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Mental Health Matters

Abuse can take many forms:

No one should live in fear of the person they love or in fear for their personal safety. Yet abuse can happen to anyone, at any age, in any life situation. And not all abusive relationships involve physical violence. It is common for emotional abuse to be downplayed or overlooked—even by the person being abused.

Domestic abuse, also known as spousal abuse, results when one person in a marriage or intimate relationship tries to control the other person. Domestic abuse that includes physical violence is called domestic violence.

Physical abuse refers to the use of force against someone in a way that injures or endangers that person. Physical assault or battering is a crime, regardless if it occurs inside or outside of the family.
Emotional abuse impacts the victim’s self-esteem and sense of independence. You may feel powerless to leave the relationship or that without your abuser, you have nothing.

Sexual abuse is defined by any situation in which you are forced to participate in unwanted, unsafe, or degrading sexual activity, even by a spouse or intimate partner. Sexual abuse is an act of aggression and violence. People whose partners abuse them physically and sexually are at a higher risk of being seriously injured or killed.

Child abuse refers to any activity that damages a child physically or emotionally. From bruises and broken bones to emotional abuse and neglect, child abuse can impact a child for the rest of their life.

Domestic Abuse/Violence

With domestic abuse or violence, perpetrators use guilt, fear, shame and intimidation to wear you down and keep you under their control. Your abuser may also threaten to hurt you or those around you. Domestic violence is the extreme of domestic abuse, wielded for the same purpose.

If you are a victim of domestic abuse, your safety is in jeopardy. Establish a safety plan that includes:

  • Escape routes and a safe haven such as the home of a friend or shelter where you can feel secure.
  • Keep a survival kit ready with a change of clothes, credit cards, medicines and legal documents that show jointly owned assets and bank accounts.
  • Avoid arguments in areas that may have potentially weapons, such as the kitchen or garage.
  • Start an individual savings account and send statements to a trusted relative or friend.
  • Call the domestic abuse hotline in your community for information on resources and your legal rights. Hotline advocates are ready to advise, intervene and assist you in a crisis so you stay safe.

Experts estimate that up to three million women are physically abused by their husbands or boyfriends each year. The National Violence Against Women survey found that 21.5 percent of men and 35.4 percent of women living with a same-sex partner experienced intimate-partner physical violence in their lifetimes, compared with 7.1 percent and 20.4 percent for men and women, respectively, with a history of only opposite-sex cohabitation. Transgender respondents had an incidence of 34.6 percent over a lifetime according to a Massachusetts survey.

Studies on domestic violence show that one-third to two-thirds of abusers do reform with help. But first, the violence must stop.

The CDC’s 2010 National Intimate Partner and Sexual Violence survey, released again in 2013, reports in its first-ever study focusing on victimization by sexual orientation that the lifetime prevalence of rape, physical violence, or stalking by an intimate partner was 43.8 percent for lesbians, 61.1 percent for bisexual women, and 35 percent for heterosexual women, while it was 26 percent for gay men, 37.3 percent for bisexual men, and 29 percent for heterosexual men (this study did not include gender identity or expression).

If the abuse has been going on for a long time, both partners should seek help separately before entering therapy together. Victims need to address the trauma they have experienced. Abusers must learn why they act violently and how they can stop. Only then can a couple consider reconciliation. When children are involved, family therapy can be helpful too. Marriage and Family Therapists (MFTS) can help you cope with the aftermath of physical and emotional abuse.

Signs & Symptoms

Abusers use a variety of tactics to exert control and power. These include:

  • Humiliation – Abusers do all they can to make you feel bad or lowly in some way. The goal is to have you believe you are worthless, that no one else would want you, so that you are powerless to leave.
  • Isolation – An abusive partner will often keep you from seeing family or friends, or going to work or school. You may need to ask permission to go anywhere or see anyone.
  • Dominance – Abusers treat their targets like a servant, child, or a possession. They make all decisions without input, tell you what to do, and expect strict obedience.
  • Threats – Abusers use threats to keep their partners in line. They may threaten to hurt or kill you or other family members. They might also threaten to commit suicide, file false charges against you, or report you to child services.
  • Intimidation – Your abuser may try to scare you into submission with threatening looks or gestures, by smashing things in front of you, hurting your pets, or keeping weapons on display.
  • Denial and blame – Abusers place blame for their behavior elsewhere – on a terrible childhood, a bad day and even the victims of their abuse. They may minimize the abuse or deny that it occurred.
  • Gaslighting — is a form of mental abuse in which information is twisted or spun, selectively omitted to favor the abuser, or false information is presented with the intent of making victims doubt their own memory, perception, and sanity.

