Coming back to lifeMarch 13, 2013 — Features
By Kevin Matthews
Well-educated, ambitious, religious. Kimiko’s wish list spelled out what she wanted in a man, and the one she married matched every particular. She was in love, at least before the fear took over. Before he chased her around with frying pans and destroyed her things. Before, when she was pregnant, he picked her up and threw her.
“You have to be very careful when you write a list of what you want,” she said, “because God will put those people in front of you.”
Kimiko left and divorced her husband while their children were young, but her next relationship also turned violent. The new boyfriend, an ex-Marine who drank even more than her former husband, nearly strangled her to death in her children’s bathroom.
How does this happen and happen again? When does it stop? Beyond staying alive, what does it mean to survive?
These are recurring questions for clients and for therapists at the Verizon Intimate Partner Violence (IPV) Intervention Program run by CLU at community counseling clinics in Oxnard and Thousand Oaks. The telecommunications company’s commitment to fighting IPV goes back to the launch in 1995 of the cellular phone donation program HopeLine. More recently, Verizon has ramped up giving in the area of mental health, according to Jesus Torres, director of government and external affairs. Since 2010, the Verizon Foundation has provided grants to CLU’s intervention program totaling $240,000.
That backing has allowed CLU master’s and doctoral students to provide free counseling and other services to more than 200 IPV victims. A separate $40,000 grant from the Women’s Legacy Fund pays for counseling for children of victims.
After 16 weeks of individual therapy and at least 12 weeks of group therapy, CLU follows up with the adult clients every three months during the first year and again at two years out. The program’s recorded rates of success for its clients – defined as a reduction of violence, regardless of the reasons reported – hover around 75 percent. Few programs measure outcomes over as long a period, but these are high numbers in a field that’s full of setbacks and disappointment.
According to the Centers for Disease Control, roughly one in four women and nearly one in seven men in the United States have experienced severe physical violence by an intimate partner.
“I think it’s a dirty secret in our society that people oftentimes don’t want to acknowledge, and the scary part is it happens on every socioeconomic level,” said associate professor Mindy Puopolo, who directs doctoral studies in clinical psychology along with the IPV program.
When Puopolo launched the program three years ago along with Morris N. Eagle, a clinical supervisor and distinguished educator at CLU, neither of these seasoned therapists had much experience with IPV intervention. Similarly, several graduate students and recent graduates who serve as therapists in the program said they really learned about this issue on the job, not from life experiences.
“It was really unusual, I think. None of us had a personal history or a personal stake in it from our families,” said Daniel Knauss ’08, a doctoral student who is writing a dissertation about types of IPV victims. “I think it has, on the one hand, freed us up to think a little bit more creatively and openly, outside of the box.”
After reviewing the literature on IPV interventions, the CLU students and clinical supervisors decided to dispense with the standard treatment regimen, known as the Duluth model, that has been employed in clinical settings since the 1980s. In keeping with that model, most programs require clients to leave their abusive partners as a condition of starting treatment, and then focus attention on imparting life skills – everything from relaxation techniques to how to balance a checkbook – that are seen as the keys to independence.
“You have to deal with the relationship,” said Puopolo, who has seen IPV clients as a volunteer at the Ventura County district attorney’s restraining order clinic. “The old model is, no, you just put the batterers in jail and work with the victims, but that’s not successful. It doesn’t work, and we know that it doesn’t work.”
Broadly speaking, the clinicians in the CLU program object to the volume of directives that victims receive from all sorts of authorities. Prosecutors may want victims to face their abusers at trial, courts may order treatment, and counseling programs, police and child protective services each add their demands.
Ironically, services intended to empower victims end up narrowing their options, or forcing choices that are far harder than they sound.
“So you have women who have these kids with no money, no support, no home, usually no car, no possessions of any kind, going to a shelter that may or may not be available. And so leaving is not always the best option,” Puopolo said.
When victims of physical abuse do leave their partners, they frequently return. Or find someone else just as dangerous, if not worse. Very much like people who abuse substances, people who work themselves up to leaving their partners may experience symptoms of withdrawal afterward. In fact, one of the risks associated with leaving is the onset of a substance abuse problem.
These aren’t just facts to be faced; a lot depends on attitudes toward them. A private marriage counselor told Annie and her husband that the latter’s only fault was “loving her too much.” Contradicting himself as he urged her to stay put, he also said that if she left her husband, she probably would end up in a worse relationship.
More and more frequently during her seven years of marriage, Annie would unwillingly flip on a “switch” in her husband, for example by standing up to him. It rested on OFF as long as he felt in control of his wife, so keeping him content became her primary concern. She ate mostly meat and dressed formally because those were things he preferred, and she hid or ended personal relationships that he didn’t approve of. She realized only after leaving him how little attention she’d paid to their children and to herself.
Annie made it to therapy at CLU a few years after her divorce. In the meantime, she lost custody of her children, and a roommate had to break down her bedroom door and call police to save her from her next boyfriend.
“If it wasn’t for going through the therapy sessions, I probably would have still somehow ended up back with him or going back and forth with him,” Annie said.
Annie arrived at the Thousand Oaks community clinic with a question in mind: what is it I do that makes men violent? Low self-esteem played a part in her thinking, evidently. But after you remove the self-blame from that question, there is something left worth asking. Nearly all of the IPV victims seen at the CLU clinics ask themselves some version of it. They say, How does this keep happening? Why do I always end up here?
The CLU program is different because it goes there. It works with the victims precisely to answer these indelicate questions, winning it some critics who believe that this amounts to blaming victims for the violence.
Not only will the clinicians, in many cases, talk through IPV victims’ life experiences, in an effort to understand what’s been driving the choices of partners, but they even walk through memories of violent episodes to figure out what triggers them. In fact, this sort of procedure, aimed at improving the clients’ “reflective functioning,” is at the core of the method being developed at the clinics.
