Helping Domestic Abuse Victims During Quarantine

• Clinical Challenges in Domestic Violence
• Pandemic-Related Challenges
• Therapeutic Planning

In a time when most Americans have been asked to stay home in an attempt to control the spread of the novel coronavirus, many domestic abuse victims are finding themselves trapped with their emotional, sexual, financial or physical abusers. Distance is the primary strategy for many victims of domestic violence. For them, shelter-at-home means no shelter at all. They cannot leave home to go to jobs, to work out at gyms, visit friends or family, attend regular therapy sessions or join support groups.

During this pandemic, most therapists are adjusting to online therapy and all the challenges it presents. Many client populations lend themselves well to telehealth options. One that doesn’t is victims who are stuck at home in abusive relationships. Confidentiality and privacy are challenging when someone lives with an abuser. But services for those stuck at home in volatile environments are essential. Finding a private place at home or in their car to participate in online therapy is only one of the many difficulties in providing help to those isolated with their abusers.

Clinical Challenges in Domestic Violence

As a therapist, one of the most challenging populations for me to work with has been victims of domestic violence. I still remember the client I treated in a psychiatric hospital 37 years ago. She’d agreed to inpatient treatment for her depression and severe PTSD and to an escape plan, only to leave the hospital AMA and be picked up curbside by her abuser.

I was young and idealistic. I could not understand how this was possible after all our work together.

I now know that domestic abuse is an extremely complicated dynamic. One complication is that those close to a victim, as well as the victim themselves, often minimize the abuse and blame the victim for what is happening. Their friends and family are unlikely to know the extent of the abuse, and the few who may are so tired of hearing the same old story that they begin to blame the victim for not leaving. “If you’re not going to do anything about it, quit talking about it,” I often hear victims report their friends and family having said to them. This only adds to the guilt and feelings of worthlessness. Victims then feel more alone and emotionally dependent on their abuser. Worse still, it can lead to a victim’s not talking about the abuse all together.

Another challenging aspect of domestic violence is that the abuser often holds a past mistake or shortcoming over the victim’s head. This past error or genetic weakness (i.e., “Your family is full of deadbeats”) is often embarrassing and leads the victim to doubt their own worthiness. Often, an abuser will convince a victim that no one else will ever love them and life with the abuser, however painful, is as good as the victim can hope for or deserves. If the victim feels guilty or indebted, escape is even more unlikely.

Many abuse victims have been raised in abusive childhood homes where belonging, food, clothing and shelter were inextricably interwoven with emotional, verbal, sexual and physical abuse. Many of these childhood norms and assumptions retreat to the unconscious. They may never have been revisited, questioned or replaced with more healthy internal models of "family.” If an abuse victim was told repeatedly throughout their childhood, “I do this because I love you,” the confusion of that message may not even be in their awareness. Part of effective therapy with abuse victims is examining these toxic, yet impactful, childhood messages.

Victims of abuse who have children at home are truly in a double bind. Staying in the volatile environment is damaging to children, but leaving often presents even scarier situations. If they leave and divorce, the odds are, with a couple parenting classes, an anger management course, a few monitored visitations and an expensive attorney, their children will be spending half the time with the abuser without supervision. Just the thought of their children being unprotected with an abusive parent can keep many victims immobilized. Supportive education and legal representation can help mitigate some of these terrifying possibilities.

Another disturbed and disturbing aspect of these toxic relationships that keeps friends and sometimes therapists and law enforcement from intervening is that after a well-intentioned person assists the victim in getting away, the recently escaped is highly likely to return to the abuser. After this occurs, both the victim and the abuser turn on the helper as a way of re-establishing the bond in the abusive relationship. This can leave those who have sacrificed time, emotions and finances feeling used and resentful. Many friends and family members of abuse victims distance themselves from the person who needs them most, because they are just exhausted and discouraged.

