Most people, upon hearing the word “abuse,” think of physical violence. However, there are several types of abuse and among those, emotional abuse is the most prevalent kind, and yet it is the least talked about. At the same time, signs of emotional abuse can be more difficult to notice, as well; and for the person who is suffering such an atrocity may not even be aware of the situation being toxic and abusive. In most cases, emotional abuse doesn’t appear to be severe, however the effects can be both intense and long lasting.
What is Emotional Abuse?
Emotional abuse involves a person trying to emotionally control and holding power over another by means of criticism, embarrassment, isolation, shaming, blaming, or manipulating the victim in different ways. It can happen in both close and impersonal relationships. In most cases, the abuser is the victim’s significant other, i.e their partner. However, the abuser can also be the victim’s:
Business partner or colleague
Relative or close family member
Such abusers tend to maintain a persistent pattern of behaviour that deteriorates a person’s sense of self esteem, self confidence and mental well being, as well as they make the victim doubt their perceptions of reality. The victim ends up feeling suffocated and trapped, and feeling too hurt and drained to continue being in the relationship. However, they also find it difficult to leave as they are afraid to do so. This kind of abuse sets up a toxic dynamic where the victim feels that they have wronged; they blame themselves for the bad relationship and try to work hard to improve or “fix” their relationship and the person that they are with.
Types of Emotional Abuse
Emotional abuse has many types and can take a number of vicious forms. They are as follows:
Verbal Abuse: This involves yelling, insulting, and hurling curses at the victim
Gaslighting: This involves manipulation of truth to make the victim doubt their own feelings, thoughts and sanity
Isolation: Abusers limit the victim’s contact with other family or friends, and restrict their mobility and movement. They might not let the victim go out and do the things that they normally do. This symptom overlaps with those of social abuse.
Humiliation and degradation: This involves name-calling, public embarrassment or humiliation, and telling the victim that they’re stupid and blaming them for all the toxicity in the relationship
Rejection: Abusers tend to entirely reject all the ideas, thoughts and opinions of the victim
Intimidation: Abusers will make the victim feel afraid, fearful and threatened. They’ll purposefully say things that hurt the victim.
Financial Abuse: This may involve stealing or withholding the victim’s finances, and not letting the victim work or be productive. This is a form of domestic violence.
Impacts of Emotional Abuse
Not only the most underreported and most common form of abuse, emotional abuse is categorized by the most debilitating and harrowing experiences that have the most long lasting effects. The reason is that emotional abuse is difficult to identify both for someone who is suffering from it and an outsider who’s trying to help. This kind of abuse cuts to the core of the victim and attacks their sentiments, thoughts, sanity and their very being. The wounds inflicted by emotional abusers take a long time to heal. The constant manipulation, isolation, false accusations and allegations, criticisms and verbal abuse wear away the victim’s sense of self brutally. The victim begins to believe everything that the abuser says at one point. They begin to blame themselves for everything and believe that they can never be good enough for anyone. They fall into a deep, dark pit of self-doubt, self-loathing, worthlessness and hopelessness.
It also impacts a person’s social life and wellbeing as they become much more withdrawn than they were earlier due to the isolation and manipulation tactics of the abuser. They thus become distant from their friends and family.
Emotional abuse also leads to a lot of mental and physical health complications as well, such as depression, anxiety disorders, heart palpitations, insomnia, stomach ulcers and eating disorders.
Tips on How to Deal with Emotional Abuse
Once a person has recognized that they are being emotionally abused, it is time to take action and finally find the way out of the abusive situation. Confronting and acknowledging what you’re experiencing for what it is helps the victim to take back the control of their lives. Following are a few steps on how to do the same:
Prioritizing Your Mental and Physical Health:
Recognize the fact that your mental and physical health are of prime importance no matter which situation you are in. Remember, the “I” is important. Prioritize yourself over pleasing the person who’s trying to manipulate and control you. The abusers generally tend to tamper with the victim’s sense of sympathy and make them neglect their own well being to take care of the abuser. So, put a stop on this unhealthy cycle and break the pattern. Eat enough healthy meals and a well balanced diet, give yourself enough time to relax during the day and spend time with your friends and family, no matter what your abuser says.
Take a firm stand and tell the person who is emotionally abusing you to stop manipulating you, stop calling you names, stop being rude to you and stop overly criticizing you. Let them know what will happen if they do not put an end to their abusive behaviour; this may mean that you’ll have to cut your ties with this person and end your relationship with them.
