The Occupational Impacts of Domestic Abuse

The perpetrator’s control, whether overt, coercive or psychological; impacts on the day to day life of the victim(s). He terrorises the vulnerable person, and the victim might be living with all sorts of restrictions such as not being allowed to go out, or only allowed to go out for specific purposes (e.g. school or work). Everything could be under the perpetrator’s control including the victim’s fashion choices, social networks, and even her diet. 

The victim might be materially dependent on the abuser, or might be coerced into materially supplying for the abuser. In extreme cases, even basic activities such as using a phone or accessing the internet might be restricted. This is because the perpetrator wants to express supreme dominance over the victim. He wants to subjugate her, and the victim might be living in chronic fear of consequences. Furthermore, the victim will most possibly become isolated, manipulated, and made to live in distress, secrecy, and horror. All of this can of course take a toll on the occupational performance of the victim. 

Individuals who are affected by domestic abuse can at times display behaviours that challenge their institution. They may take a study break in order to comply with the perpetrator’s capricious requests, or to heal actual bodily harm (ABH). They might also ask for time out in order to cope with their mental health, or to use substances as an escape route. Individuals might perform poorly in exams and assessments, might display demotivation and lack of ambition, and there is a disruption to long-term career plans.  

Furthermore, individuals affected by domestic abuse might be prevented from getting to work as a result of physical injury or restraint, might be threatened, gaslighted, and given all home-based responsibilities to stop them from going out. If the victim manages to go to work, there might be a clear deterioration in performance or jobs might be poorly done. If a manager is not engaging in trauma-informed practice, it is more likely that they will not be able to effectively safeguard a victim when she shows symptoms. The victim might not disclose the abuse, and the manager might actually exacerbate her situation with this type of subjugation. The victim might lose her job, career, and/or prospective promotions. Finally, in extreme cases a perpetrator might stalk and/or harass the victim within the workplace, and trigger conflict between the victim and her colleagues, especially if these are unaware or unsympathetic. 

Impacts on Children 

Children affected by domestic abuse find it more difficult to form secure attachments, and often show deficits in language, cognitive, emotional, and social development. This may manifest in the form of poor educational achievement, behaviour that challenges, mental health problems, and interpersonal maladaptations.  Those in puberty might behave in similar ways to their perpetrators, and engage in disruptive behaviours. They may experience truancy, and/or might attempt to protect their perpetrators. They might become isolated, and might be prevented from forming friendships. When a child is subjugated, they are prevented from exercising their freedom of thought, and from expressing their subjectivity. All this affects their psychological health, and can impair performance. 

The Complex Process of Profiling & Diagnosing Autism

According to the NHS (2019), ‘being autistic does not mean you have an illness or disease. It means your brain works in a different way from other people’. The core characteristics of autism are: (1) poor social communication; (2) poor social interaction; (3) sensory processing differences; (4) sensory sensitivity; (5) repetitive behaviours; and (6) obsessions and fixations on special interests. These characteristics can vary, and some individuals show two or three, whilst others might be more severely affected (Lincoln College, 2022). This blog post will explore these core characteristics, the unofficial subtypes of autism, and the complex process of diagnosis.

Individuals experiencing the behavioural abnormalities, will show a fixation on specific activities, tools, toys, etc. They may use these objects in particular ways. Furthermore, they may engage in repetitive behaviours such as hand flapping or spinning around, might become upset if their routine is disrupted, and will insist on maintaining consistency. Moreover, they might have unusual sensory interests, either a high or low tolerance to pain, unpredictable verbal outbursts, and might become upset at sensory intrusions. Finally, they might also engage in risky or self-injurious behaviour. 

Individuals experiencing communication difficulties might have a delayed language development, speech difficulties and/or reliance on alternative communication methods, high levels of articulation, literal interpretation of words (i.e. lack of understanding of jokes or sarcasm), problems starting and maintaining conversations, stereotyped and repetitive use of phrases, a monotonous voice tone, and poor interpretation of body language or other forms of non-verbal communication. 

Individuals experiencing social difficulties might struggle to form and sustain friendships, might show a lack of interest in social activities, might engage in inappropriate social responses, might have a lack of awareness of boundaries, might reject expressions of affection such as hugging, might prefer to role play,  and might be naive, suggestible and overly trusty of others. 

The Unofficial Subtypes of Autism

Due to current diagnostic manuals such as the DSM-V (American Psychiatric Association, 2013) and ICD-11 (World Health Organisation, 2019), individuals are generally given a diagnosis of Autism Spectrum Disorder (ASD) regardless of their profiles. Yet, there are unofficial categories used by the autistic community to understand differences better.

Individuals categorised as having Asperger’s syndrome tend to have a higher than average I.Q., and unlike other forms of autism, no speech or cognitive difficulties. However, interpersonal difficulties are prevalent for them, as they struggle to communicate and interact with others. Yet, the symptoms are invisible and difficult to spot. They may also have pathologies which affect their day to day life (Lincoln College, 2022). Asperger’s syndrome is no longer diagnosed (McCrimmon, 2018) but it is still generally seen as a subtype of autism. It is also believed that Asperger’s syndrome is a form of high-functioning autism (HFA) which according to Lincoln College (2022) entails a delay in development, an inability to read facial expressions, a hypersensitivity to light and noise, and a desire for socialisation without understanding how to effectively do it. Nevertheless, HFA is not diagnosable, although it is also recognised by autistic populations. 

Individuals categorised as having Pathological Demand Avoidance (PDA) tend to have intersubjective difficulties and to avoid the demands of everyday life. This profile is not an universally recognised form of autism by healthcare professionals, however, it is still generally used by autistic populations. According to the National Autistic Society (n.d.), an individual with this profile ‘(a) resists and avoids the ordinary demands of life; (b) uses social strategies as part of avoidance, for example, distracting, giving excuses; (c) appears sociable, but lacks some understanding; (d) experiences excessive mood swings and impulsivity; (e) appears comfortable in role play and pretence; and (f) displays obsessive behaviour that is often focused on other people’. Furthermore, Lincoln College (2022) states that these individuals have an anxiety-based desire to remain in control all the time, and can become aggressive if they feel they are not in control. They also seem to get stressed out if anything is expected of them. However, if they feel comfortable, they seem normal. 

