Identifying and Managing Common Symptoms of Domestic Violence

railway-2439189_1920I have met with dozens of survivors of domestic violence since I first started providing counseling services as an intern and later as a licensed professional. Many times, survivors of domestic violence describe feeling detached or disconnected with other people and with themselves. Survivors often tell me they feel like they were a completely different person in the past, that they want to bridge their past and present “selves”, and they want to reconnect with who they “used to be.” This post identifies some of the symptoms teen and adult survivors of domestic violence experience that keep them disconnected and provides a few ideas about how to manage those symptoms.

Some symptoms of abuse are physical in nature. There may or may not be physical signs of injury, like bruises. Physical symptoms might include things like panic attacks, stomach aches, headaches, racing heart, suicidal behavior, shortness of breath, being easily startled, disturbed sleep, and increased use of alcohol or other substances. Physical symptoms begin having negative effects on the abused person’s life as they start using avoidance to manage the symptoms. People with constant fear and stomach aches, for instance, may start calling in to work or neglecting their job duties which can lead to financial problems or job loss.

There are also cognitive symptoms related to abuse that include unwanted thoughts and  mental images called flashbacks where survivors feel like they’re reliving an abusive moment. Unwanted thoughts can be triggered by anything in the environment that reminds the survivor of the abuse. Survivors may feel triggered by news reports, odors, sounds, people with an appearance or mannerisms similar to their abuser, or symptoms may seem to come out of the blue.

Emotional symptoms of abuse include feelings of grief, depression, guilt, anger, irritability, numbness, confusion, shock, exhaustion, fear, and self-doubt. Survivors who struggle to manage their emotional symptoms often find that their relationships with friends and family are strained since the survivors feel reactive and unable to maintain healthy connections with the people closest to them. Building communication skills can help survivors convey what it is they’re feeling. The process of abuse diminishes a victim’s connection with their own feelings. Abused people are often told, through words or actions, that their feelings don’t matter or aren’t real.

Another symptom of abuse people talk with me about includes a detached feeling, a loss of interest in things normally enjoyed like hobbies, work, or social activities. Most survivors I have talked with describe feeling as though they lost their sense of identity somewhere along the way with their abusive partner. Perpetrators of abuse take away a person’s sense of identity through manipulation and control leading the abused person to become increasingly isolated and sometimes unable to make their own decisions. I work with abuse survivors to explore the identity they want to have for themselves by discussing values, likes, dislikes, and things they might become interested in.

Survivors also describe finding healthy partners after leaving abusive relationships and how the new, healthy relationship feels scary and unfamiliar. Survivors in new relationships ask questions about how to communicate, how to stop using reactive behaviors, or how to open up and feel less guarded after building a wall of protection. It can help to explore what it means to have a partner who is supportive instead of mean or violent. Domestic violence can feel like the “norm” for some survivors so when they experience healthy relationships they may feel uncertain about how to navigate the new and different ways of connecting.

Maybe you or someone you know has some of these symptoms and have been involved with a violent partner and you’re wondering what you can do to manage these symptoms?

One idea is to use affirmations, tools to relax your thoughts and rewire your mind. If you’re noticing negative thoughts, or are still in an abusive relationship and receiving negative messages about yourself, affirmations can help reframe your thinking and can help address cognitive symptoms. Affirmations are a form of positive self-talk that help send different, positive messages about yourself to your brain. You can practice using affirmations daily. Here are a few examples:

  • “I am strong”
  • “I am learning how I want others to treat me”
  • “I deserve respect”
  • “I love who I am and who I am becoming”

Other suggestions are to use various self-care activities. Take care of yourself in some way every day by doing something that feels relaxing and nurturing. What do you like to do for fun? Eat a healthy diet that limits caffeine, sugar, sodium, and fat. Exercise to keep  your body in good physical and mental health. You might also seek out counseling or find a support group for domestic violence survivors as part of your self care.swing-1365713_1920

Having a safety plan in place can also provide a sense of reassurance that steps are in place to keep you safe if you decide to leave and can provide peace of mind. Because there is a risk of written safety plans being discovered by the abuser, your plan should be kept somewhere other than your home such as with a trusted relative, coworker, or neighbor. Safety plans can include the following but should be personalized to your needs:

  • copies of important documents like birth certificates, divorce papers, restraining orders, bank account numbers, etc.
  • money
  • medication
  • medical records
  • spare car keys
  • where you will go
  • people who will support you
  • what you will do with pets
  • what to do if there are weapons in the home

Having pre-planned steps to keep you safe, a list of supportive people and their phone numbers, ideas about where you will go and what to bring with you can help you feel prepared, ease some of the symptoms and stress involved with leaving an abusive relationship, and optimize your safety when you do decide to leave.

