Wednesday 22 July 2015

The cycle of domestic violence - an addiction to abuse?

The cycle of domestic violence starts off like this:

1. Everything is going ok at the beginning - you're in love, and the relationship is good.

2. Tension grows, from the outside (for example work) or the inside (disagreements in the couple).

3. Domestic abuse happens (in one or several of its many forms).

4. Afterwards the perpetrator apologises profusely, promises it will never happen again, is particularly attentive & nice to the victim, "makes up for it" - the so-called "honeymoon-phase" of domestic violence.

5. And back to number one.

It makes me think of a roller-coaster ride, hence why a comparison to the cycle of addiction is not far off: from the heights of the high, to the lows of withdrawal... and back up (though not nearly as high, because the fear of the lows is creeping in).

In my private practice, I have seen quite a few women in domestic abuse situations, one of whom described it in a particularly striking way: when the tension was very high, she would wish for her partner to hit her, to get it over, so she would get to the honeymoon phase sooner.

It cannot be a coincidence that very many of the victims of domestic abuse I know, both through my work and within my friends, also struggle with addictions... My theory is that it is just as easy to be addicted to an abusive partner, who treats us in turns appallingly and wonderfully as it is to be to any substance, which gets us high and then crushes us.

And the road to recovery is a long one, and starts with the awareness of how we may stay in the cycle, for example by deceiving ourselves because that seems easier to do (in the current moment) than to accept that "cold turkey" is the way to go...


Monday 13 July 2015

Self-harm - a normal response to unbearable emotions?

Imagine you are feeling worthless.
That your whole life is falling apart.
And now imagine that you can't for the life of you find a way out.
And that then things even get worse.

There is extreme anguish in this. Anxiety. Panic. Sadness. Despair.

How can you possibly cope with those emotions?

Most of us will try to out-run them.
We'll suppress the emotions through alcohol, drugs, sex, endorphins, gambling ... (fill in the blanks) ... whatever we know.

Some of us will deaden the emotional hurt through self-harm. We will cut ourmselves, beat ourselves up, hurt ourselves to a point where the physical pain will drown out our emotional pain.

Physical pain acts like a reset button. We are conditioned to take body pain more "seriously" than mental anguish. For a brief instant, all we feel is the actual physical pain. The emotional pain moves into the background.

Viewed through that angle, self-harm suddenly makes perfect sense, hence my suggestion it may be a "normal" response.

Now before you start thinking that I'm advocating physical harm to help with psychological issues, let me clarify this:

Yes, it might be a normal or natural response, but that doesn't make it a good or a sustainable one. In the same way we can't drown our sorrows in the long term, we cannot self-harm our way out of mental anguish. Eventually, even our physical pain receptors will dull (that is our body protecting us from too much pain), and we would need to "up the dose" - of pain, of alcohol or whatever we use.

What I am advocating, is to look for:
1. healthy ways of dealing with emotional pain - crying, confiding in friends, writing about it, meditating etc. (each person will have their own combination that works for them)
2. different ways to lead your life, to remove sources of anguish (leaving the job where we are bullied, spending less time with the over-critical parent, not putting up with being put down by our partner etc.)
3. when 2. is not possible (for example in the case of grief over a beloved's death), working on ways to accept the new reality.

In other words, dealing with the emotions - not suppressing them.

My role as a therapist is to offer a safe space to do so, to explore the pain, and offer a reminder that you are not alone.

Sunday 5 July 2015

Of the importance of leaving an abusive relationship - and a very short review of "Big Little Lies" by Liane Moriarty

Yes, it may seem like a no-brainer to leave an abusive relationship, but for those who are in it, and have systematically been made to feel small, stupid, ugly or incompetent, some more reasons than just being told "everyone deserves to be treated well" may come in handy.

In the following, I am imagining a situation where there is a male abuser, and a female victim; but of course the opposite happens as well (just less often).

1. If you don't leave, you are putting yourself at a real risk of being maimed or killed by your partner.

2. I you don't leave, you're sending a message to your abuser that his behaviour is acceptable (as you are tacitly accepting the abuse by staying).

3. If you don't leave, your abuser is not given the opportunity to mend his ways - now that is a controversial one, and I would not recommend to offer a second chance in situations of physical abuse; but for most people, change will only occur when there are no more other options - and if he does love you, it may make them realise the necessity of changing (as you send a clear message by leaving that you do not put up with the abuse).

4. If you have children, staying in an abusive relationship is showing them the worst example: your sons will think that abusing women is normal, and your daughters will see that putting up with abuse is the normal thing to do. You're dramatically increasing the odds of your children to become part of abusive relationships themselves - either as abusers or victims.

Often people think domestic violence is about physical violence - but in reality abuse comes in many shapes and forms: http://www.domesticviolence.nsw.gov.au/what_is_domestic_and_family_violence describes how it can be physical, verbal, psychological, financial, social, sexual... The website also offers great information on your rights and where to find help (in Australia).

Liane Moriarty describes all those dynamics beautifully in "Little Big Lies" and still manages to make it a rollicking good read. It's a bit of a "chick-lit" novel, but it covers the subject of domestic violence and its toxic trickle-down effects extremely convincingly. At the same time, the book is a withering caricature of primary-school mums in all their variety and glory, and it had me laughing out loud in many places.