Individuals labelled as having Kanner’s Autism also known as ‘Classic Autism’ are described as having impairments in communication, and a fixation on activities with restrictive or repetitive behaviour such as hand flapping. The criteria for this autism profile is: (1) an impairment in the use of non-verbal skills, poor eye contact, and an inability to interpret body language; (2) inability to make and maintain friendships; (3) inability to enjoy interests or share activities; (4) inability to respond appropriately to emotion in others; (5) delay in, or complete lack of language development; (6) repetitive use of language; (7) fixation on a particular interest; (8) inflexibility to change routines; and (9) repetitive physical movements (Lincoln College, 2022). However, this is not diagnosable. 

Individuals diagnosed as having atypical autism are those whose pattern of behaviour fits most but not all of the criteria for other forms of autism. It can often be undiagnosed for many years as individuals tend to be given this label later in life. 

Finally, individuals categorised as having Savant syndrome have skills which are uncommon to most people, as well as having the general characteristics of autism. Among the extraordinary abilities seen in savant autism are being able to mentally solve complex mathematical problems, having great memory for specific details of something, high quality artistic skills, and outstanding musical talent. 

Diagnosing Autism

The advantage  of diagnosing Autistic Spectrum Disorder (ASD) is that individuals and their families can find as much information as possible about the condition and engage in psychoeducation, which can foster a sense of relief. The diagnosis might help the individuals have more clarity about their difficulties, and might give them more insight into potential comorbidities or wrong diagnoses. Moreover, a personalised care plan with strategies can be devised for ongoing support in all sectors. Nevertheless, a disadvantage of diagnosis is that individuals have to live with the stigma (i.e. negative stereotyping) associated with psychiatric labels, and how the label can affect their relationships and lead to prejudice and discrimination. Furthermore, another disadvantage is that individuals might become depressed with the fact that autism has no cure. They might also experience more adverse circumstances as a result of having a diagnosed disability, and all these negative variables might lead the individual to internalise the label and to embrace the maladaptive behaviours associated with the label which shapes their identity (Lincoln College, 2022). 

Diagnosis is usually done through a person’s GP; however, a paediatrician, a speech and language therapist, an educational psychologist, and/or a specialist psychologist might also need to be involved; and sometimes this multidisciplinary approach can take years before a diagnosis is given (Lincoln College, 2022). Moreover, information for diagnosis is also gathered from relatives, teachers and friends of the individual presenting with symptoms. The individual might be observed as he or she conducts activities and skills might be tested. Furthermore, professionals working with people with autism must take on board the National Institute for Health and Care Excellence (NICE; n.d.) guidelines. These specifically state that anyone working with autism should be skilled and competent and have tactful communication skills (Lincoln College, 2022). 

There are several factors that influence the diagnosis of autism: (1) culture— behaviours classed as ‘abnormal’ by a society might bring attention and concern to others. Some countries might perceive different behaviours as ‘symptomatic’, whilst others might see the same behaviours as completely ‘normal’. Also, stigma might become a barrier to diagnosis; (2) age— even though the symptoms of autism can be spotted when the individual is 2-3 years old, many professionals refuse to make a diagnosis until later on. However, some professionals are also reluctant to diagnose adults; (3) sex— males tend to get a diagnosis of autism more than females. Some believe that this is due to how different the characteristics manifest, with girls being more able to hide the symptoms; (4) parental attitudes— some children might not get diagnosed because their parents cannot effectively spot the symptoms, or they might ignore these manifestations out of fear of being judged. Alternatively, parents might insist to the family GP that the child has a problem even if such is not the case; (5) coexisting conditions— autism often has mental and physical comorbidities, making it more difficult to pinpoint the exact cause for specific behaviours, and making diagnosis more complicated; and (6) genetic factors— autism has a genetic link that runs in families. 

Furthermore, there are also barriers to diagnosing autism such as a lack of local services for autistic people, which means that a formal diagnosis with the necessary multidisciplinary specialists is not always possible as a GP might have limited knowledge of the condition. This might subsequently lead to individuals not being diagnosed for a long time, which might prevent them from wanting a diagnosis in the future. It can also lead to individuals not having a documented developmental history, which can affect the process of diagnosis.  Moreover, another barrier to diagnosing autism is how subtle some of the symptoms can be, and how subjective the interpretation of these symptoms also is (Lincoln College, 2022).  

References

American Psychiatric Association (2013a) Diagnostic Statistical Manual of Mental Disorders, 5th ed.

Lincoln College (2022) ‘The diagnosis and characteristics of autism’, TQUK Level 3 Certificate in Understanding Autism [Online]. Available at https://lincolncollege.equal-online.com/courseplayer/autisml3/?ls=8663048&cpid=223390  (accessed 22 February 2022). 

McCrimmon, A. (2018 ‘What happened to Asperger’s syndrome?’, The Conversation, 8 March [Online]. Available at https://theconversation.com/what-happened-to-aspergers-syndrome-89836 (accessed 22 February 2022). 

National Autistic Society (n.d.) ‘PDA — a guide for parents and carers’ [Online]. Available at https://www.autism.org.uk/advice-and-guidance/topics/diagnosis/pda/parents-and-carers (accessed 22 February 2022). 

National Institute for Health and Care Excellence (n.d.) ‘Autism’ [Online]. Available at https://www.nice.org.uk/guidance/conditions-and-diseases/mental-health-and-behavioural-conditions/autism (accessed 23 February 2022). 

NHS (2019) ‘What is autism?’, 18 April [Online]. Available at https://www.nhs.uk/conditions/autism/what-is-autism/ (accessed 10 March 2022). 

World Health Organisation (2019) ‘International Classification of Diseases – 11th Revision’ [Online]. Available at https://icd.who.int/en (accessed 22 February 2022). 