Seek Professional Help:
It is important to reach out for long term professional help in the form of therapy, support groups, and healthy friendships and relationships to help strengthen your sense of self and help you recover. Remember that you are not alone.
Work on an exit plan with those that you love and rely upon, and take action when the time is right. Now that you have recognized that you are in an abusive situation, you must maintain a plan on how to get yourself out of that dynamic. Discuss your thoughts with a trusted friend, family member, counsellor or therapist. At the same time, make sure that you give yourself enough time and space to heal from the long term effects of emotional abuse.
“My daughter has been taking handfuls of over-the-counter painkillers and has been cutting herself,” my friend blurted out to me as she and I were in the middle of our ski trip.
I instantly felt a rush of sadness, empathy, and concern. I immediately went right into my “doctor mode ” & began asking questions about her childhood. How frequently she cuts herself, her past and current relationships, her hobbies, and whether these intentional overdoses are linked to suicidal ideations.
“She never takes enough pills to have her stomach pumped; but she knows just how much Ibuprofen she needs to elicit a trip to the emergency room. Her therapist believes she is acting out because she felt that she was abandoned as a child. There has also been mention of borderline personality disorder. “
I immediately homed in on the mention of borderline personality. Individuals who have borderline personality disorder are 55-85% more likely to engage in self-harm behaviors.
Shedding light on self-harm behavior
I had a roommate in college who engaged in cutting, and I have seen this a lot in my adolescent patient population. But for whatever reason, cutting and other self-injury behaviors are not commonly discussed within the media, on college campuses, or in high school classrooms. Parents are shocked when they discover their son or daughter is engaging in these behaviors.
Approximately 14 percent of adolescents are estimated to engage in self-harm behaviors. Clinically referred to as non-suicidal self-injury; self-harm is the act of physically inflicting pain on oneself without the intention of dying. Cutting is the form of self-injury that is portrayed most often in the media .
Using physical pain to express emotions
Individuals will use sharp objects to carve into their skin (most commonly in the legs, arms, and stomach) to elicit feelings of physical pain as an unhealthy coping mechanism to relieve feelings of guilt, internal pain, shame, anxiety, and worthlessness. This physical pain induces a sense of calmness and relief and, for some, even a rush of euphoria. This instant gratification and sense of relief are quickly replaced by feelings of guilt and shame, perpetuating the vicious cycle of the urge to self-harm once again. In a sense, self-harm is similar to addiction.
This behavior can be fueled in part by drugs and alcohol ; which are also unhealthy coping mechanisms to numb internal pain. As a result, a substance use disorder can go hand-in-hand with self-harm behavior.
The link between suicide and self-injury
As a parent, watching your child engage in self-harm behavior can be one of the most gut-wrenching and frustrating experiences. Most parents do not understand why their child is drawn to this behavior. They worry that their child can be severely harmed from their physical injuries or, even worse, take their own lives.
Although self-harm behaviors can indeed result in complications such as nerve damage and wound infections, they do not always coincide with suicidal ideation. However, research shows that individuals who engage in self-harm behavior have an increased risk of suicidal ideations and suicidal attempts in the future.
According to an article in the journal PLOS ONE, “among those with a history of NSSI, 70% have attempted suicide at least once and 55% several times. The risk of death by suicide is highest during the first six months after an NSSI episode and tends to fall later on.”
Because of the increased risk for suicide attempts within this six-month window, individuals must seek professional treatment immediately to prevent suicidal ideations. Unfortunately, most individuals who engage in self-harm behaviors are teenagers and adolescents, and access to care for these age groups is quite difficult (50% do not seek help at all, and only 20% ask for medical treatment).
So how can you, as a parent, help your teenage or adolescent child who is struggling with self-injury behaviors?
Remain calm, stay connected with your son or daughter, and offer any support you can. It is important not to judge or place any blame . This can result in unwanted harmful feelings that can lead them to continue to engage in self-harm behaviors.
Educate yourself on self-harm behaviors and get yourself and your adolescent into therapy to discuss underlying triggers and treatment strategies. Self-harm behaviors may be related to low self-esteem, borderline personality disorder, eating disorders, past trauma, poor parental attachment, emotional neglect, or abandonment. Finding the right therapist can be a trial-and-error process, and it may take meeting with a few different therapists before you can find the right “fit.” Having a strong therapeutic alliance is the highest predictor of success rates for mental health and substance use disorders.
