Abuse, Trauma, and Torture - Their Consequences and Effects (11 page)

The DSM-IV-TR (Diagnostic and Statistical
Manual) criteria for diagnosing PTSD are far too restrictive. PTSD
seems to also develop in the wake of verbal and emotional abuse and
in the aftermath of drawn out traumatic situations (such a nasty
divorce). Hopefully, the text will be adapted to reflect this sad
reality.

Victims of abuse in all its forms – verbal,
emotional, financial, physical, and sexual – are often
disorientated. They require not only therapy to heal their
emotional wounds, but also practical guidance and topical
education. At first, the victim is, naturally, distrustful and even
hostile. The therapist or case worker must establish confidence and
rapport painstakingly and patiently.

The therapeutic alliance requires constant
reassurance that the environment and treatment modalities chosen
are safe and supportive. This is not easy to do, partly because of
objective factors such as the fact that the records and notes of
the therapist are not confidential. The offender can force their
disclosure in a court of law simply by filing a civil lawsuit
against the survivor!

The first task is to legitimise and validate
the victim's fears. This is done by making clear to her that she is
not responsible for her abuse or guilty for what happened.
Victimisation is the abuser's fault – it is not the victim's
choice. Victims do not seek abuse – although, admittedly some of
them keep finding abusive partners and forming
relationships of
co-dependence
. Facing, reconstructing, and reframing the
traumatic experiences is a crucial and indispensable first
phase.

The therapist should present the victim with
her own ambivalence and the ambiguity of her messages – but this
ought to be done gently, non-judgementally, and without
condemnation. The more willing and able the abuse survivor is to
confront the reality of her mistreatment (and the offender), the
stronger she would feel and the less guilty.

Typically, the patient's helplessness
decreases together with her self-denial. Her self-esteem as well as
her sense of self-worth stabilise. The therapist should emphasise
the survivor's strengths and demonstrate how they can save her from
a recurrence of the abuse or help her cope with it and with her
abuser.

Education is an a important tool in this
process of recovery. The patient should be made aware of the
prevalence and nature of violence against women and stalking, their
emotional and physical effects,
warning signs
and red flags
,
legal
redresses
,
coping
strategies
, and
safety
precautions
.

The therapist or social worker should provide
the victim with lists of contacts – help organisations, law
enforcement agencies, other women in her condition, domestic
violence shelters, and victims' support groups both online and in
her neighbourhood or city. Knowledge empowers and reduces the
victim's sense of isolation and worthlessness.

Helping the survivor regain control of her
life is the over-riding goal of the entire therapeutic process.
With this aim in mind, she should be encouraged to re-establish
contact with family, friends, colleagues, and the community at
large. The importance of a tightly-knit social support network
cannot be exaggerated.

Ideally, after a period of combined tutoring,
talk therapy, and (anti-anxiety or antidepressant) medications, the
survivor will self-mobilise and emerge from the experience more
resilient and assertive and less gullible and
self-deprecating.

Return

Victim reaction to
Abuse

By Narcissists and
Psychopaths

Personality disorders are
not only all-pervasive, but also diffuse and shape-shifting. It
is taxing and emotionally harrowing to watch how a loved one
is consumed by these pernicious and largely incurable conditions.
Victims adopt varying stances and react in different ways to the
inevitable abuse involved in relationships with personality
disordered patients.

1. Malignant
Optimism

A form
of self-delusion, refusing to believe that some diseases
are untreatable. Malignant optimists see signs of
hope in every fluctuation, read meanings and patterns into
every random occurrence, utterance, or slip. These Pollyanna
defences are varieties of magical thinking.

"If only he tried hard
enough", "If he only really wanted to heal", "If only we find the
right therapy", "If only his defences were down", "There must
be something good and worthwhile under the hideous facade", "No
one can be that evil and destructive", "He must have meant it
differently" "God, or a higher being, or the spirit, or the soul is
the solution and the answer to my prayers".

From my book,
"Malignant Self Love - Narcissism
Revisited"
:

"The
narcissist and psychopath hold such thinking in barely undisguised
contempt. To them, it is a sign of weakness, the scent of prey, a
gaping vulnerability. They use and abuse this human need for
order, good, and meaning - as they use and abuse all other
human needs. Gullibility, selective blindness, malignant optimism -
these are the weapons of the beast. And the abused are hard at work
to provide it with its arsenal."

Read
"Is Your Cup Half-full or is it Half
Empty?"

2. Rescue
Fantasies

"It is true that he
is chauvinistic and that his behaviour is unacceptable
and repulsive. But all he needs is a little love and he will be
straightened out. I will rescue him from his misery and misfortune.
I will give him the love that he lacked as a child. Then his
(narcissism, psychopathy, paranoia, reclusiveness) will vanish
and we will live happily ever after."

3.
Self-flagellation

Constant feelings of guilt,
self-reproach, self-recrimination and, thus,
self-punishment.