Photo by Polina Kovaleva

Why People Do Not Report Domestic Abuse

There are many barriers to disclosure of domestic abuse. One reason why many individuals stay in abusive relationships and/or do not report domestic is because of their own subjective feelings such as fear of consequences if they leave the relationship (e.g. dependencies), grief which manifests as feelings loss for the relationship they wanted and/or thought they had, denial of what is actually happening to them, self-blame for the abuse they are receiving (perpetrators tend to blame the victim), shame about what others might think if they found out about the individual’s situation, and guilt over their inability to prevent or stop the abuse, as well as of others witnessing the abuse (e.g. children). Furthermore, another reason why individuals do not report domestic abuse, is that they feel that the local authorities will not take them seriously (many women do report it and perpetrators still get away with their crimes), so they experience subjective feelings of hopelessness that ‘nothing would get done anyway’. 

Another reason why people do not report domestic abuse is due to societal perceptions. The way society is known to perceive and deal with victims is awful. Individuals can experience fears that no one will believe them, or that there will be impunity. They might have no faith in justice due to personal experiences, or/and exposure to high profile cases where victims were torn apart either by the criminal justice process or by the media and tabloids. Furthermore, societal perceptions of gender mean that men will feel ashamed to disclose their experiences. Similarly, homophobic perceptions lead to LGBTQ+ individuals hiding their experiences due to their private sexual orientation. And, cultural perceptions can lead to all sorts of subjective reluctance to report domestic abuse, as individuals might be afraid of repercussions, embarrassment, or honour-based abuse. 

Apart from all of the above, there are several identifiable factors that affect the disclosure of domestic abuse. These are: 

Stereotypes

These are generalised subjective beliefs that individuals have about the world, which influence how they perceive others. Because there are so many misconceptions and false stereotypes of victims of domestic abuse, such as that they are weak, poor, and submissive women without education and living in social housing; many people might be unable to relate to this, and therefore they might find it more difficult to identify their experiences as a domestic abuse; or they might feel that no one will believe them because they do not fit the stereotype. Furthermore, since there is so much stigma associated with these misconceived stereotypes, individuals might not want to be perceived in such a way, and so might not disclose their experiences. Finally, those who do relate to the stereotype might feel that it is normal because of their circumstances to report the abuse, and might feel hesitant to disclose due to how they believe they are perceived. All these misconceptions can lead to victims isolating, and losing hope.  

Labelling

Because of the stigma associated with the word ‘victim’ (i.e. stereotypes), individuals do not want the label ‘victim’ added to their subjective identity, even if indeed they are victims. They might subsequently fear other associative labels such as ‘weak’, ‘stupid’, ‘dramatic’, ‘crazy’ or ‘bad mother’. 

Stigma

Many victims are aware of the stigma, and feelings of shame come with this. They might rather stay in that relationship than risk becoming stigmatised (e.g. men might feel that people will make fun of their masculinity for speaking up). 

Discrimination

Victims might fear that due to the current awful status of justice in our society, they will be discriminated against if they disclose their experiences of domestic abuse. They might also fear that others will attribute negative and unfair stereotypes to them, or fear that they will be excluded or marginalised as a result of their seeking support from their social network and/or community. 

Victim Blaming

Finally, because of the toll that domestic abuse has on victims, individuals experience subjective feelings of self-blame. They might already have been constantly blamed by their perpetrators and might fear that other people will also blame her.  Moreover, some cultural traditions do blame women for making decisions such as leaving an abusive relationship, and so victims might genuinely get blamed by relatives or their community if they disclose their ordeal, making it less likely that they will seek support (honour-based abuse). 

In conclusion, there are many reasons why people do not report domestic abuse, and many factors which prevent victims from disclosing their ordeals. Stereotypes and the stigma created by these is a major theme when it comes to lack of disclosure. The system at times fails victims, and the dark figure of crime is ever present.

Photo by Lucxama Sylvain from Pexels

Domestic Abuse: Situational Factors

The following common situational factors tend to contribute to the risk of domestic abuse, and tend to be elements that victims report. Some of these aspects, we already have talked about in this blog

  • When individuals are experiencing the close monitoring that comes with coercive control, there is a higher likelihood of other forms of domestic abuse occurring such as physical and economic abuse. 
  • When individuals experience adverse family circumstances where elements of financial problems, unemployment, alcohol or substance use disorder are present, there is a higher likelihood of domestic abuse occurring. 
  • When individuals are connected to adverse cultural traditions such as female genital mutilation (FGM), forced marriage, or honour-based abuse; there is a higher likelihood for other forms of domestic abuse to take place. The more patriarchal the culture, the more risks there are. 
  • When individuals are connected to adverse community circumstances such as community aggression, violence, fear of others, a distrust of authority figures (e.g. police), poor housing, low socio-economic status, low education levels, and poor access to support services and facilities; there is a higher likelihood of domestic abuse occurring and individuals might have no option to turn to in the case of domestic abuse taking place.  
  • When there are individuals who are traumatised and display behaviour that challenges such as risky behaviour, this might lead to an escalation of domestic abuse at home and other interpersonal conflict. Sadly, the risk is also increased by these situational factors.
  • When there are people who have financial constraints, they are more likely to stay stuck in an abusive environment or relationship, and more likely to depend on a perpetrator. Therefore, financial problems increase the likelihood of domestic abuse occurring. 
  • When there are individuals who are isolated from their social networks, they become more vulnerable, suggestible, and the risk of domestic abuse increases. 

DID YOU KNOW? 

When a perpetrator has a history of being domestically abusive, sadistic, and/or controlling; there is a potential for recidivism to occur. This is why since 2014, victims have a right to make a request to the police for a disclosure of any history of domestic abuse from their partner. This is to prevent the perpetrator from reoffending by giving potential victims a heads up about what could happen in their relationship, as it is known that perpetrators of domestic violence rarely change. According to the Home Office (2022), ‘The Domestic Violence Disclosure Scheme (DVDS), also known as “Clare’s Law” enables the police to disclose information to a victim or potential victim of domestic abuse about their partner’s or ex-partner’s previous abusive or violent offending’. This was implemented in 2014 across all police forces in England and Wales after 36 year old Clare Wood was murdered in 2009 (BBC News, 2014). Clare was strangled and set on fire by her obsessive exboyfriend George Appleton at Salford, and it was concluded that she received no support from the local authorities even though George had a history of violence against women (VAW; BBC News, 2011). 