Remember, this is not your fault. Parents tend to blame themselves for anything that goes sideways with their child. Individuals with borderline personalities are more likely to engage in self-harm behavior; and these individuals can be very manipulative when it comes to interpersonal relationships, sometimes blaming the parents for what they are going through. Self-harm behavior, whether it goes hand in hand with borderline personality disorder or develops due to other underlying triggers, is not caused by one factor. There are usually multiple underlying reasons for this type of behavior in your son or daughter.
Be patient. Treatment takes time, and underlying triggers must be treated before recovery. There are no medications or magic potions that can make this behavior go away. Therapy may take weeks to months before there is any improvement. The ultimate goal is for your child to find healthy coping mechanisms . To deal with their internal triggers and stop engaging in self-harm behaviors; however, the immediate goal is to keep your child safe and out of harm’s way.
March is Self-Injury Awareness Month. It is dedicated to educating the public and raising awareness about self-harm while supporting those who are affected by it.
Other times, I look at my scars and see something else. A girl who was trying to cope with something horrible that she should never have had to live through . My scars show pain and suffering, but they also show my will to survive. They’re part of my history that’ll always be there.
Whether you saw it it coming or didn’t, the feeling is the same: You’re devastated. You gasp at your vulnerability and wonder, “Why did this happen?”
Life dishes up so many hardships: heartbreak, illness, injury, death, abandonment. Though we may share similar experiences, every hurt is personal. No matter how many times well-meaning people say, “We understand,” they don’t. You may even resent them for trying.
As a psychotherapist, I’ve sat with many wounded people. I witness their pain and do my best to make space for it. Even when they cry out, “Why did this happen?” I try not to engage in reactive comforting. Advice or quick answers always feel false, even insulting, when someone is deeply hurt.
Suffering as a Teacher
After nearly 25 years practicing psychotherapy, this is what I’ve learned: When you’re viciously knocked down by life, don’t get right back up. Like tripping and falling, you have the impulse to rise and start moving again. But ignoring a serious injury will make it worse. Pain demands attention; it needs to acknowledged and embraced before you can move on.
When I met Amanda, she had just suffered one of the worst wounds: the death of her young child. For weeks, in individual sessions, she sat in silence, detached and stoic. “Tears won’t bring my daughter back,” she said flatly, as she carried on working at finance job that she resented and avoided her grief.
When I asked her to attend one of my adult groups, she scoffed, “Pointless.” But, with a little prodding, she agreed. “I’ll do it for you,” she sighed, “But it’s a waste of time.”
During her first group session, when asked why she was in therapy, she exhaled and replied, “My daughter…she…my daughter….”
Suddenly Amanda couldn’t speak. She couldn’t find words. She struggled to swallow her grief and choke down her tears.
“It was a mistake to come here. Sorry.”
When she stood up and gathered her belongs to leave, an intuitive woman reached out and said, warmly,
“I lost a child too.”
Suddenly Amanda fell back into her seat and let her tears flow. She cried long and hard, gasping for air as the group made room for her pain. In the weeks that followed, she looked forward to group sessions. Slowly, with the group’s help, she realized that the best way to honor her daughter was to find a new way to embrace life.
What to Do After You’ve Been Emotionally Hurt
I count myself among the heartbroken. I have nursed the dying, lost loved ones, suffered heartbreak. I have cried alone on the street, in my office, sometimes with friends and family, sometimes with patients. I tried to dodge heartache but, like everyone, it eventually found me. It’s one of life’s cruel certainties.
How to Support Your Healing Process
1. Honor Your Pain
Avoidance of pain increases it. To heal, you must pass through the doorway of grief. Emotional wounds are beyond “sadness”; they’re felt in the depths of your being. Honor your pain; don’t run from it. Unplug, put time aside to reflect, and give yourself permission to grieve. If well-meaning people push you to “Get over it,” ignore them. Time and patience are key to recovery. Surround yourself with friends who understand that.
2. Reach Out
Being alone is part of healing, but long periods of isolation are unhealthy. Deep pain always brings out personal demons, such as blaming yourself, embracing victimhood, or bitterness. Such choices breed entrapment, not freedom. Reach out to friends, find support groups or twelve-step programs, seek comfort in prayer, meditation, or philosophy—whatever brings you peace of mind. Instead of longing for a miracle, create one.
3. Take a Break
It’s important to take a break from your pain, and engage in healthy compartmentalization. Everyone finds relief in different ways. Some find it creative activities such as writing, reading, music, art, or movies. Others find it in movement such as dance, hiking, long walks, etc. Choose a task that allows you to escape by stepping into another reality, even if it’s only for a few moments. Don’t fret: Your pain will be waiting for you when you get back, but you’ll be better fortified, rested, and ready to face it.
