Abus
Abus
THE ABUSED
WOMAN
A SURVIVOR THERAPY APPROACH
with
by
Randall C. Wyatt, PhD
&
Erika L. Seid, MA
THE ABUSED WOMAN
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Table of Contents
Tips for Making Best Use of the DVD 7
Session-by-Session Group Discussion Questions 9
Reaction Paper Guide for Classrooms and Training 11
Suggestions for Further Readings, Websites and Videos 13
Session Transcript 15
Week 1 15
Week 3 26
Week 12 28
Week 18 32
Week 32 34
Week 42 40
Week 52 47
18 Months 47
21 Months 49
Video Credits 54
Earn Continuing Education Credits for Watching Videos 59
About the Contributors 61
More [Link] Videos 62
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THE ABUSED WOMAN
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THE ABUSED WOMAN
WEEK ONE
1. Naming the Abuse: Walker helps Sarah to avoid seeing herself as a
battered woman. Does it seem to work and why is it so important?
2. Two People: Why do you think Sarah needs to see her husband as two
different people: Good Dan and Bad Dan? If you were the therapist,
would it be important for you that Sarah integrates these two into one?
WEEK THREE
3. Safety Plan: Imagine that you are Sarah’s therapist. What feelings
come up for you around working with issues of her physical safety?
WEEK TWELVE
4. Catastrophizing: Why does Walker interrupt Sarah’s catastrophizing
about her life situation? What about taking the approach of joining
with Sarah around her fears and anxiety?
5. Managing Feelings: Battered women sometimes numb their feelings
through denial and repression. How might you work with Sarah to use
her feelings of danger and anxiety for her own growth?
WEEK EIGHTEEN
6. Loving Contrition: Do you agree or disagree with Walker’s view on
loving contrition? What makes love and care after abusive behavior
appropriate or inappropriate?
7. Denial: What countertransference responses do you have to Sarah’s
denial about the ongoing risk to her safety? How do you cope with
negative feelings that might develop toward such a client for not taking
care of herself?
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WEEK THIRTY-TWO
8. Recovered Memories: Do you think that working in therapy with
battered women requires an exploration of childhood memories?
When is such childhood exploration necessary and when is it
problematic? What about the risk of implanting false memories?
WEEK FORTY-TWO
9. Severe Violence: What countertransference issues come up for you
when hearing about a serious battering incident like this one? What do
we do with such reactions?
10. Boundaries: What do you think about Walker’s response to Sarah’s
medical emergency? How might you have responded differently?
WEEK FIFTY-TWO
11. Marriage Counseling: What do you think about Walker’s views on
marital counseling in battering relationships? When, if ever, would you
recommend couples counseling to a client in a battering relationship?
EIGHTEEN MONTHS
12. Anger: What differences do you see for male and female therapists in
working with battered women around their anger toward men? How
are these differences important?
TWENTY-ONE MONTHS
13. Injustice: What reactions and issues come up for you when clients
experience unfairness in the legal system? How can therapists use this
countertransference in their work?
AFTERWARDS
14. Abuse in Therapy: How are therapists of abused women at risk of
abusing their clients? In working with a client like Sarah, what would
you watch for in yourself to make sure you were not enabling her
tolerance for being abused?
15. sAnd You? How would you feel about being Walker’s client? Lets see
a show of hands, who would be comfortable having Walker as your
therapist? Do you feel an alliance could be made and that she would be
effective with you?
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BOOKS
Walker, Lenore (2003). Introduction to Forensic Psychology : Clinical and
Social Psychological Perspectives. Springer Publishing Company.
Walker, Lenore (2000). The Battered Woman Syndrome. Springer
Publishing Company
Walker, Lenore (2000). Abused Women and Survivor Therapy : A Practical
Guide for the Psychotherapist. American Psychological Association.
Walker, Lenore (1985). A Handbook of Feminist Therapy: Women’s Issues in
Psychotherapy. Springer Publishing Company.
WEB RESOURCES
[Link] The Domestic Violence Institute
[Link] The Family Violence Prevention Fund
[Link] The Duluth Model and The Domestic
Abuse Intervention Project
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THE ABUSED WOMAN
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Complete Transcript of
The Abused Woman:
A Survivor Therapy Approach
with Lenore Walker, EdD
WEEK ONE
Walker Commentary: Now let’s begin.
Sarah is a 36 year old woman who lives with her husband, Dan, her eleven
year old daughter, Abby, and her nine year old son, Justin. She works at home
as a part time computer graphics consultant. Sarah was referred to me by
her daughter’s psychologist, who was concerned that Dan might be battering
Sarah.
Walker: So I thought maybe we could start with you just giving me some
idea of what brings you here.
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THE ABUSED WOMAN
Sarah: Okay. It’s - My daughter, Abby, has been having some problems and
so when I talked to Dr. Kelly, we thought that it might be something that’s
happening at home. And I noticed that I have been – My husband and I
have been fighting a lot more the last couple of months, and I want to try
to learn how I can make it better at home. So that’s why I’m here.
Walker: Okay, let’s talk a little bit about it. Tell me a little bit about what’s
happening with Abby, and if it’s okay with you, I want to take some notes.
Sarah: Sure.
Walker Commentary: When I suspect a new client is being battered but she
doesn’t identify the abuse, I let her describe the presenting problem the way
she sees it. I also like to ask permission before I take notes to establish that she
has certain rights here in therapy.
Sarah: She’s even quit gymnastics, which she loves, and she doesn’t want
to go at all. And I’ve really noticed that – I mean, when she used to get
home from school, she would come in and we would talk, and talk about
her day and she would sometimes help me with dinner and we would
have a really nice time. But now she just – briefly says ‘hello’ and goes
straight up to her room. She spends so much time in her room. Just really
withdrawn. Just – it really worries me.
Walker: And you think there may be some tie together between some
fighting in the house. Tell me a little bit about that.
Sarah: It’s the only thing I can think of. Just been a little bit more tension
and some fights between my husband and I.
Walker: What’s your husband’s name?
Sarah: Dan. And, I don’t know. He just is – He gets very jealous, and
sometimes just, I think, you know – He’s also under a lot of pressure at
work. And there’s just been some times when I haven’t been able to, I
guess, keep up on some of the things at home because I’ve been taking a
little bit more work myself now that the kids are in school.
Walker: What kind of work?
Sarah: I do some computer work.