It is important that as therapists, we try to remember that the victim is not staying in the relationship because they like the abuse. They are staying in the relationship for the upside (extended family, the “honeymoon” phase after a fight, the generosity, the flattery, the social community, the hope of a better future and stability for the kids), not for the downside. Many abuse victims are enticed by the kindness shown them after an abusive episode. They believe if the abuser can be nice for a short period, it may be in them to really change and show long-term kindness in the relationship. Victims often believe they can influence the abuser into this state of kindness permanently. They hope that if they accommodate enough, provide adequate logic, apologize sufficiently, and anticipate the wants and needs of the abuser, then they will be able to have the emotional safety and generosity they have only experienced periodically. In chasing this idealized fantasy, victims find themselves trying to take responsibility for the actions and emotions of their abusers.

Assisting a client in learning that they can survive, even thrive, without the upside of the abusive relationship will go further than continuously trying to get them to view the painful aspects of their circumstances. They are aware of the pain in the relationship. What they need to know is they can create or replace the good parts of the relationship.

Therapists who are working with abuse victims must focus first on immediate safety. This is not always easy to determine, as abuse victims often know the keywords that would trigger a mandated report. At times, I have called colleagues or even the attorneys through my professional organizations and professional liability company to ask questions about what is reportable and what would be breaking client privilege. These parameters are different in each state, and it is important to stay current with reporting laws. If I must make a report, I always tell a client that I am going to, why I must, and what they might expect from social service and law enforcement.

If the victim is not in immediate danger and nothing has recently happened that a therapist needs to report, the therapeutic focus then needs to be on increasing self-confidence and self-trust and creating a plan of safety for the victim.

While developing self-confidence, a sense of efficacy and self-worth are important parts of treatment, these may take time. One way for a victim to work on these is to establish relationships with other survivors. This may include reading others’ stories online or in books, feeling a sense of community by following social media dedicated to domestic violence, or joining web-based support groups for domestic abuse victims. Knowing that they are not alone and that others have found ways out are essential parts of treatment for victims. Reading that others have found ways of forgiving themselves for things that were held over their heads, or have learned that they are not worthless even though their heritage or pasts were not perfect, are emotional doors to freedom.

While building a support system and gathering other victims’ success stories, a therapist can help a victim develop practical plans. Strategizing is an important aspect of leaving, but also of staying safe before they leave. Plans can cover emergency shelter, food, money, and safety for themselves and their children.

Pandemic-Related Challenges

While providing treatment to victims of domestic violence is always challenging, the current pandemic exacerbates treatment issues. Not only are victims trapped in a confined space with their abusers, but financial issues, job loss, social isolation, loss of access to outlets like sports or hobbies, and an unpredictable future can increase the acting out behavior of an abuser who already does not possess good strategies for coping with stress. When important aspects of life are actually out of control, people who blame others for their emotions and behaviors are less equipped to problem-solve in healthy ways. Abusers who feel this loss of control may actually become more volatile and hostile.

Victims also have fewer options during this pandemic. They have fewer job choices, fewer treatment options and more financial and social restrictions. They may fear that domestic violence calls will not be a priority for law enforcement and the courts will not issue restraining orders. The choices for alternative residences with children may seem impossible. With so much uncertainty and schools and businesses closed to in-person contact, victims may feel hopeless to change their unsafe situations.

A client whom I am treating during this pandemic (details have been changed) must meet for our video therapy sessions locked in his car to keep his partner from listening through a closed door in the house. He and his partner have been together for five years. When my client’s partner found out the venue and caterer would not refund the money for their upcoming wedding after shelter-in-place orders made the event impossible, the partner became enraged, broke valuables in their home and threatened their dog. The partner blamed my client for the financial hit and took his anger and feelings of loss of control out on my client. My client was raised in a household where he was beaten and eventually thrown out due to his sexual orientation. His fears of abandonment and history of violence added to his tolerance of his current abusive situation. My client quit his job six months ago to help his partner start a new business, a business that is not viable in the current climate. He has tried to leave several times; after the most recent time, his partner promised to change and proposed marriage. Now with no job, all finances gone, isolation from friends, and a family that offers no safe haven, my client feels trapped and hopeless.

The following list contains strategies I use when working with domestic violence victims during the COVID-19 crisis.

Therapeutic Planning

I have found the following to be highly effective when planning with my clients impacted by domestic violence.

