Emotional Abuse – Domestic Violence and/or Couples Arguing in Negative Cycle

In E.F.T., we anticipate, expect verbal jousting, angry words, and even some bullets. These “bullets” as
Sue Johnson refers to them may include
 Insults
 Name calling
 Loud voices, yelling
 Contemptuous statements
 Sarcastic, caustic put-downs
 Powerful expression of abandonment or rejection thoughts/emotions
 Exaggeration, blanket statements about person’s intention or character
 Declaring relationship is done when partner is distressed

Such behaviors are not uncommon between couples triggered in to a negative cycle in an insecure
attachment relationship. Bowlby might understand them as desperate attempts to get a partner’s
attention and indirect expressions of pain. What do we do when they occur with such frequency,
intensity or both as to constitute emotionally abusive behavior? Can we do E.F.T. with these couples?

Signs of emotional abuse (as well as physical aggression and/or intimidation) must always be taken
seriously and attended to in therapy, individual, couple or family. These include but are not limited to:
 Belittling, demeaning, put-downs, frequent attacks on character of the other
 Disapproving, contemptuous looks or language, intolerant and/or lack respect
 Routinely pointing out flaws, mistakes and shortcomings
 Calling names, put labels on partner, make cutting remarks under their breath
 Using neglect or abandonment real or threatened to punish the partner
 Subtle threats, negative remarks to control or threaten the partner
 Inability to see the partner as having needs, as being a person, not object to control
 Screaming, swearing, yelling
 Isolating the partner from family, friends, work
 Name-calling, mocking
 Excessive and/or incessant criticism of partner
Assessment Tasks: 1) Severity and impact? 2) Are they part of a pattern of control and dominance?
Physical acts of aggression may also be reported, “She slapped me,” or “He blocked the door,” are these
acts of intimate terrorism, contraindicating E.F.T. or arising from situational distress in a negative cycle?

A growing segment of the domestic violence literature demonstrates that there is more than one type of
intimate partner violence (M.P. Johnson, 2005). Domestic violence, fights and arguing, take different
distinct forms. Two common distinctions are Intimate Partner Terrorism, akin to the violent controlling
behavior commonly reported of or portrayed in the media.

“In everyday speech and even in most social science discourse, "domestic violence" is about men beating
women. It is estimated that somewhere in the neighborhood of two million women in the United States
are terrorized by husbands or other male partners who use violence as one of the tactics by which they
control "their woman." Most of the literature on domestic violence is about men controlling women in
intimate relationships through the use of violence.

This is not, however, the only form of violence between adult or adolescent partners in close
relationships, and our review will therefore cover "partner violence" in a broad range of couple
relationships, including the marital, cohabiting, and dating relationships of same-gender and opposite-
gender couples.”

A leading researcher, M.P. Johnson reports “It is no longer scientifically or ethically acceptable to speak
of domestic violence without specifically, loudly and clearly, the type of violence to which we refer.” (Or
are assessing or seeing in our office). This is where E.F.T. therapists find themselves, assessing
emotional and physical violence. The assessment is key as the existence of ongoing domestic violent
abuse is a contra-indicator for E.F.T. with couples (Johnson, Susan 2004).

Johnson (M.P.) says we can distinguish between four major patterns of partner violence which he calls:

1) Common couple violence (some refer to as acute situational stress violence)

2) Intimate Terrorism (a pattern of control with violence, intimidation across time and multiple
situations that compromise the relationship and entail risk and harm to the victim).
3) Violent Resistance (to Intimate Terrorism – response to perpetration of violence)
4) Mutual violent control (both partners engaging in intimate terrorism – two intimate partners
battling for control)

The distinction between #2 (and accompanying #3) and #4 above from #1 is not based on a single
incident but on general patterns of control across the many encounters that comprise a relationship,
patterns that are rooted in the motivations of the perpetrator (and his or her partner). E.F.T. is contra-
indicated for Intimate Terrorism with or without violent resistance and mutual violent control.

Research indicates that the vast majority of victims of abuse in intimate relationships are women whose
partners are men. Emerging research has not only confirmed earlier findings, but also has indicated that
men in same-sex relationships experience domestic violence at rates at least equal to that of women in
heterosexual relationships, and that lesbians and some men in heterosexual couples also experience
abuse (National Consensus Guidelines report, 2004). Therapists are advised to check for bias and
assumptions regarding the possibility and extent of abuse in relationships that they treat.
I.P.T. exists in LBGTQ relationships, with perpertors “using all the same power and control tactics used in
heterosexual relationships.” From http://www.thehotline.org/is-this-abuse/lgbt-abuse/

An Brief Overview of Intimate Terrorism – Resources for Assessment

Hit
Insult
Threaten
Scream -

Frequency, Intensity, Impact

H.I.T.S. is an acronym and very basic assessment tool developed for use in emergency rooms and
physician offices. How often, how intensely does your partner hit you, insult or demean you, threaten or
intimidate you, and/or scream at you? It was developed to teach and support medical personal with
tools and awareness to look for and do basic assessment triage.