Walker: At home?
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Sarah: Yes. Mostly. Two days a week - I’ll go in every now and then but
mostly at home.
Walker: Tell me, if you can, what the last fight is that you can remember
about?
Walker Commentary: It’s important to give clients a clear message that it’s
acceptable to talk about abuse.
Sarah: Well, I was – I was in the kitchen. I was on the phone talking to
this guy at work, and he was having some difficulty with this new software
program and he had called me. He was really desperate, really needed my
help. So I was talking to him, going through it with him to try and get
him started and Dan was in the room. He was doing some work on some
of his papers and you could just tell that he was – he was really upset by the
way he was slamming down his briefcase and just the way he was moving,
and so I thought it would probably be best for me to get off the phone. And
I told Kevin – this guy – that I would just come in when the kids were at
school and I would help him then. And – to get off the phone. It’s really a
bad move, because that set Dan off.
Walker Commentary: This incident holds some important clues that this is
a battering relationship. Dan demonstrates extreme jealousy and his response
suggests that he feels he’s entitled to Sarah’s attention 100% of the time, and
that he has the right to punish her if he doesn’t get it.
Sarah: He told me that I was a whore. Stuff like that. And it was – just
escalating. It was getting more angry and I was trying to calm him down. I
really tried to calm him down and explain to him what was going on. And
the more I tried to explain, the worse it got. He just – He lost it, and he
started coming after me with this ball point pen so –
Walker Commentary: It may be tempting to suggest that Sarah stay off the
phone when Dan is home, but this would be a short-term solution at best.
Batterers usually continue to pursue their need for power and control in other
ways.
Sarah: I just tried to drown him out, so I put my hands up to my ears,
which was really stupid because he hates it when I don’t listen to him –
when he’s not being listened to. So, he yelled at me and said that – told me
that I should never leave, told me that I should never run away from him
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THE ABUSED WOMAN
like that and that he’d teach me to listen to him so he twisted my hands off
my ears and said – “I’ll teach you how to listen, you bitch,” and slammed
his hands onto my ears.
Walker: Show me how he did it.
Sarah: He just – like that. Really hard.
Walker: Was it really hard?
Sarah: Yeah. Yeah. It hurt.
Walker: Did you need any kind of medical attention?
Sarah: No. No, I did not. I was just dizzy. I couldn’t – I couldn’t get up
very well. My left ear I couldn’t hear out of for a while, but I was fine.
Walker Commentary: Although, Sarah is very clear about reporting the
details, she minimizes the severity of the abuse. Minimization is a typical
coping strategy used to avoid re-experiencing the high levels of anxiety that
come from abuse.
Walker: Have things like that happened before?
Sarah: Like –
Walker: Like him hurting you.
Sarah: Yeah.
Walker: They have? Can you remember the first time something like that
might have happened?
Walker Commentary: It’s important to take a detailed abuse history as part
of the initial assessment. I usually ask for four battering incidents: the first
one she can remember, a typical one, the worst, and one of the most recent.
Sarah: I was – It was probably when I was – We were first married and I
hadn’t been feeling too well. And so I wasn’t – I wasn’t able really to do the
housework and some things had sort of fallen behind. I hadn’t vacuumed
for a while and one of my best friend’s was having a baby shower, and I
really wanted to go. So I thought that I had felt well enough, and it was
that night. So I planned on going. I had gotten ready, and Dan had asked
me where I was going to be going, and when I told him, he – He just really
got – He got very upset and said that if I wasn’t well enough to clean the
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house and take care of things at home that I certainly wasn’t well enough
to be going out to any old baby shower. And he grabbed me. He grabbed
me and dragged me down the hall and threw me into the bedroom and
said that if I was sick, I had to stay in bed. And sort of kept me in my room.
Walker: So you couldn’t go?
Sarah: No. But I mean – I probably should have spent the time cleaning
the – you know, getting things ready before I left. I just didn’t quite have
the energy to do everything so I thought that maybe I could do it the next
day, but I probably should have finished.
Walker Commentary: Although Sarah has made a number of self-blaming
statements, it’s too early to confront them now. But I’ll make a note to address
them later.
LATER IN SESSION ONE
Walker: Tell me what the very worst thing was that Dan’s ever done to you
in all the time you’ve been together. The very worst that you can think of.
Sarah: [Laughs then Coughs]
Walker: I know this is hard. But it will give me an idea in a short period of
time of what life is really like for you.
Sarah: I guess, a couple weeks ago, we were going out to dinner with some
friends. I had met her at a bus stop. It was really nice to get to know her
because she was the only other person that stayed at home during the day.
And this is the first time that we had ever gone out together, and we went
down town. And Dan had dropped us off. We had a really lovely time.
But we all sort of drank a little bit too much. Dan, especially, had a lot to
drink, and when we were leaving we were walking back to the car and it
was kind of in a bad neighborhood. Not really good. And we had passed
by this – We passed by this – an adult video store and Dan just sort of was
going off on all these pictures that he was seeing and making all these
comments and really embarrassing me. And embarrassing them. And I
was just really trying to get him to leave and to come and he got this look
in his eye that – And he dashed into the video store.
Walker: Just leaving you in the street?
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THE ABUSED WOMAN
violence. It’s important to let the client know that it’s safe to re-experience
these painful feelings in the therapy session. Empathic listening and my
confidence that this is part of the healing process, will help us both get through
the tough times.
Walker: Is it getting worse?
Sarah: Yes. I think they are. He’s so stressed out with work. He’s got a
huge project coming up and I just haven’t been able to spend, I think,
the amount of time just being there for him because I’ve taken on a few
projects, also and -
Walker: Sarah, do you think that this is your fault?
Sarah: Well, I think I have a lot to do with it, yeah, I do. I think it’s -
Walker: Do you want him to hurt you that way?
Sarah: No.
Walker: So why is it your fault?
Sarah: It’s a two way street. I mean, I’m sure that I provoke him at times.
There are things that I do that –
Walker: Oh, I’m sure you do some things, but do you think the kinds of
things that you do deserve what you just described to me?
Sarah: Well - No, I don’t think that it deserved that.
Walker: It doesn’t deserve it no matter what you do.
Walker Commentary: At this point, it’s too early to know if Sarah’s
statement is indicative of self-blame, or if she really plays a part in the
escalation of the violence that needs to be changed. In order to avoid any
misconceptions that she is to blame, I emphasize that violence is never
justified.
