Domestic violence can have a huge impact on the mental and physical health of those who experience it. Domestic violence involves any type of physical, sexual or emotional abuse within a relationship or family context.
It can happen to a person of any ethnicity, gender, culture, religion, age or socioeconomic group. The most common kind of abuse occurs in relationships and is often related to one partner exerting power over the other.
Being subjected to, under threat of, or witnessing domestic violence can be distressing. It can lead to mental health challenges for many - but not all - survivors.
If you or someone you know is at risk, safety is the first priority. Having the support of a trusted therapist during the process of planning how to leave can be of great benefit. Once you are safe, therapy can also help you to heal from the psychological effects of domestic violence.
Types of domestic violence
Different kinds of abuse can occur to people in intimate relationships, the elderly, or children. If you notice any of the following, you may be experiencing domestic violence:
- Violence: Examples of violence include hitting, pushing, holding you down, or throwing things.
- Sexual abuse: Such as being pressured to have sex or being hurt during sex.
- Emotional abuse: The injury does not need to be physical to be abusive. Controlling or accusatory behavior, or isolating you from your friends or family are examples of emotional abuse.
- Verbal abuse: Includes verbal threats of violence or intimidation, for example.
Prevalence of domestic violence
The World Health Organization reports that 30% of women worldwide have experienced physical or sexual violence by a partner and that this is a major contributor to women’s mental and physical health problems. Women who have been subjected to domestic violence are more than twice as likely than other women to experience depression (1).
In the United States, around 35% of women and 28% of men have experienced sexual assault, physical violence, or stalking by a partner at some point during their lifetime (2). Of these people, nearly 30% of women and 10% of men reported at least one related impact, such as
- Feeling fearful
- Concern for safety
- Symptoms of post-traumatic stress disorder (PTSD)
- Needing for health care
- Contacting a crisis hotline
- Needing housing, victim’s advocate or legal services
- Missing at least one day of work or school
Children often witness domestic violence. A survey found that around 6.5% of children are exposed to intimate partner violence and 26% are exposed to some kind of family violence (3). Children who are exposed to domestic violence are at greater risk of mental health problems (4).
Domestic violence and mental health
Survivors of domestic violence are at increased risk of mental health challenges. People react in different ways when faced with stressful and potentially dangerous situations, but some of the common mental health challenges encountered include:
- Trauma, including post-traumatic stress disorder (PTSD)
- Substance abuse, including alcohol use disorder
- Relationship problems
- Social withdrawal
- Sleep problems
- Eating problems
- Low self-esteem
- Shame or guilt
What to do if you are a survivor of domestic violence
If you have been subjected to domestic violence, remember that you are not alone and it is not your fault. There are many things you can do to look after yourself, whether you are still in the abusive situation, or have left and are starting the healing process.
- If you need immediate support, call 1-800-273-8255, go the National Suicide Prevention Lifeline website.
- If you are experiencing abuse in your relationship, contact the National Domestic Violence Hotline at 1-800-799-7233 (who also have a live chat service) or the National Sexual Assault Hotline at 1-800-656-4673.
- If you think a child is in danger or at risk, contact the Childhelp National Child Abuse Hotline at 1-800-422-4453.
- It’s common to worry about the financial consequences of leaving a relationship, or to wonder what leaving means for the custody of children. If you have any concerns, seek advice and support from a legal professional. Many services offer legal advice free of charge in such situations. WomansLaw.org provides legal information for each state, or you can search for Legal Aid through the Legal Services Corporation here.
- Many people who have been subjected to domestic violence struggle with anxiety, depression, trauma symptoms, or substance abuse. Therapy can be a helpful way to work through your experiences, develop coping strategies and heal. Types of therapy to consider are discussed further, below.
- Pay attention to your diet, try to get sleep and rest, and exercise regularly. Find activities that you enjoy, and join a club to meet new people.
Talk to family and friends:
- Many people will feel like withdrawing at a time like this, yet family and friends are an important source of support. If you have become isolated as a result of domestic violence, try phoning helplines or getting in touch with support groups.
- Sharing experiences and learning from people who have had similar experiences can be encouraging and helps people to feel that they are not alone. Find one by searching online for groups in your local area or check those listed on the National Domestic Violence Hotline website.
Leaving an abusive relationship
Leaving an abusive relationship can be incredibly challenging. Often, a lot of time and planning goes into leaving safely. You might consider a combination of the following:
- Make a safety plan: This is a practical plan to help you to keep safe when you are in the relationship, leaving the relationship, and after leaving. It can be extremely helpful to work with a therapist to develop a plan, or you can find guidance online, from the National Domestic Violence Hotline service.
- Plan for a safe place to go: This might be a friend, family, or a local shelter. You can find local programs and shelters at WomensLaw.org
- Police: Get help from the police if you need. Call 911.
- Seek medical attention: Make sure that you see a doctor to assess and treat your physical health.
- Cease contact: Cut off avenues of contact and communication with the perpetrator.
Therapy types to consider
There are a number of different types of therapy that you could consider to help heal the psychological effects of domestic violence. Therapy types include:
- Cognitive Behavioral Therapy (CBT)
- Interpersonal Therapy
- Eye Movement Desensitisation and Reprocessing therapy (EMDR)
- Psychodynamic Therapy
Additional types of therapy to consider particularly if there is a child involved include:
- Sand tray therapy
- Play therapy
What to look for in a therapist if you’ve experienced domestic violence
The best-fitting type of therapist will depend on individual factors, symptoms, your location and finances. When selecting a mental health professional, it can be helpful to consider the following factors:
As is the case when you are seeking therapy for any reason, it’s important to consider the potential for developing a strong working relationship with your therapist. The trusting working relationship with a therapist is called the therapeutic alliance, and it’s the number one indicator of treatment efficacy.
Those leaving an abusive relationship may feel unsafe and see the world as a more dangerous place. To be able to heal, it’s particularly important to look for a therapist with whom you feel you will be able to establish a trusting relationship.
Qualifications and experience
Look for a licensed mental health professional. This ensures that the therapist has undertaken the appropriate education and training. You might want to look for a therapist who specializes in working with people who have experienced domestic violence or trauma, for example.
Talk in advance
The best way to judge how you might feel about your prospective therapist is to ask for a preliminary phone call. Most therapists will be happy to oblige. This gives you the opportunity to ask about:
- Their qualifications
- Their experience working with people who have experienced domestic violence or trauma
- You might want to ask questions about the limits of confidentiality in therapy, and how your therapist might deal with any situations where they felt your safety (or that of a child) is at risk
- Any ongoing training they are participating in that relates to therapy for domestic violence
- What type of therapy they suggest for mental health challenges related to domestic violence, and what that will be like
- Their participation in insurance plans and cost of therapy
Try to speak to a few different therapists before making your mind up.
New to therapy? Learn about how to find a therapist here.
- (1) World Health Organization, Global and regional estimates of violence against women: prevalence and health effects of intimate partner violence and non-partner sexual violence (PDF)
- (2) National Intimate Partner and Sexual Violence Survey 2010 (PDF)
- (3) Children’s Exposure to Intimate Partner Violence and Other Family Violence (PDF)
- (4) Domestic Violence
- (5) Therapeutic Interventions in Intimate Partner Violence: An Overview
- National Health Service UK, “Domestic violence and abuse”
- Therapeutic Interventions in Intimate Partner Violence: An Overview