The Silent Victims of Domestic Abuse

Domestic abuse is present in many homes and families. Not many people talk about this because somehow, it's something to be ashamed of in society. Instead of supporting each other and talking about it, we rather hide it and pretend that everything is excellent. Do people think that this way, they protect their image in society? Or are they trying to protect someone in their family? This is often the case when children are involved, but is it the best thing we can do for them?

Have we ever thought about what a child goes through in an abusive environment? Or is it because they are children that they have no clue of what is happening? People couldn't be more wrong about this because they are the silent victims of domestic abuse.

For this particular topic, we have invited Anna Perret, a child psychologist, she studied psychology for both children and adults at a university in Amsterdam, to enlighten us on how children are traumatized by growing up in an abusive environment.

Q: Hi Anna, can you tell us a bit more about yourself and your profession?

Hi Trisha, yes, of course. My name is Anna, and I am a child psychologist. However, I have studied psychology for adults and children, but I work for children and youth psychiatry. Therefore, I work with children mostly, but this includes parents and families. I am also an attention officer regarding domestic violence in my department. This means that I am responsible for keeping the department sharp on this subject and informing my department about the new developments.

On the side, I also provide relationship therapy for adults. But again, I primarily work with children and (young) adolescents from the age of six till twenty-three who meet the Diagnostic and Statistical Manual of Mental Disorders (DSM) 5 diagnosis. Children with a DSM-5 diagnosis can be, but are not limited to, traumatized, with behavioral problems or mood disorders.

Eye Movement Desensitization and Reprocessing (EMDR) is also one of the techniques that I use. EMDR is a form of trauma therapy.

You can find more information about the DSM 5 diagnosis here:

GGZ Totaal https://www.ggztotaal.nl/pg-29166-7-89824/pagina/dsm_5.html (Dutch)

America Psychiatric Association https://www.psychiatry.org/psychiatrists/practice/dsm/feedback-and-questions/frequently-asked-questions

You can find more information about EMDR here:

EMDR Vereniging Nederland https://www.emdr.nl/wat-is-emdr/ (Dutch)

EMDR Institute Inc. https://www.emdr.com/what-is-emdr/

Q: Do you only work with children who are traumatized? Are there any misconceptions about “traumatized children”?

No, I do not because I also work with children who have behavioral problems, experience systematic family issues, and many other circumstances. Netherlands’s mental healthcare is split up into two sections, primary care and specialized care. And so, I work within the specialized care where we help children with heavier cases.

Regarding misconceptions about “traumatized children”, the thing is, my profession is no hard science because, luckily, psychology keeps changing our methods and perspectives of syndromes in general. So, it’s not a fixed concept, which is a good thing because we never stop learning about trauma. And it is vital to know that even when a woman is pregnant and experiences tough times, she will have higher stress levels, creating higher cortisol levels. And that itself already negatively impacts an unborn child. By extension, a young child who cannot yet speak, which is the preverbal stage, is also affected by trauma.

For a long time, people thought that a preverbal child suffers less from traumatic events because it is less "conscious". We now know that even very young children suffer significantly from traumatic events. Children are aware, but they save such memories differently than adults. Such situations make it more challenging to track down where a child is suffering when they display particular distress or problems. Especially when they cannot talk yet, but also after, because they do not thoroughly understand or cannot explain why they feel what they feel. Therefore, it is crucial to know what happens to a child between the age of zero and four.

Q: What happens to a child who lives in a household where domestic abuse takes place? Do they know? Do they feel it? Does it affect them?

Yes, it does. As explained before, children are aware of everything and anything that happens in their surroundings. If the mother is in an abusive situation, an unborn child is also affected. A person who is in such a situation has higher stress levels. Therefore, her unborn child also generates higher cortisol levels, which leads to a more sensitive stress system for that child. One of the biggest giveaways of a person who has been traumatized is when they get stressed more quickly than others, and that is because of the higher cortisol levels. Traumatized people are more alert about their surroundings and are almost always in their fight or flight response.

