This document discusses emotional abuse and provides guidance for identifying it. Emotional abuse can be difficult to detect as there are no physical scars. However, some signs are a "haggard" look, confusion, anger without a clear cause, reluctance to communicate with their partner, atypical depression or anxiety without a clear reason, and a lost sense of self. The abuser often blames the abused for problems and does not see their own abusive behaviors as a fault. Therapy is focused on the abused person's problems. Suggestions are provided for helping emotionally abused clients leave abusive situations if they choose and for developing coping skills to deal with the abuse.

1. You don’t have to hit to hurt….
Weapon of Choice Project
Richard Johnson
hurtwords.com

3. If this was your client, your altruism and compassion
would be triggered by the visible affects of physical
abuse….

4. What if the
abuse is not
physical?
What if they’ve
learned to hide
it?
(“I’m okay.”)
What if
they’re
confused?
What if
they don’t
know
they’re
being
abused?

5. Some who are emotionally abused present as
incongruent. It can be as simple as a “haggard” look
that is not accompanied by anything that gives a
visible or clear indication of why that person is fearful,
confused, angry, apprehensive, etcetera…. There are
no scars.

6. Sadness, frustration, confusion….
With experience
you can easily
recognize the
emotionally abused
client because
there’s something
perceptibly visible
in their
appearance. The
diagnostic
interview will
explain their
emotionally
defeated
demeanor.

7. Comorbidity
The purpose of this
presentation is to
point out emotional
or qualitative (e.g.,
typical thoughts or
thought patterns)
characteristics of
this population so
that we may better
identify and serve
them.

8. What is “Crazy Glue”?
The Betrayal Bond by Patrick J. Carnes, Ph.D., CAS
Stockholm Syndrome: A deep, inexplicable bond with someone who has
continually distressed or critically hurt the client. This phenomenon is
caused when the abused person feels/holds a strong bond to their abuser.
This abuse can be physical, psychological, emotional, verbal, or any
combination of these. Regardless, the abused person develops a sense of
compassion and loyalty to their abusers. There is a tendency to see a lack
of abuse or the honeymoon periods between abuse as kindness or as proof
of their abuser’s humanity.
A “trauma” or “betrayal” bond develops when there are continually intense,
traumatic experiences or betrayals of trust taking place between intermittent
periods of reconciliation. Much like physical abuse, these cycles form an
intense and abusive relationship/bond with the perpetrator where emotional
manipulation or hypercriticism are acceptable forms of communication.

9. A key characteristic for both the clinician and the
abused is confusion. “If he’s such a great guy or
she’s such a good wife, why are clients
experiencing problems?”
• The Abused experiences….
• Confusion and/or is easily confused.
• Anger, frustration, or irritation without being able to give a
plausible reason/cause.
• Reluctance to communicate with their partner, so it
seems like they’re the ‘stonewaller’. This person is
actually trying not to get caught in the turning of tables
that often happens with emotionally manipulative
arguments because the fault is ‘magically’ (frustratingly)
placed back on them.
• e.g., Couple is longer arguing about the original point, which
is sometimes the abused person’s perception of being hurt
or abused.

10. • Atypical depression because of being confused
about why there are problems. This is a different
kind of mental exhaustion.
• The “defeated” look.
• Atypical anxiety because they don’t know why
they’re anxious.
• Being with their partner/spouse is oddly
disconcerting/dissonant (e.g., wanting to be with them but
walking on eggshells).
• Anxious to be understood (i.e., as safe, loving, caring).
• Unspoken fear because they cannot mentally/physically
justify or explain why they’re fearful.

11. • A ‘lost’ sense of self:
• The abused has spent a significant amount of time trying to
figure out their partner and has forgotten about their own
wants, needs, habits, etc.
• Can’t see/understand what’s wrong in the relationship but
knows “something” is wrong.
• PTMSD = posttraumatic marital stress disorder

12. The Abuser
• Scapegoating: Angry at person abused for
EVERYTHING. All problems seem to be the
abused person’s fault or responsibility.
• Abuser may be arrogant. Also note angry
arrogance may manifest when the abuser realizes
that you as therapist aren’t buying into his/her
dysfunctional line of reasoning.
• Does not see his/her abusive/manipulative
tendencies as a fault. It’s “helping” or
“misunderstanding ” his/her actions. However, can
easily point out abused person’s faults to the point
that the abused him/herself can rattle of “the list”
by rote memory.

13. • Well practiced in twisting the story to fit the
abuser’s justification.
• e.g., “When you come in I hear you fussing at the kids
to clean. You never give me a chance to parent!” Well,
he has to be in the home first to hear her come in so
why didn’t he use the time before she was there to
parent? Why wait until she comes home to show
action?
• Secret controller; Dr. Jekyll/Mr. Hyde
• To act out public would be rude and could blemish how
people “see” the abuser.
• Prince charming in public; Devil’s advocate in private or
with others seen as a threat. The latter may be
especially prevalent if the outside person perceived as
forming an allegiance with the abused.

14. • Personality traits/characteristics may reflect:
• Personality disorder, NOS
• Narcissistic disorder
• Antisocial disorder
• Abuse may actually be cover for:
• Insecurity
• Low self-esteem
• Anger issues
• F.O.O./‘Generational curses/cycles’

15. Clue #1: Relationship Dynamics
• Control/Coercion?
• Manipulation?
• Verbally abuses spouse/partner and/or children?
• Abused kept from family and friends?
• Abuser easily/randomly insulted/offended by innocent statements?
• Abuser pouts or has sudden outbursts of anger that are
disproportionate to the circumstances?
• Abuser often behaves coercively or becomes overly jealous?
• Abuser easily angry when spouse/partner wants/needs to spend
time away?
• Abuser destroys personal property or sentimental items?
• Abuser controls spending and makes spouse/partner accountable
for money spent? (This is not reciprocated.)
• Abuser uses insinuated threats, intimidation, or manipulation for
control?
• Abuser often humiliates spouse/partner in front of others? (…in jest)
• Abuser turns minor incidents into major arguments?
• Abuser refuses affection and sympathy, or implies weakness when
spouse/partner feels hurt or in need or nurture?
• Abuses pets?

