Physical Abuse

Physical Abuse

Overview of Physical Abuse: A history of being abused physically is often a root cause of emotional and psychological difficulties later in life. Abuse by a parent can lead to issues with anxiety, self-esteem, anger, depression, and blocks to intimacy. Most people who are abused as children manage to function as adults, but maintaining a sense of peace and happiness can be very challenging. Often, memories arise most dramatically when people who were abused begin to form intimate relationships and think about raising a family, or when they actually have children of their own.

Sometimes people get advice – from others, or from their own internal voice – to just “move  on,” “forget the past,” or “let go of negative memories.” Such advice may be well-intended (although, if it comes from the abuser, it may be quite self-serving) but it is not easy to accomplish, and may not be healthful at first. While letting go and practicing forgiveness is a good eventually goal for a survivor of abuse, dealing first with feelings of anger, grief, guilt, anxiety and other painful emotions resulting from the abuse is likely necessary before trying to “move on.”

The Medical Model and Physical Abuse: Therapy can help in a number of ways, including increasing insight into the nature of feelings that are arising, clarifying values and choices, helping with anger management and communication skills, uncovering and working through shame, and facilitating emotional catharsis. In situations where symptoms of post traumatic stress are present, Eye Movement Desensitization and Reprocessing has been shown to be very effective.

If memories of abuse are intense and interfere with one’s life in significant ways, Post Traumatic Stress Disorder may be diagnosed.  Depression, Anxiety, and some Personality Disorders (particularly if abuse is persistent and severe) are a possible outcome of physical abuse. Dissociative Identity Disorder (formerly known as Multiple Personality Disorder) rarely occurs unless there is a history of severe abuse. For children, Oppositional Defiant Disorder and Conduct Disorder sometimes develop in the aftermath of serious abuse.

Case Examples of Physical Abuse:

Ron, 40, presents with depression and reports he is having memories of being abused by his father. His wife tells him to “get over it”, but Ron finds he has great anxiety about disciplining his son, who is four. Ron has been refusing to participate in any parenting role other than playing with his son, and his wife is frustrated, but Ron is afraid he will hit his son, and admits to bouts of anger. He is afraid to disclose this in therapy, worrying that the therapist will call social services, but he says, “I really want to get better so I can be a good father.” The therapist explains the rules of confidentiality, and assures Ron that unless he actually abuses or neglects his son, his privacy is protected; thoughts and feelings are not reportable offenses. The therapist helps Ron achieve a catharsis of grief and anger at his father; this helps Ron develop a deeper sense of compassion for himself and his own son, and his feelings of anger at his son subside. The therapist invites Ron to invite his wife to their sessions, and then begins discussing with the couple some non-violent parenting techniques.

Rita, 29, is anxious and fearful, especially around men. She is unable to identify a reason for this. The therapist takes a personal history and discovers physical abuse in her family of origin, but Rita denies this is the cause. The therapist facilitates some deep relaxation sessions, and Rita begins to be open to the possibility that he experience as a child is affecting her now. Eventually, Rita begins to verbalize her emotions around her past abuse, and accepts a recommendation for a support group.

Therapy for Physical Abuse: There is a wide range of Psychotherapy Treatment Models or types of therapy used in the treatment of phsyical abuse. Most of these approaches fall into three historic camps of psychology: Psychoanalytic / Psychodynamic approaches; Behaviorism and; Humanism. Regardless of the type of therapy, there are some generally agreed upon elements of healthy therapy which are universal to all forms of psychotherapy. Before beginning therapy for physical abuse or any other issue, it is helpful to familiarize oneself with these elements.

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