Sarah: I mean, he’s not really an abusive person. He’s –
Walker: I’m not saying he’s an abusive person. Because I don’t know Dan.
I mean – But what I’m saying to you is that what you’re describing to me is
being – you’re being abused. That’s abusive behavior. Battering behavior.
And you don’t deserve it.
Sarah: He’s such a – He can be such a great man.
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angry every now and then. I mean, I probably should try to – It’s not good
when I do. It just gets worse. So I really try to stay as calm as I can.
Walker: Do the children ever get involved in a fight?
Walker Commentary: Research shows that as many as 60% of men who
batter their partners also batter their children. I’ll do a more thorough
assessment for child abuse later in consultation with Abby’s therapist.
Walker: So it sounds like everybody’s paying a lot of attention to Dan’s
needs. I wonder if maybe one of the reasons why Abby might run away to
her room is because this is getting difficult for her.
Sarah: That – That could be. I hadn’t thought of that.
Walker: What would you like to see happen?
Sarah: At home?
Walker: If you came – Well, yeah. If you were to come here and work with
me, what would you like to be different? Want me to fix Dan? Make him
all better?
Sarah: Yeah. I guess – I mean, if I could learn how to stop the fighting,
then I would be happy about that. Yes. That’s what I would like.
Walker: Well, I’ve got some good news and bad news. The bad news is
there’s no way that I can help Dan stop his fighting or stop his abusive
behavior. Only Dan can do that. The good news is that I can help you try
and figure out what you want to do about all of it.
Sarah: Yeah, I guess if I could figure out how to, you know, stop it – to
smooth it out, that would be good. That would be what I -
Walker: You can’t stop it. But what I can do –
Sarah: Well, my – I’m sure my reactions, if I can learn how to minimize it,
then –
Walker: Maybe we can help you find ways to make yourself more safe. But
we’ll have to know more about you as a person to be able to do that. But we
can’t stop Dan’s fighting. He is battering you. And that we can’t stop.
Sarah: I – I’m not a battered woman. I’m not. I’m not a battered wife.
Walker Commentary: Denial, minimization, repression, and dissociation
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THE ABUSED WOMAN
are frequently seen in battered women. They serve as healthy coping responses
to protect the woman from her overwhelming reactions to the abuse.
Walker: What do you think about when I say that? What kinds of
situations do you think about?
Sarah: That TV show, The Burning Bed. You know, I think – I think of all
these other stories. I mean, the stories I hear, they’re so horrendous, they’re
so awful. I mean, I’m not in that situation.
Walker: Well, what – How do you call when somebody hits you – hits
you on the head? Chases you? Chases after you? Gets handcuffs, forces
you to have sex when you don’t want to have sex? If I told you that about
somebody else, what would you say?
Sarah: Well, he was drunk so I think there’s things that – Do you really
think that I’m a battered woman?
Walker: Yes, I do. I really do think that you’re a battered woman. You
know, I have a lot of clients that I work with who have been battered, and
they describe things just the way you did, Sarah.
Walker Commentary: The simple act of naming the abuse can be
therapeutic in itself. Telling the client that she is like other women who have
been abused can reduce her feelings of isolation and shame.
Walker: And I don’t think that the abuse is your fault. But I think there
are some things that if you want to work together in therapy – and I’d
love to work with you – that we could do that could really help you look at
things maybe a little bit differently and maybe really feel better about what
your life is about. Is that something you think you might want to do?
Sarah: I would like to do that.
Walker Commentary: One of the basic principles of survivor therapy is
that the goals are negotiated mutually. This models egalitarian aspects of the
relationship and focuses attention on the power dynamics.
Walker: How about if for the next time that we meet together, you do a
little bit of thinking during the week. What I’d like you to think about is
what you would really like your life to be like. If you could design a life
for you, what would you like it to be like? And I’m going to give you three
times.
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SECOND WEEK
• Further Details of History
• Safety Plan
Walker Commentary: The second session was devoted to continuing to
gather further details of her history and to the concept of a safety plan. Her
homework was to develop a preliminary escape plan.
WEEK THREE
Walker: That’s great, Sarah. Where do fights usually start? Show me that.
Sarah: Usually in the kitchen, which is this right here. Because I spend
most of my time – It’s in here. That’s usually where I’m either on the phone
or –
Walker: Where’s the phone?
Sarah: The phone is on this. It’s right here. But it has a long cord so that I
can move around pretty easily.
Walker Commentary: It’s important for Sarah to generate the plan herself
rather than me suggesting what she should do. Later in therapy, I may be
faced with moments when I have to step back and let the client lead, even if I
disagree with her choices.
Walker: Now if he were to start – Think about a fight where he really
started something and you were just in that position – Let’s say, where you
were on the phone and he was sitting in there. So how would you get out?
Draw it. Maybe draw it with the pen so I can –
So you’re standing there. He starts. You’re on the phone. He’s sitting there
and you’re starting to get – Where do you feel it, when you start getting a
little nervous? It’s like, you know -
Sarah: Right here.
Walker: Okay, right here. Okay, so now can you feel it?
Sarah: Yeah.
Walker: Alright. Now you’re getting nervous. What would you do if you
wanted to start to walk out? Without talking to him, without looking at
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what I want you to remember is that feeling up here. So that when you
start to feel that way, you know it’s time to leave. Don’t wait for anything
more to happen. Just go out so that Dan is not going to start to block you.
Sarah: You don’t think that would make him angrier that I – Not just leave
the house, but get in the car and go?
Walker: Well, now we talked about that last weekend, and you were saying
you thought you could tell him that if he really starts to make you very
upset, that you were going to leave. You’d come back again and talk to him
when he’s calmed down, but that you were going to leave. So you haven’t
done that yet?
Sarah: No. I haven’t.
Walker: Okay. Alright. Well, when you’re ready to do that, we’ll talk about
how to do it. But what I want you to do now, is I want you to rehearse it. So
I want you to actually physically walk there. Put yourself in that position
and walk there. So that you see how long it takes, how you would walk. All
those little details. Think you can do that?
Sarah: Yeah.
Walker: That’s great. That’s good work. You really are paying attention to
that and that’s really important for you.
Sarah: Thanks.
Over the next few months, therapy focused on two goals that are central
to survivor therapy: helping the client become safe from violence, and
empowering her with a belief in her own strengths.
