Personality Factors Associated with Domestic Abuse:

The Importance of PerspectiveAngelique Jenney, M.S.W.(PhD Candidate)Director, Family Violence Services

OVERVIEW OF THE PRESENTATION

Why is this issue important? Impact of abuse/trauma on

Interpersonal Relationships - Importance of Perspective Challenges to Practice

Prevalence of Domestic Abuse in the Population

Domestic Violence: 29% of women ever married, or living in a common law

relationship have been physically or sexually assaulted by their intimate partners at some point in their relationship (Statistics Canada 2000)

It is estimated that about half a million children are exposed to domestic violence EVERY YEAR in Canada (Dauvergne, & Johnson, 2001)

Co-ocurrence of Other Forms of Trauma with Domestic Abuse: Experiences of War, Immigration Historical childhood abuse (physical, sexual, emotional/neglect)

Why Where You Come From is Important: History/Context

The quality of the environment directly influences the quality of caregiving - which is how we all learn to modulate stress

This care then ‘influences the development of the brain and in particular, alters the development of particular genes (largely responsible for stress/danger response).

“Under conditions of poverty, animals that are most likely to survive are those who have an exaggerated stress response”

(Meaney, as cited in Begley, 2007 p.175)

Understanding Individuals who have Experienced/Perpetrated Domestic Abuse

Experiences Thoughts/ Feelings Behaviours Needs

Effects of Experiencing Domestic Abuse and the Impact on Behaviours

hyper-arousal, numbing of emotions, and avoiding traumatic stimulus aggression or withdrawal disruption in sleep patterns, eating, lowered self-esteem, and feelings of

helplessness and hopelessness Depressive and anxiety disorders Physical health problems (chronic pain etc. and symptomology with no

apparent biological/physical cause) Cognitive distortions (making sense of the unthinkable) patterns of dysfunctional relationships (disorganized attachment/traumatic

bonding) ‘dread to repeat vs need to repeat’

“We inhabit our histories, and our histories inhabit us”-Angela Davis

Trauma, the Environment and Development

A Lesson from the natural world…

Nature vs Nurture: The Case of the Water Flea

No predator - remains unarmed Odor of predator - the same genetic clone grows

armour - MOVE that one to the no-predator aquarium - armour recedes!

Female water flea who has been exposed and then placed in predator-free zone - lays eggs - offspring are fully armoured

Nature vs Nuture: The Case of the Lab Rat

Handled vs Unhandled More exploratory Less fearful Less reactive to stress when adults

The reason? Handling increased Maternal Licking Behaviours!

High Lickers: Mellow, well-adjusted rodenthood Grew up to be HLsLow Lickers: Fearful, stressed-out Grew up to be LLs

Switch them up? LLs HLs HLs LLs

Oh The Possibilities!

Ironically….

Survival of the fittest (or most stressed out in this case) Stress hormones offer a certain amount of protection in

threatening environments - not all behaviours are maladaptive (e.g. hyper-vigilance could be protective)

Problems begin when stress response is prolonged without a break (not just in our clients - ourselves)

Homeostasis (body resilience)

Caution: People Are More Complex Than Rats (thank goodness!)

Opportunities for conditions to be mediated by social supports.

Trauma and the Brain: the science behind behaviours

Experience changes the brain Trauma is encoded in the language in which it occurs What fires together - wires together (understanding the power to

repeat) Different parts of the brain process emotion - in words and

feelings - if that process is separated - problematic (this is what EMDR attempts to address)

Memory is an interpersonal process Insight doesn’t necessarily lead to change

Trauma and the Brain:

Direct connection between trauma, prolonged stress response, and resulting disrupted neurodevelopment….

Leading to social, emotional and cognitive problems….

Which may then lead to ..health risk behaviours (smoking, substance abuse etc.)…difficulties with affect regulation and subsequently relationships.

Discourse around Trauma

Mind Over Matter sends the message that your mind doesn’t matter to me….

