A 2006 survey of American households revealed that nearly 30% of children, many of whom are very young, live in homes where there is some form of intimate partner/domestic violence. Children and adolescents who witness or experience trauma, including domestic violence, display increases in stress hormones comparable to those displayed in combat veterans. This research finding makes sense from the perspective that these children and adolescents are living in a virtual war zone! Children and adolescents may experience long term effects from chronic exposure to domestic violence which may include: impaired academic performance; reduced levels of motor and social skills; behavior problems; substance abuse; self-harming behaviors; changes in brain physiology and function; and emotional difficulties including depression, anxiety disorders and post-traumatic stress disorder.
 
Many times the question that people ask is, “Why doesn’t she just leave?”  By the time the family reaches the point where this question is being asked, the family is deeply entrenched in the cycle of violence and abuse.  The mother and children are living in a constant state of fear and anxiety and they are dominated by responses of flight, fight or freeze.  The neurobiological impact of trauma and the emotional, cognitive and behavioral adaptations that the family makes impacts their ability to makes decisions, develop safety and exit plans, and to fundamentally believe in their own ability to find safety.  The ability “to leave” is profoundly trumped by the need “to survive”.  

The coping strategies that families develop may help them survive the abuse and violence in their lives and those strategies will often go on to create patterns that wreak havoc on the rest of their lives.  

On June 1st, at my workshop at the Institute entitled, “The Impact of Domestic Violence on Children and Families,” we will identify maladaptive coping strategies that families develop to manage their reactions to abuse and violence. We will identify interventions that reinforce positive and nurturing parenting skills and explore stress reduction strategies to address the neurobiological, emotional, somatic, and cognitive aspects of traumatic stress they have experienced.  We will focus on enhancing self-regulation skills and skills that support social and peer group competence.  We will focus on collaborating with families in their healing from domestic violence by supporting secure attachment between children/adolescents and their non-abusive parent as we enhance their safety and stability.

Our counter-transferential responses can legitimately range from frustration and anger to fear, anxiety, confusion and self-doubt.  What starts out as an inquiry about the client’s issues can often morph into a questioning of why WE can’t get them to see the light, leave a bad relationship and get on with their lives.  The clients who “sometimes” see the light- before it grows dim again- can be even more challenging!  They nod their heads in agreement during the session, write down the resources and homework assignments, practice asserting themselves in role plays with you, and leave sessions stoked and inspired to make a difference in their lives.  Then they come back the next week, reporting that either they’ve changed their minds because “things are good again” or they never integrated the concept of the relationship being troubled or abusive once they left your parking lot.

Obviously, in situations of domestic violence where our clients or their children are fundamentally unsafe, we need to educate, cheerlead, connect our clients to resources, make a report to the appropriate authorities, if necessary.  But even in these cases, clients often go back to the abuser, forgive the alcoholic, cancel the restraining order, give the serial cheating boyfriend or girlfriend “one more chance.”  And our counter-transference intensifies!  These are some of the most difficult cases and they require a special amount of self-awareness and self-care in the clinician.  We have to work hard to not give up on them, not pass judgment, and not take it personally when our clients choose to stay in these kinds of relationships.  We have to re-double our efforts at psycho-education: exploring the dynamics of co-dependency, the re-enactment of family-of-origin trauma or neglect, the insidiousness of emotional abuse, the lure of the “honeymoon phase,” the power of learned helplessness, the definition of “healthy” love and intimacy.  This work takes time, patience, good boundaries, unconditional positive regard and solid ego-strength on the part of the clinician.  When all is said and done, I hold out hope that the healing power of the therapeutic alliance and the ways in which it can model safety, trust, emotional intimacy and healthy communication will win out in the end!

As clinicians we have a difficult task ahead of us. It is unclear how this story will play out in the media and the courtroom. How vocal and articulate will Sandusky’s supporters be? How much “blaming the victim” will be woven into the story? Will his attorneys attempt to distort the truth, downplaying the seriousness of his offenses or the long-term adverse effects on his victims? Will Sandusky take any responsibility for his actions or be held sufficiently accountable in a court of law? And what will be the short and long-term effects on our clients?

As is often the case, I find myself confronted with the reality that there are many things that happen in this world that are not within our control. And there are some things that are- including the meaning we choose to attach to events, the extent to which we learn and grow from them, and what we do with them once they have occurred.

I encourage my colleagues to use this very difficult event as an opportunity to continue educating both clients and the community at large about the dynamics of abuse and victimization. Focus on the innocence of children and the need to proactively protect them from predators. Let it be known that “looking the other way” makes you an accessory, and is an unacceptable and unconscionable response. Challenge the media when they use the word “relationship” to describe “rape.” Empower survivors of sexual abuse to find the courage to share their experiences, ending generational cycles of secrecy and denial. Educate anyone who downplays the severity of what was done to these children. Keep the discussion alive- it not only validates experiences, it gives survivors a voice and communicates to them that we care, deeply, about their pain and believe, deeply, in their capacity to transcend it and heal.

–Maryann Cox, MSW

–Joan Kristall, LCSW-C

–Vivian Morgan, LCPC

–Laura Greer, LCSW-C

–Angela Fowler Hurtado, LICSW

– Maryann Cox, MSW

His understanding jives with my experience of things, not only as someone for whom the onset of winter brings the challenge of Seasonal Affective Disorder (SAD), but also as a trainer of clinicians and a promoter of best practices in treatment approaches for it. It is the frame of our seeing SAD as a ‘normal reaction to an abnormal situation, a natural reaction to an unnatural environment’.

The bottom line is that the mammalian part of us humans are not really built for the current lifestyle we Westerners enjoy; one in which we are cut off from the natural environment and cycles of nature, in what we eat, how much we sleep, what we touch, our limited body movements and amount of sunlight exposure. So many of us are much too sedentary, in temperature controlled, windowless or tinted or even sealed window spaces, staring at computer and other media screens for too many hours. We spend much of our daily life in constantly lighted environments regardless of the time of day or night. Our demands ask for us to keep the same daily and sleep schedule year round, as if our bodies were oblivious to the shifts of daylight hours and seasons through the year. Additionally, our brains are being shouted at more and more from attention seeking sensory stimulating electronic sources than by the more passive and subtle features of the natural environment they were first wired for. These factors, along with the 24/7 media barrage of news and traumatic events and images from the four corners of the globe–as if these events were going down in our front yard–keeps our brains bathed in adrenaline and cortisol, the stimulants that readies the nervous system for dangers, real or imagined, in freeze, flight or fight mode.

The positive side of this holistic perspective is that it informs us, in constructive ways, as to what is needed to maintain our well-being. And for those of us who treat these conditions, it helps us develop an affirming, helpful, multi-dimensional framework for the treatment of our clients coming to us for help with these issues.

Howard Reznick, LCSW-C is currently one of the producer-editors of ifIknew.org, a youth oriented prevention education video and blog site addressing contemporary health issues. A therapist and trainer the past 30 some years, Howard will be leading an upcoming workshop titled; “Ain’t No Cure for the Wintertime Blues?“