Dear Dr. Jenn,

I have a friend who I suspect may be in a relationship with a man who is abusive to her. She has a couple of children with him and I am also worried they might be in danger too. What can I do to help my friend?

Dr. Jenn's Response:

Violence in intimate relationships is a serious problem. According to the National Domestic Violence Hotline (www.thehotline.org), “one in four women (24.3 percent) and one in seven men (13.8 percent) aged 18 and older in the United States have been the victim of severe physical violence by an intimate partner in their lifetime.”

Also known as intimate partner violence or IPV, it can include physical, sexual, reproductive, emotional, financial, and psychological abuse. Some of the signs that a person is in a violent or abusive relationship can include thins like: pulling hair, punching, slapping, kicking, biting, or choking; name calling, insulting and continually criticizing; forcing the other person to dress in a sexual way; refusing to use a condom or other birth control; or giving the other person an allowance and closely watching how she spends it. The vast majority of perpetrators of violence and abuse are men, though there are documented cases of female-to-male and mutual violence among both straight and gay couples. The fact remains that when men are violent against women, the incidence of serious injury and death is extraordinarily higher than when the woman is the perpetrator. Go to www.thehotline.org for a much more extensive discussion of the prevalence and signs of intimate partner violence.

It needs to be said out right that violence in any relationship is never OK. It is always harmful and always needs to be extinguished. In fact, it is a criminal act to be physically or sexually violent against one’s partner or if any child witness such violence between adults. Many cases of violence go unreported and unpunished because of fear of retribution and retaliation as well as the fear of the stigma that comes with being in an abusive relationship.

In the same way that it is a fact that no violence is OK in any relationship, it is also a fact that no one ever asks or wants to be abused. There is nothing that anyone can do to anyone else that warrants any form of violence. Unfortunately this message is not clearly expressed in many families or throughout our society. Many children grow up having witnessed violence and then experience it again in their adult intimate relationships. It is rare to meet a person who is or has been in an abusive adult relationship who has no knowledge of any violence in their own family of origin. On the other hand, many people who experienced abuse in their families as children choose not to abuse their partners and often leave relationships that have the slightest evidence that they may become abusive. Not everyone who grew up with abuse will end up in an abusive relationship.

If you are in a relationship where there has been violence or you know someone who is, get help because there is a good chance that the violence will not stop and could intensify over time. There are a few key steps to safely leave an abusive relationship. First, contact your local domestic violence shelter where they will have staff and resources to help your friend get out of the situation and get herself and her children safe. If the person needing help doesn't know where their closest shelter is, have them contact the National Domestic Violence Hotline at 1-800-799-7233 or www.thehotline.org. In cases where more immediate safety is needed, call 911 to get the police to intervene and help them get safe.

Many women don’t leave abusive relationships for fear that leaving will put them and their loved ones in more danger than if they stay. While there are stories in the media of abusive partners flying into rages and escalating the intensity to frighten and control their partners, having a safety plan to reduce the possibility of escalation is critical. This is why professionals need to be involved. Police, the court system, and a safe house all can help to provide the support needed to get safe and get away to start a new life.

If you notice someone you love has unusual injuries and seems nervous about discussing them, try sitting down with the friend and telling her you are not going to judge her or think differently about her if she has something hard to talk about with you. Let her know you won’t force her to do anything if she has something bad happening to her. Together you can strategize the best ways for her to keep herself and her children safe. If she is not comfortable going to or calling a shelter, have her call any therapist in the community who can help her think through how to get safe. It is important for you not to panic with your friend because the last thing she needs is more fear and trepidation for sharing details with you. Stay calm and grounded as well as supportive and loving.

Question: How do you know if a relationship is unhealthy or if it just needs work?

Dr. Jenn's Answer: 

Whether you have a long history of romantic relationships or you are just falling in love for the first time, everyone spends time assessing their relationship for health. Many people fear that if they are in an unhealthy relationship, they’ll make excuses to stay in it in spite of what messages they are getting from themself and others. So listen to the totality of what people who love you and who you trust are telling you about how your relationship looks from the outside. Don’t focus on just one friend’s opinion, get a lot of opinions from people you can absolutely trust to have your back. If your most trusted friends tell you the relationship looks unhealthy, it probably is. By going to a therapist to find out if the unhealthy relationship is workable, you can then decide what to do next. Listen to your own intuition as well. It usually is telling you the right answer.

So what is a healthy relationship? First and foremost, healthy relationships have NO violence whatsoever. That includes no physical, sexual, or emotional violence. Beyond that most basic and unwavering rule, experts like Dr. John Gottman tell us that when we use 5 positive interactions to every one negative interaction with our partners, that’s one indicator that we are protecting our relationship and giving our partner the care he or she needs. On the other hand, an unhealthy relationship is one that is fraught with what he calls The 4 Horseman: criticism, contempt, defensiveness, and stonewalling. These characteristics make people feel horrible about themselves, and they find themselves working much harder than they should to be happy in their relationship.

Healthy relationships are often based on a sense of friendship. Can you look at your partner and honestly say, “you are one of my best friends?” Along these same lines, most healthy relationships look quite equal in terms of the power each person has to make decisions and offer their influence to the other person. Frequent or constant power struggles can be an indicator of an unhealthy relationship. I often tell clients that it’s not THAT they have conflict, it’s how they RESOLVE their conflict that matters. Are you able to feel genuinely closer to your partner and feel more secure in the relationship after a typical argument, or do you find yourself replaying it over and over in your head and noticing you feel damaged by the conflict? The latter may be an unhealthy relationship.

