Emotional abuse causes organ dysfunction, parts of the brain to shrink, and a greater risk of long term illness yet victims struggle to get protection or support without external injuries.
Victim accounts of physical abuse trigger our emotions far quicker and with a much greater impact than those of psychological abuse. Consequently, victims of psychological abuse struggle to gain legal protection from an abuser without evidence of physical abuse.
If I wasn’t pushed by my doctor’s receptionist and the police to visit my doctor after they’d heard the violence over the phone, I might not have got the protection I needed.
Too many witnesses, mostly medical and family violence professionals had witnessed the psychological abusive yelling, using the children, manipulating, and controlling, many had reported incidences, yet I still believed it wasn’t that bad.
Psychological abuse may not produce visible damage, but the damage done internally can be more complex and take longer to heal.
Manipulation of a victim’s defense mechanisms alters the structure and function of multiple organs of the body. Key changes include:
So, what is psychological abuse?
The following equality and power/control wheels differentiate healthy from abusive behaviors in relationships. Negotiation rather than coercion and honesty and responsibility rather than denial and minimization are just some examples of conduct that can either strengthen or damage a person’s self-concept and perception along with the relationship.
Abuse is a pattern of tactics that undermine and distress victims which can quickly shift to good behavior when it suits, particularly in front of others, some tactics are so subtle that a victim’s reaction may seem over the top to outsiders hence the tendency for abusers to escape consequences by citing provocation.
The physiological effects of psychological abuse.
The parasympathetic nervous system responds to psychological abuse by releasing stress hormones that slow immune and digestive function to stimulate the muscles, heart, and nervous system to get ready for ‘fight or flight’ (and ‘freeze or fawn’) responses. Sustained exposure to increasing daily levels of such stress hormone levels leads to a decrease in hippocampal volume.
A number of studies have found Post-traumatic stress syndrome (PTSD), affecting more psychologically abused victims than those physically abused, is associated with a decrease in the volume of the amygdala (memory and parasympathetic responses), hippocampus (memory and learning ), and medial prefrontal cortex (memory and decision making).
Parental emotional abuse is the strongest predictor for children developing PTSD, increasing their risk of impaired memory, concentration, reduced academic performance, depression, and schizophrenia.
Studies show psychologically abused children such as the 34% of those that witness intimate partner violence (IPV), often between parents, are more likely to suffer from a range of mental illnesses in later life than physically abused children.
Abuse alters a child’s developing neuroendocrine mechanisms increasing their risk of obesity, hypertension, type 2 diabetes, and behavioral and neurobiological dysregulation such as impaired memory and concentration, elevated fear and aggression, and mental illness.
The immune system responds to psychological abuse through allostasis, releasing inflammatory mediators to protect vital functions, though if this persists it can lead to allostatic overload causing chronic pain.
Studies found children and adults who suffered such stressors demonstrated indicators of impaired immune function with increased inflammation, shorter telomeres (the caps of DNA that shrink with age), and the reactivation of herpes virus.
This interdependence of the nervous, endocrine, and immune systems in response to stress is described as a ‘supersystem’ in which its dysregulation promotes chronic pain conditions.
A review on peptic ulcer disease and psychological stress found considerable evidence for HPA (Hypothalamus-pituitary-adrenal) influence over stomach mast cells, histamine and acid production, gastric motility, mucosal integrity, and other disruptions leading to impaired gastrointestinal functioning.
Elevated cortisol levels under psychological stress increase pepsin and gastric acid levels which may over time cause damage to the lining of the gastrointestinal tract leading to peptic ulcer disease. Victims of abuse report higher incidences of symptoms of IBS (irritable bowel syndrome), chronic pelvic pain, fibromyalgia, dyspepsia, and heartburn.
Women exposed to severe emotional abuse have a 25% greater risk of elevated hypertension than women not exposed. This elevated hypertension can lead to cardiovascular disease (CVD), the leading cause of death for women worldwide.
Scott-Storey’s conceptual model identifies 3 factors that lead to this increased risk of CVD; the physiological alterations of cumulative abuse that reduces the body’s ability to fight stressors and disease, the use of known CVD risk coping strategies such as smoking and food, and symptoms of depression known to dysregulate the HPA axis and lead to CVD.
- Greater awareness of psychological abuse and the physiological impact could help to:
- Foster safety and equality within families and communities by improving their knowledge and skills in identifying psychological abuse, encouraging victims to access their support.
- Increase referrals between mental health and medical practitioners when physiological and psychological symptoms indicate a potential trauma factor.
- Strengthen the case for victims of psychological abuse within the family violence legal and social welfare framework.
To achieve a wider understanding and a greater impact on the reduction of family violence, it is essential that support for the physiological damage of psychological abuse is incorporated in prevention and treatment programs.
Thank you for reading.
Craft, Judy. & Gordon, Christopher. & Huether, Sue E. & McCance, Kathryn L. & Brashers, Valentina L. & Rote, Neal S. (2018). Understanding pathophysiology. St. Louis, Missouri : Elsevier.