Domestic Violence During the Pandemic (3/5): Knowledge

As we discussed in part 2 last week, having knowledge of domestic violence can help with therapy. It provides a common language describing abuse, shared between client and therapist. It can also help the therapist to ‘guess’ at what might have happened and facilitate disclosure from the client (to the extent that the client wishes).

Whilst the types of abuse that perpetrators use has similarity across male and female victims, the detail of the abuse perpetrated is unique to the individual. It may have cultural or religious dynamics, but will be specifically chosen to keep the victim dependent on and/or controlled by the perpetrator. Any ‘guess’ by the therapist must be within the context of the client story, rather than a theoretical intervention, and it is essential to explore how the actions impacted on the client and what that meant for them.

Cycle of Abuse and types of abuse

It is useful for therapists to understand Lenore Walker’s Cycle of Abuse, first described in 1979. This shows the process of domestic violence as one of continually increasing tension, an event or incident to de-escalate the situation, followed by a period of calm before further escalation. This concept can often be seen in abusive relationships and it is helpful to notice when listening to a client story. You can find a pictorial representation here.

It is also helpful to learn about the types of abuse. These have been outlined by the Duluth organisation, and written about in more detail by Pat Craven in Living with the Dominator for male abuse of female victims. Since then, these models have been adjusted to show that female perpetrators use the same behaviours, although the way they use these will relate to the relationship dynamic and where the perpetrator feels most powerful. For a gender-neutral graphic showing power and control behaviours, see here.

Changing contexts and circumstances

When couples are living in a lockdown situation this becomes very important, as the way that the abuse is perpetrated can change to fit the new circumstances. Previous financial abuse may now become emotional and psychological abuse. The perpetrator may previously have been monitoring trips out or meetings with friends and is now monitoring telephone calls and internet access, making it harder to seek help or to access therapy. Make sure you are up to date with the ethical framework that you work within and its implications on practice as well as any policies your employer may have regarding safeguarding and session disclosure.

During this period, where therapy is possible, it is important to start with what is going on for the client now and ensure that they have strategies to keep safe. Refer into agencies (see week 1) to help with this if there is nothing in place. It is possible that client anxiety levels will be higher than usual due to the current situation and knowing how to work with client anxiety may be particularly helpful at this time.

Complexity and enduring impact

The mental health consequences of domestic violence can be significant, ranging from severe depression to post traumatic stress, and related to client experiences. The nature of domestic violence means that the abuser may continue to be in the client’s life, either physically or psychologically. Many victims have stated that the psychological harm lasts long after the bruises and broken bones have healed. For this reason, it is important that therapists are confident in their ability to work with complexity in the life of the client and in the psychological impact of their experiences, as well as in managing safeguarding issues.

The personal characteristics required for therapists will be discussed in week 4 of this blog series.