References

BBC News (2011) ‘Salford murder victim Clare Wood “was not protected”’, 23 May [Online]. Available at https://www.bbc.co.uk/news/uk-england-manchester-13506721 (accessed 17 February 2022). 

BBC News (2014) ‘“Clare’s Law” introduced to tackle domestic violence’, 8 March [Online]. Available at https://www.bbc.co.uk/news/uk-politics-26488011 (accessed 17 February 2022). 

Home Office (2022) ‘Domestic Violence Disclosure Scheme Factsheet’, GOV.UK, 31 January [Online]. Available at https://www.gov.uk/government/publications/domestic-abuse-bill-2020-factsheets/domestic-violence-disclosure-scheme-factsheet (accessed 17 February 2022). 

The Controversial History of Autism

According to Lincoln College (2022), autism as a word was first used to describe those who suffered from schizophrenia and who were also ‘withdrawn and self-absorbed’. In 1943, the word was first used to describe a condition of its own and individuals seemed perplexing to clinicians and were scrutinised heavily (Kanner, 1943); followed by the creation of Asperger’s disease in 1944. Later in the 1950s, it was believed that autism was a result of developmental trauma, and mothers of autistic children were heavily criticised as ‘refrigerator mothers’, indicating that they had no emotional warmth. 

Eventually, during the 60s and 70s there were changes initiated by parents coming together (and forming the National Autistic Society), and by scientists recognising the disease as biological. This recognition led to segregation schools being implemented for autistic children before a genetic link was discovered in 1974. Yet, it was not until 1979 that a psychological model called ‘the triad of impairments’ was proposed which highlighted difficulties in social interaction, communication, and imagination skills. Then, in 1980 the DSM first recognised Autism Spectrum Disorder,  and in 1989 the diagnostic criteria for Aspergers was created before being recognised in 1994. From there on there were national scientific and governmental initiatives to improve practice on understanding and working with autism. Finally, since 2009 World Autism Day has been celebrated. 

Currently, there are still people who think that autism happens only to children, or that it is not a disability. Furthermore, only a minority of people understand that autism has no cure. This shows that even though there have been a lot of developments in the history of autism, many misconceptions still persist. 

Theories

Initially, it was believed that autism was a form of schizophrenia. Furthermore, the way clinicians used to relate to autistic individuals was very derogatory and subjugating throughout history. Individuals with autism were labelled as ‘mentally retarded’, ‘idiotic’, ‘feeble-minded’, ‘slow or backwards’, or ‘autistic schizoid’ (Lincoln College, 2022). Now individuals are known to have a neurodevelopmental condition which they live with, and which has unique individual needs and no cure. Moreover, autism was considered to be a matter of moral degeneration until the genetic link was discovered and its biological construct was explored. 

Kanner (1943) cited in Lincoln College (2022) was the first to propose that autism was a condition of itself and that it was not schizophrenia. This was a major breakthrough. Later on, Aspergers (1944) cited in Lincoln College (2022) proposed that ‘autistic psychopathy’ was the cluster of symptoms now known as ‘Asperger’s syndrome’. He believed that these individuals could not change because autism had no cure. He identified symptoms such as ‘lack of empathy’, and poor ability to make friends, among others. This was another breakthrough. However, autism is not the same as psychopathy, and this should be emphasised. 

Moreover, Lincoln College (2022) also states that Wing’s and Gould’s (1979) theory was the first one to mention Aspergers syndrome in a research paper challenging Kanner’s theory and they introduced the model of the ‘triad of impairments’  (social interaction, communication, and imagination). Furthermore, Baron-Cohen et al. (1980) proposed the theory of mind (ToM) theory indicating that individuals with autism struggled to understand the mental states of others. It was stated that this impairment affected most or all aspects of the individual’s life. 

Another theory was the ‘extreme male brain theory’  which states that autistic individuals have been exposed to higher levels of testosterone than the average population. This might explain why most autistic individuals are male. Furthermore, Baron-Cohen also proposed the ‘empathising-systemising theory’ which states that autistic individuals can only be empathic by imitating the behaviours of others without really understanding the subjective states of mind of others. This is because autistic individuals are more systematic than empathetic and adapt based on organisational, structural, normative, and routine schemas. This might explain why these individuals have interpersonal difficulties. Finally, the ‘autism spectrum  condition’ theory states that individuals with autism have a life-long condition which can vary based on where they are in the spectrum which can range from interpersonal difficulties to verbal communication difficulties (Lincoln College, 2022). 

Treatments & Interventions

Electroshock therapy was often used to treat autism in the past and treatments heavily relied on the use of medication. Autistic individuals were placed in asylums and separated from their families during treatment even though a cure does not exist. Nowadays, treatment takes place in the community most of the time, medication is only used where necessary,  and psychotherapy is offered in order to help build coping and distress tolerance skills. Furthermore, in the past autistic individuals were segregated from society and placed in special schools. This is now known to have detrimental effects. Hence why nowadays autistic individuals are integrated into mainstream schools with extra support for their needs.  Finally, in the past autistic individuals had little or no autonomy and were passive receivers of interventions; whereas now person-centred approaches are the norm, and individuals are encouraged to be autonomous and to live meaningful lives (Lincoln College, 2022) even though the mental health industry still has a lot to improve when it comes to co-production of care plans in general. 

