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"I made him HIT me!" Strategies for Battered Women
Battered Women continuing education counselor CEUs

Section 18
Techniques for Treating Couples

CEU Question 18 | CEU Answer Booklet | Table of Contents | Domestic Violence
Social Worker CEUs, Counselor CEUs, Psychologist CEs, MFT CEUs

Violence-eliminating strategic interventions must be melded with family therapy techniques in order to treat couples. These cognitive-behavioral-communications strategies include crisis intervention, treating aggression and homework assignments.

Crisis Intervention

Treating violence means intervening in crises; it is to be employed upon any threat of violence or if battering has occurred. The goal of the intervention is to solve the presenting problem (the crisis) through immediate response, focusing on the presenting problem with a determination of psychological and physical safety, and issuing a directive that results in a solution to the problem.

An anxious and panicked Mary called as directed to say that Fred was very angry, and she was afraid he would become violent. He had been threatening her and the family. In the background, I could hear Fred throwing furniture; Mary was yelling at him to stop, which fueled his anger. I directed Mary to stop telling him to stop because it was making him angrier and to tell Fred that I wanted to speak to him. He refused. I told her to tell him that he promised to talk to me should he feel out of control. It took three tries, but he finally came to the telephone.

He started the conversation by calling Mary a bitch and telling me in a loud voice how she made him get angry at her. I directed him to calm down, stop talking, and listen. I reminded him of his contract. He said he did not give a damn about any contract and that she had provoked him. I interrupted, saying it did not matter what his reasons were or who provoked what. What counted was that he needed to control his anger so that she did not leave him, the police would not be called, and he did not feel badly after the episode was over. I told him if he refrained from hitting her, he would feel better about himself, and that was the goal of the counseling. Did he remember that? He said, “Yes, but . . .” several times, with my interrupting him every time reminding him that he made a deal to follow the contract, and that is what he had to do now. The issue was too hot for them to deal with alone and needed to be discussed in a session. He finally agreed. I asked him to repeat what his contract said and what he had to do. I directed him to put Mary on the telephone so that I could tell her what he and I agreed to.

Mary got on the telephone; she was agitated and sobbing, so I suggested some relaxation techniques. I informed her about what had transpired between Fred and myself and told her that they were not to talk about the issue until the session because it was too volatile for them. I reminded her that she had a part to play in Fred’s contract. He was to leave the house for an hour. She was to let him go and not question him about where he went when he returned. She agreed. I asked if she felt she was OK. She still felt scared. I asked her if she wanted to visit her friend, as we agreed she would do if she felt too shaken. She thought that was a good idea.

Potential for Violence
Family violence cases always have a critical aspect to them because of the potential for violence. When working with the couples, treating the aggression is the main objective, but in that process, it is necessary to intervene in a crisis. The goal of the intervention is to stop violence from occurring by influencing the systemic behavior—a different goal than is used when not treating the batterer.

Couples presenting with violence need an opportunity to vent, complain, and even fight in the presence of the worker. Most of them have bottled feelings and need an opportunity for outpouring in a safe environment. Initially, they spill their feelings in counseling sessions. Listening to the fights demonstrates to the couple worker comfort with anger; more important, it demonstrates for the worker their fighting patterns and the issues they fight about. Fighting for too many sessions, however, repeats their patterns and serves to maintain homeostasis. Workers should intervene in the fight after the patterns and issues are established for the worker and direct them to stop fighting, since it is nonproductive. I attempt to allow fighting to occur only in the initial session. Under no circumstances should it continue later than the third session, with the worker moving the case along toward the cessation of violence.

Treating Aggression
Eliminating the violence is the reason to treat the aggression and is accomplished with several procedures. Violence cannot be eliminated without the batterer’s motivation. It can be assumed that if a batterer voluntarily enters treatment, he wants to change, but because of his psychological defenses and his fear that change is impossible, the worker needs to increase and make explicit his motivation. Implicit to motivation is the batterer’s assuming responsibility for the battering.

Batterer Responsibility
Most batterers, whether treated with or without their partners, initially deny that battering is their responsibility or that they see reason to stop. They may say, “She makes me do it because she provokes me,” “Knocking a woman around once in a while teaches her who’s boss,” or “I only gave her a little slap.” In the face of the man’s denials, rationalizations, minimizations, and externalizations, workers need to remember that batterers can and do change and they must understand defense mechanisms. In spite of the batterer’s initial lack of admission that he alone is responsible for the battering or that he needs to change that behavior, the worker proceeds on good faith and the professional knowledge that if someone comes in for treatment voluntarily, he wants to be there.

The first step is focusing on having him acknowledge that he alone is responsible for the battering. When a batterer tells me that he is not responsible (usually because she provokes him), I often ask if he thinks other partners are provocative too. Then I wonder if he thinks all men who have provocative partners respond with violence. This is one root to his seeing his responsibility for violence. If he thinks that other men may respond to provoking partners differently, he is faced with understanding why he does not. If he does say that all men who are provoked by their partners respond with violence, I question whether he can think of another way to respond, even to the point of making suggestions (“Why don’t you just walk out?” “Why don’t you tell her you want her to stop provoking you?”) in an attempt to help him see that the way he responds is his choice. The object of this initial step is to engage the batterer in order to develop a therapeutic rapport that will eventually lead to a therapeutic alliance. If a batterer acknowledges the domestic violence is his responsibility, then a dent has been made in his defensive armour, and he is open to hear about his need to change.

