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Types of Abuse

Emotional Abuse

Emotional abuse systematically undermines the victim’s self-worth, self-trust, and sense of self, much like brainwashing. Also known as psychological or mental abuse, it encompasses a range of tactics – from overt verbal abuse and constant criticism to more subtle disapproval and an unwillingness to ever be satisfied. While this abuse leaves no visible scars, it can inflict deep, lasting emotional wounds.

WARNING SIGNS OF EMOTIONAL ABUSE:

  • Berates, belittles, criticizes, threatens, calls you names, and constantly finds flaws with you.
  • Makes unreasonable demands, requires constant attention, deliberately starts arguments and has sudden emotional outbursts. Nothing is ever good enough for them and everything is always about them.
  • Accuses, threatens, gives orders and has a judgmental “I know best” attitude, then blames you for being “too sensitive” when you feel hurt.
  • Refuses to listen or communicate, withdraws emotionally, and disallows or overrules any viewpoints, perceptions, or feelings that differ from their own.
  • Manipulates the relationship so that the only feelings and opinions that count are their own, holding you personally responsible for their happiness.
  • Emotionally blackmails you by playing on your fear, guilt, compassion, religious values, or other “hot buttons” to get what they want.
  • Trivializes your thoughts, minimizes your feelings, and invalidates your pain by saying things like “You’re exaggerating and making a big deal out of nothing”, suggesting that your emotions and perceptions are faulty and can’t be trusted.
  • Disregards your personal standards or beliefs, and may try to persuade you to do things that you don’t want to do.
  • Denies your personal needs and does so with the intent of hurting, punishing, or humiliating you, and then denies that anything is wrong.
  • Denies your perceptions, memory, and sanity; seeks to distort your perceptions of your own world (causing you to doubt yourself, also known as gaslighting).
  • Must have their own way, and will hurt your feelings if necessary in order to get it.
  • You feel like you have to “walk on eggshells” around them because of their drastic mood changes and unpredictable responses, such as acting angry or upset in a situation that normally would not warrant such a response, or gets angry at certain times but not others.
  • Can be disguised as “helping” or “teaching”.

Verbal Abuse

Verbal abuse occurs when one person uses demeaning words and body language to criticize another person. It often involves ‘put-downs’ and name-calling that aim to make the victim feel unworthy of love or respect, and lacking in ability or talent. If the abused person challenges these statements, they are frequently dismissed as “just a joke” and told that the problem lies with them for not finding the “humor” in it. The abuser may even deny that any abuse is happening, claiming it’s “all in their head.”

The abusive language fundamentally attacks the core of the victim’s character and capabilities. As a result, the abused person may start to internalize these criticisms, believing there is something inherently wrong with them rather than recognizing the abuser’s behavior as the real problem. This is especially insidious because the abuser’s words and tone convey a contradictory message, masking their true, abusive feelings and allowing the abuse to persist unrecognized. Over time, this can severely damage the person’s self-esteem and self-worth.

Note: Verbal abuse can manifest in both overt and covert forms. Overt verbal abuse involves angry outbursts and name-calling, which are typically blaming and accusatory, leaving the abused person feeling confused. Conversely, covert verbal abuse is more subtle, involving seemingly innocuous comments that can approach brainwashing. This hidden aggression is even more confusing for the person, as the abuser’s true aim is to exert control without their knowledge. Over time, verbal abuse has the potential to escalate, becoming more intense, frequent, and varied.

Categories of Verbal Abuse:

  • Withholding – The choice to keep virtually all or a significant portion of one’s thoughts, feelings, hopes, and dreams to oneself and to remain silent and aloof.
  • Countering – Consistently opposes and is antagonistic toward anything you think, feel, or express, whether it’s excitement or concern.
  • Discounting – Denies the reality and experience of the abused person and distorts their actual perception of the abuse.
  • Disguised as Jokes – Disparaging comments disguised as jokes often referring to intellectual abilities, physical attributes, or competency.
  • Blocking and Diverting – Refuses to communicate openly, dictating what topics can be discussed and withholding key information; this effectively prevents any possibility of resolving conflicts – productive dialogue is blocked by making direct demands or abruptly changing the subject.
  • Accusing and Blaming – Accuses the other person of some wrongdoing, or of some breach of the basic agreement of the relationship, blaming them for their anger, irritation, or insecurity.
  • Judging and Criticizing – Expresses judgment in a critical way, sometimes framing it as “helping” or “teaching”.
  • Trivializing – Says what you have done or expressed is insignificant and inconsequential.
  • Undermining – Withholds emotional support, while also eroding confidence and determination – saying things like “Who asked you?” and “Nobody asked your opinion”.
  • Threatening – Manipulates the other person by bringing up their greatest fears, usually involving the threat of rejection, abandonment, loss, or pain.
  • Name Calling
  • Forgetting – Involves both denial and covert manipulation.
  • Ordering – Denies the equality and autonomy of the other person.
  • Denial – Denies the reality of the other person.