WEEK 12
Sarah: I went in to go see Justin’s teacher the other day, because he’s been
having some problems himself, and it made Dan furious. He got really
upset with me. He said I’ve made Abby crazy; I’m not going to make Justin
crazy, too. And he just laid into me and said that having two shrinks in the
family-He’s not going to have three. In fact, he even told me that he’s going
to stop paying for this after the insurance runs out next week. I just don’t
know what I’m going to do.
Walker Commentary: An abusive partner will frequently react to the
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Sarah: But I’m not going to be there. I mean, a couple of hours extra work
a week is not going to help my financial situation that much. I know that
it’s going to turn into being more and more and more.
Walker: Alright. Let’s stop for a minute. Just stop for a second. Do you
want to stay in therapy?
Walker Commentary: This is also a decision point for Sarah. Our
relationship is deepening, permitting us to work on a more intense level. This
can frighten some clients and they may terminate therapy at this time.
Walker: - for you. Is this something you want to do and then let’s see if we
can’t problem solve.
Sarah: Yes, I do, but I just don’t know if it’s worth it.
Walker: In what way?
Sarah: Well, it’s causing so much anxiety right –
Walker: Now is it the finance that’s worrying you, or are you really getting
scared that Dan is getting more and more upset?
Sarah: I mean – I guess he – he gets really angry whenever I come.
Walker: And is his anger starting to make you more scared?
Sarah: Yeah. It does. It –
Walker: Does therapy help you deal with that any better?
Sarah: It helps me to be able to come and talk to you about how I’m feeling
and what’s going on with my kids.
Walker: Are you feeling stronger inside as a person?
Sarah: Yes. Yes, I am. I am.
Walker: And that may be part of what’s happening with Dan, is that he
may be seeing that you’re getting stronger inside and that may be why he’s
giving you a harder time about coming to therapy.
Sarah: Oh. I’d never thought about that.
Walker: Yeah. Well, let’s talk about how you might be able to pay for it.
Sarah: I don’t – Maybe what you did say about trying to take on some work
at home so that I can still be there. I mean, I can ask them. I can ask them if
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- what kinds of things that I can be away from the office and still do.
Walker Commentary: This is an important moment for Sarah. Rather than
looking to me, her family, or to Dan, she’s taking responsibility for her own
situation.
Sarah: Well. A lot of it is really fun. I enjoy the computer graphics. I
enjoy figuring out how to make those work and creating. There’s a certain
amount of creativity that is in that, and I like that part. There’s so much
out there that I would love to learn, but I know a little bit.
Walker: Bet you know more than a little.
Sarah: I’m pretty good at what I do.
Walker: You know, it is okay to pat yourself on the back when you do
something right.
Sarah: Well, I’m pretty good.
Walker: Do you know your whole face lights up when you talk about
something you’d really like to do.
Sarah: No.
Walker: It does. It really does. You know, a lot of what we talked about
today has really made you very upset. You seem like you get more nervous,
more anxious. Are you doing this more now than you have in the past?
Sarah: Being more anxious? Yes. Yes, I am.
Walker: Would you like to learn some techniques that might be able to
help you relax a little bit more when you begin to feel this way?
Sarah: Yeah, sure. I’d like that.
Walker: Okay. One of the techniques I want to teach you is called a
relaxation training. And I’m going to teach you how to make your body
feel more relaxed.
Walker Commentary: As we focus on the reality of the abuse, the defenses
Sarah has used for many years, including minimization and denial, become
less effective in managing her anxiety. Relaxation training gives her another
choice.
Walker: -how tight that feels? Now hold it.
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In the 13th week, Dan attempted to batter Sarah, but she implemented her
safety plan to avoid serious injury.
CYCLES OF VIOLENCE
Walker Commentary: In a typical battering cycle, a period of tension
building escalates to an acute battering incident. This is followed by a period
of loving contrition that reinforces the woman’s belief that the man will stop
his abuse. However, without intervention, the cycle of violence usually begins
again, leading to further abuse.
In the weeks following the incident, Sarah reverted to her typical pattern of
minimization and denial, resisting work on revisions to her safety plan.
WEEK 18
Walker: Hi, Sarah. How are you doing?
Sarah: Doing okay.
Walker: Great. That’s good. You know, I made a note that this session I
wanted to start with checking up with you on if you’ve done the rehearsal
of the safety plan that we’ve been talking about now for the past few weeks.
Sarah: No, I haven’t.
Walker: Not yet, huh? What’s going on?
Sarah: No – I just don’t think it’s going to be that much – important
anymore right now. Things are so much better at home, Lenore. Ever since
I came here, things have gotten so much better.
Walker: Tell me about it.
Sarah: Dan is just not as angry anymore. I think coming here has really
helped our relationship at home. My being able to come and talk to you
about my problems, I don’t stress him out, and I’m able to be there for him
when he needs me. He’s been under so much stress with his new project
I was telling you about. Just my being able to be there has been so – And
open to him. Not having to take my problems in and talking about any of
these kind of stressful things he’s able to – It’s just gotten so much better.
He’s nicer all the time and just – Things are a little bit more positive.
Walker: So you’re looking pretty chipper about all this.
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Sarah: I am. I feel really great. Oh! Dan, the other night, he, he mentioned
that we should get out of town. That we needed just some time together –
Walker Commentary: As he feels the woman pulling away, a batterer will
frequently use loving behavior to seduce her back into his control.
Sarah: So we’re going to go up to a mountain home that his boss owns and
just sort of get away from everything. So that’s what I needed to tell you. I
need to re-schedule.
Walker Commentary: Even though she’s lived through these cycles many
times, Sarah wants to believe that this time he really means it.
Walker: Sure. But let me ask you a question about that. What do you know
about his mountain home?
Sarah: Well, I’ve been there once before.
Walker: Where is it? Are there lots of people around? Is it –
Walker Commentary: When I feel a client’s safety is directly at risk, I take a
very active role.
Sarah: There are a few other cabins around and – I don’t know how many
people will be up there, but there should be people up there at this time.
Walker: You feel okay about going that far away from home with Dan?
Sarah: I’m looking so forward to it. Yeah, I do.
Walker: What would you do if you were up there and you were all alone
and Dan started getting angry with you? Have you thought about that?
Sarah: No.