“Don’t forget, they’re not all going to leave. Some of them are going to stay in the relationship,” said Eagle. “If they’re going to stay in the relationship, it becomes particularly important to recognize: what are their partner’s trigger points and what do they do to push those buttons?”
According to Eagle, an expert in attachment theory, one of the most common scenarios in violent relationships is the pairing of (usually) a man who has a deep, chronic fear of abandonment with a woman who tends to withhold affection. In psychological jargon, he is enmeshed-preoccupied and she is avoidant-dismissive. It’s a combustible mixture.
When the man makes an overture to her, such as saying “I love you” after a fight, it may not be a hollow apology. He may be seeking, once again, proof that she will not abandon him. “We often repeat pretty awful things because we hope at least this time we’ll master them,” said Eagle.
By recalling just such an episode in detail, one woman in group therapy at CLU came to see her husband as a “sad little baby … not just this violent, aggressive, terrible man, which is how he dealt with being scared,” Knauss explained. The closest thing she’d seen to his behavior when she did not say, “I love you, too,” were her young son’s tantrums. Soon after, the woman’s insight helped another group member to avoid a fight.
“The more we can get them consciously making an effort to think about what drives their interactions with other people, what drives their emotional states – our hypothesis was and continues to be that they’ll be more able to navigate their relationships and make choices for themselves that will reduce violence. Whether they decide to leave or not,” said Knauss.
Most of the IPV clients are the ones on the receiving end of violence, but a significant number of them are the batterers. In a few cases, CLU has even worked with two former partners at once, each in a different location or on different days to protect survivors from further harm.
Meeting together weekly in Oxnard and in Thousand Oaks to go over the cases, the eight graduate student–therapists at each clinic and their clinical supervisors discover surprising things. For one, the violence in perhaps 40 percent of these relationships runs in both directions. That’s not to say that both partners are equally violent or equally at fault, but there’s physical retaliation.
Another surprise: when women are the batterers and men are on the receiving end of all or most of the violence, the dynamics of the relationships are no different than with the roles reversed. She is likely to be controlling, anxious, deeply insecure about his affections, and abusing drugs and alcohol; he is likely to have sexual trauma in his past and a picture of romantic love that was partly shaped by that trauma.
IPV victims are likely to attribute characteristics associated with chivalry, or being a caballero, to their male partners. Doctoral student Kristina Rodriguez ’08 discovered this in the process of looking for cultural differences between her Spanish-speaking female clients and other women in the program. But women in both groups shared these beliefs.
“They’re the kind of person who brings you flowers, they apologize, and you go into this mode of ‘everything is all right again,’” Rodriguez said. This is the positive flip side of machismo, and Rodriguez currently is planning to study how it fits into patterns of violence.
Victoria had no history of abuse in her family, but she was shy and lacked confidence, especially after she got glasses and moved to a new town in the fourth and fifth grades. Years later, she committed what she saw as an unforgivable sexual sin, and her self-regard fell off a cliff. When she met the man she would marry, “I was flattered that he liked me, because everybody loved him.”
On the honeymoon, he accused her of checking out a waiter, the first in a stream of accusations as he became obsessed with where she was, whom she was with, and what she was doing. The emotional abuse worsened over many years, but manifested as physical abuse only on one occasion. In Victoria’s case, that moment of violence and the threats that followed it constituted a turning point.
Six months later, after she asked for a divorce, the husband took his own life. As three different mental health professionals have told Victoria, she is lucky to be alive. They said that, given his psychological profile and the statistical probabilities, the story “should have” ended as a murder-suicide.
Survival is always slow. It took a long time for Victoria to see that she didn’t have to mourn her husband, because she had already done so during a deep depression. She came to the CLU clinic later, after reading about emotional abuse and realizing for the first time that this term applied to her.
“It was a place where I could speak my mind without being judged, where people understood the words that would come out of my mouth,” she said.
Like all of the therapists in the program, Rodriguez, the doctoral student working with Spanish speakers, has seen mixed results. One of her clients stopped coming after two sessions. But another who stayed with Rodriguez was able to work out many of the things that had happened to her back in Mexico.
By the end of therapy, the woman was significantly more independent and managed to arrange important matters such as after-school care for her kids. More strikingly, “she was able to go to a party just for her,” Rodriguez explained. “This is an individual who didn’t do anything for herself. She felt guilty if she went out to a party and they had food that her children liked.”
Outcomes vary widely, and the truth is that the CLU program’s high rate of success in reducing violence says little about outcomes. If there’s a theme running through the narratives of IPV survivors, it may be that as they regain some control of their lives, they begin to notice themselves.
“It’s been an interesting past few years, realizing what I like and what I don’t like, and what I can do and what I can’t do. It’s like finding yourself again,” said Annie.
Annie has found a loving relationship with a strong but peaceful partner. Victoria, for now, does not trust herself to date again. Above all, she does not want anyone telling her what to do. Kimiko, who is now homeless, insists that she will not get back into a romantic relationship with her ex-husband, but she said that she is considering leaving the country with her children to accept his financial help.
“It’s scary, but it’s probably the best option that’s out there,” she said.
Therapists in the program take the position that choices must lie with the survivors, that this is finally the only way to help.
“We are not assuming that we know what’s best for them,” said Jenna (Perry ’08) Knauss, who has been a therapist and now serves as coordinator for the program. “We say that to them at the very beginning: ‘We’re not here to tell you what to do. The therapist isn’t here to tell you what to do. The clinic isn’t here to tell you what to do, but rather to sit with you as you figure that out for yourself.’”
Names of survivors of violence and abusive relationships have been changed to protect their privacy.