One way I gauge the relative health of a relationship is how closely the two people are in terms of their opinions on big issues such as religion/spirituality, family, work, finances, and their core values. Your opinions on most of these should be at least similar between you with the ability to discuss small differences openly without hurt feelings. Most couples won’t be able to manage the strain large differences on these topics put on a relationship for the long haul. Healthy relationships allow each person to be their authentic selves, so being able to respect each others’ small differences on these large issues without much difficulty is key.

Most long term relationships, even healthy ones, go through some struggles from time to time. I warn many of my friends not to wait until it is too late to get some professional help for relationship issues. One of the biggest problems we therapists see day in and day out is couples who have waited to come in when the damage to themselves and their relationship is too far along to really repair easily. If you or your partner has started to feel like you are giving up on the relationship, it might be more work that you are willing to put into saving the relationship. Get help early so that you can prevent real damage that is too much work for you to feel like investing in.  Finally, if you can honestly say that you are unhappy with your partner or that you don’t like who you are in this relationship, it’s probably not healthy for you. If you are mad or sad most of the time, it’s time to look at getting help to end the relationship. Our love relationships should be where we can get the support, love, and acceptance for who we area that help us get through life’s toughest trials. 

When Separation Anxiety Becomes Too Much for Your Child

Separation anxiety is a normal reaction most children have from time to time when they feel insecure due to being separated from their primary caretaker. Children as young as 8 months may become clingy and seem frightened when an adult to whom they are emotionally close leaves them at school, daycare, or at home with a sitter. While the tearfulness and protest is a normal process of human development, there is a level of separation anxiety that may indicate a problem among children age 7-11. According to webMD.com, “When this fear occurs in a child over age 6 years, is excessive, and last longer than four weeks, the child may have separation anxiety disorder.”

In the U.S., an estimated 4-5% of children in this age group suffer from the symptoms of separation anxiety disorder (SAD). According to the DSM-IV-TR, a parent may want to seek professional help if their child has:

·         Excessive anxiety provoked by separation from someone to whom child is emotionally attached

·         Must last at least 4 weeks and begin before 18 years

·         Excessive worry about potential harm toward oneself or primary caregiver

·         Avoid activities that may result in separation from parents (school avoidance, fear of being alone, sleep)

·         Nightmares and somatic complaints (trembling, headaches, stomachaches, nausea, vomiting, stomach pain, sweating)

We do not know exactly what causes SAD. Some experts believe that children with SAD may have initially picked up on anxiety the parent had about being away from the child. This anxiety can be transmitted from one generation to the next. Experts have noticed that most cases of separation anxiety appear in close-knit families, and can develop after a life stress such as a move or a death in the family.

When a child begins to display the first signs of separation anxiety, parents can try spending more one-on-one time with the child, engaging in “special play time” for a half hour a week. Allow the child to choose the type of play while the parent follows along without any questioning or criticism. This is a technique in filial therapy known as reflective play. If, on the other hand, the child is showing the above symptoms for a longer period of time, parents can begin with a conversation with their child’s teacher(s) to see how they adjust to being at school each morning. Next, the child’s pediatrician can be helpful by ruling out physical illness or side effects from medications that may be contributing to the child’s anxiety. Finally, a family therapist can help the parent-child dyad work through the issues that are causing symptoms. Some therapists may recommend individual therapy for the child where play is used to help the child work through their emotions in an age appropriate way. Regardless, children with SAD should not have to suffer in silence. Allowing them to express their worries in a safe, accepting environment will help them work through their fears.

If you are looking for help dealing with your child's separation anxiety, call me at 720-340-1819 for a confidential appointment.

Balancing Work and Personal Life 

Often when a person feels off balance between their relationship, their family, their friends, and their work or school obligations, they also feel stressed. A lack of life balance and stress go hand in hand. Busy partners find themselves crossing paths once a day if they are lucky. If you are not living in the same household, a phone call might be all the contact you have with your partner in a given day.

When the person you depend on for support and stress reduction also is busy or not available when you are available, feelings can get hurt, people can start to blame the other, and conflict can increase. People often report feeling out of touch with their partner or even may try to protect their own feelings by withdrawing from their partner. This can make the time you do spend together uncomfortable and unfulfilling.

When we work with couples for whom this is the case, we encourage them to remember what it was that drew them to their partner in the first place. What things did they used to do when life was less chaotic that made them feel good and want to spend time together? Once each partner has shared their memories with each other, we encourage couples to be purposeful and deliberate in terms of planning time together during the next week. Try to plan only one week at a time. Plan for as little as one hour together doing something you both enjoy. Your plan does not have to involve activities that are expensive or flashy. It can be sharing time on the couch watching a favorite TV program. The quality of the time is critical. Try to put other needs and obligations to the side for that time you are with your partner for just that one activity.

Pre-planning for quality time together once a week is as important as making it to an exam or an important meeting at work. Doing this regularly can help each of you prioritize your relationship when work, school, or other obligations seem to be overwhelming, thereby providing the support you both need from the other.

Remember that balance is a person’s own responsibility, and it takes practicing good habits to achieve balance. If you have little ones who are in your home, this also is an excellent model for them for how to try to strike a better work/school/relationship balance for their own lives.