The second step deals with asking him how he feels when he hits her. Many people cannot identify their feelings, and sometimes they resist talking about feelings. But many batterers feel badly and guilty for their violent behavior or secretly wonder if they are crazy. At the most superficial level, most men have been taught as children that boys do not fight with girls. For men who cannot articulate their feelings, I identify these feelings for them by saying something like, “I suspect you feel bad when you hit Joan.” If I receive no verbal protest, including silence, which I interpret as consent, I assume that he agrees with me. Once a batterer admits that he feels badly about hitting his partner, he experiences his behavior as ego dystonic.
The third step in treating aggression is to develop a violence­eliminating contract. The contract is set up along lines that are both cognitive and behavioral and is aimed at redirecting violent behavior into nonviolent channels.

Contracts

The contract or agreement is made with the batterer’s participation and a cooperative effort by the partner. Its purpose is to teach self-control by delaying the urge to respond to anger with violent aggression. His partner’s participation enhances bonding and develops teamwork. When they are successful in carrying out the contract, it is empowering and reinforcing.
The procedure is as follows:

RECOGNIZING THE SIGNALS
1. Teach the batterer to recognize the cues that signal when anger will escalate to violence—for example, sweaty palms, stomach knotting, increased heartbeat, lightheadedness, dizziness, or tension in various body parts. His feeling the kind of anger that leads to violence signals him to use the contract. If he cannot identify any cues, then whenever he gets angry, he will need to employ the contract.
2. Examine what he can do to control his explosive anger—for example, take a walk, jog, go into another room, beat his fists on pillows, or vigorously play a sport. The batterer must give the final sanction concerning what will work. It has to be his decision drawn from what is normal and feasible in his life frame. Moreover, his participation in deciding alternative behavior to violence conveys his responsibility for change, which is an important shift. (The worker has to monitor its feasibility; a car ride to cool off if he has a car that does not work properly would probably increase his anger rather than decrease it.)
3. Determine exactly how much time is needed to calm down. It is necessary to be explicit and specific. The specificity builds an external structure that will eventually be internalized.

BONDING
4. Involve the partner in a cooperative execution of the contract. Cooperating in a mutual effort for the benefit of each member of the couple and the relationship teaches teamwork and provides an opportunity for bonding. Of secondary benefit, it changes the victim-assailant roles. If she participates and has influence, then her victim status changes. It is empowering for her to be of constructive assistance. During the development of the contract, she has input into whether she can agree to the terms of it. If she finds his suggestions not feasible for her, then the two of them work on it until they reach a mutual decision. The objective is to avoid violence; it supersedes other objectives until successful.

DIRECTIVES
5. Settle on a limited number of times that the couple attempts to resume a discussion that escalates to violent anger; my suggestion is no more than three times. If they cannot have the discussion without escalating anger, then the topic is considered too volatile and they are directed to table it until the session with the worker. If a volatile topic triggers violent anger, the batterer is directed to employ the contract as soon as he feels angry.
6. Review what has been agreed upon to uncover and correct any errors in the contract.
7. Have each member of the couple repeat the contract as many times as necessary until it is repeated correctly. An angry batterer is out of control. He has not been able to draw on inner resources to contain his anger; therefore, the worker must provide the structure externally, which will eventually be internalized. Give a copy of the contract to each partner, with instructions to put it in a place where there is ready access and to review it regularly. (The refrigerator door is a good spot.)

In the next and subsequent sessions, the worker reviews what transpired during the week and whether the contract was used, as well as the outcome (Did it work?). It is to be expected that the contract will have been broken initially. If violence occurred, the consequences for the resumption of the violence must be put into effect. The worker examines with the couple why the contract was not used. Is the fault with the couple or the contract? If the former, it must be repeated that the contract is to be used and when. If the problem is the terms of the contract, the terms need to be altered. Sometimes what appears to be a feasible contract on paper is not feasible in reality. Any new contract terms are repeated by the worker, then the batterer, and then his partner until it is perfect, and then it is written down. If the old contract is used, each partner repeats the contract again.
-Breaking Destructive Patterns. Geller, Janet A. The Free Press: New York. 1992.
The article above contains foundational information. Articles below contain optional updates.

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Personal Reflection Exercise #4
The preceding section was about interventions for treating couples. Write three case study examples regarding how you might use the content of this section in your practice.

Online Continuing Education QUESTION 18
If the batterer thinks that other men may respond to a provoking partner differently, in a non-violent way, he is faced with what? Record the letter of the correct answer the CEU Answer Booklet.

 
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The article above contains foundational information. Articles below contain optional updates.
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