Intimate Partner Violence
“Why the f--k are you so angry? After all, you made it home, you’re supposed to be all right and happy now, right? Isn’t that what everyone around you thinks? It hurts to know that you’re causing people pain. You don’t mean it, but they don’t understand that you don’t mean it. And you don’t know how to stop being this way. That anger keeps pushing people away from you. It’s natural for people to retreat from your anger and self-protect. Or get mad back and then you’re trapped in a cycle of conflict where no one is happy. They point at you and say it’s your fault because you’re so damn angry all the time. And you blame them because they seem to make you angry. And before you know it, you’re left alone in your world. . .”
(“I came back from combat, why the #@!% am I so angry!?,” 2014)
Many Post-9/11 combat-involved veterans experience strained family relationships including frequent outbursts of anger with associated nightmares or flashbacks. The level of behavioral difficulties experienced among this Post-9/11 veteran cohort and active duty group appears to have significantly increased from those who served prior to 9/11. One of the principal complications emanating from PTSD is the containment of disruptive anger outbursts. When physically directed towards the significant other, it is called intimate partner violence (IPV). A wide range of social, physical, and mental issues have been associated with this destructive interaction including the following: family dissolution, mental and physical health conditions, incarceration, homelessness and murder/suicide. A most glaring example of this phenomena is found in the murder of four soldiers wives at Fort Bragg, N.C. during a 6 weeks period in 2002. (Sparrow, Kwan, Howard, Fear, & MacManus, 2017)
NATIONAL STATISTIC: On average, nearly 20 people per minute are physically abused by an intimate partner in the United States. ... 1 in 3 women and 1 in 4 men have been victims of some form of physical violence by an intimate partner within their lifetime.
On average, nearly 20 people per minute are physically abused by an intimate partner in the United States. During one year, this equates to more than 10 million women and men.
On a typical day, there are more than 20,000 phone calls placed to domestic violence hotlines nationwide.
The presence of a gun in a domestic violence situation increases the risk of homicide by 500%.
Intimate partner violence accounts for 15% of all violent crime.
Only 34% of people who are injured by intimate partners receive medical care for their injuries. (“NCADV | National Coalition Against Domestic Violence,” n.d.)
Our PTSD combat veterans appear to be particularly at risk for engaging in intimate partner violence (IPV). Furthermore, this factor appears to be a primary contributor to the insidious disruption of the military family thereby extending the disturbance to the exposed children. Indeed, one of the 10 crucial factors in the Adverse Childhood Experience Inventory (ACE) is observing a parent abusing a spouse. (“Finding Your ACE Score.pdf,” n.d.)
A recent study (2017) has found that: “Certain results have corroborated earlier findings involving Vietnam veterans . . . that service members and veterans suffering from war-related PTSD have high prevalence rates of intimate partner violence (IPV). . . While the majority of service members and veterans diagnosed with PTSD do not engage in IPV, military specific risk factors, such as length of deployment and the type and level of combat exposure, including the killing of combatants and the witnessing of atrocities have been identified as factors that increase the risk of a service member or veteran with PTSD perpetrating IPV.” (Misca & Forgey, 2017)
In regards to relationship with children, a 2017 study of National Guard/Reserve fathers who sought to improve their parenting skills following deployment: “were observed during a 5-min video interaction of a structured task coded for the occurrence of positive engagement, withdrawal, avoidance and reactivity-coercion behaviors. . . (Those with) PTSD symptoms were associated with increased distress avoidance (fear, wariness, ignoring or low empathy in response to aversive behavior or affective distress of the child) during the observed interaction with children . . . analyses indicated experiential avoidance (unwillingness or inability to remain in contact with negative thoughts, feelings or sensations) appeared to diminish the association between PTSD and observed parent-child interactions patterns and was associated with less positive engagement with children.” (Creech & Misca, 2017)
“. . . Cumulative research supports the perspective that: “PTSD and IPV share a bidirectional relationship; PTSD can be both a result of and contributing factor for engaging in IPV. . . In cases of mild or non-severe forms of violence (e.g., isolated instance of a push or shove) the violent behavior tends to be bi-directional and is not used as a form of power and control. However, the more severe types which tend to be chronic and severe is predominately male perpetrated and typically used as a form of power and control. Thus, the two types of violence are delineated by the purpose (i.e., to control), frequency (how often), and severity (severe versus non-severe) of the violent behavior.” (T, 2017)
A SOLUTION: PTSD is a systemic, neuroinflammatory disorder that negatively alters trauma activated neuronal circuitry. Clinically, we have found this switching mechanism to be treatable through a unique disruption of the memory reconsolidation process by the use of a specialized binaural sound. I have conducted a case study (LBK) using pre and post measures of intimacy variables with the Personal Assessment of Intimacy in Relationships scale (PAIR). In our three times married, Vietnam, four-tour combat-veteran volunteer, dramatic changes were noted after 4 treatments (Table 1) although only the trauma variable was activated within the therapy context. The implications for renewed intimacy, family integrity and vitality clearly support my intent to further study this exciting advancement in personal and family therapy.