It certainly does affect a child because they can sense tension, both verbal and non-verbal. For instance, a child can hear the tone, a raised voice, and a certain vibe, for example, when there is no affection between their parents. And let’s say, when a mother has a higher stress level, her child senses that and takes over the same stress level. The same when a father has a higher stress level because a child feels their parents’ emotions and stress levels, and they take it over.

How is this expressed? In the younger years, a child can be more tensed, alert, often cries, or has insufficient emotional regulation. And these tensions or problems stay present at all ages. These issues might result in concentration problems because it is exhausting always to be alert or tensed. It can also result in sleep deprivation, which increases exhaustion issues. It can also be noticed when someone has problems maintaining relationships or trust issues. All in all, it stagnates the development of a child.

However, when trauma is treated with a child or adult, they often score higher on an IQ test. This shows how much trauma affects the brain because it is constantly surviving instead of developing. It results, as discussed, in many behavioral and emotional problems, but they differ because every child is different. So, the primary goal now is to survive, instead of learning new things, exploring, or learning something about themselves, discovering.

Q: Is there a difference between knowing or witnessing it? How does it affect children short-term and long-term?

Witnessing domestic abuse is by definition a trauma, but knowing of it can be traumatizing as well. This differs per child and the situation. For instance, a child might not have witnessed abuse, but they see their parent is in pain or is bleeding, and then they know there is something wrong. A child is now in a threatening environment. Witnessing abuse might be a degree worse, but even within such a situation, there are differences.

The thing is, I don’t think many people know or understand what domestic abuse entails or what the range is. If someone in his or her family emotionally neglects someone, then that too is domestic abuse. Many people forget about this, which is why I want to mention this now. It can be about a parent neglecting their child’s emotional needs, and the same goes for between two partners. Physical abuse is seen, but emotional abuse is nothing less because it can be heard and felt. Witnessing or knowing about such abuse does affect a child, and it differs how it influences a child and how they express themselves.

The short-term effects can be, but are not limited to, alertness, high stress levels, withdrawal, reliving traumatic moments, nightmares, but this could decrease over time. Luckily, our brain is able to process a lot on its own. The situation at home also influences this. Let’s say a child has emotionally present parents who help their child talk about their feelings. This gives a child’s brain the space and time to heal and process. However, if it were the opposite and parents would neglect or not acknowledge their child’s emotional distress, then a child’s brain does not get enough time, and it might even shut out any feelings regarding the trauma. It is crucial to give words to such a challenging event to process and heal.

The short-term effects affect the long-term impact because it depends on how a child can process and talk about such an event. If a brain cannot have processed things independently, this might result in a more sensitive stress level indefinitely. Acute stress levels can result in a person being easily triggered by certain events or topics. In addition to the stress pattern differing between individuals, the stress level varies in each individual over the course of a day. There is a zone (window of tolerance) within which the stress is positive or can be handled and in which the individual functions optimally. When the stress level is too high, it is called hyper-arousal. The stress network is then very active and prepares the individual for fight or flight. So, a person might react more intensely than others because consciously or unconsciously, it reminds them of a specific event. Therefore, it can activate someone’s fight or flight mode, and they might overreact to something. The reaction can be a range from very angry or upset to becoming withdrawn or insecure.

These effects are the foundation, but they keep increasing over time because someone is always alert and can quickly switch into fight or flight mode. Think of sleep deprivation, concentration problems, not being able to enjoy or indulge in life, becoming overly sensitive or sad, to avoiding things or people, to name a few. All of this is different for every person and cannot be predicted to the dot.

