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Ethical Boundaries in Balancing the Power Dynamic in the Therapeutic Relationship
Ethics Boundaries continuing education MFT CEUs

Section 11
Psychological Helplessness

Ethics CEU Question 11 | Ethics CE Test | Table of Contents | Boundaries
Counselor CEUs, Social Worker CEUs, Psychologist CEs, MFT CEUs

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♦ Realization of Abuse
How do victims come to realize that they are being abused? With the exception of a few details about how victims come to realize that they are being abused, the professional literature is for the most part silent on the topic of how and why survivors of abuse by mental health professionals manage to leave the sticky, enmeshed relationship with their abuser. As you know, escape, particularly in prolonged entrapments, is a relative term. This is a phase that may continue for many years.

Victimized people sometimes enter a state of "learned helplessness," and go through a series of abusive relationships in a vicious self-fulfilling prophecy of perpetual victimization. As you know, some victims of abuse commit suicide, or succumb to depression, alcoholism, or drug abuse. Many others make an active choice to fight or try to escape. If we draw parallels with research on battered wives the following ideas emerge.

♦ 3 Phases of the Abusive Relationship
Far from the popular notion that the physically or emotionally abused woman stays in the abusive relationship, recent work shows that she moves through a process, eventually actively preparing herself to move out.

Phase # 1 - The Beginning Phase
In the beginning phase of the abusive relationship, the woman, unable to discriminate between positive and negative relationships, focuses on her partner without any regard for her own needs. She believes that if she tries hard enough he will change and that she will still achieve the ideal family that she seeks.

Phase # 2 - The Middle Phase
In the middle phaseshe remains subservient and self-effacing: She feels anxious, fearful, and powerless, and her self-esteem suffers, but she starts to realize that her partner will not change.

Phase # 3 - The Final Phase
In the final phase, realizing that the abuse will never stop, the woman starts to regain some control over her life, recognizes that the abuse is not her fault, and knows that she has to end the relationship. For some women, termination of the relationship ushers in a sense of freedom and liberation from emotional pain; Others, unable to divorce themselves from the past, spend enormous amounts of time sifting through past scenarios trying to find out what went wrong with the relationship.

♦ Duped and Used
Survivors of abuse by a professional have described a variety of experiences that led to their gradual, or sudden, realization that they had been duped and used, and their determination to escape from the influence of the abusive professional.

For many victims, this happened when they discovered that the professional was abusing other clients, as in the case of Mary. Covered in shame and humiliation, she was forced to give up her notion that she was special, the only person with whom the professional had this kind of involvement. She began to realize that the professional had not addressed the initial problem of her divorce, had misdiagnosed them.

Dismissed by the Professional
Some victims did not engineer their own escapes, but were dismissed by the health professional. Carolyn Bates describes how she tried to extricate herself from the sexual relationship with psychologist Dr. X by spacing out the sessions and telling him she was going off her birth control pills.

Her awareness of his betrayal grew, and she realized that she was paying to provide him with sexual services. The final straw, however, that caused her to leave therapy, was his reaction when she called him, distraught, after her engagement had broken down. He invited her to his house, did not talk to her, but used her in the usual "brief, non-mutual, mechanical" fashion. As a result, she "finally allowed (herself) to see the very cold and harsh truth of what was happening to (her)" and terminated therapy.

Peer-Reviewed Journal Article References:
Breggin, P. R., & Stolzer, J. (2020). Psychological helplessness and feeling undeserving of love: Windows into suffering and healing. The Humanistic Psychologist, 48(2), 113–132.

River, L. M., Borelli, J. L., Vazquez, L. C., & Smiley, P. A. (2018). Learning helplessness in the family: Maternal agency and the intergenerational transmission of depressive symptoms. Journal of Family Psychology, 32(8), 1109–1119.

Soral, W., Kofta, M., & Bukowski, M. (Jul 13 , 2020). Helplessness experience and intentional (un-)binding: Control deprivation disrupts the implicit sense of agency. Journal of Experimental Psychology: General, No Pagination Specified.

What are the three phases a victim may experience once she realizes the truth about her abuse? To select and enter your answer go to Ethics CE Test.

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