Self-Compassion, Abuse and Recovery from a Clinical Perspective: A Journey to Change
After spending decades observing the ups and downs of life—watching friends marry, have children, and ultimately face the challenges of divorce—I found myself on a different path. I chose to remain single, which allowed me to reflect deeply on my experiences and the journeys of those around me. I have since developed a bit of a contrarian attitude in that I fail to see how anyone before age 40 can counsel people about life. It wasn't until late that I decided to pivot my career and move to Vermont to practice psychotherapy.
In my role as a therapist, I primarily work with men, many of whom come from socio-economically challenged backgrounds. I have noticed a common thread among these clients: many became fathers in their early twenties, often stemming from broken homes and facing a lack of educational opportunities. This is by no means an excuse for the men I have counseled who have been abusive, incarcerated, or in dire need of counseling. On the contrary, it is one of many layers of psychological reality that must be considered in long-term, nuanced psychotherapy.
One of the common questions people ask when they come to therapy is, "Can I change?" But the more pressing question is, "Do I want to?" Change can often feel daunting, and it's perfectly normal to hesitate. When we talk about change, we're not just talking about minor adjustments in behavior, but a fundamental shift in how one interacts with others, particularly in the context of abusive behavior. The belief in the potential for change isn't just a hopeful notion; it the central, core supposition of therapy itself. If change were entirely out of reach, we wouldn't even bother with therapy. It's about finding the motivation and willingness to embrace that change when it is correct.
Recently, a colleague asked how I felt about the famous author Lundy Bancroft, whose controversial insights into the dynamics of abusive relationships have garnered significant attention. Bancroft, a renowned author and speaker with a background in counseling, has spent a decade working with men who abuse their partners, dedicating his career to understanding the complexities of abusive behavior and its impact on victims. There's no doubt about Bancroft's commitment to helping victims of domestic abuse. His well-known work, "Why Does He Do That?: Inside the Minds of Angry and Controlling Men," explores the thought patterns and beliefs underpinning control behavior. Through his writings, Bancroft challenges so-called "traditional" notions of domestic violence, emphasizing the role of power and control over mere anger management issues. While he acknowledges the necessity of improved community-level care for victims and accountability, his perspective presents a rather bleak of men in general, and his outlook for positive change among men engaged in abusive behavior is dismal.
Unfortunately, I cannot recommend Why Does He Do That? for those seeking to change abusive behaviors or their partners. The book fails to capture the core motivations behind abusive behavior and potentially leads readers (men in particular) to feel confused and hopeless. Despite Bancroft's extensive experience, his conclusions are contradicted by broader, research-backed studies on intimate partner violence (IPV).
Differences in Perspectives:
Abuser Profile: Bancroft's work suggests that abusers are primarily men motivated by a desire for power and control. In contrast, research shows that both men and women perpetrate abuse, often motivated by unresolved emotional pain, stress, and relational conflicts.
Motivation for Abuse: Bancroft argues that abuse is a deliberate choice rooted in self-centeredness and a sense of entitlement. However, data indicates that abusive behavior often stems from personal trauma, difficulties in expressing emotions, and poor coping skills, not solely a desire for dominance.
Path to Change: Bancroft suggests that abusers rarely change without facing severe consequences. Studies, however, indicate that positive therapeutic relationships and tailored interventions can promote meaningful behavior change.
Effectiveness of Interventions: Bancroft's approach, based on a feminist model that views male dominance as the primary cause of IPV, aligns with his professional background. This model, which is a key part of Bancroft's perspective, emphasizes the societal power imbalances between men and women as a root cause of domestic violence. Conversely, research suggests that IPV dynamics are complex, often bi-directional, and influenced by trauma, personal history, and relational patterns.
Impact of Bancroft's Work: Why Does He Do That? 's popularity among domestic violence advocates stems from its alignment with the feminist model. However, this critique argues that Bancroft's perspective can reinforce harmful stereotypes, create feelings of shame, and fail to provide hope for individuals motivated to change.
Discussions around mental health are incomplete today if they do not include biological and neurological factors. It's crucial to also consider the psychological dimensions that influence behavior. In this context, Dr. Stephen Stahl's research stands out for its in-depth examination of these elements. By acknowledging the intricacies of the human brain andpsyche, Stahl sheds light on the underlying motivations for behavior and emphasizes the capacity for transformation through specific interventions. His esteemed contributions to the field of psychiatry and psychopharmacology, especially in works like "Violence in Psychiatry," provide valuable insights into the interplay between mental health disorders and violent actions, particularly in scenarios of domestic violence.
By acknowledging the multifactorial aspects of mental health, we can develop more effective strategies to support individuals in their journey toward positive transformation. Dr. Stahl points out that while specific mental health issues may relate to an elevated risk of violent behavior, including domestic violence, it's essential to realize that mental illness isn't the sole reason for such actions. When we look at violent behavior, he encourages a thorough approach that takes into account individual psychological makeup, as well as environmental and social factors. As Director of Psychopharmacology Services at the California Department of State Hospitals, Stahl worked on strategies to reduce violence among individuals with severe mental health challenges. His insights highlight that effective interventions should address both psychiatric symptoms and the behavioral aspects of violence.
Stahl's approach aligns with a broader understanding of mental health that managing domestic violence involving those with mental health issues requires a well-rounded strategy. This means incorporating suitable psychiatric treatment, behavioral therapies, and robust social support systems to tackle the complex web of factors that contribute to violent behavior. Stahl's focus on impulse control, OCD, and mood disorders showcases the importance of understanding the underlying psychological processes driving behaviors. Unlike Bancroft's more rigid view of human behavior, Stahl's findings suggest that individuals can achieve greater self-awareness and learn to manage their actions better with the proper support and pharmacological interventions.
