Behavioral Health 16 Mental Health

Nursing XVI
Abusive Behavior Over the Lifespan
Stephen Paul Holzemer, PhD, RN
Associate Professor
 Abusive Behavior Over the
Lifespan
Pathologic alteration in the need for exerting power
over another.
Desperate response to feeling out-of-control, and
unable to cope with the state of anger and anxiety.
Abuse can be physicalemotionalor usually both.
Abuse is a violent act of intent, with the abuser
attempting to regain control in the situation. In some
situations it appears to be learned as an acceptable
method of human interaction.
Major component is in indifference, apathy, and
neglect.
Abusive Behavior Over the Lifespan
The Experience of Children
The Experience of Intimate Partners Exploitation of the
The Experience of Older Persons Vulnerable

Two Important Questions

1. Who makes up the abuse cycle?
2. What physical/emotional/spiritual/cultural resources are
available to the abused person (or agent), to change the
relational dynamic?
 Abusive Behavior Over the
Lifespan
Cycle of Violence

Tension- Serious
building Battering
Phase Phase

Honeymoon
Phase

Special Concerns for Physically or Mentally Challenged Persons; are all

the needs for providing care resting on people who can provide it.
Abusive Behavior Over the Lifespan
The abused person is often cognitively, affectively
unable to respond in a psychomotor manner to
stop the abuse (fear, financial, child welfare).
The abused person mat accept full or partial
responsibility for the dynamic of abuse. Coping
mechanisms give the illusion of control and
rationality.
Family and cultural norms may not allow for a
genuine assessment and resolution of the
abusive situation.
 Abusive Behavior Over the Lifespan
Long-term Effects of Family Violence
Exposure augments dissociation of the abused
person as human loosing respect for the
abused person.
Both the abuser(s) and abused experience
change in their interaction with others not
associated with the event (inside and outside the
family/community).
The reference of survivor of abuse suggests
movement toward recovery/healing that the
term victim does not. Many people, however,
do not survive abuse or victimization.
 Abusive Behavior Over the Lifespan
The Experience of Children
The dynamic of abuse will likely change the
childs ability to interact with others for a lifetime.
Assessment of history, and existence of the
familys current, realistic, non-crisis support
system. Teen pregnancy and/or numbers of
dependents needs consideration.
Patterns of children moved in and out of the
home, accidents, discovery of various
caregivers/care-observers.
 Abusive Behavior Over the Lifespan
The Experience of Children
Patterns of child behavior with family and
others (school). What is the level of
unsupervised activity with peers, or others.
Play is the work of children and needs
evaluation (including internet).
CAN THE PERSON EXPLAIN HOW TO GET HELP
IF IT IS NEEDED?
 Abusive Behavior Over the Lifespan:
The Experience of Intimate Partners
The dynamic of abuse is tied to thoughts that
loving or caring for the abuser will change the
dynamic of abuse.
History of physical, emotional, sexual
interaction and abuse, patterns of emergency-
type hospital visits.
Patterns of response to relationships and
interaction with others (verbal and non-
verbal).
 Abusive Behavior Over the Lifespan:
The Experience of Intimate Partners
What is the relationship of the abused person
with their family/friends, related to
communication?
How can a safe place be found and used
successfully?
CAN THE PERSON EXPLAIN HOW TO GET HELP
IF IT IS NEEDED?
Abusive Behavior Over the Lifespan:
The Experience of Older Persons
Physical

Abandonment Sexual

Financial Emotional

Neglect
 Abusive Behavior Over the Lifespan:
The Experience of Older Persons
The dynamic of abuse is often linked to chronic physical or
mental health illness and the limitations of the
caregiver(s) to feel successful in their role as caregiver.
Society must take responsibility for the fact that some
people can not provide necessary care but may not be
able to admit it for emotional/religious/or cultural reasons.
What is the persons experience or connection with the
outside world (other family/ friends/ professional
caregivers)?
How can a safe place be found and used successfully?
CAN THE PERSON EXPLAIN HOW TO GET HELP IF IT IS
NEEDED?
 Abusive Behavior Over the Lifespan:
Caregiver Support and Respite
Can the caregiver seek help and assistance
without endangering their relationship with
the client, their peers, their work?
Is there a safe place for both the caregiver
and the client?
The need for therapeutic recovery touches
both the client and the caregiver.