Domestic Violence and Post Traumatic Stress Disorder

Published on November 28, 2016 by Dr. NavNirat Nibber

This weekend marked the International Day for the Elimination of Violence Against Women. I was intriguied to learn more after watching a particularly poignant PSA from an actress who is a survivor of domestic violence. It is difficult to imagine how in 2016 this issue still affects so many individuals, and yet it does. It doesn't take much effort to find reputable statistics regarding the prevalence of this social issue. It is reported that half of all women have “experienced at least one incident of physical or sexual violence since the age of 16.” The sheer magnitude of this issue left us compelled to learn more about who this affects and HOW it affects them.

It is important to note that domestic violence can happen to anyone and identification of “risk factors” does not condemn an individual to violent relationships, just as having no risk factors does not preclude an individual from them. All victims of violence deserve empathy and as a community we should ensure they have a safe and supportive environment. Avoiding any form of victim-blaming or victim-shaming should be at the forefront of every individual's mind when approaching this topic.

In a previous blog post, Delrae Fawcett, a clinical health psychologist helped us understand how post traumatic stress disorder (PTSD) develops, what can trigger episodes, and new therapies. She spoke largely to PTSD associated with war veterans, but explained that any traumatic experience can elicit this maladaptive response. Individuals can become “caught inside the events experienced during the trauma” and responding to triggers irrespective of the presence of a threat. A number of factors can impact the development of PTSD as it does not occur in all victims of spousal, intimate partner, or domestic abuse. In fact, it is estimated that 30% of domestic abuse survivors will develop PTSD. Therefore, studying how these factors can increase or decrease the risk of a domestic abuse victims in developing PTSD may help tailor tools and therapies for these individuals, making treatment and recovery more effective and sustainable.

An individual’s attachment style has been correlated with risk for developing PTSD after abuse from a partner. Attachment style refers to a theory where children develop internal models, beliefs, and expectations about relationships and whether they are “worthy of care and attention.”Attachment types range from anxious, secure, ambivalent; to avoidant, anxiety, and dependency. For example, “secure” attachment style reports a belief that the person is worthy of being loved and describe their relationships as positive and trusting. "Anxious" attachment is described by someone's insecurity in their romantic relationships, these individuals often self report negative emotions and experiences in regards to their relationships. Clinical researchers found that the fear of ending an abusive relationship was understandably exacerbated and resulted in an increased likelihood of developing PTSD even after the traumatic incident(s). This also further reinforces these anxious attachment core beliefs; perhaps explaining why therapies that address and work to remodel these core beliefs, such as cognitive behavioural therapy, can provide some sustainable support for those suffering from PTSD.

Maladaptive trauma-related guilt (TRG) is another example of a response that has specifically been linked to the development of PTSD in domestic violence survivors. Women who have experienced spousal abuse often report overwhelming feelings of guilt. This guilt often motivates an individual to stay with their abuser and can persist even after they are no longer in the abusive relationship. This guilt can drive them to avoidance behaviours which often prevents them from fully processing the traumatic experience and beginning the healing process. This is the reason that individuals who suffer from TRG are susceptible to PTSD. Knowing this information can help us develop and promote therapies for the unique population of abuse victims. Cognitive Trauma Therapy (CTT) offers a hopeful approach to rationalising and healing this guilt, thereby reducing the symptoms associated with PTSD. 

Understanding the psychology of how individuals respond to trauma is valuable but “treatment” simply starts with empathy, compassion, and kindness. If you or anyone you know is the victim of domestic abuse please reach out, seek help, and know that you are not alone.

References:

Family Violence in Canada: A statistical profile, 2013, Table 4.2. Available at: http://www.statcan.gc.ca/pub/85-002-x/2014001/article/14114/tbl/tbl42-eng.htm

Carolyn B. Allard, Sonya B. Norman, Steven R. Thorp, Kendall C. Browne, and Murray B. Stein

Mid-Treatment Reduction in Trauma-Related Guilt Predicts PTSD and Functioning Following Cognitive Trauma Therapy for Survivors of Intimate Partner Violence J Interpers Violence 0886260516636068, first published on March 10, 2016 doi:10.1177/0886260516636068

Scott, Shelby, and Julia C. Babcock. “Attachment as a Moderator Between Intimate Partner Violence and PTSD Symptoms.” Journal of family violence 25.1 (2010): 1–9. PMC. Web. 29 Nov. 2016.

The Canadian Women's Foundation. http://www.canadianwomen.org/f...