Symptoms of domestic violence can be physical, emotional, or cognitive in nature and can be managed in several ways, a few of which include using affirmations, self-care, and safety plans. If you’ve noticed any of these symptoms related to an abusive relationship, how have you worked to overcome them? What worked for you to manage symptoms? What kind of safety plan did you have in place?

If you’re not ready to seek counseling yet but want to talk with someone about abuse, the number for the National Domestic Violence Hotline in the United States offers 24/7 phone support: 1-800-799-SAFE (7233).

 

Inspired by the prompt: Overcome

3 Stages of Survival: Moving from Victim to Survivor and Beyond

Following the trauma of domestic violence people are often identified as victims. Victimhood is only one stage in the recovery process. The stages aren’t linear, they don’t proceed in a straight line. I often tell the people I work with that progress is often one step forward two steps back. The following identifies the various stages of survivorhood: victim, survivor, and thriver.

Stage 1: Victim

Victimization by a domestic violence (DV) perpetrator often leads a person to feel worthless and incapable. Domestic violence is about controlling another person and depleting their sense of power. Control and power over another person can take the form of physical, emotional, sexual, or financial abuse.

People who are victims often have low self-esteem, feel a sense of shame and worthlessness, and may not feel that they deserve nice things or that they deserve to be treated respectfully by others. Victims may be hypervigilant, always expecting a threat, and feel guarded. People in the victim stage of healing often feel alone, selfish, numb, damaged, confused, and hopeless. It’s common for perpetrators to isolate victims from friends and family. Isolated, lonely people with low self-esteem are easier to control and maintain power over.

Victims of DV are often afraid to tell their stories for a number of reasons. They may fear that their partners will retaliate or be fired from their jobs. Victims may believe that their stories are not worthy of sharing. It is also common for people in the victim stage to feel overwhelmed by their past as they come to recognize the struggles they have endured. DV victims commonly have difficulty setting healthy boundaries and find themselves wrapped up in drama and unhealthy relationships with toxic, unsafe people. Victims tend to put their own needs last and often have difficulty communicating in ways other than being passive or sometimes passive-aggressive. Victims tend to believe that suffering is just the way things are and have a hard time finding joy. Victims also frequently turn to substance abuse or codependent relationships to help them feel like they are doing okay.

Stage 2: Survivor

Once a person begins moving away from unhealthy and violent relationships with an abuser, they can begin reflecting on their experiences in a safe environment. As they recognize the struggle they have survived they begin searching for reasons why this experience happened and how they can heal. People in the survivor stage view themselves as both wounded and healing and begin gaining a sense of hope. A grieving process may take place as the survivor comes to terms with the different losses that have taken place.

Survivors are often eager to tell their stories and want to talk about all the aspects of their experience in their attempts to heal. Support groups can be a great help for people in the survivor stage since they want to share their stories and hear others’ experiences as well. Survivors begin learning ways to set healthy boundaries and explore what is safe or dangerous in their relationships. Through their curiosity and sharing of experiences with others, survivors begin identifying patterns, which can become goals to begin changing. Change takes time for survivors and doesn’t happen overnight or in a matter of weeks. Whereas victims tend to believe that suffering is normal, survivors begin gaining a sense of hopefulness and relief as they see a journey leading them forward.

Survivors also learn to laugh again. They have a healthy sense of humor and can find moments of joy. Instead of needing substances or codependent relationships, survivors can begin regulating their emotional pain and may seek out therapy to explore the new and uncomfortable feelings that have been numbed or disregarded before. Survivors begin learning about a wider range of emotions.

Stage 3: Thriver

Although many people feel satisfied reaching the survivor stage, others believe that there is still more to go on their journey and these people become thrivers. People in the thriving stage have a sense of gratitude for this new found life that seems to be overflowing with miracles and wonderment. Instead of feeling isolated, thrivers feel a sense of connection with others and the universe. Thrivers have healthy connections and are both independent and interdependent. Thrivers have a sense of pride in their ability to care for themselves. They live in the present moment and understand that emotional pain passes and can be learned from.

Thrivers set healthy boundaries with others and protect themselves from toxic people but are also capable of living with an open mind and heart. Thrivers place their own needs first as they recognize that helping others requires care for themselves first. Thrivers create peace instead of chaos and find joy around them. They use healthy humor and feel a range of positive and negative emotions which helps them feel alive and genuine.

