It is generally acknowledged that survivors of abuse benefit greatly from learning about abuse, it not only helps them recognize abuse for what it is, but tackles the feelings of isolation that are so common. With this in mind I am publishing some of a college paper on theories and types of abuse. Learning that others acknowledge what happened, or is happening, as abuse can be an incredibly powerful experience. As can understanding the wider context within which abuse occurs. 

Whilst this may be an academic paper, I know from my own personal experience that this is how some people best manage their healing and recovery, but do wish readers to be aware that you do not need to know, or understand theory to be able to heal. 

In order to discuss the theoretical aspects of abuse we first need to determine a working definition of abuse. According to the The Social Care Institute for Excellence, the body with a remit for the care of vulnerable adults;

Abuse is about the misuse of the power and control that one person has over another. In determining whether or not abuse has taken place, it is important to remember that intent is not the issue.The definition of abuse is based not on whether the perpetrator intended harm to be caused but rather on whether harm was caused, and on the impact of the harm (or risk of harm) on the individual.Failing to act to prevent harm being caused to a person you have responsibility for, or acting in a way that results in harm to a person who legitimately relies on you, both constitute abuse.                                               SCIE website 30/12/2014

It is important to be aware, however, that what is designated abusive carries a large cultural element. Practices in one culture may be considered abusive by another.

There is considerable variation in values and norms from society to society and these values and norms vary over time, thus further blurring the boundaries between abuse and normal parenting. For example in the United States it would be not be unusual to find a social worker arguing that if a family situation is such that a mother shares a bed with her three young children, this is evidence of a neglectful environment. Among parents in the United States the normative sleeping arrangement for children is that they have their own beds. However among the Kung it would be thought unimaginable and even abusive if a parent were to put an infant into a bed and put the child to sleep in a dark, seperate room.  (Gelles, Lancaster 1987)

Korbin (1981) tried to reconcile the need for cross cultural understanding of abuse with the need to be aware of practices which may be considered culturally acceptable but are in fact harmful. They were discussing child abuse specifically but their definition can be extended to other forms of abuse, for example the difference between forced and arranged marriages.

Three definitions have been suggested for culturally informed definition of child Maltreatment.1. Cultural practices that are viewed as abusive or neglectful by other cultures, but not by the culture in question; 2.Idiosyncratic departure from one’s cultural continuum of acceptable behaviour.;3.Societally induced harm to children beyond the control of their individual parents and caretakers.  (Korbin 1981)

Female genital mutilation is an example of the first, where an act that is considered good parenting within one culture is deemed to be always abusive by another, to the extent that the UK has specific legislation now aimed at FGM and those who practice it.

Arranged marriage however is not seen as abusive, and within those cultures that practice it, forced marriage is also deemed to be abusive. A tension may develop though, between cultural norms such as respect for elders and parents, and an individuals desire to choose their own sexual and romantic partners. Whilst this tension may lead to them seeking therapy, it is not considered of itself to be abusive. As therapists, an understanding of different cultural norms and values is vital if we are not to deem actions abusive based merely on our own background and traditions.

Abuse can take a number of forms, and in the next section I shall briefly list the most common ones. It must be understood that abuse rarely limits itself to one discrete box, and that one form of abuse is often accompanied by other forms,

Physical Abuse.

Physical abuse is defined by the SCIE as;

The use of force which results in pain or injury or a change in a person’s natural physical state.

                                                              SCIE website 30/12/2014

It may be considered the most obvious form of abuse, however victims may attempt to cover up or explain away the extent of their injuries. It is important for practitioners to notice things such as clothing which covers arms, legs and neck, body language which may hide things such as bruised ribs or inconsistent explanations of injuries. Within much research on domestic violence, drug and alcohol misuse are often associated with physical abuse. However, it is no longer believed that physical abuse is more or less prevalent in lower socioeconomic groups. What has been found is that stressors such as poverty, job loss or birth of a child may be associated with physical abuse.

