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

Like most difficult clinical manifestations that couples bring to us, the determination of what to intervene in depends on several issues: What is ‘real’ to the couple and how do we determine that, and are we likely to resort to a rule set for confronting destructive behaviour which is an authoritarian model, or do we rely on creative intuition and focus on what the couple contributes to the verbal or physical hurts?

In the short term we become worried by countertransference feelings that we are taking sides, that is because we are frightened of, and angered by, abusive behaviour. This may be the couple culture, and abuse without medical repercussions may have to be tolerated for awhile, depending on the level of suffering and helplessness of all parties. Thus far, separating the couple into two individual therapies is not necessary, so that keeping them in treatment appears a workable approach. It is painful however.

There is no easy solution, as Marilyn's case illustrates, and shaming can result from the therapist joining with the abused spouse, when confronting the behaviour. Until there is evidence of a therapeutic alliance, a flawed super-ego in an abusing spouse will likely result in rationalising on the one hand, or ending therapy if the therapist merely requires restraint. The male