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Trauma

Coping After Intimate Partner Violence

Avoidance coping and its lingering effects.

Source: Stockpic/Pexels
Source: Stockpic/Pexels

At 17, Katie unknowingly entered into a terribly abusive relationship. With every disagreement, she suffered being cruelly insulted or screamed at, while having objects thrown at her, and, at times, even a fist. A decade later, while she now finds herself in a safe and loving relationship, a disagreement resulting in his frustration triggers Katie into thinking the worst: Her brain and body act out old narratives, except now with the agency she didn’t have at 17, her fear-laden brain not subconsciously understanding the difference between the consequences of a disagreement then and now. In her mind, conditioned by years of earlier abuse, a disagreement could cost her more than just her dignity, but indeed, her life, and so, she shuts down and mentally, if not physically, flees.

For abuse victims, which comprise a staggering nearly 25% of all women (Black, 2011), new healthy relationships require a new set of skills and a new understanding: What a loving relationship entails; what safety means; what is considered 'normal' when disagreeing; how to let go of the past; and how to cope in a way that’s healthy, among many other new lessons and skills.

As is finally beginning to emerge in popular knowledge, leaving abusive relationships is extremely difficult. In fact, it takes a woman an average of seven times to leave an abusive relationship before finally succeeding. As studies have found, the greater the risk to an abused woman’s personal safety—meaning she sincerely believes she will be killed—the more likely she is to leave (Lindgren & Renck, 2009). Still, this leaves an ocean of room for women who suffer daily damaging abuse that may not escalate to a fear of being murdered, but may badly damage her body and/or psyche, nonetheless.

Even years after leaving, for instance, the trauma associated with an abusive relationship stays: In a study exploring whether abused and post-abused women show symptoms of trauma, 160 abused, post-abused, and non-abused women were surveyed on physical and emotional abuse by an intimate partner and PTSD. For both abused and post-abused women alike, trauma symptoms were associated with the severity of the abuse endured and the risk of being murdered. Further, symptoms were still experienced in women who had left the relationship an average of nine years ago.

What this study suggests is how complex the trauma of abuse is, and how difficult it can be to live with a past or even present experience of abuse and/or to get help. This may be because abuse is largely stigmatized still, can be shame and fear-inducing to admit, and getting help can be a matter of limited access to resources (particularly in low SES neighborhoods, which are correlated with higher domestic abuse rates) and getting help privately can be financially taxing, if available at all.

An additional complication is that the continued symptoms of trauma experienced (which can include flashbacks, nightmares, or outbursts of emotion) are related to a largely maladaptive coping mechanism that can be learned through violent relationships: avoidance coping (Krause et al, 2008). This form of coping involves just that—avoiding—or minimizing or denying anxiety-provoking thoughts or actions as a way to manage the stress associated with certain events. In short, when anxious thoughts or reminders of the abuse bubble up, the first response is to run, metaphorically or otherwise.

This coping mechanism is particularly maladaptive because it leads to social withdrawal, (or, in other words, distancing from other people). While this is a dysfunctional way to cope, it makes sense from a survival perspective, as after all, in abuse, the bedrock of love is perverted into a violent milieu of control, jealousy, and manipulation, and the essence of a relationship itself, an otherwise meaningful, safe, caring, and trusting dynamic, is corrupted into coercion, force, and emotional, physical, or financial torture. It’s therefore understandable that when an otherwise fairly commonplace event like a disagreement has, in the past, ended with serious and violent ramifications, any form of disagreement within the place of a new relationship, even with a healthy and safe partner, may form a psychological trigger in the person with an abused past that a negative blow is looming. As fear for one’s safety arises, the avoidance coping mechanism takes flight, and the person with a history of being abused shuts down to avoid the stress, or looks for an "out," rushing to end the relationship or establish some form of distance from those closest to them.

As the illuminating book, The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma by Dutch psychiatrist Bessel van der Kolk notes, however, one of the antidotes to avoidance coping or symptoms of PTSD is a loving touch, listening ear, trusting soul, and safe social connections who provide gentle words and consistency of kindness and acceptance. Indeed, perhaps this gentleness will translate into an acceptance of the past situation and forgiveness for the abuser him or herself, which has been shown, in formal therapies concentrating on forgiveness instead of anger or assertiveness, to significantly lower depression, anxiety, post-traumatic stress symptoms (Reed & Enright, 2006).

In moving forward from abusive relationships, unfortunately and unjustly, the responsibility to heal from the relationship is left with the person who has suffered the abuse. This means examining and working on minimizing how past triggers, like a disagreement, affect your safe relationships today, and developing healthier responses to stress. As with any change, it will take time, patience, and practice, but healthier, and happier relationships are on the horizon.

References

Woods, S. J. (2000). Prevalence and patterns of posttraumatic stress disorder in abused and postabused women. Issues in mental health nursing, 21(3), 309-324.

Black, M. C. (2011). Intimate partner violence and adverse health consequences: implications for clinicians. American journal of lifestyle medicine, 5(5), 428-439.

Reed, G. L., & Enright, R. D. (2006). The effects of forgiveness therapy on depression, anxiety, and posttraumatic stress for women after spousal emotional abuse. Journal of Consulting and Clinical Psychology, 74(5), 920–929. https://doi.org/10.1037/0022-006X.74.5.920

Krause, E. D., Kaltman, S., Goodman, L. A., & Dutton, M. A. (2008). Avoidant coping and PTSD symptoms related to domestic violence exposure: A longitudinal study. Journal of traumatic stress, 21(1), 83-90.

Scheffer Lindgren, M., & Renck, B. (2008). Intimate partner violence and the leaving process: Interviews with abused women. International Journal of Qualitative Studies on Health and Well-being, 3(2), 113-124.

(2013) 50 Obstacles to leaving. Retrieved from

The National Domestic Violence Hotline. https://www.thehotline.org/2013/06/10/50-obstacles-to-leaving-1-10/

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