Behind Closed Doors: Reports of Physical Abuse and How to Handle Them*

In accordance with the Journal's aim to interact with its readers and to promote dialogue and debate, in our Autumn 2011 issue we introduced this forum for our readers' comments on a clinical dilemma presented by a fellow practitioner.

Marilyn Meyers, President of Section VIII of Division 39 of the American Psychological Association (APA), generously shared a dilemma already presented to its members in an on-line members' debate. It is reproduced here, together with three responses. Your further comments on this issue will be welcomed for possible inclusion in future issues.

Readers are also invited to share other clinical dilemmas. If you would like to contribute such a piece, (of no more than 600 words), please send it to the Editor by 1st May 2012.

The Editor

My question has to do with the handling of physical and verbal abuse within a marriage. In particular, I am working with a couple where the wife describes an instance of the husband grabbing her and bruising her ribs. I am not sure how often such instances have occurred (we are only about six sessions into the treatment). He, in the session, vehemently denies that he has done this. He claims that he doesn't know what she is talking about; he looks at me and says, ‘This never happened.’ I know that this man is very disconnected from his aggression and probably is in a dissociated state when this occurs. Over the course of the session, he admits to having done this. With this admission there is very little indication of shame or guilt.

I, however, sense a great deal of shame around this, but some lack of ownership, feeling, and reflective capacity. I am aware that the husband grew up in a family with verbal and violent physical abuse in which he was often the intermediary. The wife grew up in a family of neglect in which she was left alone to fend for herself and coped by engaging in promiscuity and substance abuse. They are both recently in individual therapy. The wife is finding more of her own voice and shifting