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Cognitive-Behavioural Interventions with Victims of Abuse

April 4, 2011

Last week, I outlined how cognitive-behavioural theory (CBT) explains aggression, particularly in the context of intimate relationships. In today’s blog, I’ll discuss how CBT can be used with victims of relationship abuse.

Thoughts and Behaviours in Victims of Partner Abuse

Over the course of an abusive relationship a perpetrator will use both physical and non-physical forms of abuse to blame and control their victims. The effects of these forms of abuse is reflected in their thoughts, emotions, and behaviours. They begin to doubt their own worth (thoughts), feel depressed and anxious (emotions), and either become abusive themselves, or withdraw from the relationship and the world entirely (behaviours).

A common phenomenon in victims of abuse is their engagement in a process that many therapists, and clients, have referred to as  “crazy-making.” This occurs when the victim begins to doubt their own sanity and blame themselves – not the abuser – for the abuse in their relationship. “You made me do it!!” is a common phrase uttered by abusers. Over time, victims hear this statement so often that it becomes internalized; it becomes truth. They start doubting their own sanity and entertain the idea of whether or not they have an actual mental illness. “He (she) wouldn’t hit me if it wasn’t my fault. I must have done something wrong.” “There must be something wrong with me. Why else would he (she) be so mad and hit me?” These thoughts and self-talk eventually lead to false beliefs about oneself. It leads to “crazy-making.

Steven Gilligan (1997) uses a concept known as alien thoughts to describe how a victim will adopt thoughts and beliefs that have been ‘planted’ in their heads by an external source (i.e., the abuser). Over time these thoughts lead to what he calls negative sponsorship, whereby the victim no longer feels like himself or herself, but as someone else. The perpetrator’s thoughts are so ingrained into the victim that they begin to lose sight of who they truly are (Gilligan, 1997).

Changing Thoughts and Behaviours

An important step for ridding oneself of negative sponsorship is to identify the self-talk that perpetuates false beliefs about who is responsible for the abuse. The first step in this process is to think of a specific abusive incident and the comments and accusations made by the abusing partner. Next, think of some of the negative things you may have said to yourself as a result of what was happening. Were these thoughts influenced by what the perpetrator was telling you? Did you agree with what the abuser was saying? These are important questions for differentiating between thoughts that are true and congruent with how you see yourself versus how the abuser wants you to see yourself.

The next step is to reflect on how your feelings (emotions) have been impacted by your thoughts. For example, are you feeling depressed, anxious, tired, or unmotivated? Now look at how your behaviours might have been influenced by your feelings and thoughts. For example, sleep is a behaviour that is commonly affected by our thoughts and feelings. Victims of abuse experience depression, which in turn affects their sleep patterns. How has your sleep been affected by the abuse in your relationship?

The most important piece to recognize in all of this, according to CBT, is that the perceptions and thoughts we have about our relationships and ourselves greatly influences how we feel, and ultimately, how we behave. Challenging and changing our thoughts, therefore, will lead to new ways of feeling and behaving in our relationships.

Hoping your week, and relationships, are filled with much knowledge and growth….

Dr. Richard Amaral
www.richardamaral.com

References

Gilligan, S. (1997). The courage to love: Principles and practices of self-relations psychotherapy. New York: W. W. Norton & Company.

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