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What is Abuse?
Abuse is an action or behavior in which another person is intentionally harmed, subjugated, or injured. Abuse can be verbal, mental, physical, or emotional.
Abuse can cause psychological trauma that is more difficult to treat than physical wounds. Long after the abuse has stopped, survivors may still feel intense negative emotions. For example, those who have experienced abuse often endure anxiety, flashbacks, and grapple with trust issues. In addition, a victim of abuse may have trouble forming relationships and finding happiness.1
In the United States, more than 1 in 3 women (35.6%) and 1 in 4 males (28.5%) have experienced rape, physical abuse, and/or stalking by someone they were intimate with in their lifetime.2 In addition, around 61 million American women and 53 million American men have suffered psychological abuse from an intimate partner, according to the Centers for Disease Control and Prevention (CDC).3 Furthermore, in a study of 21-year-old victims of child abuse, around 80% met the criteria for at least one mental illness.4
Types of Abuse
Abuse comes in many different forms. Abuse can be categorized based on its type or its environment. Any relationship, whether familial, professional, or social, can experience abuse. It can also happen with strangers, though this is less common.
You can be ready to react to situations in a way that is safe for you and others by being aware of the numerous ways that abuse manifests and overlaps. Below are the most common types of abuse:5
- Physical Abuse: Intentional bodily harm in the form of slapping, pinching, choking, kicking, pushing, inappropriately employing drugs or physical restrictions, or related.
- Emotional and Verbal Abuse: A persistent manipulation pattern used to exert influence over someone else. Examples of tactics include verbal attacks, gaslighting, social exclusion, humiliation, and threats.
- Sexual Abuse/Coercion: Any sexual interaction without permission. Incest, rape, and other forms of sexual violence fall under this category.
- Reproductive Coercion: When one partner deprives the other of the ability to manage their reproductive system, this is referred to as reproductive coercion. Recognizing this type of coercion can be challenging since it is less obvious than other forms of simultaneous abuse. It may take the shape of pressure, guilt, or shame related to having or wanting children (or not having or wanting them).
- Financial Abuse: When someone abuses someone with money, they might rob someone’s identity or take over their bank account, incurring debt. Financial abuse also includes seizing or selling someone else’s property without their consent.
- Digital Abuse: The bullying, stalking, intimidation, and control of a relationship through technology and the Internet. This behavior frequently takes the form of online verbal or emotional abuse.
- Stalking: Stalking happens when a familiar person, a former partner, or a stranger frequently observes, follows, or harasses you and leaves you feeling uncomfortable, terrified, or insecure.
- Elder Abuse: This is when an older adult is harmed, taken advantage of, or neglected. A family member or nursing home employee in charge of the elder’s care is frequently the abuser. Around 1 in 10 Individuals over 60 in the US has been a victim of elder abuse.
- Child Abuse: This is when a minor under 18 is harmed, taken advantage of, or neglected. According to estimates, 1 in 4 American children has been the victim of abuse or neglect.
Insurance may be able to help cover the cost of therapy. Find out if your insurance provider can help with the costs by filling in our confidential insurance verification form below.
Causes and Risk Factors
Abuse is a learned behavior and a choice. Several factors can make someone more prone to abuse. Yet, these factors do not cause abuse. Rather, they provide an explanation.
Abusers frequently possess authority over their victims. This influence could come from income, social standing, physical prowess, or another kind of power. An abuser could believe they have the right to treat the victim in whatever way they choose because of their relative authority.
Some learn it gradually via friends, popular culture, or structural injustices in society; others slowly pick it up from their families as they grow up. Anyone who engages in abusive behavior does so voluntarily; they might also choose not to, regardless of where they learned these behaviors.
If the offender was abused themselves, that is the most significant indicator of abusive behavior. Many people who endure or witness abuse draw on their memories to stop the cycle of violence and recover without hurting others. Abusers frequently struggle with depression or substance abuse as well. Although not everyone with these disorders abuses others, abusers often have these illnesses.6
Some abuse others to compensate for a lack in other areas of their lives. For instance, a person who lost their job could lash out at their spouse to relieve stress. Abusers frequently struggle with low self-esteem and anger management issues. To stop someone from “abandoning” them, they might attempt to exert control over them.
Abuse can also result from problems with one’s mental health. Strong risk factors for the propensity toward abusive behavior include a narcissistic or antisocial personality.
Signs & Symptoms of Abuse
Various signs and symptoms are associated with the different categories and contexts of abuse. However, not all forms of abuse have visible indications or warnings. Some of them, such as emotional abuse, may impact you before you are even aware.