The Revised Conflict Tactics Scale (Straus) gives a sense of the types of behaviors found in Intimate
Partner Terrorism. This is an example of more detailed tool for assessment. We need both. Tools to
use in the moment, and those for further exploration and uncovering of the extent of abuse, and the
type of abuse as described above. The Danger Assessment Tool assesses immediate, severe danger.

Start in your initial inquiries: Include a summary of H.I.T.S. in your couples questionnaire at intake as an
opening: How often does your partner hit or physically intimidate you? How often does your partner
insult or demean you? How often does your partner threaten you physically or relationally? How often
does your partner scream at you? How often do you do these things to your partner?

Putting Emotionally Abusive Behavior or Situational Violence in to Context: This grid outlines
differences in these types of violence as identified by researches such as M.P. Johnson, Stith, McCollum
and others. It is not intended for use as or substitute for an assessment tool:

Situational Common Violence Intimate Partner Terrorism

Acute Outbursts
Stress Response, Stress Related
More often mutual, reciprocal
Not part of overall strategy and tactics to control,
intimidate partner
More likely to accept responsibility when in safe
therapy environment
Both partners more likely to be involved
Less severe impact on partner’s view of self and
place in the world
Not as likely to escalate over time
Physical and emotional consequences less severe
Expressions of attachment distress expression
related to attachment styles, escalated cycles
Chronic Embedded Pattern
Characterological, Control Driven
One dominant, abusive partner
Often violence or emotional abuse is just one of
many tactics to control partner
Elements of deception, denial, manipulation of
therapy process by perpetrator
More likely to be perpetrated by men
Powerful, progressive harmful impact on victims
view of self over time and place in the world
More likely to escalate over time
Severe consequences to physical health,
emotional well-being, overall well-being for
victims
Most typically is connected to a general pattern
of control
 Couples therapy can be beneficial; individual Couples therapy contra-indicated; not allowed in
without couples work may be harmful court-ordered treatment of domestic violence

From Medical Community – Possible Signs of Domestic Violence sign in Medical Offices:

For Adults • Failure to keep medical appointments, or comply with medical protocols • Secrecy or
obvious discomfort when interviewed about relationship • The presence of a partner who comes into
the examining room with the patient and controls or dominates the interview, is overly solicitous and
will not leave the patient alone with her/his provider • The patient returns repeatedly with vague
complaints • A patient who presents with health problems associated with abuse • Unexplained injuries
or injuries inconsistent with the history given • Somatic complaints • Delay between an injury and
seeking medical treatment • Injury to the head, neck, chest, breasts, abdomen, or genitals • Bilateral or
multiple injuries, especially if in different stages of healing • Physical injury during pregnancy, especially
on the breasts and abdomen • Chronic pain without apparent etiology • An unusually high number of
visits to health care providers • High number of STI’s, pregnancies, miscarriages, and abortions • Repeat
vaginal and urinary tract infections. (Note: different lists available for children and the elderly).

Assessment – Common or Situational Couples Violence (C.C.V.) or Intimate Partner Terrorism (I.P.T.)

It becomes essential to assess whether a couples emotionally abusive outbursts, an incident of physical
aggression or other behaviors fits or arises and is an expression of Situational Common Couples Violence
or Intimate Terrorism. Research indicates that these may be two relatively distinct populations and
types of violence. Distinguishing what has been called patriarchal violence from the more common,
more prevalent situational acute violent episodes is essential. Emotionally harmful statements spoken
in and outside of sessions are a common caution flag for E.F.T. and E.F.F.T. therapists. Such behaviors
turn our attention to the importance of assessment.

Intimate Partner Terrorism is not appropriate or safe for Emotionally Focused Couples Therapy. I.P.T.
occurs in relationships across cultures, relational orientations, age, economic status, and when present
must be taken seriously. The distinguishing feature of I.P.T. is a pattern of violent and non-violent
behaviors that indicate a motive to control (Johnson M.P. & Ferraro, 2000).

Stud-
ies indicate that
couples who use
this type of violence
(Intimate
Terrorism) should
receive individ-
ual therapy
specifically aimed
at helping the
violent partner
disrupt the cycle of
control before
considering conjoint
therapy (Johnson,
1995; Johnson,
2006; Stith et al.,
2012). In these
cases,
treating IPV with
couples counseling
or framing violence
within a relational
system can be seen
as
providing excuses
for the perpetrator
and may exacerbate
the risk of violence
to the victim
(Adams, 1988; Stith
et al.)
Studies indicate that couples who use this intimate terrorism type of violence should receive individual
therapy specifically aimed at helping the violent partner disrupt the cycle of control before considering
conjoint therapy (Johnson, 1995; Johnson, 2006; Stith et al., 2012). In these cases, treating IPV with
couples counseling or framing violence within a relational system can be seen as providing excuses for
the perpetrator and may exacerbate the risk of violence to the victim (Adams, 1988; Stith et al.).