Tips & Recommendations

If you suspect that someone you know is being abused, start a dialogue:

  • Set up a time to talk in private.
  • Point out the things you have noticed that make you worried.
  • Tell the person you are there whenever they feel ready to talk.
  • Reassure the person that you will keep whatever is said between the two of you confidential.
  • Offer to help in any way you can while being mindful of your own safety.

Expressing concern will let your friend or loved one know you care and may even save their life. Many victims need encouragement to open up and finally address the abuse.

Physical Abuse

Physical abuse, assault or battering is a crime whether it occurs inside or outside of the home. Victims should be aware police officers have the power and authority to protect you from physical attack and your attacker.

Warning signs of physical abuse:

  • Frequent injuries that are dismissed due to “accidents”
  • Inappropriate dress aimed at hiding bruises, lacerations or scars (such as wearing sunglasses indoors or pants and long sleeves in the summer)
  • Frequently missed work, school, or social occasions without explanation

Sexual Abuse

Rape occurs when sexual intercourse is non-consensual, or one person forces another to have sex against their will. It can occur when the victim is intoxicated from alcohol or drugs, or threatened with violence. It is a felony offense, the most serious type of crime that a person can commit. People, regardless of their gender identity, sexual orientation or age, can be raped. Sexual assault is never the victim's fault--ever.

Signs & Symptoms

Studies show that 76 percent of sexual assaults committed against women are by a current or former husband, lover, friend, or date. There is an average of 293,066 victims (age 12 or older) of rape and sexual assault each year. In the U.S., it is estimated 17.7 million and 2.78 million men have been victims of sexual assault or rape. Every 2 minutes, another American is sexually assaulted.

After rape, the victim may suffer from a variety of physical and psychological after-effects. Victims may experience:

  • Shame
  • Embarrassment
  • Guilt
  • Feelings of worthlessness

They may also have trouble with:

  • Fear
  • Depression
  • Anger
  • Trust
  • The inability to enjoy sex without intrusive memories of the abuse
  • Flashbacks
  • Nightmares
  • Falling and staying asleep

Tips & Recommendations

Rape victims should receive comprehensive care that addresses both the short and long-term effects of rape. Frequently a victim's intimate relationship, if there was one prior to the assault, falls apart within one year of the rape. This adds another psychological burden on the rape victim. Men who experienced childhood sexual abuse are at much greater risk for serious mental health problems such as symptoms of post-traumatic stress disorder, depression, alcoholism and drug abuse, suicidal thoughts, suicide attempts, problems in intimate relationships, and underachievement at school and work.

Marriage and Family Therapists (MFTS) can help you cope with the lingering psychological effects of trauma and rape.

Article Sources

1 (Dube, S.R., Anda, R.F., Whitfield, C.L., et al. 2005).
(Source: here)

Emotional Abuse

Just as physical abuse can leave scars, emotional abuse is devastating to one’s self-esteem and long-term wellbeing. In reality, emotional abuse can be even more damaging than physical abuse. Examples include:

  • Yelling
  • Name-calling
  • Blaming and shaming
  • Isolation
  • Intimidation
  • Controlling Behavior
  • Threats of physical violence or other repercussions

Someone who is being emotionally abused may:

  • Be depressed, anxious or suicidal
  • Have very low self-esteem, even if they used to be confident
  • Exhibit major personality changes (e.g. an outgoing person becomes withdrawn)

Child Abuse

Child abuse can occur on many levels, but the common element is the emotional effect on the child. Children need structure and clear boundaries. They need to know their parents are looking out for their safety. For abused children, the world is an unpredictable frightening place with no rules. From a slap or harsh comment, to the uncertainty on when the next meal may come, the result is the same: a child who feels unsafe, uncared for and alone.