16. Clue #2: Therapy Dynamics
• In therapy because it’s the abused person’s “fault”.
• Therapy needed because of the abused person’s “problems”.
• The abuser is often a “hostile” witness.
• Relationship has cycles of break ups or separation. Both are equally at fault for
renewing this dysfunctional relationship cycle. The abused because they’ve
often left impulsively. The abuser may leave because the abused
leaving/rejection has injured the abuser’s psyche.
• In therapy the abuser is unusually cool (over confident) or has sporadic anger
outbursts (low frustration tolerance). Visibly runs warm and cold.
• The abused isn’t afraid of the abuser but doesn’t like abuser either.
• The abused doesn’t trust abuser but can’t tell you why.
• Abused feels “crazy” because they’re caught in trying to solve a problem that
doesn’t exist or a situation that’s been manipulated to look like they’re the cause
(gas lighting/“not your crutches” confusion).
• Abused caught in the abuse cycle and cannot give an exact reason why they
should leave but they want to leave nevertheless.
• The abuser is not confused AT ALL. No responsibility taken for their
dysfunctional behavior and if you’d just “fix” the abused person to listen and do
whatever the abuser says, everything would be MUCH better. Again, he/she may
even appear confident or cocky.

17. Questions to ask…
• Examine both for self-esteem deficits that can be amended or
restructured….
• Examine F.O.O. for a history of dysfunction both know to be
“comfortable” or familiar….
• Do either have history of abuse that has been normalized?
• How far is the abuser psychologically enmeshed in the abused
person’s psyche?
• Who is speaking when the abused speaks? e.g., “Tom told me I
was making too much of him yelling at me.”
• Does one/both come from an “abusive” home?
• Note: Don’t use the term abuse because each may not consider
their childhood normal despite outside reactions that it was not.
Abuser may even justify the abuse of their past as necessary for
making them the “good/great” person that they currently are.

18. Should I stay or go? Can I “fix” this?
• Despite the abused person’s complaints many are in a position, as
with any abusive controlling relationship, where they cannot easily
leave. Also remember, the abused person cannot connect
disparaging feelings to any tangible reason/cause for leaving.
Therefore many are convinced that things will work out. Despite
multiple attempts to leave, the cycle, and professional opinions, they
stay bound by crazy glue.
• Community resources for those in imminent danger (Escape Plan):
For those ready to leave, an emergency plan should be developed, just as if
person was in a physically abusive relationship. Emotional/verbal abuse can
be the gateway for physical violence. Actually leaving can be the catalyst
that triggers violent acts in addition to emotional abuse.
• Abused may need coping skills to deal with the abuser’s behaviors
while they are beginning to transition to independence or leaving.
• Caveat for the person who willingly chooses to stay without
requiring change within their own paradigm or requiring change from
the abuser. They should no longer complain about something they
willingly and knowingly accept or allow.
• Of course if the abuser TRULY chooses to change, this is also an
option (Possible & rare).

19. We’re still talking
about abuse. It
becomes insidious
because it’s
intangible. Have
you ever considered
you can’t file a
protective order for
emotional abuse?

20. Suggested Reading
• The Betrayal Bond: Breaking Free of Exploitive Relationships by Patrick
Carnes
• Why Does He Do That?: Inside the Minds of Angry and Controlling Men by
Lundy Bancroft
• The Gaslight Effect: How to Spot and Survive the Hidden Manipulation
Others Use to Control Your Life by Robin Stern
• Too Good to Leave, Too Bad to Stay: A Step-by-Step Guide to Help You
Decide Whether to Stay In or Get Out of Your Relationship by Mira
Kirshenbaum
• The Emotionally Destructive Relationship: Seeing It, Stopping It, Surviving It
by Leslie Vernick
• The Emotionally Abused Woman: Overcoming Destructive Patterns and
Reclaiming Yourself by Beverly Engel
• Not to People Like Us - Hidden Abuse In Upscale Marriages by Susan
Weitzman

21. Journal Articles
• Foa, E. B., Cascardi, M., Zoellner, L. A., & Feeny, N. C. (2000). Psychological and
environmental factors associated with partner violence. Trauma, Violence, & Abuse,
1(1), 67-91.
• Gavin, H. (2011). Sticks and stones may break my bones: The effects of emotional
abuse. Journal of Aggression, Maltreatment, & Trauma, 20, 503-529.
• Haeseler, L. A. (2013). Women’s coping experiences in the spectrum of domestic
violence abuse. Journal of Evidence-Based Social Work, 10, 33-43.
• Lachkar, Joan (2000). Emotional abuse of high-functioning professional women: A
psychodynamic perspective. Journal of Emotional Abuse, 2(1), 73-91.
• Sackett, L. A. & Saunders, D. G. (1999). The impact of different forms of psychological
abuse on battered women. Violence and Victims, 14(1), 1-13.
• Sims, C. L. (2008). Psychological victimization and maltreatment. Journal of Emotional
Abuse, 8 (4), 375-402.
• Queen, J. and Brackley, M.H. (2009). Being emotionally abused: A phenomenological
study of adult women’s experiences of emotionally abusive intimate Partner
Relationships. Issues in Mental Health Nursing, 30, 237-245.

22. Sticks & stones will break my bones;
mean words can also hurt me.
Proverbs 15:1