Controlling, the instrumental use of anger to force a partner to do something or to not do something,
forcing will on another and worse, these are some of the aspects of intimate terrorism. One can readily
see, that any physical aggression or emotional abuse towards a victim of intimate terrorism is
unacceptable, extremely harmful, and dangerous to their health and well-being.

Emotionally Abusive or Physical Aggression in Couples Therapy: Emotional abuse is a tactic seen in
I.P.T. and can also occur during escalated situations with common couples violence. Emotionally abusive
language, bullets, always harmful, need to be assessed and addressed with an understanding of what is
going on here with this couple? Intimate terrorism or situational couples violence. This brief article is
intended as a resource to open exploration for therapists only.

In assessing possibility or severity of domestic violence, we need to frame and ask questions
effectively. Below are some examples from the National Consensus Guidelines (2005):
Framing questions:

• “Because violence is so common in many people’s lives, I’ve begun to ask all my patients about it”
• “I am concerned that your symptoms may have been caused by someone hurting you”
• “I don’t know if this is (or ever has been) a problem for you, but many of the patients I see are dealing
with abusive relationships. Some are too afraid or uncomfortable to bring it up themselves, so I’ve
started asking about it routinely”
Direct verbal questions:
• “Are you in a relationship with a person who physically hurts or threatens you?”
• “Did someone cause these injuries? Was it your partner/husband?”
• “Has your partner or ex-partner ever hit you or physically hurt you?”
• “Do you (or did you ever) feel controlled or isolated by your partner?”
• “Do you ever feel afraid of your partner? Do you feel you are in danger?”
• “Is it safe for you to go home?”
• “Has your partner ever forced you to have sex when you didn’t want to? Has your partner ever refused
to practice safe sex?”
• “Has any of this happened to you in previous relationships?”

Effective assessment strategies when working cross culturally: It is important to adapt your assessment
questions and approach in order to be culturally relevant to individual patients.
Listen to patients, pay attention to words that are used in different cultural settings and
integrate those into assessment questions.

For example: for coastal Inuit groups, “acting funny” describes IPV, in some Latino communities,
“disrespects you” indicates IPV.

Focusing on actions and behaviors as opposed to culturally specific terminology can also help, or
some groups may be more willing to discuss abuse if you use general questions.

Be aware of verbal and non-verbal cultural cues (eye contact or not, patterns of silence, spacing
and active listening during the interview).

SOME EXAMPLES INCLUDE:

• Use your patients language: “Does you boyfriend disrespect you?”

• Be culturally specific: “Abuse is widespread and can happen even in lesbian relationships. Does your
partner every try to hurt you?”
• Focus on behaviors: “Has you partner ever hit, shoved, or threatened to kill you?”
• Begin by being indirect: “If a family member or friend was being hurt or threatened by a partner do
you know of resources that could help them?”
Above from: National Consensus Guidelines, On Responding to Domestic Violence Victimization (2004) The Family Violence Prevention Fund

What questions might you ask to open the conversation about physical aggression and emotional
abuse? _________________________________________________________________________
Therapist suspects or assesses that Intimate Partner Terrorism is Occurring:

1) Do not proceed with an Emotionally Focused Therapy approach that fosters

vulnerability in session. Stop, observe, gather information, create a safety plan.
2) Increase assessment focus on violence and abuse, prioritizing assessment before
proceeding further in the Steps and Stages of E.F.T. or E.F.F.T.
3) Individual session with each partner, to create space for the possible victim to share
openly and in detail with the therapist.
4) Seek consultation and support as needed (respecting confidentiality).
5) Use of Self: Address and attend to issues of intimidation, perpetrators of I.P.T. can often
intimidate or unbalance therapists. Some may be charming in the office, with only
subtle micro-cues or micro-aggressions towards the partner sufficing to shut them
down. Our own experience of abuse can impact our ability to see clearly what is being
presented. Gender, culture norms, knowledge level regarding domestic violence are
just a few of the factors impacting our ability to engage with C.C.V. and/or assess I.P.T.
6) Conjoint therapy with I.P.T. is contra-indicated in line with consensus among domestic
violence programs, the therapy field, and researchers in the domestic violence field.
7) Ending Conjoint Therapy: If a clinician due to a complicating factor assesses that
conjoint therapy cannot be stopped abruptly, move to a therapy approach not centered
on accessing and fostering vulnerable emotions and dialogue. Make plan to end
conjoint therapy as soon as possible.
8) Duty to Report laws, in most jurisdictions, therapists cannot break confidentiality to
report domestic violence, intimate partner terrorist acts, to social services or the police.
Seek legal advice. Exceptions likely exist with homicidal risk, child or elder abuse.
9) Focus on the victim of abuse, though the couple came in as the client, a moral, ethical
responsibility regarding safety arises in the face of I.P.T.
10) Resource the Victim of I.P.T. – if terminating couples therapy is required resource the
victim. Referrals to domestic violence hotlines, safety plan, encourage de-isolating
(prompting or helping the victim to contact old friends and family), referral to therapists
who work with victims or seeing them individually (clinical judgment assessment), and
being clear about the rights and dignity of the individual.
11) Acknowledge the difficulty of saying “no” or leaving; recognize most victims want the
abuse to stop. Insisting they leave may shut down communication, cut off resources.
Situational or Common Couples Violence Overview: Situational couple violence contrasted
with I.P.T. is described by Johnson (1995) as specific arguments in a partner relationship that
escalate to violence without being embedded in an overall context of power and control.
This type of domestic violence may be amenable to E.F.T., but risks of further escalation or
exacerbation of aggression and violence needs to be assessed in an ongoing manner.