Furthermore, Lincoln College (2022) states that in the past autism was treated with medication on a trial and error basis, sometimes having dangerous and now-illicit substances administered such as LSD. Of course, this was harmful. Moreover, aversion therapy was used to operationally condition unwanted responses using punishment as the reinforcing method. Individuals were slapped on the wrist, splashed with cold water, and given electric shocks every time they displayed unwanted behaviours. This was done with the intention of extinguishing such behaviours, and was inhumane. Nowadays, this would be classed as unethical and degrading. 

Needless to say, in the past individuals were excessively put through electro-convulsive therapies which consisted of electrocuting the individual’s head in order to forcefully and drastically alter the biological make-up of the brain. This practice is known to induce seizures,  memory loss, and other effects. Sadly, this type of torture is still used as treatment in many countries, including the UK. There are several human rights movements such as the Citizens Commission on Human Rights (n.d.) which have made documentaries advocating against this form of therapy due to its many harmful effects. However, among the positive services offered to autistic individuals nowadays are community care (i.e. ensuring individuals are not hospitalised), speech and language therapy, occupational therapy, family therapy, behavioural therapy, medication, parent education, psychosocial treatments, and counselling (Lincoln College, 2022). 

References

Citizens Commission on Human Rights (n.d.) ‘Therapy or Torture? The Truth About Electroshock [Online]. Available at https://www.cchr.org/ban-ect/watch/therapy-or-torture-the-truth-about-electroshock.html (accessed 22 February 2022). 

Kanner, L. (1943) ‘Autistic Disturbances of Affective Contact’, Pathology [Online]. Available at https://neurodiversity.com/library_kanner_1943.pdf (accessed 22 February 2022). 

Lincoln College (2022) ‘The historical context of autism’, TQUK Level 3 Certificate in Understanding Autism [Online]. Available at https://lincolncollege.equal-online.com/courseplayer/autisml3/?ls=8663048&s=23416 (accessed 22 February 2022). 

Categories
Forensic Psychology

Signs, Symptoms and Indicators of Domestic Abuse

This blog post will educate the reader about the signs of domestic abuse, and how to identify it in every day life. It also touches on the specific symptoms and indicators of female genital mutilation, forced marriage, honour-based abuse, and digital domestic abuse; as well as who is most at risk from experiencing these.

Physical Abuse

Individuals affected by physical violence present with recurrent physical injuries such as black eyes, bruises, split lips, marks on the neck, or sprained wrists. Moreover, the explanations given for these injuries might be inconsistent, and might be obviously a cover-up for something else. Finally, they might also wince when making motor movements as if in pain and trying to avoid pressure on a specific part of the body. However, it must be noted that perpetrators tend to be wary of where they leave marks, so as to avoid getting caught. So in many cases, physical abuse is hidden from the public eye and the victim is manipulated into keeping things secret. Physical signs of domestic abuse might not always be visible because the perpetrator might be ensuring that they leave no evidence that could incriminate them. This might mean that they will attack the victim in specific hidden places such as the head, the stomach, or breasts, among other places. Furthermore, they might have manipulated the victim to hide the marks, or to keep silent; and the victim might actually be using clothing, make-up, and accessories to actively cover the injury. 

Emotional & Psychological Abuse

Individuals affected by emotional abuse present with symptoms of agitation and anxiety, chronic tiredness and insomnia, substance or alcohol use disorder, submissiveness (e.g. apologising all of the time), anhedonia, low self-esteem, low self-confidence, fear or wariness, depression, and/or suicidal ideation. Whilst these symptoms might not always be caused by domestic abuse, these are commonly experienced by people who are in abusive relationships. Therefore, it is important to take into account these indicators when safeguarding adults from potential abuse which might be hidden. Emotional signs of domestic abuse are inherently invisible and can only be detected by observation. If the victim does not have a support network who knows them well, it might be more difficult for anyone to notice any differences in behaviour. Furthermore, not everyone is equipped with the knowledge to correctly identify signs of emotional abuse. Moreover, victims might actually avoid disclosing anything, especially if the perpetrator has manipulated them to keep things to themselves through blame and/or threats. 

Individuals affected by domestic abuse present with behavioural markers that could reveal their ordeal such as drastic behaviour or personality changes, unjustified self-isolation, being unable to attend scheduled meetings, avoidance of social gatherings, the sudden reluctance to engage in activities once enjoyed, and/or secretive behaviours. Furthermore, the individual might appear anxious and/or fearful, and their behaviour might seem extremely ‘well-behaved’ when around their perpetrator. These individuals may try to cover up the abuse they are being put through by giving excuses that are unrelated to what is actually happening. Behavioural signs of domestic abuse are difficult to pinpoint if the victim is not known to the witness very well, and therefore the witness cannot notice a change in usual behaviour. This means that unless someone notices the situation, a bystander intervention is unlikely, especially when the victim makes excuses for apparent unusual incidents which no one can recognise as an inconsistency. 

Coercive Control

Individuals affected by coercive control present with signs and indicators such as asking their perpetrator for permission to socialise with others, receiving numerous texts and/or calls from their perpetrator, having no money or access to it, having no car and being picked up by their perpetrator all the time, and/or needing to be home at specific times. These individuals might also keep these patterns secret, and might actually feel shame related to their ordeal. Signs of coercive control are often quite hidden from everyday life because the victim might appear to be respectful rather than fearful of her perpetrator. Others might not pick up on the abusive flood of texts and/or calls, or might not understand that all of these communications come from the perpetrator. Furthermore, victims might feel embarrassed to disclose their financial situation and/or dependencies, and might avoid answering truthfully when questioned about details. 

Female Genital Mutilation (FGM)

Women who have been genitally mutilated present with difficulty walking, sitting, or standing; they show signs of being in pain, and may spend longer in the toilet than usual. They might be anxious, depressed, and/or might be self-isolating without a justification. They might present with drastic changes of behaviour and personality, may engage in truancy at school/college/university, might become absent from work and/or might withdraw from social activities. Furthermore, the Home Office has a list of countries flagged as ‘risky’ when it comes to female genital mutilation. These are Somalia, Kenya, Ethiopia, Sierra Leone, Sudan, Egypt, Nigeria, Eritrea, Yemen, Kurdistan, and Indonesia. Women and girls at risk of female genital mutilation are those who speak about special ceremonies or rituals about womanhood in their culture, those who say that they are going on holiday outside the UK, those who say that a ‘special’ relative is coming to visit them, and those have family members who have been already mutilated. This means that when women and girls present with any of the above indicators, and especially when they have connections to any of the blacklisted countries, they should be safeguarded through bystander intervention.