Someone who has witnessed domestic abuse in their childhood might develop a personality disorder in their puberty. An avoidant personality disorder is one form of it. This is when someone avoids all kinds of situations where they don’t feel comfortable or safe, just to keep their stress levels low. Therefore, they never take risks or go out of their comfort zone and learn that they are capable of much more, which boosts their confidence to explore and discover. Otherwise, with both adults and children, we often see that they have ADHD, autism-related complaints. Still, the range is too extensive and different. Hence, when we start digging with people who come in with such complaints, it often turns out that they are traumatized.

Trauma is often the underlying reason why people suffer from certain disorders or complaints but is not always apparent at first.

Opinions are divided on whether someone who is traumatized needs help or treatment as soon as possible. If the complaints we have discussed before remain present for more than six months, a person needs trauma treatment. At the same time, some say that a person needs time and the opportunity to know their strength and process things independently. However, I feel a bit different because I believe that when you give a child that particular push they need, you could interrupt the chain reaction of becoming overly alert and sensitive, being constantly on standby in a fight or flight mode, having flashbacks, and other trauma-related complaints can be very difficult and can cause a child's development to stagnate. That is why I advocate rapid treatment so that children can regain their strength.

Q: Does age play a role in how much a child is affected by witnessing domestic abuse? Are there different stages?

Yes, and no. Because it depends on so many factors, such as the severity of a situation, but mainly on a child, every child and situation are unique.

The thing about trauma is that you cannot always notice it immediately. Children might go all the way into their survival mode, and it may look like they are doing well or are independent. When suddenly, they have a relapse or are triggered. For instance, they could have avoided all sorts of situations, building a solid self-protecting mechanism so that they cannot feel things or become hurt. And eventually, it could create a situation where a person feels a certain emptiness inside them or sadness. Or they are not able to empathize with others.

Coming back to the question, I know it is more difficult to notice such trauma with more minor children. Because they cannot always explain what they are feeling, especially children who cannot speak yet, they do not thoroughly understand what hurts them or what they feel. Again, I say that I believe that too many people underestimate how much it affects small children. Parents might think that because their children cannot speak yet, they cannot understand what their parents say. While on the contrary, a child’s stress levels from the age of zero to six are built in that period, and their surroundings influence the severity of their stress levels. The stress network develops from conception through adolescence, driven by genetic predisposition and interaction with the environment. The degree of stress experienced by the growing child influences this development, especially in the phases of life in which the brain develops rapidly (pregnancy, first years after birth, and adolescence). In this period, a child’s foundation is made for the rest of their life on how they regulate stress. Hence, we could say that the younger a child is, the more fragile their emotion regulation abilities are. A young child cannot handle their stress and emotions because they do not possess the right tools and skills yet. Whereas someone who is sixteen years old and witnesses domestic abuse, and if they had a childhood with low stress levels, they have the better tools and skills to process and heal.

Nevertheless, regardless of age, be it a young child or an older adult, witnessing domestic abuse can be severely traumatizing.

Q: Is there any way that people can shield children from long-term damages?

First, signaling domestic violence and making sure it stops to create a safe home again. It’s essential to go in for treatment on time, but it is crucial to signal on time to do that. The latter should be socially regulated; for instance, in The Netherlands, we have a five-step reporting code obligation. It means that therapists, psychologists, psychiatrists, and so on have the duty to be alert whether there is a hostile or abusive environment at home. Hence, the earlier we professionals take on signals like these and intervene, the earlier we can treat someone. The longer the wait, the longer the abuse takes place, the more severe the consequences can be, both short-term as long-term.

Therefore, the first thing would be to create a safe environment for the child, and they should receive help to process the trauma. I believe you can achieve a lot to help a child this way, and I also think that, even now, we intervene too little or too late. Even up to the point where the responsibility of signaling is placed with the child, saying that “they’ll tell us if they experience any difficulties or need help,” but this is mostly never the case. Moreover, I plead for better collaboration between institutions like “Veilig Thuis” in The Netherlands and the government. Especially since a child is in an abusive environment, they feel an unquestionable loyalty towards their parents. Hence, they won’t tell their therapist about it. This is why our responsibility is to be more alert about this and not go along with someone’s denial or avoidance. Perhaps they don’t want to talk about it because it is too painful. Still, it is crucial to keep checking whether they can talk about it at another moment. We have to give the space to do so, but also the trust that it is OK. Also, make them aware of discussing issues since they tell you that they’re experiencing sleeping, concentration, or eating problems. Otherwise, why would they have such complaints?

