Domestic abuse can have very negative consequences for a person’s mental health and may result in symptoms of depression or anxiety, or even both. This is your body’s normal reaction to the overwhelming stress that being in an abusive relationship puts you through. It doesn’t mean that you are weak or flawed, it means you are human! You are not alone in your experience. While this is a normal reaction, that does not mean that it cannot be treated. There are ways of working through this and for it to get better.
A therapist could help you understand the nature of your condition and the process of your recovery. They can teach you ways to deal with both your symptoms as well as with negative life events. Most importantly, they are someone you can talk to in a safe environment and in confidence, someone who will listen to you without being critical or judgemental in any way. A list of some of the most popular and effective types of talking therapies are listed below.
Cognitive Behavioural Therapy (CBT)
The aim of CBT is to deal with current symptoms, instead of focusing on events from earlier on in life. CBT is normally a brief type of therapy which lasts between 6 weeks and 6 months. Sessions typically take place approximately once a week and last around one hour each.
Clients are required to engage in specific ‘exercises’ in their daily life, such as keeping a diary of their negative thoughts and feelings. The aim of this is for the therapist to monitor which thoughts and interpretations of the client’s life events are negative or biased. The goal is to help an individual find evidence that challenges biased and negative thought patterns, as well as to help them develop strategies that encourage positive and realistic assumptions.
CBT is about reprogramming the brain into thinking in a positive and realistic way rather than a negative and self-defeating manner. The therapist will also help people understand why they feel the way that they do. Apart from challenging a flawed way of thinking, CBT also encourages clients to engage in activities that are likely to help them have positive experiences, such as taking up a new hobby or going out with friends, in order to improve their social support network and break the cycle of depression, withdrawal, and avoidance.
CBT as a treatment for panic disorders
CBT has been found to be particularly effective for treating panic disorders. Typically, CBT therapists explain to the client that the symptoms of a panic attack are the body’s normal reaction to stress. The therapist will also try to use evidence to challenge the client’s false belief that the panic attack will lead them to have a heart attack, a nervous breakdown, or worse. The therapist helps the client to interpret their symptoms in a realistic, rather than a catastrophic manner.
A part of the CBT treatment for panic disorder is exposing the client to the sensations they find threatening to help the client realise that these sensations are not life threatening. Additionally, clients are taught relaxation techniques such as breathing exercises so that they can calm themselves down and understand that they are experiencing bodily reactions that can be controlled.
Exposure therapy is used as an effective treatment for posttraumatic stress disorder (PTSD), as people who suffer from this disorder often try to avoid particular situations. Through exposure, the therapist tries to break the association that the client has made between a traumatic event and another stimulus or situation. The aim is to help the client realise that the stimuli (for instance, a particular environment) they have associated with the traumatic event are not threatening, and that they can be in control of the situation.
There are two types of exposure therapy: imaginal exposure and in vivo exposure. During in vivo exposure, the situations that are related to the traumatic event are confronted in real life, for example the person would visit the area where the event took place.
During imaginal exposure, the person relives the traumatic memories by visualising the traumatic event and describing it using present tense in as much detail as possible, including the way they feel. The idea is to help the client understand that they can face a situation which they view as stressful without any harm taking place in real time, and so hopefully reducing their feeling of anxiety.
To help with the invoked feels of anxiety, the client is taught relaxation techniques before facing repeated and brief confrontations (either imaginal or in vivo) with the stressful stimuli. The individual is asked to use the relaxation techniques while confronting the stimulus to help break the association between the stimulus, and feelings of stress or fear.
Relaxation techniques could include muscle relaxation by consciously tensing and then relaxing each major muscle group in the body, as well as learning to take slower and deeper breaths and pausing between inhales and exhales, as well as between each breath. Inhaling is typically performed through the nose while exhale through the mouth.
Counselling (person-centred therapy)
Counselling is an effective type of treatment if you generally feel that you have no one to talk to, especially if you don’t understand why you feel the way that you do, or feel confused about your emotions. Counselling often runs for a longer period of time and it might be that the client meets with a therapist multiple times per week. As with any type of psychological treatment, confidentiality is guaranteed.
Contrary to CBT where the therapist will teach you certain techniques or will give you instructions on how to deal with your problem, counselling does not involve doing ‘homework’ such as keeping a diary. The therapist’s role is to help you understand your feelings and recognise your self-worth by interpreting the information you provide but without leading the therapeutic process: this type of therapy is client led.
One technique that is sometimes used in counselling is the ‘empty chair technique’ during which the client talks to an empty chair as though it was themselves, about a particular feeling they are experiencing or another person. Sometimes the client may even change seats and answer back, having a discussion with themselves. This can be helpful as it gives you the opportunity to explore aspects of yourself or of your emotions, and to confront people in your life who you cannot actually confront (because, for example, they have passed away, or you are scared of them). This can be a particularly helpful technique for people who have experienced of abuse as they would be able to virtually confront their abuser without feeling afraid.
Interpersonal therapy is mainly focused on how problems in the client’s current relationships can negatively affect their psychological well-being. Therefore, it is the therapist’s job to help the client identify and express the feelings they have regarding their relationships, and then help the client solve any problems they may have in them. The therapist explores patterns in the client’s relationships that could lead to unpleasant feelings, and helps their client improve their way of dealing with these patterns.
Contrary to CBT, this does not involve doing ‘homework’, and usually focuses on one, or more, of the following four interpersonal issues:
- Unresolved grief – for instance, experiencing delayed grieving after losing a loved one.
- Role transitions – for example, transitioning from child to parent or from single to having a partner
- Role disputes – for example, resolving different relationship expectations between partners.
- Interpersonal or social deficits – for example, being unable to start a conversation with a stranger.
Interpersonal therapy usually runs for a short period of time, during which the therapist will try to improve the client’s communication and problem solving skills, and will propose new and more positive behaviours to engage in.
Although talking therapies can be extremely helpful, there are instances in which it may be worth considering taking prescribed medication as well. There are a wide range of medications which treat mental illness. For information on medical treatment, please consult your General Practitioner.