People who have experienced domestic violence or intimate partner violence (IPV) often feel afraid, guilty, confused, shocked, angry or numb. Relationship violence is associated with mental health conditions including post-traumatic stress disorder (PTSD), anxiety, depression and substance use disorder.
After leaving a violent relationship, a difficult first step to seeking help is recognizing that these feelings are normal, and that help is available. A helpful tool for this is a specialized type of cognitive therapy called Cognitive Processing Therapy (CPT).
CPT is research-based psychotherapy that helps survivors identify and shift the thoughts and feelings that often remain long after the immediate danger has passed from a violent relationship. It also can help survivors form healthier and more balanced thoughts by guiding the individual through core issues on safety, power and control, trust, intimacy and self-esteem.
The treatment is effective for people with PTSD – whether the survivor has trauma from an isolated event or has ongoing trauma from a longer period of time.
Kim Eisenberg, LCSW, who serves as the lead therapist for the Trauma and PTSD Recovery Intensive Outpatient Program (IOP) at Sharp Mesa Vista Hospital, explains that PTSD symptoms encompass four main categories: re-experiencing, avoidance, negative thoughts and mood and changes in arousal.
Common re-experiencing symptoms include experiencing flashbacks and intrusive thoughts and images. This can contribute to feeling an array of negative thoughts and emotions such as guilt, shame, fear, horror and feeling disconnected from other people. Avoidance symptoms include avoiding certain memories, thoughts and feelings, as well as avoiding people, places and things that are associated with the trauma. Lastly, “hyper” arousal symptoms include always being on alert, acting impulsively and having irritable outbursts and trouble sleeping, whereas “hypo” arousal refers to feeling numb and disassociating.
Eisenberg explains that some people may also experience physical symptoms.
“Physical health issues, either directly or indirectly related to the abuse, can include chronic pain, autoimmune issues and other chronic conditions that may have been neglected or exacerbated during the period of time the abuse was happening,” she says.
Survivors should meet with a clinical primary care provider or a trauma-informed OBGYN, if appropriate.
Eisenberg specifies that working through a comprehensive treatment plan can be the most helpful to restore a survivor’s sense of personal safety and create a sustainable plan for long-term recovery.
“Treatment and recovery are not one-size-fits-all,” she says. “Case management services such as housing, financial and vocational help can be also useful. Including aid to care for children or other household members and embedding traditionally or culturally based practices, peer support groups and wellness activities in the overall treatment can be helpful as well.”
An important point to note is that couples counseling is not recommended for people in abusive relationships, even if the perpetrator states they are motivated to change their behavior.
“Engaging in couples counseling while the abuse is ongoing often leads to an escalation in the abusive behavior,” Eisenberg says. “Perpetrators are recommended to seek their own treatment separately.”
Getting out of a violent relationship can be a complicated, lengthy process. It may involve progress, pauses and changes in plans, and it might not occur on a particular timeline.
“First and foremost, prioritize your (and your children’s) safety,” says Eisenberg. “Seek help and the support of people you trust and agencies that specialize in services for survivors.”
If you or someone you know needs help or information about leaving a violent relationship, advocates with the National Domestic Violence Hotline are available 24 hours a day, 7 days a week at 1-800-799-SAFE (7233), in over 170 languages. All calls are confidential and anonymous.
If you or someone you know is struggling with post-traumatic stress disorder due to a violent relationship, Sharp Mesa Vista can help. Learn more about Sharp Mesa Vista’s trauma and PTSD recovery program, which offers evidence-based integrative recovery services in a structured setting, or call 858-836-8309.
For the news media: To talk with Kim Eisenberg about CPT for an upcoming story, contact Erica Carlson, senior public relations specialist, at email@example.com.