Below are some common signs and symptoms of abuse:7
- Physical Abuse Signs & Symptoms
- Welts, lacerations, black eyes, bruises, and broken bones
- Untreated open wounds, cuts, punctures, and injuries in varying states of healing
- Individual’s report of being struck, slapped, kicked, or otherwise mistreated
- Caregiver’s reluctance to let guests visit a vulnerable adult alone
- Broken eyeglasses, as well as any outward indications of punishment or restraint
- Sexual Abuse Signs & Symptoms
- Bruising in the genital or breast region
- Undiagnosed genital infections or venereal diseases
- Unknown anal or vaginal bleeding
- Ripped, bloodied, or ruined underwear
- Individual’s report of sexual assault or rape
- Psychological / Verbal / Emotional Abuse Signs & Symptoms
- Emotional distress or agitation
- Being very withdrawn, unresponsive, or uncommunicative
- Abnormal conduct frequently linked to dementia (i.e., sucking, biting, rocking)
- Anxiety around particular people
- Being repeatedly shamed, blamed, humiliated, or guilted
- Individual’s report of verbal or mental abuse
- Neglect/Abandonment Signs & Symptoms
- Dehydration, malnutrition, otherwise poor personal hygiene
- Unsanitary or dirty living conditions (i.e., animal/insect infestation, foul odor)
- Homelessness or a severely inadequate living arrangement
- Unattended or untreated health conditions
- Individual’s report of being abandoned or neglected
- A deserted vulnerable adult in a public place
- Financial / Exploitation Abuse Signs & Symptoms
- Abrupt changes in banking habits, such as an unauthorized withdrawal of large quantities of money
- Unplanned modifications to a will or other financial documents
- Unexplained disappearance of money or valuables
- Despite having the money to pay the bills, they are not yet paid
- Unexpected inclusion of previously uninvolved family members asserting ownership of a vulnerable adult’s assets and possessions
- Providing unnecessary services
Experiencing any of the above signs and symptoms is reason enough to seek abuse counseling, even if you’re unsure if you’re experiencing abuse or normal conduct. Therapists can help you distinguish between abusive and normal behavior, which can be confusing. It’s especially challenging when considering that someone you care deeply for is intentionally harming or controlling you.
How Abuse Affects Mental Health
Abuse can have a negative impact on our mental health. For example, physical abuse and the fear of it provide unique difficulties for women in particular. Chronic health issues, including headaches and back pain, are related to experiencing frequent violence and the stress of anticipating injury.8 In addition, women whose partners abused them report greater rates of anxiety and depression.9
The following mental health disorders have also been linked to various forms of abuse:10
- Post-traumatic Stress Disorder (PTSD)
- Substance Abuse
- Anger Issues11
- Sexual Dysfunction12
- Mood Disorders
- Borderline Personality Disorder
- The Development of Phobias13
- Eating Disorders14
- Please call the Suicide and Crisis Lifeline at 988 if you or someone you know is contemplating suicide. Someone can help 24 hours a day, and services are available in English and Spanish.
Abuse Counseling, Therapy & Treatment
Various forms of therapy are designated for different circumstances. For instance, couples counseling may enable a victim of child abuse to develop a more intimate relationship with their partner. Although, few professionals would advise couples therapy in cases of domestic abuse. In addition, children require distinct care from adult patients. Every individual has different needs that must be taken into account.16
It’s safe to express and process challenging feelings in abuse therapy. Your therapist won’t criticize you based on how you handle your unique situation. For example, some people have an obsessional resentment toward their abuser, while others still feel affection and desire for the abuser. Throughout this spectrum, you are free and safe to go back and forth. Anger, humiliation, relief, and a sense of loss are acceptable and common emotions. Abuse therapy rescues the lives and the self-worth of many people who have shared those same feelings.
Therapy for abuse survivors can assist in ending harmful relationships or in recovering from traumatic experiences. It can teach assertiveness, help you develop tools to manage stress and emotions, and boost your self-esteem. It can also prepare you for healthier relationships in the future.
Making a plan for the time before, during, and after you leave or confront an abuser is advised by the National Domestic Violence Hotline. According to research, when victims attempt to flee an abuser, they are at their most vulnerable.17 Abuse counseling can assist you in creating a safe exit strategy if you are still in an abusive relationship.
