Beyond the Surface: A Therapeutic Perspective of Abuse
Content note: This article discusses abuse and its psychological impact. While the discussion is educational and non-graphic, some readers may find the themes emotionally challenging. Please read at your own pace and prioritise your wellbeing.
With thanks to our member, Raine John, for this blog.
Abuse is a complex phenomenon that cannot be understood through a single lens. In therapeutic and educational contexts, it is essential to approach abuse with nuance, recognising its many forms, understanding how it is experienced subjectively, and creating spaces where individuals feel safe enough to explore their experiences without fear of judgement or stigma. This article explores abuse from multiple perspectives, outlines key signs practitioners may notice, integrates insights from research, and reflects on how Emotion Focused Therapy can support safe, non-stigmatising exploration of clients’ lived experiences. The discussion is situated within the professional and cultural context of practice in Wales.
Conceptualising Abuse: Beyond a Single Definition
Abuse is often narrowly framed as physical violence, yet research and clinical experience consistently show that abuse can be emotional, psychological, sexual, financial, coercive, neglectful, or relational (Johnson, 2019; West & George, 1999). Importantly, abuse is defined not only by behaviours, but by patterns of power, control, and impact on individuals. From a relational perspective, abuse involves a persistent erosion of autonomy and emotional integrity (Greenberg et al., 2004). What makes an experience abusive is not always the presence of overt harm, but the cumulative effect of fear, intimidation, invalidation, or domination over time. This understanding helps practitioners avoid rigid checklists and instead remain attuned to meaning and the context of their clients (Elliott et al., 2007).
Signs and Indicators of Abuse
Rather than definitive proof, signs of abuse are best understood as invitations to curiosity and gentle exploration. These may include:
● Heightened fear, hypervigilance, or emotional shutdown
● Persistent self-blame, guilt, shame, or feelings of worthlessness
● Difficulty trusting one’s own perceptions or emotions
● Sudden changes in mood or behaviour
● Restrictions around autonomy, finances, communication, or social contact
Practitioners should remain cautious not to assume or label prematurely, while also not dismissing patterns that suggest harm (Greenberg, 2002).
A recurring theme across sessions with several clients was an internalised belief that they were somehow responsible for the harm they experienced. Rather than challenging these beliefs directly, therapy involved slowing down and exploring the emotional logic behind them. As clients began to recognise self-blame as a survival strategy rather than a truth, shame softened and self-compassion became more accessible.
Individual and Lived Experience
Clients may not initially align their experiences with abuse. Many describe confusion, self-blame, and guilt, loyalty to the perpetrator, or minimisation of harm. Cultural narratives, attachment histories, and survival strategies all shape how abuse is perceived and articulated (Johnson, 2019). Respecting the client’s language and pace is therefore central to ethical practice.
In one session, a client described patterns of emotional withdrawal and financial restriction but repeatedly returned to the idea that they were “overreacting”. What stood out was not uncertainty about events, but uncertainty about whether their emotional responses were legitimate. Therapeutic work focused less on defining abuse and more on gently validating the impact of these experiences, allowing the client to begin trusting their own emotional signals rather than dismissing them.
Socio-Cultural, and Structural Contexts
Abuse often sits within an intersection of gender norms, socioeconomic inequality, disability, migration status, and cultural expectations. These can all influence vulnerability, disclosures, and responses to abuse. In Wales, awareness of bilingualism, rural isolation, and limited access to services are also relevant when considering how abuse is experienced and supported.
One client described enduring significant harm while simultaneously expressing pride in “not making a fuss”. Support required careful pacing and cultural sensitivity, recognising that disclosure itself could feel like a rupture of identity rather than a relief. Another client from the rural farming community , presented with symptoms of coercive control, physical harm and emotional neglect. This client felt that it is the “way of life” and it is ‘normal for us’. It was only through a public incident that led to the client being referred, giving them an opportunity to reflect and unpack their experience, thinking patterns and vulnerabilities.
Relational and Attachment Perspectives
Attachment informed research highlights how abuse often occurs within relationships that also carry emotional significance. This duality of love and fear/care and harm can create deep internal conflict (Johnson, 2002; Greenberg et al., 2004). From an Emotion Focused standpoint, abuse can be understood as profoundly shaping emotional responses and attachment needs (Greenberg & Paivio, 1995). A particular client spoke with deep affection for their partner while simultaneously describing ongoing fear and emotional harm. Moments of disclosure were often followed by guilt for “betraying” the relationship. From an attachment informed perspective, this ambivalence reflected a profound conflict between the need for safety and the need for connection. Holding both experiences in the room, without rushing to resolve the contradiction, became central to the therapeutic process.