Each of the first two stages takes time move on from and some people feel quite content and happy living life in the second stage. Some people experience great difficulty moving from victim to survivor stages and even become more comfortable staying in the victim role. The victim role offers familiarity. Oftentimes when I meet with survivors of DV who have entered into what seem to be healthy relationships, they describe feeling fear and confusion because they don’t know how to cope with a healthy partner and it feels scary. Survivors have often learned a number of coping skills during the victim stage to get through a violent relationship and learning to be in healthy relationships can require learning or building on a whole new set of skills. Reaching out for support is common for survivors and many of them turn toward family and close friends.

More can be found on these stages in the book: Surviving Domestic Violence: A Guide to Healing Your Soul and Building Your Future by Danielle F. Wozniak, PhD, and Karen Allen, PhD.tree-338211_1280

Inspired by the daily prompt: Survival

10 Types of Trauma

When you experience a traumatic event it can change your beliefs about yourself, other people, the world in general, and your future. Trauma creates fragmented memories that are often sensory in nature. This means that we oftentimes don’t remember every detail of a traumatic event, but bits and pieces of the trauma become stored throughout our body in the form of mental images, smells, tastes, sounds, or touch. Following a trauma you may notice feeling triggered by something in the environment that causes you to recall parts of the event. Triggers may include loud noises, the smell of certain food cooking, or seeing a vehicle that resembles one involved in an accident. The result of having fragmented memories and changes in your beliefs might be that you notice feeling angry, fearful, distrustful, shameful, anxious, and other negative emotions.

You may experience traumatic events at any point in your development including childhood, adolescence, adulthood, and old age. This post describes ten types of traumas that may affect you or someone close to you over the course of your lifetime. Most people do not experience long term impairment following a traumatic event and it is possible to experience healthy growth following a traumatic incident and build resilience.

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Natural-Caused

Natural traumatic experiences can affect a small number of people in a neighborhood or a larger number of people within a community. The following are some examples of natural-causes of trauma.

  • Tornadoes
  • Lightning strike
  • Wildfires
  • Avalanche
  • Earthquakes
  • Volcanic eruptions
  • Hurricanes
  • Floods
  • Famine
  • Landslides

How you respond to natural-caused trauma depends on how much devastation has occurred, the extent of loss, the amount of time it takes you to get back to daily activities, and the accessibility of services in your area. Having relief services available following a natural-caused traumatic event can greatly reduce the traumatic stress and aid in the recovery process.

Human-Caused

Human-caused trauma are those caused by human behavior. These types of trauma can be accidental or intentional. Here are some examples of human-caused traumatic events.

  • Structural collapses
  • Plane crashes
  • Gas explosions
  • Oil spills
  • Gun shootings
  • Arson
  • Terrorism
  • Sexual assault/abuse
  • Domestic violence
  • Human trafficking
  • Home invasion

There is a difference in the way people perceive natural versus human-caused events. Natural events are often perceived as unavoidable whereas human-caused events are considered to be either intentional or unintentional. Following any type of traumatic event, people often feel a sense of anger, loss, frustration, fear, and sadness. When a trauma is perceived as intentionally harmful and human-caused, the event is often experienced as more traumatic and people attempt to make sense of the perpetrator’s personal characteristics and motivations for performing the act.

Individual

An individual trauma is one in which the traumatic event is experienced by one person. This type of event can be a one-time occurrence such as a physical attack or it could occur multiple times such as with repeated assaults. If you’ve experienced an individual trauma, you may feel that you don’t have the support in your community that is provided when larger, group traumas happen. It can be difficult for many individual survivors to disclose what has happened to them and you may feel isolated, shameful, or secretive about what happened to you if there is no validation or comfort available to you.

Group

Group trauma refers to types of traumatic experiences that affect specific, small groups of people. This type of trauma affects groups such as first responders, firefighters, emergency medical personnel, commercial fishing crews, and military service members. Group trauma survivors are more likely to experience repeated trauma and tend to only discuss the trauma experiences with other members of their group.

Group survivors have great influence over other group members. They may encourage others to repress their traumatic experiences or discourage other members from seeking help if there is a sense of fear that the group may be shamed. Members may also discourage help-seeking if they believe that acknowledging the trauma will mean having to manage the repressed feelings that could surface. In other instances, groups can create a strong, supportive environment that can help members handle multiple traumas, aid in making adjustments over time, manage traumatic stress symptoms, and address mental and substance use disorders.