Forced Marriage

Forced marriage happens here in the UK and also abroad. Sometimes only the woman is forced, and other times both parties are forced. Individuals affected by forced marriage present with truancy or absence from work, fearfulness and anxiety about holidays, failure to return to occupational life after a holiday, not being allowed to study or work, having excessive parental control,  depression or isolation, and/or attempts to escape their ordeal at home. Furthermore, those at risk of being forced into marriage include those who have connections to those who have already been forced to marry, and those whose culture promotes early marriage. Countries known to have child marriage include Nigeria, Central African Republic, Chad, Bangladesh, Mali, South Sudan, Burkina Faso, Guinea, Mozambique and India (Reid, 2018); as well as Pakistan (Ijaz, 2018). 

Honour-based Abuse

In some cultures, the family or community might attempt to protect or defend their shared values through abusive means and/or threats of abusive means such as harassment, assault, imprisonment, murder and rape. This is what is known as honour-based abuse and it is directly linked to beliefs, and attitudes. Individuals affected by this type of abuse present with drastic changes in behaviour or personality, anxiety, demotivation, poor performance, excessive control by others, self-isolation which cannot be justified, confrontational and argumentative behaviours, truancy or absence from work, attempts to escape their ordeal, self-harm, depression, substance or alcohol use disorders, suicidal ideation, and/or actual bodily harm (ABH). Furthermore, individuals at risk of honour-based abuse include those who have relatives who have been forced into early marriage, and those who come from cultures where honour-based abuse is perceived as normal. Countries flagged as risky when it comes to this type of abuse include Turkey, Kurdistan, Afghanistan, South Asia, Africa, the Middle East, South and Eastern Europe, and traveller communities. This means that people from these cultures are particularly at risk of being abused. 

Digital Domestic Abuse

Digital domestic abuse entails harassment, bullying, and/or stalking through an online platform, and/or the restriction of someone from  accessing technology. Individuals affected by digital domestic abuse present with an excessive number of texts/calls, appear visibly upset or distressed after texts/calls, online attacks against their integrity, and online embarrassing media involving them. Furthermore, individuals who are being coercively controlled through technology present with a monitored access to social media, emails, and/or the internet by their perpetrators,  signs that others have access to their personal digital accounts, a controlled access to technology by the perpetrators, a recurrent pattern of asking for permission from their perpetrator before connecting digitally with the people in their lives, an excessive guardedness about what is said in emails or other digital platforms, and/or a recurrent pattern of borrowing other people’s technology for access to the internet. Moreover, an individual can be both abused digitally, and also face to face, with punishments, reprimands and other negative consequences used by the perpetrator to intimidate the victim into obeying. 

References

Ijaz, S. (2018) ‘Time to End Child Marriage in Pakistan’, Human Rights Watch, 9 November [Online]. Available at https://www.hrw.org/news/2018/11/09/time-end-child-marriage-pakistan (accessed 14 February, 2022). 

Reid, K. (2018) ‘Untying the knot: 10 worst places for child marriage’, World Vision, 6 July [Online]. Available at https://www.worldvision.org/child-protection-news-stories/10-worst-places-child-marriage (accessed 14th February, 2022).  

Film Review: We Are Monster (2014)

This film directed by Antony Petrou is rich in forensic psychological detail. It really shows the dark side of the criminal justice system (CJS). Based on a true story, We are Monster tells the story of the murder of Zahid Mubarek by Robert Stewart.

Psychoanalytic film theory: It is clear that many of the attitudes Stewart displayed were inherited from his father’s personality. In other words, the film captures the phenomenon of introjection, a defence mechanism which consists of internalising and adopting personality traits and/or behaviour of other people, especially authority figures. The film shows Stewart recalling a memory of his father arguing with his mother about her having been sexually involved with a person of a darker skin. From this scene it is clear that his father had an extremist and antisocial attitude towards people of different skin colours, and he is heard using racial slur. Consequently, Stewart came to associate a darker skin with ‘filth’ and ‘evil’, having internalised his father’s attitudes. The film constantly shows him having a conversation with a hallucination of himself similar to the way his father used to speak in general. In psychoanalytical terms, it could be said that the film shows Stewart’s ID talking to him all the time. The ego or self is shown to negotiate with this hallucination, and to be led and manipulated towards specific behaviours. It is difficult to say whether the introjection was accompanied by reaction formation, because it is difficult to differentiate Stewart’s criminogenic attitudes and/or actions from those of his father. The film portrays his childhood as self-less, cold, and full of trauma. Therefore, it is unclear whether these behaviours constitute an exploration of his father’s ego through a primary regression to a narcissistic state in which the superego is formed based on values learned from the world; or whether it is his self that has become established as a personality (i.e. whether this would be his behaviour if he was not experiencing a psychotic break). The film captures his schizophrenic crisis quite well. It allows the viewer to enter the criminal mind from thought to action. Petrou manages to illustrate the criminal insanity perspective by placing emphasis on the hallucination as the drive towards criminogenic activity.

Political anchors: This case was a huge scandal in the year 2000 and many inquiries were launched at Feltham Young Offender Institution in order to investigate the steps the government of the UK could have taken in order to prevent this tragedy, and what steps could be taken to prevent it from ever happening again. It was concluded that legally, there was much more the system could have done to prevent this re-offending, and the death of Zahid Mubarek. This case was a scandal when it occurred, and it is perceived as a double-edged cumulative failure.