1. Seek shelter with someone else. If possible and safe, find an excuse to stay with another close family member or friend. Maybe they need help working from home or with their children or pets. Maybe the neighbor’s dog needs to go for a walk. Maybe your kids need a playdate with another child. Maybe you need to take food to someone who cannot cook for themselves. Find a reason to get out, at least for a while.

2. Stay prepared. Hide an extra car key, jacket, credit card and walking shoes. Keep your phone charged. If things escalate, you need a way to leave. Planning is essential because when you are under pressure with adrenaline pumping through your brain, you may not be able to think as clearly.

3. Avoid escalating things with your abuser. Many arguments escalate faster (and may become violent more quickly) when you try to explain yourself. Let your abuser believe false things about you, i.e., “You always…,” “You never…,” “You think that…,” “You didn’t keep your word about…,” “I always give you…” “I do everything for you, you don’t…,” etc. Let them view you incorrectly, at least for the time you are stuck at home. Note: If your abuser has ever been violent, or you think they may become violent, this is not a suggestion to allow or put up with harm. If you are in danger, leave the situation and/or seek help from someone you trust as soon as you judge it safe to do so.

4. Don’t try to resolve this fight. Remember that this won’t be your last fight. Often abusers rope victims into arguments threatening that “this is your last chance, or…” You will most likely have this argument again. If they threaten to leave or divorce, remember they will probably say it again in the future. This will not be the last argument. Allow the tension to not be resolved. Do not chase them to “understand” you or your perspective.

5. Reach out to people you can trust. Tell people who care about you. This is the time to reach out to those who love you. If you don’t have trusted friends or family, call the National Domestic Violence Hotline at 1-800-799-7233. If your abuser forbids you to continue therapy with your current provider, there are other therapists offering phone or video sessions during this crisis. Some counselors are even offering discounted therapy sessions during the pandemic. If for any reason you can’t continue therapy with your current provider, search for a trustworthy therapist here. If you feel suicidal or have thoughts of hurting yourself, call the National Suicide Prevention Lifeline at 800-273-8255, call 911, or go to a local emergency department for help.

6. Practice self-care. Take care of your emotions. Switch activities up if your abuser clamps down on one or two. Exercise, listen to music, play video games, go for walks/bike rides, garden, do creative projects, or join online groups. Your feelings are legitimate. You are not overreacting. Pour your emotions into a healthy activity.

7. Avoid being trapped. Try not to be stuck in a car with your abuser. Try to avoid confined places where you cannot leave. Make excuses to get away or take separate cars. Call 911 if you feel in danger.

8. Don’t let your abuser pull you back into an argument. When you stop responding in an argument, don’t get pulled back in by “See, you don’t care, you’re just walking away,” “There you go giving up on us,” “Come back here, I’m not done talking to you,” or “See, you’re not interested in resolving this!” Walk away anyway. Don’t explain why. Remember that you can tell your therapist about this in your next session. You don’t have to process it with your abuser.

9. Remember the abuse is not your fault. Remember that an abuser isn’t abusive because they don’t understand you or the facts, they are abusive because of who they are. And no matter what you do or don’t do, say or don’t say, you can’t change them. This is extremely difficult; it may seem like you caused their anger and are responsible for it, but you didn’t and you aren’t.

10. Get help if you feel threatened. Go to a neighbor’s home or call 911 if you feel threatened. There are many domestic violence safe houses that can pick you up and keep you safe from your abuser and help you with legal issues like restraining orders. Many have accommodations for children as well.

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Let your clients know they deserve to be compassionate to themselves even if they feel they are not making progress fast enough. Remind them that they did not cause anyone to treat them in an abusive way. They are never to blame for someone else’s behavior. They deserve respect, no matter how they have reacted in the past. As their counselor, you can model this and help build their sense of self-worth in therapy.

As a therapist, you have a unique role. In that role, you may be able to demonstrate compassion and kindness the victim has never experienced before. Even if you feel disappointed that the victim has once again returned to their abuser, demonstrate that you believe they will eventually leave and that you are there to support them on their journey. Don’t be discouraged. The seeds you plant may grow to fruition long after your client has discontinued therapy with you.
 

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