FROM
SCARED TO
REPAIRED:
USING AN
ATTACHME
NT-BASED
PERSPECTI
VE TO
UNDERSTA
ND
SITUATION
AL COUPLE
VIOLENCE
Christine
Schneider
St. Louis University
Andrew S.
Brimhall
East Carolina
University
Situational couple
violence (SCV) is a
common problem in
couples presenting
for therapy.
SCV, as seen
through the lens of
attachment, can be
viewed as a result
of an insecure
attach-
ment system within
the couple.
Although several
authors have
discussed individual
attach-
ment styles as
predictors of both
the receipt and
perpetration of
violence, in this
article we
seek to portray the
attachment system
as a relational and
changing construct.
As such, we
argue for conjoint
treatment for SCV
as a way to
restructure a more
secure attachment
sys-
tem within the
couple. Cautions for
the appropriateness
of couples
counseling with
ongoing
violence are
included. Finally,
we discuss the use
of an attachment-
based safety plan
and
time-out strategy to
use with couples
experiencing SCV.
Situational couple
violence (SCV) has
been shown to be
the most common
form of violence
both in the overall
population (Johnson
& Leone, 2005;
Tjaden & Thoennes,
1999) and in
couples
seeking conjoint
therapy (Dutton et
al., 2006; Simpson,
Doss, Wheeler, &
Christensen, 2007)
S.C.V. is the most common form of violence seen in couples seeking conjoint therapy, and in the
general population (Whisman, Dixon, Johnson M.P., 1997). While intimate terrorism exists, it is
a minority of the cases (Johnson, 1995, 2006; Johnson & Leone, 2005), thus the term
“common” was coined by Michael P. Johnson in 1995 and continues to be used.
“Although the term common couple violence has now become more widely used…”common”
should not imply that this type of violence is more benign or acceptable. Any conflict that
escalates to the point of physical aggression is used can put couples in danger.” The legal
system also does not differentiate, violence is a crime, and couples need to be aware of this.
When considering couples treatment for SCV, it is important to remember that all violence is
not the same. Use of scales such as the Revised Conflict Tactics Scale (Straus, Hamby, Boney-
McCoy, & Sugarman, 1996) can help a clinician to not only assess for violence, but also to form
an opinion as to whether or not the violence is happening within an overall context of power
and control (IT). When such a context exists, couples therapy is contra-indicated (McCollum &
Stith, 2008; Stith et al., 2012).
Situational couple violence is described by Johnson (1995) as specific arguments in a partner
relationship that escalate to violence without being embedded in an overall context of power
and control. For these couples, violence tends to be more bidirectional in scope and is typically
caused by situational frustration or anxiety (Johnson & Leone, 2005; Johnson, 2006). In
attachment terms, such arguments that escalate to violence may be seen as expressions of
attachment styles in a highly escalated negative cycle (Schneider, Brimhall, 2014).
It is reported by therapists as one of the most difficult problems to treat in couples therapy.
One of the most clinical difficult decisions is whether couples therapy with ongoing violence is
prudent, effective or safe. Studies indicate no increased danger of violence in S.C.V. couples
when treatment directly addresses violence (Stith, McCollum, et al, 2012). Thus, the ongoing
attention to whether violence is Type #1 (see page one) or Types #2, 3 or 4 (intimate terrorism)
is essential.
“Systemic Perspectives on Intimate Partner Violence Treatment,” Stith, McCollum, Amanor-
Boadu, Smith, Journal of Marriage and Family Therapy, September 2011
“From Scared to Repaired: Using an Attachment-Based Perspective to Understand Situational
Couple Violence,” Schiender and Brimhall, JMFT, May 2013