Categories
Journalism

Book Review: Snakes in Suits: When Psychopaths Go To Work

This is a book I had been reading for a while, and which I have been sharing quotes about. Hare and Babiak’s (2006) Snakes in Suits: When Psychopaths Go To Work attempts to draw the similarities between clinical psychopathy, corporate psychopathy, and the general dark side of business. It also delves on topics such as personal relationships, and every day business contexts. It speaks to both, those who see themselves as psychopathic, and those who do not. It also speaks to victims of narcissistic relationships who have been played by callous and unemotional people, and brings the context back to the faculty of social sciences:

‘Indeed, this diffusion of responsibility is big business; witness the large number of psychologists, psychiatrists, social workers, and counsellors ready and eager to explain or exculpate criminal behaviour. This is good for criminals in general and for psychopaths in particular’.

Robert D. Hare & Paul Babiak (2006, p. 277)

Indeed, forensic psychology is a science that begins its investigative journey with the question: ‘what is a psychopath?’, and this is why books such as The Mask of Sanity, Without Conscience, and Snakes in Suits are relevant to wrapping up a general view about the label; and it is precisely because the label ‘psychopath’ is so controversial and so sensationalised that real experts on the topic, or students of the discipline feel like forensic psychology can be quite the depressing career. I mean, what to do with all this understanding about how psychopathy works when mainstream society finds researching the topic an insult itself? In regards to this, Hare and Babiak (2006, p. 278) state:

‘Perhaps this is why so many of those in the helping professions find themselves in big trouble by trying to help a psychopath’.

Robert D. Hare & Paul Babiak (2006, p. 278)

There are many troubles that can arise from trying to understand psychopathy. First of all, generally speaking, people perceive research which is focused on attempting to comprehend callous or unemotional behaviour as a dark behaviour itself. Second, many people think that when forensic psychologists speak of psychopathy as a scale, the majority of people are exempt from it. Third, most people associate the label ‘psychopathy‘ with criminal behaviour. However, this is not always the case. Hare and Babiak (2006) truly manage to capture this idea that psychopathy can happen in everyday contexts. Moreover, the book provides- so to say- a behavioural anatomy of traits associated with the label, and these traits (according to the authors) are very commonly found in business and organisational settings; as well as corporations. The title of the book (in my opinion) challenges the criminal stereotype often associated with the label, and although the authors do include such a behaviour too; it becomes clear that what is deemed as psychopathic can also appear dressed in a suit with a tie; an allusion to how seemingly ‘normal’ people can be psychopathic or have psychopathic traits.

Critical Note

I think Hare and Babiak (2006) risk sensationalising and stigmatising what is considered helping, validating, or empathic behaviour. Some parts of the book also paint a picture of a therapist’s approach as threatening:

‘The psychopath will try to convince you that he or she accepts you as you are’.

Robert D. Hare & Paul Babiak (2006, p. 275)

Yet, the book also states:

‘Some avoid talking to psychologists because they fear they will learn something uncomfortable about themselves. Psychopaths are well aware of these concerns and capitalize on them.

Robert D. Hare & Paul Babiak (2006, p. 271)

Considering that validating behaviour is constructed as potentially psychopathic, it is no wonder that some avoid therapy! The demonisation of helping behaviour is precisely what leads people to become paranoid when someone takes a collectivist approach to social interaction. In reverse, it can also lead to people not helping in order to avoid risking impression management. This can be problematic.

Categories
Opinion

Authoritarianism in Mental Health Settings

When I began this journey in Forensic Psychology, I did not expect to learn as much as I have. The main tenet of this career consists in understanding psychopathy, and psychopathology.

It does make me question authoritarianism and the ways in which it can manifest. For instance, Milgram and Adorno et al. studied the psychology of obedience under pressure, and how following orders led to the holocaust. An aspect that has been questioned little is how scarcity or the fear of scarcity has led to similar phenomena due to how people have been conditioned to see money as an enabler of everyday behaviour. For instance, when Milgram conducted his obedience experiments during the 60s, he monetarily rewarded his participants for taking part in the studies. Modern psychologists have attempted to re-examine the dynamics at Yale’s laboratory and what might have led the participants to show that they were capable of being sadistic under such conditions. An example is Gibson’s (2013) work which meticulously examines the prods given by the experimenter. In a way, Gibson seeked to understand how the orders and requests given by the authority figure contributed to the decision-making processes of the participants. However, I have not come across much research highlighting the role of the monetary incentive in everyday behaviour; or how being given a monetary incentive places a subconscious obligation on individuals to comply with requests, even if such requests at times make them feel uncomfortable.

The c/s/x movement, also known as ‘the psychiatric survivors movement‘ (Wikipedia, n.d.) explores how a large number of individuals report feeling or having felt dehumanised by the mental health system. For the unstigmatised person, it is often more common to assume that all these people expressing dissatisfaction with the system are crazy, than to understand the nature of what it means to respect a person’s dignity and human rights. It is quite a complex situation, because it is unclear what reinforces and keeps some mental health settings from actively listening to their patients’ concerns.

According to Turner (2015), signal detection theory (SDT) “describes processes whereby information that is important to the perceiver (known as the ‘signal’) is distinguished from other information that is unimportant and potentially distracting (known as the ‘noise’)”. It is my hypothesis that some of the inherently dehumanising behaviours occurring in the mental health system happen as a result of the hyper-normalisation of object-relations with patients. As I mentioned on my post Investigating the neuropsychopathology of prejudice‘, people can at times perceive those with stereotyped and stigmatised characteristics as non-human objects. This would of course increase the chance of mental health settings staff processing signals coming from clients as background noise, rather than as worth-listening-to human signals. Such established conscious and unconscious behaviours leading to the dehumanisation of many clients are reinforced through monetary incentives, and through an intragroup, mob-like co-validation of such unconscious biases. Like Eichmann, many live their lives constantly affirming to themselves that they were just following procedures and orders, or just doing their job; and therefore they believe it is not their responsibility to reflect on how clients are impacted by this. But the signals coming from mental health patients often stand in stark contrast to the common belief that these dehumanising, and at times non-empathic methods are appropriate, or even de facto acceptable.