Restoring self-esteem is a common objective during therapy for abuse. Many treatments can assist patients in managing their emotions and achieving their goals, including the following types of therapy:
- Eye Movement Desensitization and Reprocessing (EMDR): EMDR is a mental health treatment technique involving moving your eyes in a specific manner while processing traumatic memories.18
- Cognitive Behavioral Therapy (CBT): CBT teaches you to recognize inaccurate or harmful thoughts to view challenging circumstances more clearly and react effectively.19
- Group Therapy: Studies have shown that group therapy was a noticeably more effective treatment for abuse victims than individual therapy alone for anxiety and depression.20
- Psychodynamic Psychotherapy: With the aid of psychodynamic therapy, you can better understand how your current emotions and behavior are influenced by past events, unconscious thoughts, and impulses.21
- Family Therapy and Parent-Child Interaction Therapy (PCIT): These are frequently helpful therapies when the offender is a family member. Family therapy can repair or strengthen non-offending family members’ relationships, while the relationship between the parent and abused child is frequently the subject of PCIT.
Various types of therapists and counselors can work with abuse victims, including domestic violence counselors. In most cases, domestic violence counselors must complete at least 40 hours of Tennessee state-approved survivor advocate training to get certified.
State regulations require domestic violence counselor accreditation. This guarantees that advocates for abuse survivors have the right attitudes, knowledge, and abilities to serve a vulnerable population without causing further harm. When first responders are uneducated on psychological trauma, unintended revictimization can occur.22
In addition to domestic abuse certification, there are additional certifications a psychologist or other mental health professional can obtain, including child abuse and sexual abuse counseling certifications. It’s important to see a therapist certified in the specific abuse(s) you have experienced.
During your initial appointment, your therapist will usually learn more about you and inquire about the issues you want to address. The therapist may ask about your past and present physical and emotional health to comprehend your abusive situation more thoroughly. If you think you would benefit from additional treatment, such as medication, your therapist may bring it up.
A psychiatrist may prescribe medications if you are experiencing any related mental health disorders. For example, many common comorbid illnesses, including depression, anxiety disorders, and sleep disorders, can be treated with medication. They’re particularly beneficial in reducing the symptoms of PTSD.23 Additionally, in cases of sexual abuse, medications may be necessary to prevent or manage certain sexually transmitted diseases.
Abuse Therapy Treatment Costs & Insurance Coverage
The following costs for abuse counseling are estimated. Various factors contribute to the final cost, including your location in Tennessee and your insurance coverage.
According to the CDC, the average cost for people seeking mental health services following physical abuse was $1,017 per occurrence. For victims of sexual abuse, the average cost was $978 and $690 for stalking victims.24
Cognitive behavioral therapy (CBT) sessions are typically 45+ minutes long and cost between $100 and $200.25 CBT is generally regarded as a short-term treatment, with therapy sessions ranging from 5 to 20. Additionally, eye movement desensitization and reprocessing (EMDR) therapy usually costs between $100 and $250 per hour per session without insurance. Given that it may take several therapy sessions to achieve desired outcomes, the total cost of EMDR may be between $800 and $2,000.26
Furthermore, parent-child interaction therapy (PCIT) is frequently covered by insurance companies as either family therapy or individual therapy, though each coverage varies.27 From client intake until the final session, PCIT therapy costs around $1,000 per client.28
In Tennessee, insurance often pays a portion of the cost of psychotherapy. Yet, many insurance companies may only cover a predetermined number of sessions and demand a formal diagnosis. However, several additional variables, such as your particular insurance plan, the location of the therapy, and whether the provider is in or out-of-network, may affect your out-of-pocket expenses.
Additionally, prescription drug policies usually cover antidepressants and anti-anxiety medications. Insurance policies, however, might only cover specific classes of drugs, dosage schedules, or the generic form, not the brand name.
You can access affordable coverage not linked to your abuser that addresses your particular situation thanks to the Affordable Care Act, which prohibits plans from charging more based on your health status. Plans must also offer a comprehensive benefits package that includes a variety of health and behavioral health services, known as the essential health benefits.29
Athena Care has multiple mental health clinics throughout Tennessee. We are also in-network with most major insurance plans. Therefore, filling out our free, no-obligation online insurance verification form is the most efficient way to gain the information needed to begin abuse therapy.
Allow our highly experienced, knowledgeable care coordinators to handle the challenges of contacting your insurance carrier for more information about your coverage. After submitting the form, a care coordinator will review your policy and thoroughly explain your options for abuse counseling. Any information you provide or discuss is kept entirely confidential.
Abuse Therapy Treatment Success & Outlook
Although the repercussions of abuse might last a lifetime, the intensity of those effects can be minimized with treatment. Victims of abuse can go on to lead happy, fulfilling, and healthy lives with the help of abuse counseling. Early intervention is always ideal. However, we understand that it’s also not always possible. Fortunately, it’s never too late to seek treatment.