Historical

Historical, or generational, traumas are those that directly affect specific cultures and may indirectly affect the generations that follow. Examples of historical trauma include enslavement of African Americans, the forced assimilation of American Indians, the extermination of Jews during World War II, and genocide in Rwanda.

Historical trauma can lead to a loss of cultural knowledge, language,and identity. Additionally, it is associated with a reduced sense of well-being, depression, grief, traumatic stress, domestic violence, and substance abuse.

Mass

Mass traumas affect a large number of people and can be natural or human-caused events. This type of traumatic event may result in significant loss for individuals and communities. Examples of mass trauma include tsunamis, nuclear reactor meltdowns, earthquakes, and mass shootings. This form of trauma often challenges the available resources of the affected communities and makes it difficult to respond in a timely way. Mass traumas often result in chain reactions in which one trauma can lead to another. Following the initial destruction of a mass traumatic event, such as a hurricane, people may have difficulty meeting basic needs of receiving food, water, shelter, and safety as they are displaced from homes. In mass traumas it may seem as though you are no sooner trying to adapt to one trauma when another traumatic event occurs.

Mass traumas can create a sense of community and decrease the sense of isolation that occurs with individual trauma. People often feel more confident asking for help because others around them are getting help too.

Interpersonal

Interpersonal traumas are those that occur between people. Interpersonal trauma commonly happens between people who know each other such as partners or families and includes physical abuse, sexual abuse and assault, domestic violence, elder abuse, and teen dating violence.

Political Terror and War

Terrorism is a human-caused type of trauma with a goal of creating uncertainty and fear within communities. Terrorism leads to fear around the unpredictable nature of terrorist acts, increased security, and intensified suspicion about groups of people or cultures. War threatens the health, well-being, and livelihoods of communities.

Refugee Experiences

Refugees are people fleeing their homelands because they have experienced fear and persecution there. They may be differentiated from immigrants who choose to leave their homes in search of new prospects for themselves or their families. Refugees may have been exposed to torture; witnessed deaths due to execution, starvation, or beatings; and experienced imprisonment, fear, loss of property, separation and/or loss of family members. Following their migration out of their homelands, refugees may also experience difficulty assimilating and adjusting to their new environments in their host country, feel socially isolated, and experience traumatic stress. Communities that are receptive and provide social support with culturally responsive services may help alleviate the development of mental illness and substance use disorders among refugees.

System-Oriented Trauma and Re-traumatization

System-oriented trauma and re-traumatization occurs when treatment settings, service providers, or agencies recreate a traumatic experience for individuals, sometimes without realizing they are doing it. System-oriented traumatization might occur if staff is unaware of a client’s traumatic history, an agency fails to screen for trauma history prior to treatment, providers discount or minimize reports of abuse, or if agencies impose strict policies and rules without allowing clients to respond or question them.

Providers who plan for the risk of re-traumatization by creating trauma-informed policies and procedures and responding sensitively to traumatized clients and their histories can achieve more positive outcomes with the people they serve.

Resilience

There are a number of qualities that can encourage resilience, the ability to adapt to adversity, among trauma survivors including having strong family bonds, having a spiritual or religious practice, valuing friendships, utilizing humor and creativity, helping others, creating routine, and maintaining certain belief systems. Learning and building resilience can help you in your journey toward overcoming trauma.

If you have experienced trauma, how have you adapted in healthy ways? How were you able to build your resilience? What helped you recover along the way? If you’re a provider, how do you provide trauma informed services that are sensitive to the needs of survivors to prevent re-traumatization?

Reference

Substance Abuse and Mental Health Services Administration. (2014). Trauma-informed care in behavioral health services. Treatment Improvement Protocol (TIP) Series 57. Chapter 2. Rockville, MD: Substance Abuse and Mental Health Services Administration.

Leslie Morgan Steiner Describes Her Experience with Domestic Violence in this TEDTalk

October is Domestic Violence Awareness Month. Here is a 2013 TEDTalk by Leslie Morgan Steiner on her experience as a domestic violence victim and survivor. She encourages everyone to “talk about what you heard here, abuse thrives only in silence. You have the power to end domestic violence simply by shining a spotlight on it.” She encourages everyone to recognize the signs of abuse and to talk about it with their children, coworkers, friends and family. She asks her listeners to create a different view of survivors as “wonderful, lovable people with full futures” and not blame them for the abusive situations they’re in.