50 Shades of Domestic Violence: Recognizing Patterns of Abuse

Understanding Codependency

An emerging perspective on Domestic Violence is that it is a disease with distinct causation, effect, and distinguishing characteristics, and that it is more of a psychological phenomenon as opposed to being a character flaw reserved for those afflicted with substance abuse disorders or of the low-income population.

One way to look at the disease of domestic violence is that at it’s core, it is an addiction to the need to be needed. The 3 components of the Disease of Domestic Violence (DV) are Gaslighting, Codependency, and Distinct Abusive Behavioral Patterns. Codependency encompasses the addiction to the need to be needed.

The need to being needed is a perfectly normal and natural human desire. However, this need to be needed becomes unhealthy when we begin to define our self-worth in the context of how much we do for others and feel we aren't enough. When a set of unhealthy behavioral patterns results from an external or identifiable source, such as the need to be needed, that is when something is considered an addiction by societal standards.

Understanding Mental Illness

Understanding the Roles of Codependent Dominant and Codependent Submissive

Codependency is a psychological construct that underlies a wide variety of close relationships. This includes parent-child, intimate partners, adult and elder parent, spouses, non-intimate domestic partners, employee-boss, and even some unhealthy friendships. In a codependent relationship, there will be a dominant and a submissive. There is debate in the academic community as to whether codependency itself is a form of emotional addiction. The widely accepted view is that codependency in it of itself is an abnormal behavioral pattern, and that another component of codependency, the “need to be needed” can manifest in varying degrees and in some scenarios can take on the severity of addiction. As such codependency is currently treated as an abnormal behavioral pattern that can be effectively treated with therapy and a desire to change.

Codependent dominants have a propensity towards needing to provide and to be recognized as a provider. This desire becomes unhealthy when their expectations of others they provide for violates personal boundaries and crosses the line to emotional abuse. Codependent submissives develop an unhealthy need to please others, stemming from their psychological conditioning by a codependent dominant. Pleasing the codependent dominant in their life satisfies their need to be needed.

The desire to please others becomes unhealthy when we begin to undermine our own self worth because we feel inadequate, sometimes causing codependent submissives to turn to drugs or alcohol to find an escape from the feelings of unworthiness. A common misconception about domestic violence is that it arises due to substance abuse. While substance abuse may be present in some cases, domestic violence is at its root the addiction to the need to be needed. Failing to address the codependency and the psychological addiction to being needed causes victims of the disease to repeat the same patterns in their next relationship.

Learn More About Codependent Roles

Transform Your Life with 50 Shades of Domestic Violence: Principles of Assessment

Without the presence of substance abuse or physical violence, domestic violence can still flourish. Drawing from my countless personal experiences, from those of friends and family, and from those of the close to 1000 victims or patients I have come in contact with during my medical career and as a volunteer for domestic violence and sexual assault organizations, I introduce in the book I am writing, 50 Shades of Domestic Violence, the following classification schema to help providers and victims of the disease better understand the condition.

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DV presents with many different variations

Categories of Abuse

The 'Asymptomatics': Early Detection Saves Lives

Specific Examples of Abuse

The Venn diagram above facilitates the conceptualization of DV as a disease, ‘The Clinical Spectrum of DV’. The three main circles of the Venn diagram in part A are shaded to demonstrate sets of patients with EMOTIONAL, PHYSICAL, or SEXUAL presentations. The overlap of the circles produces seven subsets, in which those manifestations are present alone or in various combinations.

Specific Examples of Abuse

The 'Asymptomatics': Early Detection Saves Lives

Specific Examples of Abuse

DV presents with many different variations

On the DV spectrum, just as with autism, DV presents with many different variations (ie. physical abuse in one person and financial abuse in another). Also of importance is that just as in PTSD (post traumatic stress disorder), there is a wide spectrum of variations in the severity or acuity of a victim’s response to the psychological trauma of domestic violence.

An eighth subset, containing asymptomatic patients, is appended to the upper right and left

These are the patients who complain to their friends about destruction of personal property, violation of personal boundaries, sexual avoidance, and economic abuse, but are perceived to be extremely low risk by societal standards for engaging in the stigmatized behavioral patterns commonly associated with DV (aka. doctors, lawyers, software engineers, actors, dentists, and other career professionals).

Learn More About Coercive control

The 'Asymptomatics': Early Detection Saves Lives

These patients will not realize they have a disease because they have been conditioned to the common misconception that there is a demarcation between physical and sexual acts of aggression resulting in bodily harm such as rape, a broken nose, or a black eye, and minor environmental acts of aggression such as putting out a lit cigarette in your car, expecting you to provide them with considerable financial support, and socially isolating you from your friends and family.

I have designated this subgroup as asymptomatic because most often these patients will not admit to symptoms when they are present because the addictive component of this disease causes them to rationalize the initial red flags they already know to look out for, particularly in relation to DV.

CODEPENDENCY and GASLIGHTING will be present in this homes of this 'asymptomatic' patient population and these patients will not realize they have a disease, just as asymptomatic diabetics will not realize they have high blood sugar. Screening for signs of emotional and even minor physical and sexual abuse can help direct this early manifestation of DV to the appropriate therapy and reduce long term complications.

SAHA Severity Scale of DV

Codependency Causes Stress, and Stress Causes Diseases

The 'Asymptomatics': Early Detection Saves Lives

In the disease of diabetes, when a person’s creatinine level is found to be dangerously high signaling renal insufficiency, the AMA recognizes this as an indicator for a poor outcome in a patient.

Similarly, the SAHA Severity Scale of DV and High Conflict Divorce is intended to help providers and victims understand when a victim of the disease is at high risk for imminent death. Hopefully, the implementation of these classification schemas into assessments by law enforcement officers and medical professionals can improve long term outcomes of people afflicted with the disease of domestic violence, which encompasses high conflict divorce, by allowing for earlier detection and by providing guidelines for intervention.

DV Causes Stress, and Stress Causes Diseases

Codependency Causes Stress, and Stress Causes Diseases

DV causes stress, and stress left untreated causes inflammation in our bodies, which is the underlying cause of many diseases. Early detection of DV and behavior modification saves lives.

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Codependency Causes Stress, and Stress Causes Diseases

Even when physical violence is not present, prolonged codependency in the home causes stress, and irrespective of physical violence, living with toxicity physically manifests as serious health issues.

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