Emotional and Psychological abuse

These two forms of abuse are often difficult to separate. Emotional abuse may include threats, deprivation of contact, shouting, ignoring, cruelty, bullying, humiliation, coercion and undermining self-esteem. Psychological abuse may be more subtle, such as an undermining of confidence, control of dress, who the victim is able to associate with, or isolation from social networks. The abuser may seek to make themselves indispensable to the victim by undermining them psychologically and emotionally. This has come to be known as coercive control when it is between adult partners.

This is because coercive control targets a victim’s autonomy, equality, liberty, social supports and dignity in ways that compromise the capacity for independent, self-interested decision making vital to escape and effective resistance to abuse.       Stark (2012)

Sexual Abuse.

Unwanted sexual contact, of any nature, is considered to be sexual abuse. However, children and vulnerable adults are deemed to be unable to consent. Therefore sexual abuse does not rest solely on the victim saying the sexual contact is unwanted, but on society’s view of whether they are able to consent.

 

Financial Abuse

Financial abuse may be accompanied by other forms of abuse, such as coercive control, where an abuser controls all of the finances in a household or may be the theft of money from vulnerable adults. Adult children can also be the victims of financial abuse, where their parents control their income. This is a particular issue if they are vulnerable by reason of disability.

Institutional Abuse.

According to the SCIE;

Institutional abuse is the mistreatment, abuse or neglect of an adult at risk by a regime or individuals. It can take place within settings and services that adults at risk live in or use, and it violates the person’s dignity, resulting in a lack of respect for their human rights.

Institutional abuse occurs when the routines, systems and regimes of an institution result in poor or inadequate standards of care and poor practice. It can take the form of an organisation failing to respond to or address examples of poor practice brought to their attention.                               SCIE website 30/12/2014

Whilst this definition is for adults institutional abuse can also apply to children. Currently Institutional abuse is making headlines as stories such as the North Wales Care homes scandal are being discussed. It is clear that some institutions are deliberately abusive and have a culture which actively aided abusers. In other cases the abuse may be by neglect or omission. A number of investigations into old peoples’ homes have shown this kind of abuse by omission. This links to the early discussion of societal norms and abuse, since for many cultures the northern European practice of putting elders into residential care homes is of itself neglectful and abusive.

Self-Harm.

According the the MIND website self-harm is;

Self-harm is when you hurt yourself as a way of dealing with very difficult feelings, old memories, or overwhelming situations and experiences. The ways you hurt yourself can be physical, such as cutting yourself. They can also be less obvious, such as putting yourself in risky situations, or not looking after your own person.  Mind website 30/12/14

It is clear from this definition that self-harm extends beyond the classic idea of someone who cuts themselves, and can be expanded to include a number of behaviours which put someone at risk. As therapists it is important to understand the underlying motivation. Self-harm is a coping strategy that an individual has developed for themselves. Unlike other forms of abuse self-harm does not usually include another person, although it may for example in cases of risky sexual behaviour.

Since the late nineteenth century, Western society, and in particular the US, Europe and the UK have recognised certain forms of behaviour as abusive. The ASPCC was founded in 1875 and the NSPCC in 1884. As certain forms of abuse became socially unacceptable people started to study why abuse occurred, moving from a simplistic view of either evil or mental illness. Theories to explain abuse have tended to take one of two stances, either looking inward at the abuser or outward at the society and culture which enables the abuse. In the next part of this essay I shall be looking at three different theories which attempt to explain why abuse happens.

The Intergenerational Theory of Abuse is perhaps the one the layman is the most familiar with. One of its earliest proponents was Curtis, who summarised the literature which seemed to show that abusive parents produce abusive children in his paper for the AJP  Violence Begets Violence, Perhaps? (1963). In it, he sums up the idea as a form of “Monkey see, monkey do” and details a number of studies of incarcerated offenders who had been physically abused as children.

Research on this idea has continued, particularly on the idea that domestic violence and child abuse are transmitted from generation to generation. This research has also considered why those who have witnessed abuse, or suffered from abuse, go onto to create family structures where similar dysfunctions exist.