Think about people who have schizophrenia. If they receive proper treatment, it could result in almost a complete recovery from it.

Trauma treatments are hard but necessary, and it does pay off long-term.

Q: Are there any specific/common disorders children suffer from when brought up in such an environment?

One of the most common disorders is Post-Traumatic Stress Disorder (PTSD), and someone should also meet the DSM-5 criteria. However, not everyone does.

But as I said before, there are so many different disorders a person can suffer from when traumatized. You could instead say, “what isn’t.” The range of it is too extensive due to diverse and unique situations and personalities.

The thing is, trauma can, or probably is, the underlying reason for so many disorders or issues a person can suffer from. Unfortunately, it also happens that someone is misdiagnosed. Children who are traumatized can show ADHD or autism-related complaints on a behavioral level. As a result, they may be wrongly diagnosed with ADHD/ASD. ADHD and ASD are congenital developmental disorders and should not be "provoked" by experience. You can't treat ADHD or ASD either, but you can learn to deal with it more. Often when traumatized children receive the proper trauma treatment, the ADHD or autism-related behaviors decrease. Therefore, a thorough diagnosis is crucial to make a good distinction between the various diagnoses and thus the various treatment options. It is also known that personality disorders and schizophrenic disorders often have underlying trauma.

Q: Is there any advice or wisdom you would like to share with our readers with your professional opinion?

Yes, certainly. Talk about it if you have any suspicions. Create an open environment where it is safe to discuss these emotions and events. Involve an institution that is specialized to assist and treat people who have witnessed abuse. It is essential to know for someone who wants to help that others might feel ashamed about such events; therefore, it is crucial to keep the conversation neutral. Avoid victim-blaming by labeling someone for overreacting, being oversensitive, that they are seeking attention, or comparing their situation with someone else’s. Help people, especially children, to give words to their traumatic events.

If you find this difficult or feel it is not your place, you can always reach out to institutions specializing in these matters.

Q: And last but not least, if you could say anything to a child who witnessed domestic abuse. What would you tell them?

The first thing that comes to my mind is telling any child who has witnessed domestic abuse not to feel guilty or responsible. I often have had conversations with children who say that their parents are fighting because of them. While in reality, this is never is the case because domestic abuse is always the perpetrator's responsibility. You cannot provoke such an event. That does not exist because there is never a valid reason to hurt someone physically or emotionally.

Several institutions can help you and people you trust from your environment because you need to know that you are not responsible. It might be scary to go in for treatment or talk to a professional. Still, it can genuinely help you and your development. Even though it might feel easier to put all your energy into not thinking about it, it will benefit you to share your feelings. In the beginning, it can be difficult or scary because it reminds you of the events. It is important to realize that not talking about it will create new problems. You are putting so much energy into not thinking about it that you experience sleeping or concentration problems. Whenever you go in for treatment, know that you decide the pace, and you have the time to bond with your therapist. Think of it as a safety net. Someone who can help you when things are tough, teach you skills, and give you the right tools to deal with it. Once you are through this challenging period, you will notice how much weight is lifted from your shoulders, how relieving it is. Eventually, all the other complaints, such as sleeping, concentration, eating, or alertness problems, will start to reduce. Even when you don’t have any complaints, it is always good to talk about it and let it out in the world.

Because again, you are not responsible nor guilty, and you deserve the sanity and happiness to enjoy life.

Thank you for sharing such valuable insights with us, Anna. People need to know and talk about this. Even if a child is not the one being abused, they will always be affected somehow by knowing about it or witnessing it.

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