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Dr. Mark
Dr. Mark, Psychotherapist
Category: Mental Health
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Experience:  Dr. Mark is a PhD in psychology in private practice
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I was in an emotionally abusive relationship for the past 6

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I was in an emotionally abusive relationship for the past 6 years. I have been told I'm showing signs now that I have left. I should be happy because I'm out but I'm not. I feel lost and dont even want to go to work or even be with people. Is this normal? All things I loved to do I no longer care about. I find myself just sitting and before I know the day is over. When will this end?

Hi! I believe I can be of help with this issue.


First, let me say I can imagine how distressing and overwhelming this situation must be for you. That you have sought help and are working with a social worker is a very good thing. I would like you to make sure that the social worker is experienced with working with women recovering from abusive relationships so that he/she is able to help with your anxiety and depressive symptoms from the post traumatic stress disorder (PTSD) you are suffering.

I mentioned PTSD but I don't want you to be worried or surprised. Most people think of PTSD as being what soldiers come back from wars with. Well, in a sense, if you think about it, being in an abusive relationship is a little like that: you have periods of calm and then there are the explosions. It's very disorienting and it takes a toll on you. So don't be concerned that there is indeed an element of PTSD we now know that exists when women emerge from an abusive relationship. Feel good about yourself that you've exited the relationship and are making a new start. And know that there is a post traumatic stress that is going to need work now that you're free and away from the relationship.

But it is important for you to recognize that your symptoms and those of so many women who emerge from abusive relationships are indeed very consistent with PTSD. And untreated PTSD can lead to further and further social irritability and isolation and further exacerbation of your other symptoms.

 

I'm going to give you here the Diagnostic and Statistical Manual of Mental Health Disorders criteria for PTSD. Note the various criteria and which ones are relevant to your situation. Not all will be. But you will see how coming out of an abusive relationship is very much like coming out of a traumatic experience.

When the symptoms will end is an answer that we can't give in general. Every woman is unique. You had a unique relationship and you came into it as a unique person with your own history and your own personality and skills and strengths and needs. And so you have emerged with all of these factors needing to be brought back to being a healthy you. How long that will take is thus not possible to pinpoint. There are exposure therapies that sometimes can help in making the therapy process more quick. They can be intense, however. So you need to think about whether you want to take it a little slower with regular therapy like it sounds you're doing (as long as it's with an experienced person). Or if you want to look into exposure therapies.

I have found EMDR can be very useful. It is a type of therapy specifically for PTSD originally. Here is the International Society's website:

http://www.emdria.org/


On the web you will find many opinions on EMDR both for and against. I am trained in it and have found it useful. Exposure therapy is also very helpful. However,I have found that you need to combine these types of therapy with a more introspective, humanistic approach. If we actually look inside, we can find great relief and meaning. And we can feel whole in ourselves in ways that we haven't for decades. So ask your social worker if he/she works with EMDR or if they can refer you to someone.

Okay, I wish you the very best!

My goal is for you to feel like you've gotten Great Service from me and the site. If we need to continue the discussion for that to happen, then please feel free to reply and we'll continue working on this. If the answer has given you the help you need, please remember to give a rating of 5 (Great Service) or 4 (Informative and helpful), or even 3 (Got the job done) button. This will make sure that I am credited for the answer and you are not charged anything more than the deposit you already made by pressing any of these buttons. Bonuses are always appreciated! If I can be of further help with any issue now or in the future, just put "For Dr. Mark" in the front of your new question, and I'll be the one to answer it. All the best, XXXXX XXXXX

Here's the DSM-IV criteria:

Criterion A: stressor

The person has been exposed to a traumatic event in which both of the following have been present:

  1. The person has experienced, witnessed, or been confronted with an event or events that involve actual or threatened death or serious injury, or a threat to the physical integrity of oneself or others.
  2. The person's response involved intense fear,helplessness, or horror. Note: in children, it may be expressed instead by disorganized or agitated behavior.

Criterion B: intrusive recollection

The traumatic event is persistently re-experienced in at least one of the following ways:

  1. Recurrent and intrusive distressing recollections of the event, including images, thoughts, or perceptions. Note: in young children, repetitive play may occur in which themes or aspects of the trauma are expressed.
  2. Recurrent distressing dreams of the event. Note: in children, there may be frightening dreams without recognizable content
  3. Acting or feeling as if the traumatic event were recurring (includes a sense of reliving the experience, illusions, hallucinations, and dissociative flashback episodes,including those that occur upon awakening or when intoxicated). Note: in children, trauma-specific reenactment may occur.
  4. Intense psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event.
  5. Physiologic reactivity upon exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event

Criterion C: avoidant/numbing

Persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness (not present before the trauma), as indicated by at least three of the following:

  1. Efforts to avoid thoughts, feelings, or conversations associated with the trauma
  2. Efforts to avoid activities, places, or people that arouse recollections of the trauma
  3. Inability to recall an important aspect of the trauma
  4. Markedly diminished interest or participation in significant activities
  5. Feeling of detachment or estrangement from others
  6. Restricted range of affect (e.g., unable to have loving feelings)
  7. Sense of foreshortened future (e.g., does not expect to have a career, marriage, children, or a normal life span)

Criterion D: hyper-arousal

Persistent symptoms of increasing arousal (not present before the trauma), indicated by at least two of the following:

  1. Difficulty falling or staying asleep
  2. Irritability or outbursts of anger
  3. Difficulty concentrating
  4. Hyper-vigilance
  5. Exaggerated startle response

Criterion E: duration

Duration of the disturbance (symptoms in B, C, and D) is more than one month.

Criterion F: functional significance

The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.




So, take care of yourself, and give yourself time to get over the trauma. I wish you the very best!

My goal is for you to feel like you've gotten Great Service from me and the site. If we need to continue the discussion for that to happen, then please feel free to reply and we'll continue working on this. If the answer has given you the help you need, please remember to give a rating of 5 (Great Service) or 4 (Informative and helpful), or even 3 (Got the job done) button. This will make sure that I am credited for the answer and you are not charged anything more than the deposit you already made by pressing any of these buttons. Bonuses are always appreciated! If I can be of further help with any issue now or in the future, just put "For Dr. Mark" in the front of your new question, and I'll be the one to answer it. All the best, XXXXX XXXXX

Dr. Mark and other Mental Health Specialists are ready to help you
Customer: replied 3 years ago.

Thank you for your help. I have never felt like this before and I'm worried I will never be the way I was before I met my fiance.


My days are up and down. I almost dont know how I'm feeling just numb.

Numbness is the number 1 symptom that people with post traumatic stress report after coming out of the traumatic experience, whatever that traumatic experience was. And how long that "coating" of numbness will take to fade away so that the "real" you can emerge again, is difficult to say, of course.


But you must have faith in the process of healing and time. This is so important. Human beings are very resilient and once we're out of the abusive traumatic situation, finally, then our natural selves slowly emerge. So be patient with yourself and have faith in yourself.


All the best,
Dr. Mark
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