In The Cumulative Burden Borne by Offspring Whose Mothers Were Sexually Abused as Children, Noll, Trickett, Harris and Butler (2009), published a longitudinal multi-generational study which followed their cohort over 18 years. In their conclusion, they state

Results from this multi-generational study constitute convincing evidence that childhood abuse is a distal risk-factor for later physical, emotional, and psychological problems, and that the sequelae of childhood abuse can become the risks for subsequent violence against women and children.       Noll et al (2009)

Studies of Holocaust survivors have also shown that trauma can be transmitted to subsequent generations, even whilst the parents themselves are not actively abusive.  Diane Harvery (2006) wrote that;

During their childhood,children of Holocaust survivors, or the 2nd generation survivors as they have some to be known, have been the unwitting recipients of their parents’ trauma. Survivor parents have unconsciously transmitted onto their children much of their own traumas as well as investing them with their own memories and hopes.

                                                                                                 Diane Harvery (2006)

Studies on Holocaust survivors and intergenerational transmission may give us some understanding of why those who have witnessed abuse, or been abused go onto abuse themselves. Attachment may be dysfunctional or not existent, and in the works of Melanie Klein her description of the Paranoid Schizoid position, where the traumatized child splits off the good nurturing parent from the bad neglecting parent, may also help understanding.

One of the biggest problems with the intergenerational theory of abuse is that not all abused children go on to become abusers. Much of the research, necessarily, comes from those who have disclosed abuse or come into contact with social services and other forms of authority. We know very little of those who are abused but do not go onto replicate their abuse. There is some suggestion that attachment to a caregiver may mitigate, just as social and economic factors may exacerbate.

The importance of attachment was emphasized in the 2013 study by Jaffe which concluded

Safe, stable, nurturing relationships between intimate partners and between mothers and children are associated with breaking the cycle of abuse in families. Additional research is needed to determine whether these factors have a causal role in preventing the transmission of maltreatment from one generation to the next. Jaffe (2013).

 

A development of the intergenerational theory which attempts to explain why some who are survivors of abuse go on to ignore, tolerate or encourage abuse in adult was developed by Berne, and influenced by Bowlby. In a family where parentification occurs the eldest child often takes on a caregiving role as the mother withdraws, often due to their own inability to cope due to their own childhood experiences.The child, usually female, becomes the caregiver, as she matures her self concept is built upon meeting the needs of others, without meeting their her own needs, leading to emotional exhaustion.

She might then attempt to get emotional support from her child, often her eldest daughter and this daughter then begins to experience parentification. …The Incest survivor’s daughter becomes at risk of incest as the processes of parentification and marital estrangement are repeated.The survivor, experiencing an untreated traumatic neurosis, will avoid stimuli that provoke memories of their own abuse and is therefore less likely to detect or attend to the abuse of her daughter. Druker, Martsoff (2010)

Thus the intergenerational theory of abuse connects with the work of both Bowlby and Miller as they attempted to explain how abuse would be transmitted through the generations. Particularly important is the idea that maladjusted attachment in a young child not only makes one susceptible to abuse, but may cause you to abuse as an adult, as you fail to bond adequately with your own children..

The Ecological Model of Abuse attempts to consider some of the areas which the Intergenerational Model cannot fully explain, most specifically the problem of why some people with seemingly similar life experiences do, or do not, go onto abuse.

The Ecological Model is based on the idea that no single factor can explain why some people or groups are at higher risk of abuse, while others are more protected from it. This framework views abuse as the outcome of interaction among many factors at four levels—the individual, the relationship, the community, and the societal. It was first proposed by Edgar Auerswald . It was developed and elaborated on by Uri Bronfenbrenner who proposed a four-level ecological model used to illustrate the complex layers of factors found to influence and explain variations in individual behavior.

The strength of the ecological model is that it not only can be used with other models but attempts to explain why people with similar life experiences do or do not go onto abuse. The intergenerational model would fit into the first category, the microsystem, in explaining why a particular family exhibits dysfunction.The next layers, mesosystem, exosystem and macrosystem are used to explain why a particular  form of abuse is either ignored, perpetuated or even in some circumstances allowed to occur.

The ecological model of family violence prevention presented in this paper illustrates the complex interplay of individuals, family units,educational settings, health care, community, and society across the life cycle. Reilly, Gravad (2012).