Examples of child abuse include:

  • Telling a child they are “no good," "worthless" or "a mistake"
  • Constant shaming and humiliating a child
  • Making negative comparisons to others
  • Ongoing yelling, threatening, or bullying
  • Ignoring or rejecting a child as punishment
  • Withholding affection-- no hugs or kisses
  • Giving a child the “silent treatment”
  • Exposing a child to the abuse of another-- be it a parent, sibling or even a pet

Signs & Symptoms

Warning signs of emotional child abuse. The child may:

  • Demonstrate a lack of attachment to the parent or caregiver
  • Seem excessively withdrawn or fearful
  • Be constantly anxious about doing something wrong
  • Show extremes in behavior (extremely obedient or extremely defiant; extremely passive or extremely aggressive)
  • Act either inappropriately adult-like (taking care of other children) or inappropriately infantile-like (rocking, thumb-sucking, temper tantrums)

Warning signs of physical child abuse:

  • Frequent injuries such as bruises, welts, or cuts
  • Injuries appear to be from a hand or belt
  • Is always watchful and “on alert,” as if waiting for something bad to happen
  • Shies away from touch, flinches at sudden movements, or seems afraid to go home
  • Wears inappropriate clothing to cover up injuries, such as long-sleeved shirts on hot days

Tips & Recommendations

Tips for talking to an abused child:

  • Don’t interrogate or asking leading questions. Let the child explain to you in their own words what happened.
  • Avoid denial and remain calm. If you display denial or shock to a child, they may be afraid to continue and will shut down.
  • Reassure the child that they did nothing wrong. It takes a lot for a child to reveal abuse. Reassure them that you take what is said seriously and that it is not the child’s fault.
  • Safety comes first. If you feel your safety or the child’s would be threatened if you intervene, contact the authorities.

Marriage and Family Therapists (MFTS) can help you or your child manage your feelings and cope with the lingering effects of abuse.

Bullying

Bullying is a form of unwanted, unprovoked aggressive behavior in which someone intentionally and repeatedly causes another person injury or discomfort. Bullying can take the form of making threats, sexual harassment, spreading rumors, attacking someone physically or verbally, and excluding someone from a group on purpose. There are four main types:

  • Verbal bullying
  • Social bullying
  • Physical bullying
  • Sexual harassment

Bullying is based on a real or perceived power imbalance. The behavior is repeated, or has the potential to be repeated, over time.

Here are some facts about bullying:

  • Over 3.2 million students are victims of bullying each year.
  • Approximately 160,000 teens skip school every day because of bullying.
  • 17% of American students report being bullied 2 to 3 times a month or more within a school semester.
  • By age 14 less than 30% of boys and 40% of girls will talk to their peers about bullying.
  • 65% of LGBT students heard homophobic remarks like “fag” or “dyke” frequently or often; 85% were verbally harassed in the past year.
  • Over 67% of students believe that schools respond poorly to bullying, with a high percentage of students believing that adult help is infrequent and ineffective.
  • 71% of students report incidents of bullying as a problem at their school.
  • 90% of 4th through 8th graders report being victims of bullying.
  • 1 in 10 students drop out of school because of repeated bullying.
  • Physical bullying increases in elementary school, peaks in middle school and declines in high school. Verbal abuse, on the other hand, remains constant.

Cyberbullying includes sending hurtful or threatening e-mails or instant messages, spreading rumors or posting embarrassing photos of others. Cyberbullying among preteens and teens has increased dramatically in recent years as young people spend more time socializing online, according to the Second Youth InternetSafety Survey.

Young people who are victims of cyberbullying are more likely to report social problems and interpersonal victimization. Being victimized also increases their chances of harassing peers online themselves.

Signs & Symptoms

Oftentimes children will not tell an adult about bullying for various reasons such as fear of backlash from the bully, rejection from peers, or fear of punishment from the adult who may judge them for being weak. Stopbullying.gov lists some warning signs that may indicate a bullying problem:

  • Unexplainable injuries
  • Lost or destroyed clothing, books, electronics, or jewelry
  • Frequent headaches or stomach aches, feeling sick or faking illness
  • Changes in eating habits, like suddenly skipping meals or binge eating
  • Difficulty sleeping or frequent nightmares

Tips & Recommendations

If you suspect your child is being bullied, you can intervene by using these tips:

  • Talk about what bullying is and tell them bullying is unacceptable.
  • Discuss how your child can stand up to it safely, such as using humor and saying “stop” directly and confidently.
  • Talk about what to do if those actions don’t work, like walking away.
  • Talk about strategies for staying safe, such as staying near safe adults or safe groups of kids.
  • Encourage kids to speak to a trusted adult if they are bullied or see others being bullied.
  • Check in with kids often. Listen to them, know their friends and ask how school is going.
  • Encourage kids to do what they love. Special activities, interests, and hobbies can boost confidence, help kids make friends, and protect them from bullying behavior.

Marriage and Family Therapists (MFTS) can help your child manage his or her feelings and cope with the lingering effects of bullying.

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