Physical Abuse

Physical abuse encompasses the intentional use of physical force with the potential to cause death, disability, injury, or harm. This includes a wide range of actions, such as scratching, pushing, shoving, throwing, grabbing, biting, choking, shaking, slapping, punching, burning, using a weapon, or using one’s body or strength against another person (CDC, 2007). Physical abuse can also include behaviors such as denying the victim of medical care when needed, depriving the victim of sleep or other functions necessary to live, or forcing the victim to engage in drug/alcohol use against their will. It may also involve inflicting harm on other targets, such as children or pets, to psychologically torment the victim.

PHYSICAL INDICATORS

  • Sprains, dislocations, fractures, or broken bones
  • Burns from cigarettes, appliances, or hot water
  • Abrasions on arms, legs, or torso that resemble rope or strap marks
  • Internal injuries evidenced by pain, difficulty with normal functioning of organs, and bleeding from body orifices
  1. Bruises – The following types of bruises are rarely accidental:
    • Bilateral bruising to the arms (may indicate that the person has been shaken, grabbed, or restrained)
    • Bilateral bruising of the inner thighs (may indicate sexual abuse)
    • “Wrap around” bruises that encircle a person’s arms, legs, or torso (may indicate that the person has been physically restrained)
    • Multicolored bruises (indicating that they were sustained over time)
  2. Injuries healing through “secondary intention” (indicating that they did not receive appropriate care)
  3. Signs of traumatic hair and tooth loss.

BEHAVIORAL INDICATORS

  • Injuries are unexplained or explanations are implausible (they do not “fit” with the injuries observed)
  • Family members provide different explanations of how injuries were sustained
  • A history of similar injuries, and/or numerous or suspicious hospitalizations
  • Victims are brought to different medical facilities for treatment to prevent medical practitioners from observing a pattern of abuse
  • Delay between onset of injury and seeking medical care


Sexual Abuse

Sexual assault is a serious violation that involves the physical invasion of a person’s body. It can result in physical harm or injury, as well as profound psychological and emotional trauma. The legal definition encompasses acts such as rape, as well as a range of other unwanted sexual behaviors. These non-consensual acts include inappropriate touching, groping, attempted rape, forcing a person to perform sexual acts, or penetrating any part of the body with a body part or object. If the situation involved ANY unwelcome physical contact, it may very well have constituted sexual assault.

Note: Informed consent is a mutual, voluntary, and sober process that should be discussed before any and all sexual activity. Both partners should enthusiastically communicate their needs and wants without fear of their partner’s reaction. Conversely, force encompasses more than just physical pressure – perpetrators may use emotional coercion, psychological force, or manipulation to compel a victim into non-consensual sex. Some go further, employing threats like harming the victim or their family as an intimidation tactic. It’s crucial to remember that consent cannot be given legally if a person is impaired, intoxicated, drugged, underage, mentally challenged, unconscious, or asleep.

INDICATORS OF SEXUAL ASSAULT IN ADULTS:

Physical Presentations:

  • Chronic pelvic pain, back pain, and headaches
  • Gastrointestinal symptoms/distress
  • Muscular and skeletal complaints
  • Asthma or respiratory ailments
  • Insomnia or other sleep disorders
  • Sexual dysfunction
  • Eating disorders
  • Addiction
  • Pseudocyesis (false pregnancy)

Psychological and Behavioral Presentations:

  • Depression and anxiety
  • Post-traumatic stress disorder symptoms
  • Dissociative states
  • Repeated self-injury
  • Suicide attempts
  • Lying and stealing
  • Compulsive sexual behaviors and/or poor contraceptive practices
  • Not following medical recommendations
  • Sexual dysfunction: problems include but are not limited to – intolerance of/or constant search for intimacy, avoidance and/or fear of intimacy, compulsively seductive, shutting down sexually, feeling emotionally numb during sex.