Those working to identify and ameliorate abuse within society make use of the ecological model to identify at risk families. The weakness of this may be that other structural issues such as poverty, poor housing, unemployment may come to be blamed for abuse, leading to the stigmatization and othering of certain sectors within society.

Whilst the ecological model attempts to look at an individual as the result of a number of external and internal influences upon them it does not try to explain the causes of those influences. The feminist theory, or more accurately feminist theories of abuse do claim to be able to explain both the microsystem and the macrosystem, and how they lead to abuse.

Feminist theories of abuse examine differential power relationships within society and the family. They argue that the most adequate explanation of the motivation for, and incidence of, male abuse of women, whether sexual or other forms of abuse, is found in the complex interplay between existing social structures, conventional attitudes and socialisation, in particular, the differential gender socialisation of males and females in patriarchal society.

Feminist theories explain the macrostructure of society as patriarchal, a system which privileges men over women and teaches men from birth that women are subordinate and should respond to men’s needs. Abuse is a result of this belief. Many feminists, such as Dworkin, Dines and Bindel see men as inherently violent under patriarchy, and believe that all male/female relationships will reflect this.

In identifying a series of beliefs which inform all gender relationships, and calling this patriarchy, feminism has been able to explain why abuse such as domestic violence, child sexual abuse and rape cuts across all socioeconomic groups and cultural backgrounds. They would argue that all men are taught to abuse, whether implicitly or explicitly, and therefore it is to a degree only natural that they make use of their power. In a situation such as incest, a feminist theory of abuse would posit that historically men have seen their wives and children as nothing more than possessions (the original meaning of the word chattel), and thus see no reason not to act on sexual urges they may have towards their property.

Feminist theories have extended our understanding on many aspects of abuse, so now it is standard to see rape as about power rather than lust, and domestic violence as a way some men assert power and control, rather than being provoked by a nagging wife or momentarily losing control. Feminist theories challenge the victim blaming that still to some extent exists within society and has led to the founding of rape crisis centres and refuges for victims of domestic violence.

It has also led to the development of treatment programs for men who abuse, since  it believes they need to be re-educated out of patriarchal thinking, the most famous of which is probably the Duluth model.

The Duluth program takes an avowedly feminist stance to not only explain domestic violence but to tackle it by re-educating perpetrators.

Although many men experience themselves as out of control or controlled by emotional outbursts when battering, their behaviors are not without intent. They may become almost automatic, but with few exceptions each abusive act can be traced to the intent of the batterer. For example, a man may use degrading names, calling his partner a whore or slut before grabbing, shaking, or slapping her. Although he does not think, “First I’m going to objectify her, then I’m going to hit her,” objectifying his partner through degrading names allows him to hit the object he has created rather than his partner. This pattern may be so ingrained in his history and cultural experience that it seems second nature to him.

Pence, Paymar (1993).

Most batterers are informed by cultural messages justifying dominance and vigorously defend their beliefs as absolute truths with slogans such as “Someone has to be in charge,” “You can’t have two captains for one ship,” “If I don’t control my child/wife/ partner, she will control me,” “God made man first, which means he is supposed to rule woman,” or “This is my child, it is my responsibility to control him.”

Pence, Paymar (1993).

The weakness of the feminist theories of abuse is that they fail to cover women who abuse, or abuse by those outside the gender binary. By having a very rigid explanation of gender relationships, they ignore the lived experience of many. For a long time, women abused in same sex relationships and men who were abused were simply told they did not exist. Such abuse did not fit into a patriarchal explanation of abuse, and rather than looking at the theory, people were ignored and left in abusive situations without support.

Knowledge of the models mentioned, and of others, is useful for a counsellor. They increase understanding, allow for UPR and being non judgemental, and may give an insight into the pressures and stresses upon an individual. Many therapists might find  this particularly helpful when working with the perpetrators of abuse.  However, in the therapy room, theory must be pushed to one side as you work with the client, who is a living, breathing, autonomous individual and not a theory to be observed, or case to be investigated.

For a client knowledge is power, as they work to change the beliefs an abuser has passed on, or challenge abusive ideas embedded in their family, culture or wider society.