Studies demonstrate the overall effectiveness of various therapy for abuse survivors. For example, using CBT protocols over six weeks was very successful in reducing not only depressed and chronic PTSD symptoms but also more subtle symptoms such as dissociation, impaired self-reference, and dysfunctional sexual behavior.30
Another study found that more success in reducing the prevalence of sexual assault-related PTSD may be attained when the therapies available are brought together at the appropriate points in the recovery process. These therapies include psychotherapy, medication, and the support of loved ones.31 In addition, although there is still much to understand, EMDR is a successful, affordable, short-term intervention therapy for treating acute and persistent PTSD in sexual assault victims.32
Regardless of how long the abuse persisted—a few months or several decades, therapy for abuse survivors requires time and effort before desired therapeutic outcomes become evident. In actuality, “getting over it” may never be part of the process for a survivor. After a few weeks, you may notice a decrease in your symptoms. Usually, however, this happens over several months, and it’s not uncommon to feel worse before you begin feeling better.
- “The Psychological Effects of Abuse.” GoodTherapy, 21 Nov. 2019, www.goodtherapy.org/learn-about-therapy/issues/abuse.
- “Domestic Violence Statistics – the Hotline.” The Hotline, 23 Feb. 2023, www.thehotline.org/stakeholders/domestic-violence-statistics.
- “Fast Facts: Preventing Intimate Partner Violence.” Centers for Disease Control and Prevention, 11 Oct. 2022, www.cdc.gov/violenceprevention/intimatepartnerviolence/fastfact.html.
- Springer, Kristen W., et al. “The Long-term Health Outcomes of Childhood Abuse.” Journal of General Internal Medicine, vol. 18, no. 10, Springer Science+Business Media, Oct. 2003, pp. 864–70. https://doi.org/10.1046/j.1525-1497.2003.20918.x.
- “Types of Abuse – the Hotline.” The Hotline, 24 Feb. 2023, www.thehotline.org/resources/types-of-abuse.
- “Why Do People Abuse | the National Domestic Violence Hotline.” The Hotline, 14 Mar. 2022, www.thehotline.org/identify-abuse/why-do-people-abuse.
- “Types and Signs of Abuse | DSHS.” Washington State Department of Social and Health Services. www.dshs.wa.gov/altsa/home-and-community-services/types-and-signs-abuse. Accessed 21 Mar. 2023.
- “Understanding and Addressing Violence Against Women.” World Health Organization (WHO), 2012, apps.who.int/iris/bitstream/handle/10665/77431/WHO_RHR_12.43_eng.pdf;jsessionid=D1B7E6B334ACAC29C299E454B6EEA62E?sequence=1. Accessed 21 Mar. 2023.
- Malik, Mazhar, et al. “Domestic Violence and Its Relationship With Depression, Anxiety and Quality of Life: A Hidden Dilemma of Pakistani Women.” Pakistan Journal of Medical Sciences, vol. 37, no. 1, Professional Medical Publications, Dec. 2020, https://doi.org/10.12669/pjms.37.1.2893.
- U.S. Department of Health & Human Services. “Abuse, Trauma, and Mental Health.” Office on Women’s Health, 16 Feb. 2021, www.womenshealth.gov/mental-health/abuse-trauma-and-mental-health.
- Iverson, Katherine M., et al. “Anger-Related Dysregulation as a Factor Linking Childhood Physical Abuse and Interparental Violence to Intimate Partner Violence Experiences.” Violence & Victims, vol. 29, no. 4, Springer Publishing, Jan. 2014, pp. 564–78. https://doi.org/10.1891/0886-6708.vv-d-12-00125.
- Gewirtz-Meydan, Ateret, and Eugenia Opuda. “The Impact of Child Sexual Abuse on Men’s Sexual Function: A Systematic Review.” Trauma, Violence, & Abuse, vol. 23, no. 1, SAGE Publishing, July 2020, pp. 265–77. https://doi.org/10.1177/1524838020939134.
- Medicine Organization in Isfahan Province.” Journal of Family Medicine and Primary Care, vol. 11, no. 2, Medknow, Jan. 2022, p. 487. https://doi.org/10.4103/jfmpc.jfmpc_538_21.
- Astudillo, Rosa Behar, et al. “Child Sexual Abuse as a Risk Factor in Eating Disorders.” ResearchGate, 1 Oct. 2016, www.researchgate.net/publication/311899862_Child_sexual_abuse_as_a_risk_factor_in_eating_disorders.