INDICATORS OF SEXUAL ABUSE IN CHILDREN AND ADOLESCENCE:

Physical Signs:

  • Difficulty walking or sitting
  • Bloody, torn, or stained underclothes
  • Bleeding, bruises, or swelling in genital area
  • Pain, itching, or burning in genital area
  • Frequent urinary or yeast infections
  • Weight changes/major changes in appetite
  • STI, especially if under 14 years old
  • Pregnancy

Behavioral Signs

  • Inappropriate sexual knowledge and/or sexual behavior
  • Nightmares or night terrors; fear of being alone in the dark
  • Suicide attempts or self-harming, especially in adolescents; pattern of being a victim (victimizing oneself after being victimized by others) and/or re-victimization by others
  • Shies away or seems threatened by physical contact (avoidance of being touched)
  • Low self-esteem; poor/distorted body image.
  • Failure to remove clothing even when appropriate to do so (while swimming, bathing, or sleeping)
  • Inability to recognize, own or express their anger/rage, fear of someone else’s anger/rage (actual or imagined) or being constantly angry
  • Having a startle response (always on guard)
  • A total inability to trust, or trusting indiscriminately, or absolute trust that turns to rage when disappointed
  • Difficulties with attachment and abandonment (gets too close too quickly or has trouble connecting)
  • Runs away from home
  • Post-Traumatic Stress Disorder or Rape Trauma Syndrome symptoms

Common Reactions:

  • Depression, anxiety, and withdrawal
  • Feelings of shame and guilt
  • Difficultly sleeping (trouble falling asleep and/or staying asleep)
  • Psychosomatic symptoms (stomachaches, headaches/migraines)
  • School problems (absences, drops in grades)
  • Poor hygiene/or excessive bathing
  • Regressive behaviors – thumb-sucking, rocking, bed-wetting, etc.

Financial Abuse
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Financial or material abuse can take the form of fraud, theft or using of the vulnerable adults property without their permission. It includes behaviors to intentionally manipulate, intimidate, and threaten the victim in order to entrap that person in the relationship. The forms of financial abuse may be subtle or overt but in general, include tactics to conceal information, limit the victim’s access to assets, or reduce accessibility to family finances.

Warning Signs:

  • Controlling how all of the money is spent; withholding money or giving “an allowance”
  • Sudden inability to pay their own bills and/or sudden withdrawal of money from an account
  • Forbidding the victim to work; sabotaging employment opportunities
  • Forcing the victim to write bad checks, file fraudulent tax returns, forcing them to turn over public benefits
  • Person lacks belongings that they can afford
  • Purchase of items that individual does not require or use; personal items going missing
  • The person managing the vulnerable adults’ finances is evasive and uncooperative
  • Reluctance to accept care services
  • Refusing to pay or evading child support or manipulating the divorce process by drawing it out by hiding or not disclosing assets
  • Withholding funds for the victim or children to obtain basic needs such as food and medicine
  • Not allowing the victim access to bank accounts; not including them in banking decisions
  • Running up large amounts of debt on joint accounts.
  • Refusing to work or contribute to the family income.
  • Stealing the victim’s identity, property, or inheritance.

Neglect

Neglect is a form of mistreatment by individuals resulting from inadequate attention, especially through carelessness or disregard for the needs of others.

Physical neglect includes

  • failing to attend to a person’s medical, hygienic, nutrition and dietary needs, such as changing bandages, bathing, grooming, dressing, or failure to provide ample food to maintain health.

Emotional neglect includes:

  • causing emotional pain, distress or anguish by ignoring or belittling the needs of others (i.e. neglecting or discounting the emotional well being of others and actions taken to isolate others from visits or contact by family and friends).

Abandonment involves:

  • deserting the care giving needs of an individual while neglecting to arrange sufficient care and support for the duration of the absence.

Financial neglect involves:

  • disregarding a person’s financial obligations (i.e. such as failing to pay rent or mortgage, medical insurance or invoices, utility and garbage bills, property taxes and assessments).

Self-neglect involves:

  • seniors or adults with disabilities who fail to meet their own essential physical, psychological or social needs, which threatens their health, safety and well-being (including failure to provide adequate food, clothing, shelter and health care for one’s own needs).

Bullying

Bullying is unwanted, aggressive behavior that involves a real or perceived power imbalance. The behavior is repeated, or has the potential to be repeated, over time.

In order to be considered bullying, the behavior must be aggressive and include:

  • An imbalance of power: Kids who bully use their power – such as physical strength, access to embarrassing information, or popularity – to control or harm others. Power imbalances can change over time and in different situations, even if they involve the same people.
  • Repetition: Bullying behaviors happen more than once or have the potential to happen more than once. Bullying includes actions such as making threats, spreading rumors, attacking someone physically or verbally, and excluding someone from a group on purpose.

There are three types of bullying:

1. Verbal bullying (includes saying and writing mean things about someone)

  • Teasing
  • Name-calling
  • Inappropriate sexual comments
  • Taunting
  • Threatening to cause harm

2. Social bullying (involves hurting someone’s reputation or relationships)

  • Leaving someone out on purpose
  • Telling other children not to be friends with someone
  • Spreading rumors about someone
  • Embarrassing someone in public

3. Physical bullying (involves hurting a person’s body or possessions):

  • Hitting/kicking/pinching
  • Spitting
  • Tripping/pushing
  • Taking or breaking someone’s things