Grief and Loss Across the Lifespan, Second Edition

192 Grief and Loss Across the Lifespan

psychological pain and disrupting social relationships” (Cerulli et al., 2012,

p. 778). These additional effects will now be explored in Jane’s case. Although

the literature usually describes the experiences of the “victims” of IPV, it is

typically more helpful clinically to refer to the clients as “survivors” in order

to expand their view of themselves and their resilience.

Social Development

Like many survivors of IPV, Jane sometimes assumed responsibility for her

husband’s mistreatment of her, a belief that caused her to isolate at work as

well as from friends and family. Jane was employed full time as a college

instructor but she never told any of her colleagues about the physical and

emotional abuse she was enduring at home. She felt embarrassed that she

was in an abusive relationship and she did not want others to judge her

for staying with her husband. In her words, she did not want others to see

him as a “totally bad guy” because she “still thought that he had endearing

parts.” She alternated between knowing that what he was doing was not her

fault and then, at other times, believing that she “must have done something

wrong” for him to treat her the way that he did. This combination of loyalty

toward her abuser and the internalization of his negative beliefs about her

kept her silent and isolated for many years. As years passed, the isolation

from others took more of a toll on her psychological well-being because her

own “reality-testing” did not have the benefit of others’ perceptions of her

many positive qualities. By the time she sought therapy, she acknowledged

that her husband’s negative beliefs about her outweighed anyone else’s

beliefs that might contradict his.

Psychological Development

In a research study conducted by Cerulli et al. (2012), women who were

victims of IPV “described frequent psychological symptoms that included

depression, anxiety, paranoia, panic attacks, and flashbacks” and these

symptoms, like the physical ones, “lasted beyond the abuse and criminal

prosecution for their perpetrators” (p. 777). IPV is one type of “complex

trauma” (also called complex PTSD) which is defined as a type of trauma

that occurs repeatedly and cumulatively, usually over a period of time and

within specific relationships and contexts (Courtois, 2004, p. 412). Survivors

of complex trauma include prisoners of war as well as “those subjected to

totalitarian systems in sexual and domestic life,” including IPV (Courtois,

2004, p. 412). Characteristics of complex trauma include the following: diffi-

culty in regulating emotions; changes in consciousness leading to amnesias

and dissociative episodes; distorted perceptions of self, including a chronic

sense of guilt; incorporation of the beliefs and perceptions of the perpetra-

tor; chronic difficulties in trusting others; and somatic complaints and/or

medical problems (Cloitre et al., 2012).

Jane displayed each of these six characteristics. Especially in the months

following the assault that precipitated counseling, she suffered from over-

whelming anxiety and terror that made it difficult for her to sleep at night