Sessions can help both the abuser and the abused

Last week, National Football League owners met for their annual general meeting and discussed not football, but domestic violence. They spent the morning with intimate partner assault educators. The league and commissioner Roger Goodell were harshly criticized for lack of action on the video showing Ray Rice of the Baltimore Ravens knocking out his fiancée. The scandal in the NFL focuses attention on one of the most intransigent societal problems. According to a 2011 Justice Institute report, 17,297 women and children became residents of British Columbia’s more than 100 shelters for abused women. We know witnessing domestic abuse is a significant adverse childhood experience, one that sets people up for a lifetime of struggles. Yet only 22 per cent of incidences of domestic violence came to the attention of the police. So what happens to the rest? Often, the victim won’t let police know for fear of escalating her abuser’s anger. We know the most dangerous time for a woman in an abusive relationship is right after she’s left it, so sadly, many women stay and endure. The rare ones end up in my office. If the relationship is new — like Ray Rice and his bride, Janay — if the violence is not yet deeply entrenched, and if both spouses are committed to change, there is a chance this relationship can be saved. I never counsel a woman to stay with an abusive man. I often suggest they live apart until therapy has been completed. I meet with each partner separately. With the woman, we use CBT techniques to bolster assertiveness and self esteem. For men, I use motivational interviewing and cognitive behaviour therapy to dismantle attitudes toward power and dominance and to question beliefs that allow the abuser to minimize and justify his behaviour. A key component here is to help the abuser build empathy for his victim. Emotional regulation and anger management skills are layered in. Then we meet together and role- play issues that caused tempers to flare in the past. I work with both spouses to enhance their communication skills. I’m not going to kid you. It’s the unique relationship that survives this. During the course of therapy, I’ve had women decide to leave their relationships. With new insight and sense of empowerment, they come to the conclusion themselves. So if you know someone who is in an abusive relationship and loves her man and rejects any suggestion she leave him, suggest counselling instead. The end result may well be the same. In cases where the police get involved, abusers are often directed to spousal assault programs. The data around the success of most of these programs suggest they are not effective. Many re- offend. Intimate partner violence experts now believe a broad social- systemic solution offers the most hope. Starting from an early age, boys will get the message: violence is wrong. The NFL wants to be part of that plan. It may be too late for Ray Rice and his wife, but not for a generation of boys for whom NFL players are heroes.