Walker: I don’t want to be a wet blanket or throw cold water on this
because it sounds like it might be fun. But let’s think about some of the
ideas or things that you could do just to make sure that you’re safe.
Sarah: Well.
Walker: Anybody have a telephone?
Sarah: Well, yeah, they do have a telephone.
Walker: And a telephone number that works?
Sarah: Yeah. As far as I know. I haven’t called it but –
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THE ABUSED WOMAN
Walker: So do you think you could give that telephone number to some
people? You know, like maybe – Who’s going to take care of the kids?
Sarah: My sister is. I could give it to my sister. Yeah.
Walker: Could you make sure she calls you a couple of times? And have
like a pre-arranged signal with her?
Walker Commentary: I’m very concerned about Sarah going away with Dan
to a secluded place. She is resistant to the idea that Dan’s anger could escalate
to a dangerous level. I’ll use our relationship to get her to develop a safety
plan.
Walker: Well, I would feel a whole lot better if I knew that you would
make a safety plan. Do you think you could do it?
Sarah: Yeah. I can do that, Lenore.
Walker Commentary: Sarah did develop a safety plan for her trip to the
mountains. Fortunately, the weekend went well and she didn’t have to use it.
Over the next few months, therapy focused on helping Sarah replace her old
coping strategies with new skills for handling her anxieties. While Sarah
hoped to preserve her marriage, she was also beginning to realize that her
growing strength might ultimately threaten it.
WEEK 32
Walker: Hi, Sarah. How you doing?
Sarah: Fine. Guess what?
Walker: What?
Sarah: I got a call from a marketing research group the other night and
they want me to work two days a week in their office to do a multi media
program.
Walker: Now what does that involve?
Sarah: It’s going to involve a lot. It’s going to take video images, putting
them – feeding them into the computer, and using some of my own
computer graphics, putting them together, and then putting audio for
both of them. And the difficulty is trying to get all these things to talk to
each other and work.
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THE ABUSED WOMAN
Walker: Sarah, something else sounds like it’s going on here. What – I
mean, what are you really feeling inside about those children and not
being there?
Sarah: My mother was never home for when – for me and –
Walker Commentary: Sarah’s reluctance to be away from her children
and her anger at her own mother for leaving her alone when she was a child
have come up a number of times already, and we dealt with it in relation to
the immediate situation. Now, I think she’s ready to look at the underlying
dynamics.
Sarah: I swore I would never do that to my kids.
Walker: Okay. Let’s stop for a minute. Let’s talk a little bit about you as a
kid. You know, we haven’t spent a lot of time doing that. Let’s look at that.
Can you kind of get yourself into a mindset and think about when you
were a little kid and think about a time when you were home when your
mother wasn’t there.
Sarah: Almost every time after school. She – She worked at the store. And
she was not there for several hours and all night on Thursdays. She was at
the store.
Walker: Okay. What was it like for you? Can you get back to the feelings
about being a kid and coming home from school. Was it an empty house
when you came home?
Sarah: Well, both my brother and I got home around the same time.
Walker: Okay. Was anybody home?
Sarah: Not at first. No. I would have to take care of getting things ready
for dinner and making sure the house was cleaned up. My uncle was there
on Thursdays, and I was expected to make sure that he was taken care of
and fed. My aunt also worked late on Thursdays. Both she and my mother
worked late on Thursday, so –
Walker: So once a week he was there.
Sarah: Yeah.
Walker: Your face is changing. Are you remembering something?
Sarah: Well. I just –
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Walker: Stop for a minute. I want you to put yourself back there. Can you
make yourself like a little girl again? Just kind of think ‘little girl’ for a
minute, okay? And I just want you to close your eyes, maybe, and think
about being little Sarah coming into the house. You come into the house
with your brother and it’s all empty in the house. You got that picture?
Walker Commentary: Because some courts have ruled that hypnosis may
produce unreliable information, it’s preferable to use guided imagery when
the legal implications are not yet clear.
Walker: How are you feeling?
Sarah: I feel – I feel resentful.
Walker: Did you get angry?
Sarah: Yeah.
Walker: Could you show anybody how angry you were?
Sarah: No, no.
Walker: You couldn’t show it.
Sarah: I would just do things – No, I didn’t tell anybody. I was -
Walker: You’re getting all curled up in a ball. What do you need? What are
you thinking?
Sarah: I just was scared.
Walker: Are you feeling scared now?
Sarah: Yeah.
Walker: Can you attach that feeling of being scared to anything that’s
going through your mind right now?
Sarah: Sometimes when it was late and my mom hadn’t been home, I’d
lock myself up in my room to just get away from everybody and expect my
uncle to take care of things for my brother and sister, and my dad would
get really mad.
Walker: Your dad would get mad because you’d lock yourself in your room?
Sarah: Yeah.
Walker: And that was when just your uncle was there?
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THE ABUSED WOMAN
Sarah: Yeah.
Walker: Are you seeing anything in your mind right now?
Sarah: I just remember being – lying on my bed with my pillow over my
head.
Walker: Are you getting scared?
Sarah: Yeah.
Walker: Angry?
Sarah: Yeah. Mostly scared. Mostly scared.
Walker: You want your mother?
Walker Commentary: Research shows that half of all battered women were
sexually abused as children.
Sarah: Yeah.
Walker: Did you ever tell her?
Sarah: That I was scared?
Walker: That you wanted her those times. Or were you not allowed to talk
about that?
Sarah: It never was right to talk about it. I – I told her that I wished she
was home, but she –
Walker: So you had – as a little girl – you had to fend for yourself. You had
to do everything for yourself. Did you feel unprotected?
Sarah: Yeah, I did.
Walker: Every night? Or especially the nights your uncle was there?
Walker Commentary: Because it’s often difficult to access incest memories,
it’s important to continue asking questions.
Sarah: It was especially on Thursday nights. Dad didn’t get home until
around 6 or 7.
Walker: I want to ask you something, Sarah. Do you think there’s any
chance or do you have any memories of your uncle maybe touching you in
ways that made you feel bad?
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There’s something about Thursdays, Sarah, that just doesn’t feel like
anybody can be protected on Thursdays. That, that may be tied more to
you as a little child than to your children’s needs.
Sarah: That could be. Yeah. That could be.
Walker: Hard stuff, huh? But good work.
Sarah’s work outside of the home brought her increased recognition, and Dan
became increasingly jealous and upset. He continually rejected suggestions
that he seek therapy for himself.
