How To Get Your Abusive Husband Into Therapy…Safely

If your husband is abusive it can be really, really difficult to get him into therapy for help. And yet, this leaves the wife in a very difficult place — not only because of the abuse — but because usually the burden of mending the relationship and the problems are placed on her. That’s part of the abusive dynamic. So how do you get past the control and manipulation? How do you convince an abusive husband they need to get help? How do you approach them about the issue when any confrontation could get dangerous very quickly? The trick here is that in these kinds of situations the blame has been laid for too long at the feet of the abuse survivor. So it is really challenging to safely and effectively motivate the abuser to seek help. Before we get into this, remember that our episodes should be considered a self-help tool and do not replace individual counseling or direct support from professionals, or even law enforcement in your area as may be required in a situation like this. If your situation is severe you should be pursuing emergency help and establishing safety before you consider trying to intervene on your spouse at all. Barriers to Confronting Abusive Husbands I want to start by acknowledging why it can be so hard to confront an abusive husband. I’m going to speak directly to wives in this situation but also want to acknowledge that there can be husbands out there too, and their wives are abusive, and this is also a very challenging and complex situation for you. The first issue is the most obvious and that is that your physical safety could be at risk or even the safety of your children. In extreme cases your life may be at risk. If that’s your situation you need a safety and escape plan. Another possibility is that the constant cycle of abuse in your marriage has worn you down to the point where your self-esteem is completely eroded. The humiliation, the lack of control and the isolation — those can lead to feelings of worthlessness and even that you should just accept the abuse since you won’t ever be able to make it stop[i]. Control is also an issue here. If there’s been isolation, or loss of identity, or fear of violence, or financial control or other kinds of restrictions it can make it very hard for you to take action. Of course there is also the manipulative thinking imposed by abusers so that you may even believe the abuse is your own fault (Chang et al, 2006) And then there’s trauma bonding. Abusive marriages often create a sense of dependency in you where your low self esteem and sense of powerlessness makes you feel that you need your abusive husband in order to survive[ii]. In this situation you may not confront your husband or try to convince him to get help for fear that he may leave. Or, you may have no power to actually convince him since he believes you will never actually leave him. This is really tough stuff. Finally, hopelessness comes into play. Long-term abuse can lead to a tangible sense of powerlessness and hopelessness. Many abused wives experience symptoms of depression and mental illness. You may therefore believe that there is no hope that your situation will improve, and so make no effort to seek help. What Can You Do? There are a few options to consider here. Police Action In the case of physical abuse, police intervention can act as a strong deterrent and also provide motivation for future change. A study in 1995[iii] looked at police intervention into domestic abuse, and found that being arrested and prosecuted after committing domestic violence significantly reduced the likelihood of future events. This is likely because after arrest, the abuser is often required to undergo mandatory therapy, court-ordered counseling or some other form of intervention[iv]. So as a way of getting your husband into treatment, police action is a drastic but effective strategy. I get that this is a tough decision to make — it really exposes what is happening in your marriage to the public but it’s also worth considering that him getting caught can be a gift of grace to help him face issues that he may not otherwise find the space to face. During Reconciliation Abuse has a cycle to it: typically, a honeymoon phase, then walking on eggshells, then the outburst, then reconciliation and then the honeymoon again. It seems that possibly the best time to motivate an abusive husband to seek help and engage in it is during reconciliation. That’s a good time to try and hopefully he will engage in a program where he will stay committed to it and stick with hit. Separation Another way to motivate your husband into treatment is to consider a therapeutic separation. If you had any concern for your safety or the safety of your kids at all you would want to initiate this through an escape plan. What I see in abusive marriages is that the husband is often most motivated to seek help and to engage in therapy when the wife is separated from him. Then there’s no covering up what’s going on, there’s nobody to manipulate, just the obvious truth that a problem is there and hopefully he can see that he is the one who needs help. It’s really critical for people supporting a situation like this — be they friends or family or church members — you may want to see the marriage healed, but the abusive mindset has to be corrected before any marriage counselling should even begin to happen. Don’t rush that part — the wife needs time and space to regroup and then if the husband is in therapy she also needs as much time as she requires to gather evidence through slowly increasing levels of interaction to see if he truly has had a change of mind and is safe to be with again. Counseling Interventions So what kind of therapeutic interventions are available, and what are they like at getting abusive husbands to change? There are a couple psychotherapy models that are used in this case. Cognitive Behavioral Therapy is one approach where abusive husbands can learn better ways of coping with their anger and healthier ways of relating to others. CBT for barterers also teaches them empathy and challenges them to change either underlying beliefs about women or themselves. This is an especially critical component of recovery. There’s also the Duluth Model. I’m not familiar with this but I understand it is an educational intervention based on feminist principles. This method teaches respect for women and challenges the ideas that men have the right to exert power and control over their wives. It also aims to reduce the behaviors that focus on power, control and dominance and increases the behaviors which relate to equality and fairness. Are they Effective? A pretty important question to ask before you try and get your husband into therapy is, “does it work?” To answer this, a study in 2004[v] conducted a meta-review (a study of other research studies) to determine if these treatment methods were effective in motivating abusive husbands to change. It was found that both intervention types reliably produced "small but significant" reductions in abuse. Both therapy types were relatively similar in their effect, and both produced effect sizes which were only slightly better than the effect of being arrested and prosecuted without getting treatment. So unfortunately therapy isn’t the magic cure-all you might hope it was: it can help but probably won’t be the slam-dunk you want. Despite the overall modest effect of these interventions, some specific factors have been identified which motivate a man to enter, and stay in, treatment. These include: Creating a supportive and collaborative alliance within the couple: you want to encourage your husband into help, rather than forcing him. Confrontational and hostile tactics reduce the abusive husband's motivation to change. Being aggressive with him also reinforces his belief that relationships are built on anger and forcing people to do what you want. But showing support for him and viewing him as in need of help rather than deserving of punishment enhances the outcome of interventions[vi]. Obviously this is a very hard perspective to take of the man who is abusing you, but if you can separate the man you love from the abuse he is carrying out, he has a better chance of permanently stopping. The content of the first introductory session in the intervention was also important in convincing abusers to actually want to seek help. A study in 2008[vii] found that programs which have a day-long "orientation" session which teaches practical skills as well as developing the husband's feelings of compassion were more successful in motivating the husbands to stay in the program. So if you’re looking into different interventions and therapy options, that’s something to ask about. Is Your Husband Ready to Change? Choosing your moment carefully is very important when you’re trying to get your husband the help he needs. According to the trans-theoretical model of behavior[viii], any major change to your lifestyle or actions happens in a cycle of five stages. For an abusive husband it would look like this: Pre-contemplation stage: the husband not believing he has any need to change, or that he is not capable of change Contemplation: husband recognizes the need to change but doesn't yet take any action Preparation: husband decides to change and begins making a plan to do so Action: your husband gets help and begins to change his behavior Maintenance: after treatment your husband attempts to maintain his new behavior Which stage the abusive husband is at determines how motivated they will be to attend therapy, and how successful they will be in different therapy types. A study in 2003[ix] found that men in the contemplation stage show little change in levels of empathy, communication skills and levels of abuse as a result of treatment, but men in the preparation stage and action stage showed posi