With the presence of emotionally abusive behaviors, physical aggression, or other examples of
possible control and dominance intent, we need to Stop, Think, Observe and Evaluate before
Proceeding. When we see the first signs of possible I.P.T versus C.C.V., how can we explore and
expand our clinical assessment and understanding. Examples of presenting issues that can have
multiple meanings, exist within either C.C.V. or I.P.T., and different levels of reciprocity or harm:
Financial Control: A partner’s reported obsession about the budget, and tracking every penny
spent, is it a sign of O.C.D. type issues? Is it a hobby and drive now that they are retired, an
expression of fear about their future security, so they are on the internet all day learning about
stocks, bonds, inflation and the like? Are they trying to get their partner to listen and respect
their frugal view of money? Do they put their partner down, insult and scream at them and
threaten to cut off all access to funds? Are they using finances to control, as one tactic in a
larger pattern of control and dominance? Is it just annoying or is it a sign of darker
undercurrents in the marriage?
Sexuality Differences: The request to engage in this particular sexual behavior, which the other
partner does not want to do. Is this part of an intimacy dance? Have these partners
experienced this before, were one partner wants to expand their sexual range of experience, the
other balks. With dialogue and time, the support of the therapist, the discussion may foster
intimacy, egalitarian dialogue and increased safety? Is the request a sign of misattunement,
misreading signals or cues in the relationship, or could it be a reach? Is there sexual trauma
history for either partner? Does the partner try to coerce or force the other to comply with their
request? Do they lose connection or forget their partner’s feelings, experience and needs? Is
their force applied, threats and intimidation? Is this part of a larger pattern of control and
dominance?
In-Law Conflicts: a demand or request by one partner to another to not have to interact with
in-laws: Have the in-laws seriously harmed, demeaned, ignored, rejected or insulted the
partner? Is the conflict with the in-laws a trigger for and a part of the couple’s negative cycle?
Are their issues of trauma and loss related to the conflict? Or is one partner isolating the other
from their family? Do they exacerbate conflicts to control the situation, and isolate partner?

General Considerations with Common Couples Violence – Emotional Abuse with use of E.F.T.
Working in a intensive treatment milieu with easily escalated or overwhelmed adolescents, or
team’s motto was “Safety First.” We studied Therapeutic Crisis Intervention techniques
(T.C.I.). We received annual trainings regarding the assessment of violent risk, risk of self-harm
and other risk factors involving our clients, their families and in the community.
Safety is the first consideration. If a clinician assesses through individual sessions, couples
behavior, surveys and other information that a partner is a victim of intimate terrorism or a
couple is locked in mutual violent control, referrals need to be made, educational material
shared and community resources made available (such as domestic violence hotlines). The
clinical decision that couples therapy and E.F.T. are contra-indicated leaves us still with an
opportunity to leverage or involvement to increase the possibility that the violence ends or at
the least the victim is able to find a safe place away from intimate terrorism.
Ideas and Suggestions for Safety with common couples violence:
1) Contract for Honesty, as with addiction work, an agreement and encouragement for
partners (or family members in E.F.F.T.) to be honesty and upfront about relapse is
essential.
2) Ask, check-in, as one might with an individual client with severe depression assessing
suicidal risk, ask about violence frequently.
3) Validate and explore, to the degree possible without condoning violence, let couples
know that you as a clinician understand that violence does occur in couples.
4) Use #3 above as an opportunity to educate and expand the dialogue:
a. Outline the difference between common couples violence and intimate
terrorism – encourage vulnerable dialogue with you in session.
b. If it is I.P.T., a partner reporting common violence may increase awareness that
their partner is more abusive, aggressive and violent than acceptable, and
c. In this way, even if has not been safe to share extent of the control, therapy
educates the victim. Knowledge is power in these situations for victims.
5) Assessment:
a. Use your individual sessions to ask some of the questions referenced above,
b. Ask the H.I.T.S. questions in your written questionnaire,
c. Ask about violence with every couple, as you might ask about addiction, trauma
and affairs early on – ask again if they have an intense escalation of their cycle.
6) In session: “Stop, stop, whoa…” Sue Johnson, EFT in Action Training DVD (2011)
a. Do not allow their cycle to escalate and remain up in the room,
b. It is essential to establish the office as a safe haven, and
c. Establish your therapy relationship as a secure base.
d. Use E.F.T. Tango, Empathy, validation and cycle frame to slow session down.
7) Individual sessions, if you discover signs of violence during the course of treatment, ask
for individual sessions. Since you may not know if it is I.P.T. or C.C.V., clinicians may
want to offer a more generic explanation of why you need these session.
8) Anxiety & use of self, sometimes anger in the room, reports of violence, can create
anxiety in a clinician or a therapist may be intimidated by the expression of anger. Seek
consultation and support to allow yourself to provide the structure necessary in
therapy. Remember, your presence and care is a resource for C.C.V. couples.
9) Anxious people need structure, an old supervisor used to say to me. When violence
exists or has occurred for a couple, assume increased levels of distress and
dysregulation during and between sessions.
a. Provide a structure or rhythm for sessions where you have clear beginning,
middles and ends. Avoid opening up new stressful topics late in session.
b. Provide educational frameworks for understanding what is happening between
them grounded in attachment theory – tie bows to vulnerable experiences.
c. Have them read Love Sense first, as these couples can learn from that book
before delving in to the more intimate, intense process of having the
conversations in Hold Me Tight. This work they likely need to do with you.
d. Inquire about anger outbursts, escalated cycle outbreaks, H.I.T.S. and the like
routinely and early in session – and after any intense outburst of the cycle.
10) Therapeutic Leadership: It is essential with these couples that we take process
leadership in session and we are clear that violence is not acceptable.
a. Lead the therapy process – take charge of sessions.
 b. Reduction and elimination of physical aggression and emotional abuse must be
central and primary goals of therapy.
c. Provide structure for outside of session as needed, including tools such as “adult
time outs” which are attachment based if needed (see “From Scared to
Repaired” article above).
d. Resource yourself to increase your grounding in this issue and your confidence
in addressing. There are numerous excellent sites with a plethora of
information and resources regarding domestic violence, emotional abuse and
common couples violence. Don’t do this work alone.
e. Seek support and consultation as needed.
Alcohol, Substances and C.C.V. including emotional abuse and escalated cycles:
Researchers commonly agree that alcohol is not a major contributing cause of violence in I.P.T.
It may increase the level of violent behavior though.
file:///C:/Users/Owner/Documents/EFT/sa-and-ipv-bennett-and-bland-vawnet_ii1.pdf