WEEK 42
[Phone buzzes.]
Walker: Yes?
Phone: I’ve got a Dr. Adams on the line. He’s in the emergency room at
Metropolitan General. He’s got Sarah there.
Walker: Oh, no.
Walker Commentary: Of course, I always feel terrible when I get a call like
this, but my first priority is taking care of Sarah. I’m a member of a feminist
therapist support group where I can deal with my own feelings when a client
gets hurt.
Walker: Oh, no. Is she hurt very badly?
Walker Commentary: A therapist who does not specialize in this work, may
want to seek consultation with someone who has more experience working
with an abused woman.
Walker: Oh, no. Her ribs, too. Oh, this is not the first time, I’m afraid. Do
you know what’s happened to her?
Walker Commentary: At times like this, I wish I could simply make a client
leave an abusive partner. Unfortunately, I can’t make her leave. Besides,
leaving does not stop the violence.
Walker: Well, I’m not sure that we really – Does she want to be admitted?
Sarah: No. No. I said I didn’t want the police.
Walker: Do you want her to call the police? I hear her in the background.
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my place.
Sarah: I really need to be with you, though.
Walker: Well, if you really want to see me tonight, I’ve got one more client
and I could stay so you could come here and we could have a session if you
want.
Walker Commentary: It’s important to maintain appropriate boundaries
throughout the therapy, especially at times like this. I want to make myself as
available as possible for Sarah, while still respecting the proper therapeutic
limits.
Walker: You’re sure you want to stay alone? You don’t want to go to your
sister’s?
Sarah: No. I don’t want my kids to see me like this right now.
Walker: Uh huh. Can you call your sister and at least have her look in on
you or call you?
Sarah: Yeah, I’m sure she would.
Walker: Okay. Now listen: I’m going to be at home tonight, so if you need
anything, I want you to call me, okay?
Sarah: Okay.
Walker: Maybe just give me a call to check in. You have my home number?
Sarah: Yeah. Yeah, I do.
Walker: Alright. Let me talk to Dr. Adams, okay? And you know what, I
want to see you in the morning. Can you come in at 10 in the morning?
Sarah: Yeah. I can do that.
Walker: Okay. You can do that?
Sarah: Yeah.
Walker: Alright. Listen, you take care. You’re safe now, Sarah. You did
a good job. You’ve got yourself to the hospital. Okay. I want you to rest
tonight. Call me if you need anything, and I’ll see you first thing in the
morning.
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Sarah: Okay.
Walker: Alright. Let me talk to Dr. Adams.
Sarah: Alright. Here he is.
Walker: Okay
10 AM SESSION THE FOLLOWING MORNING
Walker: Hi, Sarah.
Sarah: Hi, Lenore.
Walker: How you doing?
Sarah: I feel awful.
Walker: Wow. Look at your arm.
Sarah: It still hurts. I really – My ribs are really sore.
Walker: Are they? The doctor said you were pretty banged up.
Sarah: Yeah.
Walker: What happened?
Sarah: The day that my project was due, I went to get it and Dan had
deleted all of my files. He had permanently deleted them. I ran a check
on them. I couldn’t retrieve them at all. There was nothing there. I was
so angry. I was so mad. I mean, how dare he do that to me? I had worked
so hard. I had worked so hard on all of that. And he had – He just – He
deleted everything that I had done. And when I – When I confronted him
with this, he blew.
Walker Commentary: When a batterer realizes he has lost his control over
the woman, he will sometimes seek vengeance by destroying something she
values. In Sarah’s case, her competence at work was synonymous with her
growing sense of self, and this is where Dan chose to attack her.
Sarah: - He threw me down the stairs. He kicked me.
Walker: Wow.
Sarah: I am so mad at him.
Walker: It sounds like this is the worst he’s ever done.
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Sarah: He could have killed me. He could have killed me. I have never seen
that look in his eye. I have never seen him like that before. I have never
been – I have never been like this. I am just so mad at him.
Walker: Sounds like this time you really understand that there was
nothing that you did, that this comes from inside Dan.
Sarah: I didn’t do anything to deserve this.
Walker: No, you didn’t.
Walker Commentary: Although there was no way to predict that Dan would
beat Sarah so severely when she angrily confronted him, she was aware that
her growing strength and independence was likely to threaten him.
Sarah: I don’t know what to do, Lenore. I just don’t know what to do.
Walker: Have you been doing a lot of thinking about it?
Sarah: I have, but I haven’t come to any kind of conclusions. I know I
don’t want to see him. I know I don’t want him around.
Walker: Uh, huh. You scared of him?
Sarah: Yeah. I’m scared of what else he might do. I mean, he could have
killed me. I don’t want him around.
Walker Commentary: Although battered women will often say they’re
leaving and then change their minds, with this incident, I felt some line had
been crossed and Sarah would never go back.
Walker: This is hard, isn’t it?
Sarah: It is. I never thought I’d hear myself saying that. I guess I need a
lawyer, huh?
Walker: Well, this is not the time to make permanent decisions. You’re in
a crisis state, so you’ve got to take your time, think things through the way
we’ve been learning how to do.
Sarah: Yeah.
Walker: You might want to find out, at least, what you can do and what
your rights are and things. You ready for that?
Sarah: I think I am.
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into jail, and I don’t want the kids to have that, either. I don’t want their
father to be in jail, so – No. I don’t want the police involved.
Walker: Well, you know, Sarah, you don’t have to report it now if you
don’t want to, but you can change your mind at any point. And I’ve
documented it, as well, so it will be in my records. So at least we have some
of that information. And if you change your mind, we can do it.
Sarah: Okay.
Walker Commentary: A therapist who works with abused women has to
know the laws in his or her own jurisdiction. You should be prepared to help
clients deal with situations involving police, judges, lawyers, doctors, and even
custody evaluators. It’s helpful to know in advance the specific individuals
and resources in your own community to whom battered women can turn
when they need help.
Walker: This is a step that you have to really take, and you can do it.
Sarah: Yeah. Yeah. I think it’s the best thing to do.
Walker: Now remember: You make the decisions in this.
Sarah: Yeah, I know. And I know that this is not going to turn into my
mother and father’s situation. I’m different. It’s not going to happen. This
case is different. I know that.
Walker: Yeah, you’ve been doing a lot of work with that, aren’t you? Good
for you.