I do think everyone deserves to be paid for their labour, and that having access to a basic form of income is an important foundation in any society; and I also think that mental health settings need to be encouraged or trained appropriately to detect clients’ signals as more than just background noise (i.e. as more than non-human objects signals) in order to reduce risk outcomes. The situation is problematic, persistent, and pervasive with these manifestations of authoritarianism in mental health settings. It would indeed be arrogant to assume that all the patients/clients expressing dissatisfaction with the service are wrong, or to culturally pathologise reasonable dissent. It would also be irresponsible and de jure unacceptable to fail to take steps towards alleviating feelings of ‘being dehumanised’ in civil society, especially if such feelings of dehumanisation have the potential to lead to never events, such as suicide.

References

Gibson, S. (2013) ‘Milgram’s obedience experiments: A rhetorical analysis’, British Journal of Social Psychology, vol. 52, York, The British Psychological Society/York University, pp. 290-309 [Online]. Available at https://pmt-eu.hosted.exlibrisgroup.com/permalink/f/gvehrt/TN_cdi_gale_infotracacademiconefile_A332152211 (accessed 11 October 2020).

Turner, J. (2015) ‘Making sense of the world’, in Turner, J. and Barker, M. J. (eds) Living Psychology: From the Everyday to the Extraordinary, Milton Keynes, The Open University, pp. 7-45.

Wikipedia (n.d.) ‘Psychiatric survivors movement’ [Online]. Available at https://en.wikipedia.org/wiki/Psychiatric_survivors_movement (accessed 11 October 2020).

Categories
Opinion Tips

Blogging as a Method for Democratic Therapy

Blogs are a great way to express your voice. Even if your experiences have made you feel silent, oppressed, and unfairly treated at an intergroup relational context; you can still assert your thoughts, feelings and opinions in the online community. This way, blogging can be a method for cognitive-emotional democratic healing at both individual and collective levels.

Why is expressing your voice important?

Actions and reactions happen at inter and intra group levels for many reasons. Sometimes communicating our perspective helps elucidate a particular situation. So for instance, if you feel that some members of your social milieu have displayed hostility towards you as a result of the hostility that they themselves have been subjected to, you might be correct in assuming that such a hostility might have become hypernormalised at the group’s cultural level, and that such members are experiencing reactive-formative symptoms of trauma. For the minority individual, the experience of being let down, or rejected by a group, culture, system, or apparatus can be debilitating (i.e. it can feel like mob behaviour), and when this happens for a prolonged period of time; it can create feelings of marginalised frustration. Blogging is a good way to use your freedom of speech in a way that directly addresses the public audience, whilst simultaneously being an interpersonal method for expression.

The risk is to stay silent.

Setting up a blog

There are different ways in which you can begin your blog. The most common problem I hear when I speak with people about blogging is ‘I do not not what to say. I would not know where to start’. My answer is that such is precisely the way to start a blog. You do not need to know what to write about in order to express that you do not know what to write about. Sometimes it could be sharing your professional work. Other times it could just be about sharing an experience you went through. I tend to shift between these modes. Most of the time, I share some of my thoughts, feelings, and add something interesting that I have been researching about. Regardless of what your needs for expression are, blogging is an effective method for online communication and an interdisciplinary style for socialisation. But, what blog to use?

Choosing a blogging platform

Different people will prefer different types of blogs for their journalism depending on how much time or effort they wish to invest in the endeavour. Here are a few options:

  • Blogger: A very simple and generic user experience design for expressing thoughts. It has an archive of dates which store your thoughts across time. The interface is easy to learn, and it is free of charge. It is ideal for those only getting started in cybercultural activities.
  • Google Sites: This platform truly is flexible in terms of allowing the user to experience freedom in how to structure their pages. It is useful for creative projects and for getting started with digital design. It lacks an automatic blogging archive, so if what you are looking for is a place to log your thoughts, Blogger is a better option. All you need is a Google account.
  • WordPress: This blog (as you can see at the bottom of the page) is powered by WordPress. The reason why I personally prefer this platform is because it gives me a wide margin of flexibility when it comes to design, as well as simultaneously having an archive for blog posts which permits organization.
  • Medium: For those who do not wish to either hassle neither with the design nor with the other technicalities, Medium allows people to register and write. It is a community project, meaning that people from all walks of life contribute to the discussion.

Good News: My Blog is Back

What a day. Today my blog was saved (thank you, Juan!) after it was hacked and taken down following two articles I wrote which now I am nervous to publish after that. I’m currently reading several books at once and sometimes feel so devastated to realise some barbarities about the world around me. But having my blog back is so comforting, and so I have another reason to continue surviving all these difficult situations, yay!

In the meantime, I started a channel on Medium where I might journal now and then. You can read my post Thriving Against Oppression Now there where I speak about what it has felt like lately for me to go through a lot of problems. I will be reviewing and republishing the commentary articles I had published prior to the hack attack within the next few days. I am currently so busy with my studies that I have to spend more time inputting than outputting information. But I will try to retake a more informal and more frequent blogging style, because I feel it is certainly therapeutic to blog.

Also, in response to some commentary as to whether I have conditioned myself into these situational factors, the answer is that there are some unconditional, natural elements when it comes to the good side (writing, blogging, studying); and some conditioned elements that have been institutionalised (e.g. verbiage and time-keeping). It is difficult with psychology, you know. Specially when there are incentives, rewards, and negative reinforcement schemes in many of the contexts of practice. But there are factors of situations which are outside my locus of control, yet I get through, thriving on the roller-coaster life.

So tired of being oppressed.

Thank you to anyone reading!

Categories
Journalism Videos

Introducing the Youtube series: All racists are narcissists

Hello everyone!

Lately I have been focusing my time towards doing some research and I will be publishing the findings on my Youtube channel. In these series of episodes I will be describing the key terminology related to matter, and then I will touch on psychological theory, and neuropsychological research about racism and narcissism. So if you are interested in understanding the psychology of these phenomena, please tune in!

And thank you for subscribing.

Betshy P. Sanchez Marrugo