1. You dont have to hit to hurt.Weapon of Choice ProjectRichard Johnsonhurtwords.com

2. If this was your client, your altruism and compassionwould be triggered by the visible affects of physicalabuse. 3. What if theabuse is notphysical?What if theyvelearned to hideit?(Im okay.)What iftheyreconfused?What ifthey dontknowtheyrebeingabused? 4. Some who are emotionally abused present asincongruent. It can be as simple as a haggard lookthat is not accompanied by anything that gives avisible or clear indication of why that person is fearful,confused, angry, apprehensive, etcetera. There areno scars. 5. Sadness, frustration, confusion.With experienceyou can easilyrecognize theemotionally abusedclient becausetheres somethingperceptibly visiblein theirappearance. Thediagnosticinterview willexplain theiremotionallydefeateddemeanor. 6. ComorbidityThe purpose of thispresentation is topoint out emotionalor qualitative (e.g.,typical thoughts orthought patterns)characteristics ofthis population sothat we may betteridentify and servethem. 7. What is Crazy Glue?The Betrayal Bond by Patrick J. Carnes, Ph.D., CASStockholm Syndrome: A deep, inexplicable bond with someone who hascontinually distressed or critically hurt the client. This phenomenon iscaused when the abused person feels/holds a strong bond to their abuser.This abuse can be physical, psychological, emotional, verbal, or anycombination of these. Regardless, the abused person develops a sense ofcompassion and loyalty to their abusers. There is a tendency to see a lackof abuse or the honeymoon periods between abuse as kindness or as proofof their abusers humanity.A trauma or betrayal bond develops when there are continually intense,traumatic experiences or betrayals of trust taking place between intermittentperiods of reconciliation. Much like physical abuse, these cycles form anintense and abusive relationship/bond with the perpetrator where emotionalmanipulation or hypercriticism are acceptable forms of communication. 8. A key characteristic for both the clinician and theabused is confusion. If hes such a great guy orshes such a good wife, why are clientsexperiencing problems? The Abused experiences. Confusion and/or is easily confused. Anger, frustration, or irritation without being able to give aplausible reason/cause. Reluctance to communicate with their partner, so itseems like theyre the stonewaller. This person isactually trying not to get caught in the turning of tablesthat often happens with emotionally manipulativearguments because the fault is magically (frustratingly)placed back on them. e.g., Couple is longer arguing about the original point, whichis sometimes the abused persons perception of being hurtor abused. 9. Atypical depression because of being confusedabout why there are problems. This is a differentkind of mental exhaustion. The defeated look. Atypical anxiety because they dont know whytheyre anxious. Being with their partner/spouse is oddlydisconcerting/dissonant (e.g., wanting to be with them butwalking on eggshells). Anxious to be understood (i.e., as safe, loving, caring). Unspoken fear because they cannot mentally/physicallyjustify or explain why theyre fearful. 10. A lost sense of self: The abused has spent a significant amount of time trying tofigure out their partner and has forgotten about their ownwants, needs, habits, etc. Cant see/understand whats wrong in the relationship butknows something is wrong. PTMSD = posttraumatic marital stress disorder 11. The Abuser Scapegoating: Angry at person abused forEVERYTHING. All problems seem to be theabused persons fault or responsibility. Abuser may be arrogant. Also note angryarrogance may manifest when the abuser realizesthat you as therapist arent buying into his/herdysfunctional line of reasoning. Does not see his/her abusive/manipulativetendencies as a fault. Its helping ormisunderstanding his/her actions. However, caneasily point out abused persons faults to the pointthat the abused him/herself can rattle of the listby rote memory. 12. Well practiced in twisting the story to fit theabusers justification. e.g., When you come in I hear you fussing at the kidsto clean. You never give me a chance to parent! Well,he has to be in the home first to hear her come in sowhy didnt he use the time before she was there toparent? Why wait until she comes home to showaction? Secret controller; Dr. Jekyll/Mr. Hyde To act out public would be rude and could blemish howpeople see the abuser. Prince charming in public; Devils advocate in private orwith others seen as a threat. The latter may beespecially prevalent if the outside person perceived asforming an allegiance with the abused. 13. Personality traits/characteristics may reflect: Personality disorder, NOS Narcissistic disorder Antisocial disorder Abuse may actually be cover for: Insecurity Low self-esteem Anger issues F.O.O./Generational curses/cycles 14. Clue #1: Relationship Dynamics Control/Coercion? Manipulation? Verbally abuses spouse/partner and/or children? Abused kept from family and friends? Abuser easily/randomly insulted/offended by innocent statements? Abuser pouts or has sudden outbursts of anger that aredisproportionate to the circumstances? Abuser often behaves coercively or becomes overly jealous? Abuser easily angry when spouse/partner wants/needs to spendtime away? Abuser destroys personal property or sentimental items? Abuser controls spending and makes spouse/partner accountablefor money spent? (This is not reciprocated.) Abuser uses insinuated threats, intimidation, or