Assessment starts from the first contact with the client, including noting when the abused person raises the issue: Is it the reason she seeks out a therapist or does mention of the abuse arise down the road or in an off-hand manner?
What is the client’s initial emotional presentation of the abuse (minimizing, offering facts without feelings, defending the partner, feeling like a victim, laughing it off, fearful, etc.)?
having mental health problems, abuse victims frequently would rather consider themselves intrinsically defective than accept that they are being abused.
This form of label denial protects their fragile egos, helps them feel in control, and keeps them from having to confront the real problem: They have chosen an abusive mate.
A simple but effective model involves laying out stages of recovery from partner emotional abuse, as well as collaborating with clients in an ongoing assessment of their strengths and challenges in each stage.
In Stage 1, clients are in denial, function passively, and walk on eggshells around the abuser.
Rather than provide lengthy therapy and communication coaching that is actually going nowhere because the abusive partner lacks the capacity or motivation to change, the therapist must lay on the line what he or she observes.
I have heard of too many cases in which therapy has gone on for years without meaningful relationship change, reinforcing not only abuse but also the misguided belief that this is what a partnership is meant to be.
In Stage 3, assuming there is an insufficient reduction of abusive behavior, they end the relationship.
At this point, the therapist’s job is to help clients shift their perspective from believing that control comes from fixing a defective self to acknowledging that real power and recovery come from confronting and changing external circumstances as well.
Strengths that help clients in this stage are accepting validation of being abused from friends and family, a willingness and capacity to explore and identify patterns of abuse from childhood to the present, a belief that they have the power to improve their lives, and trust that the therapist can help them do so.
Stage 1: Denial, Passivity, Walking on Eggshells Because depression, anxiety, eating disorders, and substance abuse are symptoms that may develop from partner emotional abuse, it is often easier for clients to blame themselves for their difficulties than to lay blame on the abuser.
Just as addicts may be more comfortable thinking of themselves as chemically dependent vs.
Letting out emotions pent up from years or decades or a lifetime of abuse, talking back and arguing with the abuser, and engaging in behavior that does not make them feel like a victim helps clients feel strong, powerful, and in control.