With Common Couples Violence, alcohol may correlate with increase escalation in their
negative cycle, and the incidents of emotional abuse or physical aggression, violent or rageful
behavior were addressing. Alcohol is not an excuse for physical or emotional violence.

Separate assessment of alcohol and other substance use may be required. However,
substance use and drinking are not excuses for aggression, nor should such explanations be left
unchallenged in E.F.T. Safety first may require discussing abstinence from alcohol or reduced
use in any one drinking episode (such that neither partner reaches an intoxication level that
contributes to escalated).

a partner
relationship that
escalate to violence
without being
embedded in an
overall context of
power and control.
For these couples,
violence tends to be
more bidirectional
in scope and is typi-
cally caused by
situational
frustration or
anxiety (Johnson &
Leone, 2005;
Johnson, 2006).
Jacob-
sen and Gottman
(1998) discussed
SCV as part of a
relational cycle that
contains negative
reciprocity, rapid
escalation, and a
lack of withdrawal
rituals from
escalating
arguments. Distin-
guishing factors of
SCV include the
even dispersal of
violence between
male and female
partners
and lower levels of
violence (Dutton et
al., 2006; Johnson,
2006; Johnson &
Leone, 2005;
Simpson
et al., 2007)
Situational couple
violence, however,
is described by
Johnson (1995) as
specific arguments
in
a partner
relationship that
escalate to violence
without being
embedded in an
overall context of
power and control.
For these couples,
violence tends to be
more bidirectional
in scope and is typi-
cally caused by
situational
frustration or
anxiety (Johnson &
Leone, 2005;
Johnson, 2006).
Jacob-
sen and Gottman
(1998) discussed
SCV as part of a
relational cycle that
contains negative
reciprocity, rapid
escalation, and a
lack of withdrawal
rituals from
escalating
arguments. Distin-
guishing factors of
SCV include the
even dispersal of
violence between
male and female
partners
and lower levels of
violence (Dutton et
al., 2006; Johnson,
2006; Johnson &
Leone, 2005;
Simpson
et al., 2007)
Situational couple
violence, however,
is described by
Johnson (1995) as
specific arguments
in
a partner
relationship that
escalate to violence
without being
embedded in an
overall context of
power and control.
For these couples,
violence tends to be
more bidirectional
in scope and is typi-
cally caused by
situational
frustration or
anxiety (Johnson &
Leone, 2005;
Johnson, 2006).
Jacob-
sen and Gottman
(1998) discussed
SCV as part of a
relational cycle that
contains negative
reciprocity, rapid
escalation, and a
lack of withdrawal
rituals from
escalating
arguments. Distin-
guishing factors of
SCV include the
even dispersal of
violence between
male and female
partners
and lower levels of
violence (Dutton et
al., 2006; Johnson,
2006; Johnson &
Leone, 2005;
Simpson
et al., 2007)
Situational couple
violence, however,
is described by
Johnson (1995) as
specific arguments
in
a partner
relationship that
escalate to violence
without being
embedded in an
overall context of
power and control.
For these couples,
violence tends to be
more bidirectional
in scope and is typi-
cally caused by
situational
frustration or
anxiety (Johnson &
Leone, 2005;
Johnson, 2006).
Jacob-
sen and Gottman
(1998) discussed
SCV as part of a
relational cycle that
contains negative
reciprocity, rapid
escalation, and a
lack of withdrawal
rituals from
escalating
arguments. Distin-
guishing factors of
SCV include the
even dispersal of
violence between
male and female
partners
and lower levels of
violence (Dutton et
al., 2006; Johnson,
2006; Johnson &
Leone, 2005;
Simpson
et al., 2007)
Catching Bullets – Stopping Bullets – Safety in Face of Emotionally Abusive/Harmful Words:
Whenever violence is acknowledged within a couple, the safety (both physical and emotional) and
empowerment of both partners is the fundamental task. This applies in the office, where clinicians must
be active, taking charge of sessions, and addressing emotionally abusive behaviors in session (and
present or historical reports of emotional abuse, physical aggressive behavior and other forms of
situational violence that are unsafe)