Sarah did consult an attorney, who helped her obtain a Domestic Violence
Protection Order. Her husband moved out of the house, and agreed to a legal
separation.
Like many abused women, Sarah maintained frequent contact with her
husband, who alternately tried to seduce her back into the relationship, and
to control her with verbal intimidation.
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WEEK 52
Sarah: Work seems to be going much better. They’re giving me a lot more
to do, and I’ve got – Work keeps me busy almost every single day, which is
good. And I enjoy it.
Walker: That’s great.
Sarah: Yeah. I’m enjoying it a lot. And it seems to be working out better
all the way around. Dan has been – He’s actually even said he would like
to go into marriage counseling. He seems very sincere about it. I mean, he
would really like to try to work on things.
Walker: What do you think?
Sarah: Well, I think that would probably be a good idea. I know that you
haven’t been so hip on that in the past, but I really think that that would
be good for us. I want to try everything I can to make things work.
Walker: So you still think maybe – even though you’ve filed for divorce
– that maybe this relationship is still going to work out?
Sarah: If he is willing to change and willing to want to work on it, which
he seems that he is, then yes. I’m willing to do that, too. I mean, I miss not
having him around. I mean, he wasn’t always bad. And the times when he
wasn’t were really wonderful, and I miss that.
Walker Commentary: As expected, Sarah is receptive to reconciliation
when Dan asks nicely. When women like Sarah begin to identify and pursue
their own needs, it can disrupt the balance within the family system. In
the absence of violence, family therapy would be perfectly appropriate to
help them both adapt to these changes. But the use of violence is never an
appropriate response to these stresses, and the source of the violence is not
the family system, but Dan’s own internal problems. Until Dan deals with
these problems in special batterers treatment, marital counseling is not
appropriate.
Walker: If he really wants to change, why won’t he go into counseling for
himself? Why not go into individual counseling so he can work on his
problems?
Sarah: I think he feels that because it’s a marriage, that we should be
working together to try to make it work.
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there exactly at 5:00 then he blows his stack, I mean – You’re right. He has
to change. He has to change. It has to be his decision that he is going to
change and stop this kind of behavior. I’m not going to take it anymore.
I’m not going to listen to that anymore.
Walker: How will you know that he’s really going to change?
Sarah: When he gets help. When he gets help.
Walker: Well, it’s very helpful for me to listen to it, because sometimes
you minimize and you just want to make believe that the good Dan is the
only person there. It’s hard for you to really sit with the kind of things that
he does.
Sarah: I have no choice but to see what he really is.
Walker: Dan can change, Sarah, but only if he takes responsibility and
wants to change. It’s the only way.
Sarah: It is. It is the only way. That’s – And if he changes, then maybe we’ll
talk about what our future holds.
As Sarah worked through her denial, she began to recognize the underlying
patterns of Dan’s behavior.
Her sense of physical safety combined with an understanding of her husband’s
manipulations allowed her long-suppressed anger to emerge.
As with many abused women, this anger quickly generalized to include all men.
18 MONTHS
Sarah: The judge sent over this psychologist, this guy that comes over.
And I know Dan probably had something to do with the fact that it’s a
man coming over to evaluate what kind of mother that I am. And he tries
to portray himself as being this sensitive, really caring, gentleman kind of
guy, and I know he doesn’t believe a word that I say.
Walker: How do you know?
Sarah: Oh. How he reacts. The look in his eye. The demeanor. Just sort of
the little reactions whenever I tell him. I know he doesn’t believe anything
that I say about Dan. Nothing.
Walker: Is he letting you talk about some of the abuse?
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Sarah: Oh, he tries. You know, he – He pretends that he’s listening and
that he’s, you know, that he’s concerned about all this. And he kind of
brings up every now and then so that I might trust him, but it – I know
that it doesn’t believe me. I know he doesn’t at all understand what I’m
saying. He’s just trying to –
Walker: Now, wait. Wait a second. If – How do you know that he doesn’t
believe you? I mean, what are the signals that he’s giving you that say he
doesn’t trust you?
Sarah: It’s just his demeanor. It’s just the look. Like I said –
Walker Commentary: Anger at men is very common when women are
healing from abuse. It’s important for the therapist to permit the woman to
work through her anger at her own pace.
Sarah: It’s like the doctor when I went to the hospital, he kept asking me
what I had done to Dan that might have provoked the situation. I mean,
who was being treated there? I was the victim. Things- I was the one that
was hurt. I was the one that had a broken arm, and yet he was asking me
what I had done to Dan. They all stick together.
Walker: All who?
Sarah: All these men.
Walker: Oh, so you’re angry with all men.
Walker Commentary: This can be an uncomfortable time for male
therapists who may try to rush the woman through this period before she’s
ready. The therapist can help her learn not to express this anger destructively.
At the same time, giving her confidence that she won’t always feel this way.
Sarah: Can’t you talk to me? Can’t you just like be open and sort of – But
no. They’re always like trying to come on. And they’re always just trying
to, you know, chat you up for one thing.
Walker: What’s the one thing?
Sarah: Oh, they want to get you in bed. I know that’s exactly what they’re
trying to do. That is it. They have no other interests in finding out who I
am. They don’t care what I think. They don’t care what I have to say about
any issues. They don’t want to talk about issues. It’s like, ‘So what’s your
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sign?’ And ‘What did you do’- Don’t even get me started.
Walker: So you’re not into the dating scene yet, huh?
Sarah: No. I don’t – I’m fine with my friends right now. I’m not at all
interested in – I just haven’t met anybody who’s going to – who’s piqued
my interest.
Walker: You think they’re all like Dan?
Sarah: Oh, I don’t know if they’re all like Dan –
Like many abusive partners, Dan attempted to regain control of his wife
through their children, convincing the custody evaluator that she would
alienate them from him.
As frequently happens, Sarah’s evaluation took place during her intense anger
period, and the judge accepted the evaluator’s recommendation of shared
rather than sole custody.
21 MONTHS
Sarah: You know what the worst thing about this whole thing is?
Walker: What?
Sarah: Is that there’s not one mention in the decision that Dan ever hurt
me. Not one word. It’s like – It’s like it never even happened as far as
they’re concerned.
Walker: Really.
Sarah: No. Not one thing. And I’d also have to give the kids over to Dan if
I was ever going to leave here, which I’m not going to do.
Walker: It doesn’t feel like much justice got done.