4. Learn from It
I’ve heard it said that the road to wisdom is paved with suffering. Reflecting, exploring, and pondering, without self-attack or blame, opens you up to greater understanding and compassion for yourself and others. An attitude of learning will help you unearth value in the experience. You may also discover a curious new freedom: Recovering from an emotional trauma or heartbreak makes you stronger, wiser, and more resilient.
5. Move On
Some people allow suffering to define them, shape them and, ultimately, rob of them of living. Many years ago, I was invited to attend a wedding between two widows in their 90’s. Every person who attended was deeply moved, not by the service, but by the spirit of the couple to keep living. After you give yourself time to grieve and mourn, after you reach out to others for support and make space for your recovery, you have to make a decision: Will you allow emotional pain hold you back or will you decide to use it to propel you in a new direction?
Years after finishing her group therapy, Amanda phoned to update me on her life. She left her bank job and acquired a degree in early childhoodeducation. She was working at the elementary school that her daughter was to attend before she died. When I asked Amanda how she was feeling, she replied simply, “I still miss her. But I have so many children to care for now. I like to imagine that my daughter, wherever she is, is very proud of her mom.”
We often hear the term “depression” thrown around lightly in conversation. We may come home from a stressful day at work and tell our family at dinner that we are depressed. We may have received some bad news about a loved one and tell ourselves that we are depressed. And sure, we may be depressed, but often we are confusing sadness with depression. Sadness is a symptom of depression, and because we associate these together, we often struggle to differentiate between these two common psychological states.
This creates a significant problem.
The inability to differentiate between sadness and depression can lead us to neglect a severe psychological condition (depression) and overreact to a normal emotional state (sadness). If we overuse the term depression when we are describing our emotional state of sadness, we are simplifying a major mental health disorder. Depression is a serious mental health disorder that has vast implications on our personal lives, professional lives, and society as a whole. As of 2017, 300 million people around the world have depression.
What is sadness ?
Sadness is a normal emotion that is triggered by a specific adverse event or bad experience. In other words, we become sad about something specific. This emotional state dissipates after some time or after something good, replaces the hurtful event that triggered the initial sadness. Sadness is temporary. We may feel sad for a moment, an hour, or even a couple of days. Every individual will experience sadness, probably more than once, in his/her lifetime. You may become sad because you ended a romantic relationship, or you did not do well on an exam, or you spent the night fighting with a friend. We can often find some relief from our sadness by crying, venting, or talking about our situation.
What is depression?
Depression is a mental health disorder, an abnormal mental and emotional state, which affects how we think and feel about everything. Depression leaks into every aspect of our life, and when we are depressed, we feel numb or sad about everything. Everything in our life is less enjoyable, less interesting, and less important. The things we once loved and were passionate about no longer bring us meaning or purpose. Depression, unlike sadness, does not have to have a specific underlying trigger. Individuals are often depressed “for no specific reason.” On the surface, they may seem like they have their life together. A great job, a loving family, a beautiful home, but in reality, they are hiding their emotions behind a mask. They may be barely able to get out of bed in the morning. They may be struggling with their relationships. They may be lonely. They may no longer find satisfaction or purpose in their job. Depression makes us less patient and quick to anger. Unfortunately, many individuals assume that one can snap out of their depression. They misinterpret that depression is not a choice or a state of mind. Depression is a mental illness.
Signs and symptoms of Depression
To be formally diagnosed with major depressive disorder (MDD) an individual must experience a depressed mood or loss of interest or pleasure in almost all activities for at least two weeks as well as at least five other symptoms including the following:
Change in sleep: Either difficulty falling asleep or sleeping too much.
A decrease in energy or feelings of fatigue daily.
Change in appetite or weight: Gaining weight, losing weight, overeating or eating much less.
Sadness (depressed mood) is just one symptom of depression.
Treating sadness versus treating depression
Sadness can be overcome within time. You can express your emotions, “cry it out”, go out with friends, or spend time outdoors. Expressing sadness over the loss of a loved one may take some time, but you can still find happiness in other aspects of your life. Engage yourself more with these happy aspects.