In my practice of therapy, my goal is to navigate the unique layers of a person's personality, background, and mind, fostering a holistic environment ripe for growth. This journey involves addressing issues like impulse control and mood disorders in tandem with a pharmacological approach. Believing in everyone's potential for change is critical. It's about meeting clients where they are and guiding them on a path of self-discovery and transformation, using insights from research to enhance our therapeutic methods and medication to foster stability and confidence.
Self-Compassion in Therapy: A Pathway to Real Change
In therapy, we strive to help individuals recognize their ability to change genuinely. We aim to meet them where they are and support them as they grow. This process can be intricate because it relies on creating a safe space for clients to explore and challenge themselves. I've found that Acceptance and Commitment Therapy (ACT) offers a transformative framework, especially in areas where more traditional methods may feel restrictive. While addressing these patterns is crucial, Bancroft overlooks the complexity of multifactorial diagnostics central to psychological healing. His approach, by definition, is limiting. While having a one-sided viewpoint can be beneficial for selling books and attracting an audience, Bancroft's claim that all men who engage in abusive behavior are destined to remain stuck in that behavior commits two significant errors.
First, women who unfortunately choose to stay with abusive men are portrayed solely as always victims, which ignores their role in the dynamic. Second, Bancroft promotes the flawed feminist notion that all men are inherently and archaically aggressive. This rather flimsy and loaded assertion appears to appeal to a specific audience that subscribes to a particular ideology—3rd and 4th wave feminism. Let me be clear. Some men do abuse women. Some men are sociopaths. Women deserve equal if not tremendous respect, and society must ensure their safety, just as all citizens do. Nor is there anything inherently problematic or controversial about women's empowerment. The more women in roles of power, the better. However, this is not the focus of Bancroft's work. Instead, he presents a bleak and restrictive view of couples grappling with severe mental health issues.
On the other hand, recent insights from Dr. Stahl regarding impulse control, OCD, and mood disorders emphasize how interconnected psychological dynamics can profoundly influence our actions. This research points us toward a kinder, more adaptable approach that looks at what's happening beneath the surface rather than just the behavior itself
Acceptance and commitment theory deploys a framework that balances recognizing unhelpful patterns with genuine change in my practice. CT's six core components—acceptance, defusion, self-as-context, values, mindfulness, and committed Action—uniquely foster self-compassion and personal growth.
Acceptance encourages individuals to acknowledge their thoughts and feelings without judgment. This doesn't mean condoning negative behaviors but rather creating a compassionate stance towards oneself. This foundation of acceptance is particularly impactful for those dealing with mental health issues, as it allows for an honest exploration of their inner world rather than avoiding or resisting these parts.
Defusion counters Bancroft's emphasis on altering thinking patterns by helping clients see thoughts as mere mental events, not ultimate truths. This act of separation, or "defusing," empowers clients to challenge harmful beliefs that often perpetuate distress.
Self-as-context gives a broader sense of identity beyond isolated thoughts or behaviors. While Bancroft's work focuses heavily on behavior, ACT emphasizes the "observer-self," the part of us that remains constant amidst changing experiences. This helps clients see themselves as more than just a collection of actions, opening the door to self-transformation.
Values are a cornerstone of ACT, focusing on what truly matters to clients. In contrast to Bancroft's focus on behavior modification, ACT encourages individuals to clarify and live according to their core values, making change intrinsically meaningful rather than punitive.
Mindfulness enables clients to live in the present, experiencing their lives as they are without being overwhelmed by judgment. This present-moment awareness is invaluable for breaking free from habitual negative patterns and embracing a more open, receptive stance toward change.
Committed Action focuses on taking steps aligned with one's values, even amidst difficulties. This principle promotes accountability and responsibility by empowering individuals rather than focusing solely on behavior correction.
The journey toward change, especially for individuals grappling with abusive behaviors, is fraught with complexities that must be thoroughly understood within a nuanced framework. While Mr Bancroft's perspectives shed light on certain aspects of domestic violence, they can inadvertently perpetuate negative stereotypes and a sense of hopelessness for those seeking reform. Conversely, a more comprehensive approach, as seen in the work of professionals like Dr. Stephen Stahl, emphasizes the multifaceted nature of abusive behavior and the potential for meaningful change through targeted psychological interventions. Fostering self-compassion and a willingness to confront brutal truths can empower individuals and communities to break the cycle of violence. By prioritizing understanding, healing, and accountability, we can pave the way for healthier relationships and a more supportive environment that encourages genuine transformation. Change is not only possible; it is a journey that can lead to profound personal growth and a more compassionate society.
Resources and Notes:
https://domesticviolenceresearch.org/pdf/FindingsAt-a-Glance.Nov.23.pdf
Impulsivity and compulsivity are symptoms that cut across many psychiatric disorders. Some conditions with impulsivity as a prominent feature have already been discussed, including mania (Chapter 4); attention deficit hyperactivity disorder (ADHD; Chapter 11), and agitation in dementia (Chapter 12). Several other disorders in which impulsivity and/or compulsivity are core features are discussed in this chapter. Full clinical descriptions and formal criteria for how to diagnose the numerous known diagnostic entities discussed here should be obtained by consulting standard diagnostic and reference sources. Here we emphasize what is known or hypothesized about the brain circuits and neurotransmitters mediating impulsivity and compulsivity, and how engaging neurotransmitters at various nodes in impulsivity/compulsivity networks can result in successful psychopharmacological treatments.
1. Stahl SM. Impulsivity, Compulsivity, and Addiction. In: Stahl’s Essential Psychopharmacology: Neuroscientific Basis and Practical Applications. Cambridge University Press; 2022:538-578.