A Hidden Injury - not hidden for those living with it What may be seen as a problem, bad habit, or self-

destructive behaviour may actually be a coping mechanism or adopted solution for an unknown traumatic life experience

Never assume that the trauma you are intervening with is the most influential event in the person’s life

Our expectations should not do harm to families

Challenges to Recovery

Inability to make connection between symptoms and previous experiences (actions/behaviours) - so change is problematic!

Unwillingness/inability to talk about or remember traumatic experiences

Getting worse before getting better is not that attractive!

Feeling defensive/protective of family - potential that victimization is ongoing

(adapted from Perry, 2003)

Maintaining focus of intervention within context of abuse/trauma

Recognition of the issues, needs and expectations of the patient-doctor relationship

Reality checking and grounding in the present Recognition of strengths and limitations of both doctor

and patient Recognizing and responding to evocative emotions Helping patients access resources/material supports to

meet tangible needs Using skills in engagement as well as goal setting REPEAT, REPEAT, REPEAT (this issue took years to become

entrenched, we must think about longer term intervention)

VOLUNTEERS???

Importance of Perspective

Appreciating/managing diversity: cultural differences in the expression of emotion Differences in thoughts/beliefs about relationships particularly about marriage, parenting and child

development recognizing, surviving and working through

miscommunication

Recognizing Diversity

Individual differences contribute to the human experience - including the likelihood of getting the full benefit of community resources

Stresses inherent in poverty bring out personality differences and accentuate their implications for receptivity to helping relationships

Individual differences tend to be especially apparent under conditions of difficulty.

How do people manage trauma?

Engagement and the Importance of Relationships

Quality of personal relationship or working alliance between doctor and patient is central to engagement levels

Client’s relationship history may affect his or her ability to engage effectively

Personality is linked to the quality of individual’s interpersonal experiences and expectations

strong relational base will be protective factor in the event of difficult decision making (challenging risk behaviours and reporting to authorities)

Acts of Resistance or Survival?

Challenging the legitimacy of professional claims or expertise

Non-compliance with physician’s direction Concealing practices such as contact with abuser

(possibly to present herself as compliant) Actively avoiding services Ambiguity between wanting help and resisting scrutiny

(McIntosh, 1987; Bloor & McIntosh, 1990)

Engagement:Finding the Connections

The need for empathic connection - the only way to getthrough difficult areas - find a way to understand and careBuild on: Use the knowledge base of child development and

infant research: (attunement, joining, yielding, tracking) Harm Reduction Compromise (e.g. leaving may be more

frightening than staying; so support staying with a solid safety plan)

What You Can Do:

Have posters/pamphlets (educational/service related) about domestic violence in your waiting room (research shows it increases patient comfort with disclosure (Ahmad, 2009)

Know the people in your neighbourhood (pass the baton) Never underestimate the power of listening and

acceptance (change takes time; you want them to keep telling you) Intervene when you must (child welfare, police) Follow-Up (the last time I saw you…how are things now?) Keep it in perspective (windows of opportunity)

What to Avoid:

Assuming patients will get the help they need from someone/somewhere else (health care providers are often the first point of contact and sometimes the only point)

Prescribe a bitter pill (if you know they won’t take it) Not having a back up plan (These patients WILL catch you off

guard - consider it like any other medical issue - suggest a follow up visit)

If all else fails: “I’m glad you told me”

Key Provincial Resources:

Assaulted Women’s Helpline (24 hr crisis line) Toronto: 416.863.0511 Toll-Free: 1.866.863.0511 http://www.awhl.org/

Shelternet (access to shelters and on-line safety plan) http://www.shelternet.ca/en/

Kids HelpPhone (24 hr crisis line) 1-800-668-6868 http://www.kidshelpphone.ca/

LANDSCAPES EXERCISE

WHICH OF THE FOLLOWING LANDSCAPES DO YOU PREFER?

How Important You AreA Final Note:

Research shows that the most high-risk individuals in regards to domestic abuse - particularly men and women who later become involved in domestic homicides have only one common intervention entry point:

The Healthcare System.