- Rakovec-Felser, Zlatka. “Domestic Violence and Abuse in Intimate Relationship From Public Health Perspective.” Health Psychology Research, vol. 2, no. 3, PAGEPress (Italy), Oct. 2014, https://doi.org/10.4081/hpr.2014.1821.
- “Getting Help for Abuse.” GoodTherapy, 25 June 2018, www.goodtherapy.org/learn-about-therapy/issues/abuse/get-help.
- “Domestic Violence Statistics.” The Hotline, 23 Feb. 2023, www.thehotline.org/stakeholders/domestic-violence-statistics.
- “EMDR Therapy: What It Is, Procedure and Effectiveness.” Cleveland Clinic, my.clevelandclinic.org/health/treatments/22641-emdr-therapy.
- Mayo Clinic Staff. “Cognitive Behavioral Therapy.” Mayo Clinic, 16 Mar. 2019, www.mayoclinic.org/tests-procedures/cognitive-behavioral-therapy/about/pac-20384610.
- Westbury, Elizabeth, and Leslie M. Tutty. “The Efficacy of Group Treatment for Survivors of Childhood Abuse.” Child Abuse & Neglect, vol. 23, no. 1, Elsevier BV, Jan. 1999, pp. 31–44. https://doi.org/10.1016/s0145-2134(98)00109-4.
- “What Is Psychodynamic Therapy : Types of Therapy.” Bacp, www.bacp.co.uk/about-therapy/types-of-therapy/psychodynamic-therapy. Accessed 21 Mar. 2023.
- “How to Become a Certified Domestic Violence Counselor.” Work – Chron.com, 5 Oct. 2020, work.chron.com/become-certified-domestic-violence-counselor-24607.html.
- Putnam, Frank W., and Jaclyn E. Hulsmann. “Pharmacotherapy for Survivors of Childhood Trauma.” Seminars in Clinical Neuropsychiatry, vol. 7, no. 2, Elsevier BV, Apr. 2002, pp. 129–36. https://doi.org/10.1053/scnp.2002.31792.
- Costs of Intimate Partner Violence Against Women in the United States Department of Health and Human Services. “Costs of Intimate Partner Violence Against Women in the United States.” Centers for Disease Control and Prevention, Mar. 2003, www.cdc.gov/violenceprevention/pdf/ipvbook-a.pdf.
- Lauretta, Ashley. “How Much Does Therapy Cost?” edited by Alena Hall, Forbes Health, 2021, https://www.forbes.com/health/mind/how-much-does-therapy-cost/
- “How Much Does EMDR Therapy Cost?” HowMuchIsIt.Org, 2018, https://www.howmuchisit.org/emdr-therapy-cost/
- Kudla, Linda, Psy. D. “Parent Child Interaction Therapy (PCIT): How It Works, Cost, and What to Expect.” Choosing Therapy, 29 June 2022, www.choosingtherapy.com/parent-child-interaction-therapy.
- Goldfine, Matthew E., et al. “Parent-Child Interaction Therapy: An Examination of Cost-Effectiveness.” Journal of Early and Intensive Behavior Intervention, vol. 5, no. 1, 2008, pp. 119–41. Crossref, https://doi.org/10.1037/h0100414.
- Brewer-Muse, Lynn. NCADV | National Coalition Against Domestic Violence. ncadv.org/blog/posts/the-ahca-and-what-domestic-violence-survivors-need-to-know-about-it.
- Resick, Patricia A., et al. “How Well Does Cognitive-Behavioral Therapy Treat Symptoms of Complex PTSD? An Examination of Child Sexual Abuse Survivors Within a Clinical Trial.” CNS Spectrums, vol. 8, no. 5, Cambridge UP, May 2003, pp. 340–55. https://doi.org/10.1017/s1092852900018605.
- Chivers-Wilson, Kaitlin A. “Sexual assault and posttraumatic stress disorder: a review of the biological, psychological and sociological factors and treatments.” McGill journal of medicine : MJM : an international forum for the advancement of medical sciences by students vol. 9,2 (2006): 111-8.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2323517/
- Posmontier, Bobbie, et al. “Sexual Violence: Psychiatric Healing With Eye Movement Reprocessing and Desensitization.” Health Care for Women International, vol. 31, no. 8, Taylor and Francis, July 2010, pp. 755–68. https://doi.org/10.1080/07399331003725523.
If you or someone you love would benefit from talking to a mental health provider in Tennessee, contact Athena Care.
One of our Care Coordinators will help you get the care you need.