Domestic Violence

Injuries sustained by a partner are the most common reason American women under the age of 50 seek emergency care. (At age 50, domestic violence is no less common, but other ailments that come with advanced age surpass it in frequency). Domestic violence (DV) can range from the apparently mild – such as a single incident of pushing or slapping – to the very severe, such repeated beatings leading to injury and, more often than we’d like to believe, homicide. Even apparently mild cases of DV can become severe quickly, and in most cases DV does not get better without outside intervention and some very direct action by the recipient of the violence, such as police intervention, or leaving the relationship.

• Relationships and Domestic Violence
• Relationship Cycles and Domestic Violence
• How to Stay Safe When Leaving a Domestic Violence Relationship
• Counseling for Couples and Domestic Violence
• Therapy for Survivors of Domestic Violence
• Medical Model Disorders and Batterers
• Couple in Therapy for "Blow Ups" - Case Example
• Husband Feels like "Jekyll and Hyde" - Case Example

Relationships and Domestic Violence

Domestic violence appears to be most commonly committed by men against women, but all combinations are possible, and sometimes the violence goes both ways. Certainly, in general, men are bigger, stronger, and more aggressive than women (though there are certainly plenty of exceptions) and women are at greater risk statistically, by far, of being seriously injured by DV.

Domestic violence usually does not occur suddenly or in an isolated context without warning signs. Most often, it occurs in the context of a controlling, emotionally abusive relationship between a person with an aggressive personality and one who is more passive. Often, such relationships are codependent. Other forms of abuse are already present, such as controlling finances, isolating the recipient of the violence, making threats, and verbally abuse.

Relationship Cycles and Domestic Violence

Domestic violence usually has some predictable cycles, often described as:

• Tension – in which arguments and threats escalate

• Act of violence – usually more becoming more severe over time

• Honeymoon – in which the couple reunites, experiences intense “closeness,” idealizes the emotions felt in the relationship, and promises never to fight again, and the perpetrator of the violence apologizes profusely, or blames the recipient, who often accepts the blame, especially early in the relationship.

How to Stay Safe When Leaving a Domestic Violence Relationship

Domestic violence is most likely to be most serious, and even fatal, when the recipient of the violence attempts to leave the relationship. This is one reason people stay in violent relationships. It is essential to get help from a DV agency or experienced therapist, who can provide safety plans and other measures to protect all parties from harm.

Counseling for Couples and Domestic Violence

It is important to know that couples’ counseling is generally not appropriate when violence is present in a relationship, in particular chronic or severe violence, and certainly when the violent partner does not fully understand the unacceptable nature of their behavior. The safety of the therapy session encourages open communication, but such communication can be dangerous in a violent relationship and subject the recipient to more violence. Also, couples’ work is based on the agreement of shared respect for another and shared responsibility for the relationship outcome and process. When violence is present, one person has more power than the other, and is taking less responsibility for his or her actions. Until the violent partner gets help to stop their abusive behavior, and until the recipient is able to discover why he or she tolerates such abuse, couples work is likely to harm more than it helps.

Therapy for Survivors of Domestic Violence

Therapy can be a powerful tool to facilitate healing in survivors of domestic violence. Children who were victims of domestic abuse carry scars of their trauma into adulthood, often seeing the negative consequences of the trauma manifest through lost jobs, troubled relationships and unhealthy behaviors. By addressing, rather than avoiding, the trauma of domestic violence through therapy, survivors can free themselves of fear, resentment and guilt. Therapy allows a survivor to identify their role in the trauma and let go of self-blame. By acknowledging they were a victim, not a perpetrator; clients are able to see themselves in a new light, often seeing their own value and self-worth for the very first time. Survivors of domestic violence struggle with self-esteem, abandonment, fear and post-traumatic stress that can impact every area of their lives. Therapy allows these clients to gain a healthy perspective on the trauma, thus decreasing the negative symptoms associated with it. 

Medical Model Disorders and Batterers

Domestic Violence perpetrators may be diagnosed with intermittent explosive disorder, antisocial personality, or narcissistic personality. They are also more likely than the general population to abuse drugs or alcohol, and may have underlying depression. Many were abused or neglected as children.

Domestic Violence recipients often meet criteria for dependent personality, and are often depressed and/or anxious. Many were abused or neglected as children and may have post traumatic stress disorder, due both to childhood abuse and to more recent incidents of DV.

Couple in Therapy for "Blow Ups" - Case Example

Danielle and Randy, both 26 years old, present for couples’ counseling. Halfway through the first session, the therapist asks for more information about the “fights” and “blow-ups” they report. Danielle reports Randy recently pushed her down, and that he sometimes pulls things – the phone, the TV remote – out of her hand. Randy admits to this, and counters by accusing Danielle of pushing him once, which Danielle says was self-defense. The therapist informs the couple that he will see them separately, effective immediately. They agree to this, and the therapist begins by meeting alone with Randy. The therapist spends the session forming an alliance with Randy, rather than confronting his violent behaviors. In a brief meeting with Danielle, the therapist provides the name of a colleague who can see her, and obtains a release of information from Danielle so the therapist can share his impression of the couple with the new therapist. Randy’s therapy centers on anger management, as well as on his beliefs about women, and his lack of empathy. Progress is quite slow. Danielle, meanwhile, explores her codependency, and soon resolves to leave the relationship.

Husband Feels like "Jekyll and Hyde" - Case Example

Trudy, 32, seeks therapy because she feels “crazy” ever since she married her long time boyfriend Jack. Trudy reports that Jack calls her names, forces her to have sex at times and in ways she does not want, and stays out very late without telling her what he is doing, getting angry if she even asks. Before the marriage, he was extremely charming and always kind to her, if a little possessive and jealous (she found this flattering). Now he seems to have pulled a “Jekyll and Hyde” act. Trudy tried to separate from him but he followed her to her friend’s house and “nearly broke down the door” knocking on it at 3am, demanding she “come home”. She did. Trudy is convinced Jack can’t live without her; he even threatens to kill himself if she does leave. But she can‘t stand the verbal abuse. She denies Jack is violent, though the therapist points out that forced sex is a violent act, as is “demanding” anything from her with such aggressiveness as Jack displays. Trudy is able to see the true nature of her relationship only after Jack hits her hard in the face, sending her to a doctor. The therapist helps her plan to leave in safe way, and finds a DV shelter she can live in temporarily. He also expresses concern for her safety at her job, as Jack knows where she works, and eventually Trudy realizes that involving law enforcement is necessary to protect her safety. She obtains a restraining order and Jack seems to give up. Further therapy helps her work through feelings of grief and guilt about the relationship, and to identify how she can choose a more appropriate partner in the future.

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