11.2: Therapy

Therapy

One of the initial goals of therapy with an abuser is to get the person to accept responsibility for what he/she has done, and for the harm that it has caused. This is not always an easy task. The following is a summary of a scientifically reviewed article written by Dr. Sherry Stines, LPCC, and published by Psych Central, Jan. 23, 2017 (www.psychcentral.com). This article was written and reviewed for medical professionals and can be viewed in its entirety here, it is titled “When an Abuser goes to Therapy (Including the Narcissist, Psychopath, Master Manipulator”. What follows is a summary of this content:

Treating Abusive Personalities in Therapy

Effectively treating individuals with abusive personalities requires a different approach than traditional therapy methods. A fundamental principle to remember is that people engage in behaviors that provide them with some form of reward.

Motivations Behind Abusive Behavior

Abusers may derive various benefits from their harmful actions, such as power, control, vindication, punishment, and retaliation. These motives are detrimental to healthy relationships and societal norms.

Defensive vs. Offensive Abuse

Abusive behaviors can be categorized into two types: defensive and offensive. Defensive abusers react to external stimuli, aiming to protect themselves. Offensive abusers, on the other hand, seek gratification and a sense of superiority from inflicting harm on others.

Therapy Approaches

When treating an abuser, it's crucial not to treat them as a victim or coddle their emotions. Even if the abuser perceives themselves as responding to hurt, they make a conscious decision to harm another person. Many abusers adopt a victim mentality, using statements like, “I know what I did was wrong, but I felt hurt,” to justify their actions. This belief serves several purposes:

1. Portraying themselves as victims.
2. Justifying their behavior.
3. Saving face as an injured party.
4. Inducing guilt in the actual victim.
5. Gaining sympathy from others.
6. Attempting to absolve themselves by admitting wrongdoing and expecting forgiveness.

Victim Dynamics

Victims of abusive relationships often stay due to their conscientious nature. They are compassionate, understanding, and forgiving—traits that abusers exploit. Therapists can also fall into the same pattern of responding sympathetically to abusers.

Projection/Introjection Dynamic

The relationship between abuser and victim can be understood through the projection/introjection dynamic. The abuser projects negative behavior onto the victim, who internalizes (introjects) it. Conversely, the victim projects their good nature onto the abuser, assuming they are misunderstood. This creates a cycle where the victim feels responsible for the relationship's well-being and takes on more responsibility when blamed by the abuser.

In an abusive relationship, both the abuser and the victim engage in a process where they reflect each other's characteristics back onto each other. However, the victim ends up in a disadvantageous position by internalizing the abuser's negative traits.

For instance, a victim who feels overly responsible for maintaining the relationship's health might introspect deeply when blamed by the abuser. They might think, "Perhaps I was too harsh" or "Maybe I shouldn't have done that," and as a result, they assume even more responsibility for the relationship's issues. Meanwhile, the victim also projects their positive traits onto the abuser, rationalizing the abuser's actions as stemming from a place of misunderstanding, such as thinking, "He's just lashing out because he feels misunderstood." This dynamic means the victim internalizes the negative behavior of the abuser while attributing their own good intentions to the abuser.

Essentially, the relationship acts like a mirror, where each person reflects what they experience from the other. This mirroring effect can deeply affect the victim's sense of self and responsibility within the relationship.

The Therapist’s Role

Therapists must recognize the dynamics at play in both the victim-abuser relationship and the therapeutic relationship with the abuser. Maintaining strong psychological boundaries is essential to avoid falling into the projection/introjection trap. Understanding that they are dealing with a master manipulator is crucial, as the abuser can exploit the therapist's good qualities for their advantage.

In summary, treating abusive personalities in therapy involves recognizing their manipulative behaviors, avoiding victimization of the abuser, and maintaining firm boundaries to prevent being manipulated. Understanding the complex dynamics of projection and introjection is vital for effective treatment.