Chapter 7: Child Abuse SEE ATTACHED TEXT BOOK PAGES https://www.youtube.com/watch?v=il0u2s_WGXA https://www.nytimes.com/2014/03/10/us/the-trial-that-unleashed-hysteria-over-child

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Journal ofFamily Violence, Vol. 21, No . 3, April 2006 (© 2006) DOI: 10.1007/s10896-006-9019-l

The Effects of Childhood Physical Abuse or Childhood Sexual Abuse in Battered Women's Coping Mechanisms: Obsessive-Compulsive Tendencies and Severe Depression

Debra K. Miller1,2

Published online: 31 August 2006

What role does childhood abuse have on the coping choices made by a battered woman? Ancillary to a depression study (Bailey, 1996) in 79 battered women from a Houston area women's shelter were compared for past abuse experiences and how the women were coping with abuse in adulthood. This study compared coping styles between two groups of battered women: those who experienced childhood physically abuse (CPA) (n = 35), and those who did not experience childhood physically abuse (NCPA) in childhood (n = 44). All of the women filled out a battery of questionnaires in­ cluding The BriefSymptom Inventory (BS/), and a scale for learned helplessness. At-test conducted on obsessive-compulsive tendencies (OCT) scale of the BSI found that women who were NPPA had significantly lower BSI-OCT scores t(77) = – 2.05, p < .05 than women who were PPA. No statistically significant differences were found between groups for learned helplessness. Out of the 35 battered women who reported physical abuse in childhood were more likely to report sexual abuse as girls than battered women who were not physically abused, t(77) = – 3.40, p < .001. Battered women who had been physically and sexually abused in childhood were more severely depressed. Battered women who were not abused in childhood had more obsessive compulsive tendencies. The ramifications of these findings for therapeutic treatment are discussed.

KEY WORDS: battered women; coping mechanisms; learned helplessness; obsessive-compulsive tendencies.

Traditionally, the principal characteristics associated with battered women have been learned helplessness and posttraumatic stress disorder (PTSD). The battered woman syndrome was a term used by Lenore Walker for the assortment of symptoms endured by battered women–consisting primarily of learned helplessness and PTSD (Walker, 1984). Her theory was that battered women, parallel to the dogs in Seligman's (1 974) classic investigation, have to relearn the feeling of having control and that they have the ability to escape unbearable cir­ cumstances. Walker's hypothesis of learned helplessness as an explanation of why battered women stay in an abusive home was not supported by statistical analysis.

Seligman (1974) was first to find empirical support for learned helplessness. In his original research, dogs

1University of Houston, Houston, Texas. 2To whom correspondence should be addressed at 1452 Waseca, Hous­ ton, TX 77055; e-mail: [email protected].

185

were placed into cages-the dogs that were studied were unable to escape mild electrical shocks. The dogs became unmotivated to search for escape. When the opportunity for escape was presented the animals did not immediately attempt escape or take advantage of the opportunity. If learned helplessness was a result of battering the indi­ cators of susceptibility, according to the battered woman syndrome, included seven factors that indicate suscep­ tibility to becoming a battered woman: social learning (gender roles taught to children), learned helplessness in childhood, early and repeated sexual molestation, phys­ ical assault, a high level of family of origin violence, critical events over which the child has no control, and those who are at high risk for depression. Hotaling and Sugarman (1986) performed a meta-analysis of risk mark­ ers for women who would likely experience battering in adult relationships. The most prevalent risk marker was witnessing violence in their family of origin as children. This study looked at the antecedent factors of childhood

0885-7482/06/0400-0185/0 © 2006 Springer Science+Business Media, Inc.

186

physical abuse and childhood sexual abuse as determi­ nants of coping styles in battered women. Does a woman who experienced physical abuse in childhood exhibit pre­ dictable reactions to abuse in adulthood? Does sexual abuse in childhood have a predictable influence on the coping choices made by a battered woman?

Recent research has shown multiple reactions to bat­ tering. Talbot et al. (2000) measured personality traits in adult women who experienced incidence of sexual abuse in childhood-the women were much more intro­ verted and much less open to new experiences than other women. Sexually abused girls have a tendency to become re-victimized as battered or sexually assaulted women (Bleiberg, 2000). Incest survivors have a higher preva­ lence of dissociation and greater general distress (Brown, 1998). The women in Brown's study also had increased body image distortion. Barber (1998) noted a frequent oc­ currence ofdissociation in incest victims and children who experienced traumatic events. The impact of sexual abuse dominated the list of antecedent events resulting in greater use of dissociation. Other antecedent variables include loss, greater frequency of traumatic events, and younger age of onset. Depression and anxiety are pervasive in women who endured sexual abuse during childhood. And they have longer duration of depressive symptoms and greater frequency of suicide attempts.

Survivors of incest are often diagnosed with post­ traumatic stress disorder. One relevant study by Courtois (2000) supports the presence of"complex PTSD"-a pro­ posed diagnostic spectrum that includes long-term reper­ cussions of severe childhood sexual abuse. The diagno­ sis encompasses dissociation along with other disorders and a deficit of normal developmental skills. Kessler and Bieschke (1999) examined the relationship between incest survivors and adult victimization. They found that shame was a significant predictor of those who were abused in childhood as well as adulthood. Smith (1999) disclosed four major characteristics of women with a history of childhood sexual abuse: nightmares, hopelessness, feeling "like a failure", and hypersexual behavior. Mothers who experienced sexual abuse in their own childhood tended to have delayed reactive symptoms when they discovered sexual abuse in their own child (Green et al., 1995). The symptoms included acute schizophrenic reaction, depres­ sion, insomnia, anorexia, or panic attacks. In addition, the symptoms included reliving their own experience­ described in diagnostic criteria of PTSD as acting or feel­ ing as if the traumatic event was reoccurring (flashback episode, hallucinations).