manipulation forcontrol? Abuser often humiliates spouse/partner in front of others? (in jest) Abuser turns minor incidents into major arguments? Abuser refuses affection and sympathy, or implies weakness whenspouse/partner feels hurt or in need or nurture? Abuses pets? 15. Clue #2: Therapy Dynamics In therapy because its the abused persons fault. Therapy needed because of the abused persons problems. The abuser is often a hostile witness. Relationship has cycles of break ups or separation. Both are equally at fault forrenewing this dysfunctional relationship cycle. The abused because theyveoften left impulsively. The abuser may leave because the abusedleaving/rejection has injured the abusers psyche. In therapy the abuser is unusually cool (over confident) or has sporadic angeroutbursts (low frustration tolerance). Visibly runs warm and cold. The abused isnt afraid of the abuser but doesnt like abuser either. The abused doesnt trust abuser but cant tell you why. Abused feels crazy because theyre caught in trying to solve a problem thatdoesnt exist or a situation thats been manipulated to look like theyre the cause(gas lighting/not your crutches confusion). Abused caught in the abuse cycle and cannot give an exact reason why theyshould leave but they want to leave nevertheless. The abuser is not confused AT ALL. No responsibility taken for theirdysfunctional behavior and if youd just fix the abused person to listen and dowhatever the abuser says, everything would be MUCH better. Again, he/she mayeven appear confident or cocky. 16. Questions to ask Examine both for self-esteem deficits that can be amended orrestructured. Examine F.O.O. for a history of dysfunction both know to becomfortable or familiar. Do either have history of abuse that has been normalized? How far is the abuser psychologically enmeshed in the abusedpersons psyche? Who is speaking when the abused speaks? e.g., Tom told me Iwas making too much of him yelling at me. Does one/both come from an abusive home? Note: Dont use the term abuse because each may not considertheir childhood normal despite outside reactions that it was not.Abuser may even justify the abuse of their past as necessary formaking them the good/great person that they currently are. 17. Should I stay or go? Can I fix this? Despite the abused persons complaints many are in a position, aswith any abusive controlling relationship, where they cannot easilyleave. Also remember, the abused person cannot connectdisparaging feelings to any tangible reason/cause for leaving.Therefore many are convinced that things will work out. Despitemultiple attempts to leave, the cycle, and professional opinions, theystay bound by crazy glue. Community resources for those in imminent danger (Escape Plan):For those ready to leave, an emergency plan should be developed, just as ifperson was in a physically abusive relationship. Emotional/verbal abuse canbe the gateway for physical violence. Actually leaving can be the catalystthat triggers violent acts in addition to emotional abuse. Abused may need coping skills to deal with the abusers behaviorswhile they are beginning to transition to independence or leaving. Caveat for the person who willingly chooses to stay withoutrequiring change within their own paradigm or requiring change fromthe abuser. They should no longer complain about something theywillingly and knowingly accept or allow. Of course if the abuser TRULY chooses to change, this is also anoption (Possible & rare). 18. Were still talkingabout abuse. Itbecomes insidiousbecause itsintangible. Haveyou ever consideredyou cant file aprotective order foremotional abuse? 19. Suggested Reading The Betrayal Bond: Breaking Free of Exploitive Relationships by PatrickCarnes Why Does He Do That?: Inside the Minds of Angry and Controlling Men byLundy Bancroft The Gaslight Effect: How to Spot and Survive the Hidden ManipulationOthers Use to Control Your Life by Robin Stern Too Good to Leave, Too Bad to Stay: A Step-by-Step Guide to Help YouDecide Whether to Stay In or Get Out of Your Relationship by MiraKirshenbaum The Emotionally Destructive Relationship: Seeing It, Stopping It, Surviving Itby Leslie Vernick The Emotionally Abused Woman: Overcoming Destructive Patterns andReclaiming Yourself by Beverly Engel Not to People Like Us - Hidden Abuse In Upscale Marriages by SusanWeitzman 20. Journal Articles Foa, E. B., Cascardi, M., Zoellner, L. A., & Feeny, N. C. (2000). Psychological andenvironmental factors associated with partner violence. Trauma, Violence, & Abuse,1(1), 67-91. Gavin, H. (2011). Sticks and stones may break my bones: The effects of emotionalabuse. Journal of Aggression, Maltreatment, & Trauma, 20, 503-529. Haeseler, L. A. (2013). Womens coping experiences in the spectrum of domesticviolence abuse. Journal of Evidence-Based Social Work, 10, 33-43. Lachkar, Joan (2000). Emotional abuse of high-functioning professional women: Apsychodynamic perspective. Journal of Emotional Abuse, 2(1), 73-91. Sackett, L. A. & Saunders, D. G. (1999). The impact of different forms of psychologicalabuse on battered women. Violence and Victims, 14(1), 1-13. Sims, C. L. (2008). Psychological victimization and maltreatment. Journal of EmotionalAbuse, 8 (4), 375-402. Queen, J. and Brackley, M.H. (2009). Being emotionally abused: A phenomenologicalstudy of adult womens experiences of emotionally abusive intimate PartnerRelationships. Issues in Mental Health Nursing, 30, 237-245. 21. Sticks & stones will break my bones;mean words can also hurt me.Proverbs 15:1