The five types of intimacy utilized in the above scales are: Emotional Intimacy - experiencing a closeness of feeling with others; Social Intimacy - having common trends and similarities in social networks; Intellectual Intimacy - the experience of sharing ideas; Sexual Intimacy - the experience of sharing general affection and/or sexual activity; Recreational Intimacy - the sharing experience of interest in hobbies such as mutual participation in sporting events. (T. Schaefer & H. Olson, 2007)
LBK noted that: “Since my treatment and following that time, my wife and I have gotten back together. Our communication has picked up significantly. I am able to sit down and talk about things such as feelings about what the PTSD was and what it wasn’t. When we started sharing things, our relationship got a lot better. After the therapy, I kind of liked the closeness and intimacy. My sexual involvement picked up with all the closeness and the holding hands and being affectionate. We’re both enjoying each other. We have mutual respect for each other and understanding and, as they say, the third one’s a charm.”
Within the RESET Therapy perspective, we propose that humans can non-verbally ‘reset the trauma switch’ thereby re-establishing emotional balance in their lives. We further assert that this change is analogous to changing from the ‘protect and defend’ mode to the ‘growth and explore’ style. These changes due to RESET Therapy offer the potential to not only change the veteran’s emotional health, they may also help to restore and improve the dynamics of the extended family.
References
Creech, S. K., & Misca, G. (2017). Parenting with PTSD: A Review of Research on the Influence of PTSD on Parent-Child Functioning in Military and Veteran Families. Frontiers in Psychology, 8. https://doi.org/10.3389/fpsyg.2017.01101
Finding Your ACE Score.pdf. (n.d.). https://www.ncjfcj.org/sites/default/files/Finding%20 Your%20ACE%20Score.pdf
I came back from combat, why the #@!% am I so angry!?!? (2014, September 13). https://lifeafterwar.org/2014/09/13/i-came-back-from-combat-why-the-am-i-so-angry/
Kar, H. L., & O’Leary, K. D. (2013). Emotional intimacy mediates the relationship between posttraumatic stress disorder and intimate partner violence perpetration in OEF/OIF/OND veterans. Violence and Victims, 28(5), 790–803.
Misca, G., & Forgey, M. A. (2017). The Role of PTSD in Bi-directional Intimate Partner Violence in Military and Veteran Populations: A Research Review. Frontiers in Psychology, 8, 1394. https://doi.org/10.3389/fpsyg.2017.01394
NCADV | National Coalition Against Domestic Violence. (n.d.). https://ncadv.org/statistics
Sparrow, K., Kwan, J., Howard, L., Fear, N., & MacManus, D. (2017). Systematic review of mental health disorders and intimate partner violence victimization among military populations. Social Psychiatry and Psychiatric Epidemiology, 52(9), 1059–1080. https://doi.org/10.1007/s00127-017-1423-8
T. Schaefer, M., & H. Olson, D. (2007). Assessing intimacy: The PAIR inventory. Journal of Marital and Family Therapy, 7, 47–60. https://doi.org/10.1111/j.1752-0606.1981.tb01351.x
T, M. (2017). PTSD and Intimate Partner Violence: Clinical Considerations and Treatment Options. Journal of Addiction Medicine and Therapeutic Science, 001–006. https://doi.org/10.17352/2455-3484.000018