Depression is best treated with a combination of medications and psychotherapy. The most common medications used to treat depression are selective serotonin reuptake inhibitors (SSRIs). All medications, including SSRIs, come with side effects, and therefore it is essential to have a conversation with your healthcare professional before starting this treatment. Cognitive Behavioral Therapy is the mainstay psychotherapy approach in treating depression. Treatment for depression does not happen overnight; this is a process and can take some time, and different treatment approaches. Depression is a prevalent mental illness, and many treatments benefit most individuals.
Depression is a mood disorder that involves a persistent feeling of sadness and loss of interest. It is different from the mood fluctuations that people regularly experience as a part of life. Major life events, such as bereavement or the loss of a job, can lead to depression. However, doctors only consider feelings of grief to be part of depression if they persist. Depression is an ongoing problem, not a passing one. It consists of episodes during which the symptoms last for at least 2 weeks. Depression can last for several weeks, months, or years.
Reduced interest or pleasure in activities once enjoyed.
A loss of sexual desire.
Changes in appetite.
Unintentional weight loss or gain.
Sleeping too much or too little.
Agitation, restlessness, and pacing up and down.
Slowed movement and speech.
Fatigue or loss of energy.
Difficulty thinking, concentrating, or making decisions.
The medical community does not fully understand the causes of depression. There are many possible causes, and sometimes, various factors combine to trigger symptoms.
Factors that are likely to play a role include:
Changes in the brain’s neurotransmitter levels.
Psychological and social factors.
Additional conditions,such as bipolar disorder.
Depression is treatable, and managing symptoms usually involves three components:
Support: This can range from discussing practical solutions and possible causes to educating family members.
Drug treatment: A doctor may prescribe antidepressants.
Psychotherapy: Psychological, or talking, therapies for depression include CBT, interpersonal psychotherapy, and problem-solving treatment, among others.
For some forms of depression, psychotherapy is usually the first-line treatment, while some people respond better to a combination of psychotherapy and medications.
CBT and interpersonal psychotherapy are the two main types of psychotherapy for depression. A person may have CBT in individual sessions with a therapist, in groups, over the telephone, or online.
Interpersonal therapy aims to help people identify:
Emotional problems that affect relationships and communication.
How these issues also affect their mood.
How all of this may be changed.
Aerobic exercise raises endorphin levels and stimulates the neurotransmitter norepinephrine, which is linked with mood. This may help relieve mild depression.
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If you love someone who struggles with a mood disorder, chances are you’re often confused or challenged as to how to best help.
One of the first things to know is that friends and family members can be a lifeline for someone who lives with depression. And second, that, there are many things you can do to help.
Tips for Supporting a Loved One
1) Listen Compassionately: One of the most important things you can do is just listen to your loved one. Ask how they’re feeling, but don’t force them to talk if they aren’t interested. When they do share, allow conversations to flow in an easy and open way. Don’t tell them how to feel better or what to do to feel better. A good way to be a great listener is to know that the word listen contains the same letters as the world silent. And great listeners are quiet. They listen to hear what the other is experiencing. They listen to offer support. After you listen to your loved one, ask what things you can do to help them when they’re feeling depressed.
2) Understanding Depression: It’s also important for you to understand the illness of depression, its symptoms, course, and treatments. This will help you understand your loved one better. It will also help you know if your loved one is improving in a timely way, if they need different treatment, or require more assistance.
3) Supporting Their Treatment: One critical area of support for loved ones with depression is helping them maintain their treatment plan. This includes taking medications as prescribed, seeing healthcare practitioners as recommended, and seeking additional support as necessary. You may need to be the person to remind your loved one to take medication every day. You may also help by setting up and/or taking them to healthcare appointments.
4) Help with Day-to-Day Living: Often, people with depression have difficulty with some of the basics of day-to-day living. If severe enough, depression can leave a loved one completely immobilized, unmotivated and unable to do many of life’s simplest tasks. During these times, a person with depression will need support in ordinary activities. You may need to encourage them to shower, to eat, or to get some fresh air. And sometimes people might need help going to the grocery store, cleaning the house and paying bills.
5) Supporting Regular Activities: Try to encourage your loved one to maintain the activities he or she regularly does when they’re not depressed. Be it work, school or socializing. Don’t force them to do things if they aren’t ready, but do try to help them stay involved in their lives.
6) Recognizing Warning Signs forSuicide: It’s important to know that people with depression are more likely to attempt suicide or die by suicide. Take any comments about not wanting to wake up, wishing to die, never feeling any more pain or you’ll be better without me as requiring immediate attention. So, too, is the giving away of items, feeling suddenly better and other suicide warning signs.