1) Emotionally harsh, abusive, harmful words impact on the other partner must be
attended to in E.F.T.
2) Therapists must take charge and slow the session down when one or both partners
engage in emotionally abusive words and actions.
3) Assessment of Trauma: Escalated cycles may be indicators of a trauma response,
explore and attend to possible trauma history, and high scores on the adverse childhood
experience scale (ACE’s). https://www.cdc.gov/violenceprevention/acestudy/
4) Assessment of Attachment Injury: Escalated cycles may be indicators of underlying
attachment injury being expressed indirectly through rage or defensive withdrawal.
5) When witnessing a bullet or emotionally abusive words, we need to slow down and
insert ourselves in to the process; take leadership and move to slow things down.
6) We need to be careful to attend to the object of the contempt, name-calling, insult or
put-down for example. If we get lost in the reflection, we may not see the harm or
reaction of the receiving partner. The escalated partner can be more compelling in
these situations.
7) Moving towards the partner who is giving emotional bullets can help us to validate
reactivity and look for openings in to deeper meaning, yearning and vulnerability.
8) Empathy and validation should not become collusion with, acceptance of use of a
phrase such as “He’s just evil,” or “She is an emotional midget.”
9) When treating escalated negative cycles such as extreme harsh pursuit or intensive
defensive withdrawal (attack back), the clinicians can:
a. Set the tone for emotional safety, escalated couples rarely do this on their own.
b. Name and attend to “bullets” that are emotionally abusive, harmful.
c. Work collaboratively with the couple to identify, stop, reflect in session when
such words start being used;
d. Work towards identifying the distress as it arises in the moment, in session,
e. Help partners to stop themselves in session, and attend to what is happening
inside, what is being triggered, processing in the moment within patterns and
positions.
 10) Some couples who are able to deescalate these behaviors in session, cannot do so at
home when triggered. Overt conversation about this is required.
11) Let them know that until they are able to de-escalate the negative cycle, their ability to
refrain from these harsh behaviors may be limited. This can serve as motivation to work
together to understand and get felt sense of their negative cycle, triggers, together.
12) Use the cycle frame, as common enemy, and get in to their experience of the cycle, and
13) Explore the impact of the negative cycle, C.C.V. behaviors, on their closeness, felt sense
of security and comfort, when these behaviors occur,
14) Move towards each partner when caught in escalated cycles involving emotionally
abusive, harmful words and behaviors. Do not leave them alone with this.
The E.F.T. Model and Emotional Abuse, Physical Aggression with C.C.V. Couples:

Stage One: De-Escalation of the Cycle:

 Focus on de-escalation, with a clear focus and plan for immediate reduction of
emotional abuse and/or physically aggressive behaviors at home (and certainly in
session).
 Task alliance must be established with both partners; with clear agreement that they
will work to reducing and eliminating these behaviors.
 Attunement work takes on extra intensity as clinicians need to attend the impact of
C.C.V. behaviors on each partner, on their relationship and their cycle.
 Accepting presence: Demonstrate ability to discuss, explore and attend to C.C.V.
 Rupture and repair with each other and therapist are common and to be expected.
 Attunement and then mis-attunement to reattuning are both expected and part of
bonding with the couple; become a secure base for addressing C.C.V.
 Validating secondary emotion is essential; often needs repeating early in Stage One:
o Necessary to validate and explore with empathy for both partners
o Cannot be done in fashion that condones emotional abuse or aggression
o Sue Johnson discusses in Externship Handout, the necessity of turning down
anger generally and going beneath; especially true in these situations.
o Holding multiple truths is essential, such as “the violence is harmful, wrong
and needs to stop” and “you are distressed, locked in negative cycle, and
people can get escalated and act in these ways.”
o Attend to gender factors – physical factors – other contextual factors that
may impact the meaning of emotional abuse, physical violence or aggression:
 The meaning of yelling, the impact may be different for a partner who
group up in a demonstrative family versus one whose family was
generally quiet and expressed less conflictual, angry emotion.
 Pointing your finger at me when you are taller, larger, may be
physically intimidating.
 Etc.
 The Cycle Frame and Cycle Work provide important scaffolding for these couples.
 o Remember the process goal of each partner getting a “felt sense” of where
their action tendency comes from emotionally.
o This is particularly important with C.C.V. couples who engage in emotional
abuse or other forms of violence.
 Zooming In and Zooming Out is a key move, tracking the level of dysregulation and
window of tolerance in each partner for exploring underlying emotional experience.
o Zoom In to validate secondary
o Zoom In to uncover vulnerable, primary emotion
o Zoom In to slow session and cycle down
o Zoom Out to enact
o Zoom Out to organize and make sense of what is happening between them
 Accessing primary emotion expands the emotional range in the couple in session,
Step 3 work is essential.
o As one person accesses vulnerability through primary emotion, a therapist
might need to “sit on the edge of their seat” ready to block bullets, slow the
session down further.
o One partner’s vulnerability in these couples may trigger the others pain or
shame, holding both couples vulnerability at once (dual empathy) is often
required.
 All aspects of their cycle, including C.C.V., are potential openings in to primary:
action tendency, negative attribution, bodily experience, initial appraisals, partners
voice tone – facial expression – images and so on.
 Emotionally abusive language is both a trigger for one partner and an action
tendency for the other. Foster vulnerable sharing with therapist about the impact
on the partner. Sometimes it is hearing the impact of my behavior on my partner
that changes everything: See “In Session, with Jim Thomas,” (2011), where female
partner hears a vulnerable expression of the harm caused when she rages while
intoxicated. She stopped drinking shortly thereafter. In another training clip, the
impact of “selfish, so selfish” led the partner to share feeling “homeless.”
 Meaning Matters: Explore the meaning to each partner of these incidents,
sometimes motivation to change can be found in that exploration.
 Attachment lens is impactful, do not force it on the couple, however, the realization
that my partner does have an impact on me and I on them, can slow a couple down
in session, and later at home.
Stage 2: Restructuring the Bond
 It is in Stage 2, bonding events, the partners secure attachment systems arises and
come to the forefront, and
 Within an emerging secure bond, C.C.V. behaviors become less possible.
 Attachment injuries may be present as a result of behaviors that occurred in the
relationship related to name-calling, violence, and associated behaviors.
 We trust attachment theory, that violent behaviors are rare between couples with
secure bonds. Secure bonds foster egalitarian relationships.
  The harm of C.C.V. incidents may arise in Step 5 work, specific work, including
reaches and asks in Step 7 are often necessary, healing and bonding.
Stage 3: Consolidation
 The new narrative will and needs to integrate an understanding of how they got to
the place of C.C.V. and
 How they are proofing their relationship against such violence, new solutions to old
problems arise.
Summary: Emotional abuse, physical aggression, controlling behaviors must be attended. They
signal a need for assessment. Research indicates strongly the existence of two main types of
violence in couples relationships. I.P.T. is a contra-indication for E.F.T. Couples Therapy.

E.F.T. may be beneficial for couples experiencing C.C.V. The model itself, based on slowing
down the cycle, empathic attunement, validating secondary, and making meaning leading to
bonding events may be have increased efficacy for such couples. We await research on that.
Until then, stop, observe, assess and proceed with caution when dealing with C.C.V.

This paper is intended to increase awareness, increase focus on the potential for C.C.V., and
provide some initial ideas within E.F.T. and resources.

Scholarly articles by M.P. Johnson, et al, are good resources for understanding the types of
domestic violence.
Stith and McCollum write clearly about systemic considerations in the treatment of C.C.V. and
are also good resources for E.F.T. clinicians.
Research on the applicability of E.F.T. with C.C.V. is needed and would be a great benefit for
couples, families and E.F.T. therapists.

Resources:
National Consensus Guidelines, On Identifying and Responding to Domestic Violence in Health
Care Settings, 2004, Produced by Family Violence Prevention Fund, Multiple Authors
http://www.futureswithoutviolence.org/userfiles/file/HealthCare/consensus.pdf
Definitions, research followed by:
Page 26: Protocols for Mental Health Settings/Providers
Page 27: Dilemmas faced by Health Care Providers (much is applicable to clinicians)
Page 36: Guidelines for referrals for LGBTQ I.P.T.
Page 39: Abuse Assessment Screen
Page 40: The Danger Assessment Tool
Page 44: Safety Planning Protocol

The National Domestic Abuse Hotline: Invaluable resource for victims of I.P.T. – helps define
abuse – provides resources – safety planning – and more
http://www.futureswithoutviolence.org/userfiles/file/HealthCare/consensus.pdf

Colorado Resource – Colorado Coalition Against Domestic Violence

http://ccadv.org/resources/
Check in your State or Province for local resources for victims and perpetrators (AMENDS
program, and other services provided for perpetrators of I.P.T.)

For couples or partners with C.C.V. or high escalation cycles and conflict – local Colorado
resource – The Conflict Center http://conflictcenter.org/programs-classes/anger-management-
classes-denver/