love
  • Loss of the life they expected to have
  • Loss of the idea of who they thought their partner was
  • Loss of friends and family because of isolation

These are just a few examples of the types of loss survivors may experience. These feelings of loss are further complicated by the fact that survivors of IPV may not think sadness is an appropriate response to leaving a toxic relationship. They may find it hard to understand their feelings of loneliness and sadness when others expect them to feel freedom and happiness.

I still remember the day my abuser was taken away in handcuffs. I had looked forward to that day for months. I knew that he would be sentenced to four years in prison and that I would finally have my life back. The irony of watching him being arrested — not for the crimes he committed against me but for something totally unrelated — left me with a sense of bitterness instead of the peace I craved. After seven long years of being on an emotional rollercoaster, the ride was finally over.

However, when the authorities handed me his valuables, placed the handcuffs on his wrist and escorted him away from the courthouse, tears began to roll down my face. My bitterness was replaced with sadness. My anger was replaced with remorse, and my joy was replaced with the fear of loneliness. I cried the entire drive home.

For months, I couldn’t sleep. The sound of the house settling at night caused me to awaken with anxiety. The stairs creaking at 3 a.m. reminded me of the nights when he would come home drunk and take his stress out on me.

I sank into depression, struggling to understand how my mind, heart and body didn’t seem to agree with the verdict. I became angry at myself for missing him, but I also knew I didn’t want him back. This whirlwind of confusing emotions made me feel out of control.

I didn’t understand what was happening then, but now I know this feeling was grief. Grief that I was too embarrassed to explain to anyone else. I was with my abuser for seven years. During that time, we woke up together, went to bed together, ate together, struggled together and celebrated together. It may be hard for some to understand, but I lost my friend. I lost a sense of familiarity. I lost what I thought was love.

Now as an expert in the field, I talk to other survivors every day who have had similar experiences. They are desperately trying to sort through their feelings and understand how they could miss something so toxic. I give my clients space to feel that loss, to grieve it. Similar to those who overcome addiction, survivors of IPV may go through withdrawals or even relapse. For these clients, having a counselor who understands that they are experiencing loss and is invested in helping them explore the journey back to themselves can be life changing.

What counselors must understand

No matter how much abuse was present in the relationship, it was still a relationship. At one point, two individuals loved each other. At one point, the survivor felt safe enough to allow their partner to get close to them to let their guard down. At some point, the survivor let their abuser in — not just into their home but into their heart. Because, let’s be honest, manipulation, gaslighting and the cycle of abuse would not be as effective if the abuser never gained the trust and love of their victim.

Imagine falling in love with someone, feeling a sense of closeness, and then one day waking up next to a stranger, feeling like you don’t know the person you’ve been sleeping with at all. Imagine that the person who once brought you immense joy is also the very person to cause you pain.

If you can’t imagine it, count your blessings to have never experienced something so psychologically damaging. This is indeed a loss. Grief comes in waves, and because the survivor is grieving multiple losses, they may find it hard to communicate or name their feelings.

The client’s mental conflict about ending the abusive relationship can easily be confused (by both the client and the counselor) with missing the abuser when, in reality, it’s often the uncomfortableness of being alone. Counselors can help clients process their feelings and learn to understand the difference between the two. They don’t miss their abuser; they miss themselves — the version of who they were before the abuse happened.

The client may have spent a lot of time and energy attempting to “fix” their partner, and now that they are alone, they may be faced with the idea of “fixing” themselves. Having to examine oneself closely is hard. A good counselor, however, can help clients realize that being in their own company is not necessarily a bad thing. 

How to be a supportive ally

You can be a supportive ally by putting a name to what the client is experiencing: disenfranchised grief (i.e., grief that is not or cannot be openly acknowledged, socially validated or publicly supported). And you can remind them that grief is a normal response to any type of loss.

Give the client a sense of normalcy by explaining the cycle of abuse and why they may have these unexpected feelings. Become familiar with the power and control wheel, and help your client to understand it as well. Explain how manipulation and gaslighting play a part in the mixed emotions.

During sessions, you can also talk about various ways the client can rediscover themselves. Help them to sort their feelings and reconnect to the world in this new phase of their lives.

For example, they could join a club, find a new hobby or reconnect with a passion they had put aside because their former partner didn’t like it. As they grieve who they wanted to be, who they once were and the relationships that have been lost, encourage them to enjoy the journey of self-discovery and reconnection. It may be more manageable to help them acknowledge and work through each loss separately.

Now that you have a better understanding of one of the aftereffects survivors may face upon leaving an abusive relationship, you will be better equipped to serve as a professional and an ally.



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.



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.