Adults who disclose abuse in their childhood tend to be socially stigmatized by acquaintances as well as their immediate family. Tunick (2000) substantiated this fact

Miller

in an exploration of adult survivors of incest and phys­ ical abuse. Abuse survivors described past abuse, which was reviewed by 1375 professionals-including psychia­ trists, psychologists, undergraduate psychology students, and social workers. The incest survivors were significantly stigmatized over the physical abuse group and the control group-even among psychological professionals.

The emotional coping skills used during childhood by those who were sexually abused in childhood were withdrawal, distraction, or dismissing-avoidant attach­ ment behaviors. They also reported elevated levels of fear, sadness, anger, guilt, and shame. Depression and anxiety were related to lower perceived support from nonoffend­ ing parents in sexually abused girls (aged 11-18 years) as noted by Spaccarelli and Fuchs (1997). The girls relied on cognitive avoidance coping-tending to deal with social problems by self-distraction.

Gleason (1993) tested 62 battered women for per­ sonality characteristics. He found that 99% of the battered women had anxiety symptoms: obsessive-compulsive disorder, generalized anxiety disorder, PTSD, major depression, and substance abuse. Obsessive-compulsive tendencies were prevalent in the group of battered women who were living in the home with their assailant.

ACTIVE OR PASSIVE COPING MECHANISM

How a woman reacts to battering varies depending on her cognitive schema and her emotional development. These two elements are profoundly influenced by abuse in childhood and by what type of abuse she endured. Some battered women may try to do everything they can to forestall a battering incident; conversely, some battered women may feel that there is nothing within their power that she can do to stop the battering.

The Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 2000; DSM-IV-TR) outlined defense mechanisms stating that defensive functioning deals with internal or external stressors by action or withdrawal. To differentiate between active and passive coping mechanisms we can define coping as physical or mental effort put forth to effect a change in circumstances or environment in one's own favor. Examples of active coping mechanisms are acting out, altruism, devaluation, displacement, reaction formations, and self-assertion. Passive (withdrawal) coping mechanisms are exemplified by little or no effort put forth to effect a favorable change–efforts might only be toward escape or denial. Examples of passive means of coping are anticipation, denial, dissociation, repression, and suppression. Obsessive-compulsive tendencies and

Obsessive-Compulsive Tendencies in Battered Women

learned helplessness can be understood in the framework of active or passive coping mechanisms.

Obsessive-compulsive tendencies are symptomatic expression of active coping means. They are ritualized behaviors that reduce anxiety and impact circumstances in a beneficial way (hopefully lessening the chances of a bat­ tering incident). Obsessive-compulsive tendencies (OCT) are differentiated from obsessive-compulsive disorder and obsessive-compulsive personality disorder by the reduced pathology associated with a tendency versus a disorder. Obsessive-compulsive tendencies are coping responses to stress–characterized by an impulse to take action to re­ duce stress. Obsessive-compulsive tendencies are directed toward a specific purpose-that of alleviating a distressing situation or avoiding a distressing situation in the near fu­ ture. Dumont (1996) describes the extreme reaction many obsessive-compulsive disorder sufferers have to feelings of anxiety. Feelings of panic invoke worries of having a heart attack in obsessive-compulsive sufferers, who have a strong belief in the danger of their racing heart, tightness in the chest, and shortness of breath indicates the onset of imminent danger. Obsessive-compulsive disorders are also characterized by magical thinking-the performance of ritual to extinguish threatening thoughts and feelings. The belief is that if the ritual is performed correctly, then the source of their stress will be removed or altered. To insure this result, someone with an obsessive-compulsive disorder must repeat the ritual over and over again. Very often she will avoid situations that create anxious feelings and the subsequent compulsion to perform rituals. There is some awareness and embarrassment over the illogical thinking that fuels compulsions, but she is not able to re­ sist following through with the ritual that will be rewarded by alleviating anxiety. In a battered women, however, the rewards can be very real-the prevention of a battering incident or even saving her life.

Belief that one's actions can prevent a negative event proves to be an insidious means of living life. Preven­ tion calls for supreme diligence. If the battered woman feels she can reliably predict an outcome to her obsessive­ compulsive action then she feels more confident in per­ forming a preventative action. For example, if she knows that if the batterer consumes alcohol, then there is a high probability that the evening will end in a battering inci­ dent. The prevention of consuming alcohol is a concrete and reasonable preventative action to take-a reasonable active coping mechanism. If, on the other hand, she can never predict whether a particular circumstance or event will cause the batterer to get angry, such as the possibility that dust on the furniture will initiate a battering incident, then she has to continually dust the furniture to prevent a battering incident. Escalation into formidable levels of

187

cleanliness is inevitable. Ironically no matter what efforts she puts forth the batterer will eventually get angered-if not about dust, then angry about something else. Realiza­ tion that the dust does not having anything to do with the level of her batterer's anger is hard to come by. If there is even a small chance that removal of the dust will prevent pain and injury, she will be

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