The victim of sadists, paranoids,
narcissists, borderlines, passive-aggressives, and psychopaths
internalises the endless hectoring and humiliating criticism and
makes them her own. She begins to self-punish, to withhold, to
request approval prior to any action, to forgo her preferences and
priorities, to erase her own identity – hoping to thus avoid the
excruciating pains of her partner's destructive
analyses.

The partner is often a
willing participant in this shared psychosis. Such folie a deux can
never take place without the full collaboration of a voluntarily
subordinated victim. Such partners have a wish to be punished, to
be eroded through constant, biting criticisms, unfavourable
comparisons, veiled and not so veiled threats, acting out,
betrayals and humiliations. It makes them feel cleansed, "holy",
whole, and sacrificial.

Many of these partners, when they
realise their situation (it is very difficult to discern it from
the inside), abandon the personality disordered
partner and dismantle the relationship. Others prefer to
believe in the healing power of love. But here love is wasted
on a human shell, incapable of feeling anything but negative
emotions.

4.
Emulation

The psychiatric profession uses
the word: "epidemiology" when it describes the prevalence of
personality disorders. Are personality disorders communicable
diseases? In a way, they are.

From my book,
"Malignant Self Love - Narcissism
Revisited"
:

"Some
people adopt the role of a professional victim. Their existence and
very identity rests solely and entirely on their
victimhood. They become self-centred, devoid of empathy,
abusive, and exploitative. These victim "pros" are often more
cruel, vengeful, vitriolic, lacking in compassion and violent than
their abusers. They make a career of it.

The
affected entertain the (false) notion that they can
compartmentalize their abusive (e.g., narcissistic, or
psychopathic) behavior and direct it only at their victimizers. In
other words, they trust in their ability to segregate their conduct
and to be verbally abusive towards the abuser while civil and
compassionate with others, to act with malice where their
mentally-ill partner is concerned and with Christian charity
towards all others. They believe that they can turn on and off
their negative feelings, their abusive outbursts, their
vindictiveness and vengefulness, their blind rage, their
non-discriminating judgment.

This, of
course, is untrue. These behaviors spill over into daily
transactions with innocent neighbors, colleagues, family members,
co-workers, or customers. One cannot be partly or temporarily
vindictive and judgmental any more than one can be partly or
temporarily pregnant. To their horror, these victims discover that
they have been transmuted and transformed into their worst
nightmare: into their abusers - malevolent, vicious,
lacking empathy, egotistical, exploitative, violent and
abusive."

Return

The Three Forms of
Closure

For her traumatic wounds to heal, the victim
of abuse requires closure - one final interaction with her
tormentor in which he, hopefully, acknowledges his misbehaviour and
even tenders an apology. Fat chance. Few abusers - especially if
they are
narcissistic
-
are amenable to such weakling pleasantries. More often, the abused
are left to wallow in a poisonous stew of misery, self-pity, and
self-recrimination
.

Depending on the severity, duration, and
nature of the abuse, there are three forms of effective
closure.

Conceptual Closure

This most common variant involves a frank
dissection of the abusive relationship. The parties meet to analyze
what went wrong, to allocate blame and guilt, to derive lessons,
and to part ways cathartically cleansed. In such an exchange, a
compassionate offender (quite the oxymoron, admittedly) offers his
prey the chance to rid herself of cumulating resentment.

He also disabuses her of the notion that she,
in any way, was guilty or responsible for her maltreatment, that it
was all her fault, that she deserved to be punished, and that she
could have saved the relationship (
malignant
optimism
). With this burden gone, the victim is ready to
resume her life and to seek companionship and love
elsewhere.

Retributive Closure

When the abuse has been "gratuitous"
(
sadistic
),
repeated, and protracted, conceptual closure is not enough.
Retribution is called for, an element of vengeance, of restorative
justice and a restored balance. Recuperation hinges on punishing
the delinquent and merciless party. The penal intervention of the
Law is often therapeutic to the abused.

Some victims delude themselves into believing
that their abuser is experiencing guilt and conscience pangs (which
is
rarely the case
). They revel in his ostensible
self-inflicted torment. His sleepless nights become their sweet
revenge.

Regrettably, the victim's understandable
emotions often lead to abusive (and illegal) acts. Many of the
tormented
stalk
their erstwhile abusers and take the law into their own hands.
Abuse tends to breed
abuse
all around, in both prey and predator.

Dissociative Closure

Absent the other two forms of closure, victims
of egregious and prolonged mistreatment tend to repress their
painful memories. In extremis, they dissociate. The Dissociative
Identity Disorder (DID) - formerly known as "Multiple Personality
Disorder" - is thought to be such a reaction. The harrowing
experiences are "sliced off", tucked away, and attributed to
"another personality".

Sometimes, the victim "assimilates" his or her
tormentor, and even openly and consciously identifies with him.
This is the
narcissistic
defence. In his own anguished mind, the victim becomes omnipotent
and, therefore, invulnerable. He or she develops a False Self. The
True Self is, thus, shielded from further harm and
injury.

According to psychodynamic theories of
psychopathology, repressed content rendered unconscious is the
cause of all manner of
mental
health disorders
. The victim thus pays a
hefty
price
for avoiding and evading his or her
predicament.