Sarah: No. I feel like I was totally – It totally failed me.
Walker: They did fail you. They did fail you, Sarah.
Sarah: That’s what I feel. It just – It hurts. It doesn’t –
Walker: So for you to follow what this court has ordered, this joint
custody decision, that means you have to stay here for a while.
Sarah: Exactly. And I don’t want to be here. This is such a small town.
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Everybody knows what’s been happening. Dan has all these connections
everywhere. I don’t want to be around where he is. I’d just really like to
leave and make a new start somewhere. You know, career-wise, it would be
much better for me to be somewhere else. And there’s just not that much
here to offer me anymore.
Walker Commentary: Unfortunately, battered women must frequently share
custody with the abuser if he has not directly hurt the children. This is often
a painful reality for both client and therapist. It’s clear that Sarah will have
to put aside some of her own personal goals if she wants to remain with her
children. Although she’s justifiably angry now, I’ll help her find ways that she
can still continue to grow.
Walker: So let’s take a look at what your options are. If you stay, then you
have to have certain options, and we’ll look at them in a minute. If you
leave, you have to give up the kids to leave.
Sarah: Right. And I don’t want to do that. So, we’re going to appeal the
decision. My attorney and I –
Walker: So that’s one of your options is to stay and appeal the decision.
Sarah: Right.
Walker: What could you do if you had to stay here? What are your
options?
Sarah: I don’t know.
Walker: You’ve been making such great progress. You’ve been growing.
Really finding yourself. What are you going to do to not lose yourself
again?
Sarah: I’ve got work to do, and most – You know, it’s good work. It’s just
not – It’s just not as far as I can go. You know, there’s so much more in this
field, and other things that I would like to explore and do.
Walker: Like what?
Sarah: I would just like to learn more about what – that’s out there in
computers, but I would also like to just try some other things – You know,
find out more about what other skills that I have that might be useful to me.
Walker: So how would you go about doing that?
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THE ABUSED WOMAN
Sarah: Well, do some research on it. Talk to people. Maybe take some
classes here and there.
Walker: This is a university. Think big!
Sarah: You know what I think would be really nice is to maybe go into
city and take a couple business classes. It might help sort of broaden my
abilities.
Walker: Think you could get a degree?
Sarah: I don’t know about a degree. I mean, that would take so much time.
I have to raise two children. I’ve got to work –
Walker: But is it something you might like?
Sarah: Yeah. Yeah, I really would. I would like to get a degree. I think I
could get a degree. I don’t know if I’ve got any time right now. I mean, it
seems like it’s worse than it ever was.
Walker: Well, it seems to me that one of the things that we can work on is
really trying to help you figure out what the best use of the limited amount
of time that you really have would be for you.
Sarah: Yeah. I feel pulled in so many different directions. You know, I just
– I want to give to my kids and to work and to myself, and I just never feel
like I have enough time to do all that.
Walker: Well, balance is the hardest thing to get to.
Sarah: So how do I do that? I mean, how do I get there?
Walker: Well, that’s something we’re going to have to work on together.
You’re going to have to really figure out what your priorities are and how
to really enforce that.
Sarah: Yeah
Walker: You can do it.
Sarah: Yeah.
Walker Commentary: Once Sarah felt more safe, we could reinforce her
sense of inner strength. That allowed her to overcome her denial at her own
pace and to make decisions in her own way. While Sarah ultimately chose
to leave her husband, I want to emphasize that the goal of survivor therapy
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is not to end the relationship. Rather, the goal is to help the woman become
more safe, whether or not the relationship continues.
Sarah terminated therapy several months after this session. We left open the
possibility of her coming back, either for a check up or for further therapy. In
survivor therapy, the door is left open for the abused woman. She may want to
return if she faces a specific developmental landmark, a crisis, a life cycle issue
or maybe new childhood memories that break through into awareness.
About eight months later, in fact, Sarah formed a serious relationship. As they
became more intimate, she began to experience childhood memories of sexual
abuse by her uncle. She returned to therapy, and we spent the following year
examining and helping her heal from the trauma of incest, using many of the
same techniques you have seen in this video.
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Credits
EDITORIAL CONSULTANTS:
Suzanne Boyll, Ph.D. COORDINATING PRODUCER:
Adjunct Professor of Graduate Psychology Marge Lurie
La Salle University, Philadelphia, PA
EXECUTIVE PRODUCER:
Barbara Brown, Ph.D.
Private Practice
Lilian Schein
New Hyde Park, NY EXECUTIVE IN CHARGE
Arthur Freeman, Ed.D., A.B.B.P. OF PRODUCTION:
Professor, Core Doctoral Faculty & Director Richard Kelley
Cognitive Therapy Training Program
Adler School of Professional Psychology FOR WHITEBIRCH
Chicago, Illinois PRODUCTIONS
Leo Goldberger, Ph.D. PRODUCTION MANAGER:
Professor of Psychology
Joshua Holland
New York University
New York, NY CAMERA:
Beverly Greene, Ph.D. Larry Revene
Associate Professor of Psychology Richard Von Kaenel
St. John’s University SOUND:
Jamaica, NY
Larry Provost
Susan Heitler, Ph.D.
Private Practice LIGHTING:
Rose Medical Center, Denver, CO Ned Hallick
SCRIPT: MAKEUP:
Julie Stockler Jennie Marino
MUSIC: EDITORS:
Dave Holland Donna Boundy
SARAH PLAYED BY: Tom Colello
Laura Tietjen Bart Friedman
Bob Caniglia
FOR NEWBRIDGE PRODUCTION SERVICES:
PROFESSIONAL PROGRAMS
PTI Betacam
GRAPHICS: PRODUCED AND DIRECTED BY:
Ellery Engala John Holland
PRODUCTION ASSOCIATE:
Joseph Craig
© 1994, 2006 [Link] LLC.
PROJECT EDITOR AND All Rights Reserved
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Notes…
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MANUAL AUTHORS
Randall C. Wyatt, PhD, is Editor-in-Chief of [Link] and a
practicing psychologist specializing in post traumatic stress, couples and
family therapy, and cultural diversity in Oakland and Dublin, California.
Erika L. Seid, MA, MFT, Educational Programs Manager at Psychotherapy.
net, is a practicing psychotherapist in the San Francisco Bay Area,
specializing in cultural issues and sexual offender treatment.
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