Creating a Safe Space for Exploration
Safety is not a single intervention but an ongoing relational process. Research consistently shows that disclosure of abuse is more likely when individuals feel emotionally believed, not interrogated, and not pressured to take action before they are ready (Pos & Greenberg, 2006; Elliott et al., 2007).
Key elements of a safe therapeutic space include:
● Emotional validation without confirmation or denial of facts
● Clear boundaries and transparency about confidentiality and safeguarding
● Collaborative pacing that honours the client’s window of tolerance
● Language that centres impact rather than blame (Johnson & Campbell, 2026)
Safety in therapy often emerged gradually rather than through explicit disclosure. In some sessions, clients tested the therapeutic space by sharing small fragments of experience and closely observing the response. Being met with emotional validation rather than interpretation or pressure allowed trust to build incrementally, reinforcing the sense that their experiences could be explored without judgement or obligation to act.
Emotion Focused Therapy and Work with Abuse
Emotion Focused Therapy offers a particularly compassionate framework for working with abuse, as it prioritises emotional meaning, attachment needs, and experiential processing (Greenberg et al., 2004). Rather than asking “Why did this happen?”, Emotion Focused Therapy invites exploration of “What did this feel like?” and “What did you need in that moment?” (Greenberg, 2002). Through this lens, symptoms are reframed as adaptive emotional responses to threat, loss, or disconnection, reducing shame and supporting clients in reclaiming emotional agency and self-compassion (Paivio & Pascual-Leone, 2010).
From an Emotion Focused perspective, moments of emotional overwhelm were reframed as meaningful responses to threat rather than signs of pathology. When clients were supported to access and articulate emotions such as fear, grief, or anger, these responses often revealed unmet attachment needs and adaptive survival strategies. This reframing reduced shame and supported a more compassionate understanding of self.
Research Insights
Contemporary research emphasises that recovery from abuse is supported by relational safety, empowerment, and meaning-making (Elliott et al., 2007; Greenman et al., 2022). Studies consistently highlight the harmful effects of disbelief, victim-blaming, and overly pathologising responses. Trauma informed and emotion focused approaches are associated with improved emotional regulation, reduced shame, and strengthened self concept (Greenberg & Paivio, 1995). Importantly, research also cautions against universal trajectories of healing. There is no single correct response to abuse, and resilience may coexist with ongoing vulnerabilities (Johnson, 2002; Elliott et al., 2007).
Avoiding Stigma in Discourse and Practice
Stigmatisation often arises when abuse is framed as a personal weakness, a fixed identity, or a moral failing. To counter this, practitioners and writers can use person-centred, non-defining language (Johnson, 2019):
● Emphasise survival and adaptation
● Avoid sensationalising or simplifying narratives of abuse
● Acknowledge ambivalence and complexity
● Normalising a wide range of emotional responses helps dismantle shame and supports more inclusive conversations about abuse.
Normalising a wide range of emotional responses helps dismantle shame and supports more inclusive conversations about abuse (Pos & Greenberg, 2006).
Key take-aways
Exploring abuse requires humility and compassion. By integrating research, emotion focused principles, and an awareness of social context, practitioners can create spaces where individuals feel safe to make sense of their experiences without stigma. In doing so, abuse is not reduced to a label, but understood as a human experience that deserves respectful and emotionally attuned engagement (Greenberg et al., 2004; Johnson, 2019).
References
Elliott, R., Watson, J.C. and Greenberg, L.S., 2007. The essence of process‑experiential/emotion‑focused therapy. American Journal of Psychotherapy, 61(3), pp.241‑254.
Greenberg, L.S., 2002 (2nd ed. 2015). Emotion-Focused Therapy: Coaching Clients to Work Through Their Feelings. Washington, DC: American Psychological Association.
Greenberg, L.S. and Paivio, S.C., 1995. Resolving ‘unfinished business’: efficacy of experiential therapy using empty chair dialogue. Journal of Consulting and Clinical Psychology, 63(3), pp.419‑425.
Greenberg, L.S., Watson, J.C., Goldman, R.N. and Elliott, R., 2004. Learning Emotion-Focused Therapy: The Process‑Experiential Approach to Change. Washington, DC: American Psychological Association.
Greenman, P., Johnson, S.M., et al., 2022. Emotionally Focused Therapy: attachment, connection, and health. Current Opinion in Psychology, 43, pp.146‑150.
Johnson, S.M., 2002. Emotionally Focused Couple Therapy with Trauma Survivors: Strengthening Attachment Bonds. New York: Guilford Press.
Johnson, S.M., 2019. Attachment Theory in Practice: Emotionally Focused Therapy with Individuals, Couples, and Families. London: Routledge.
Johnson, S.M. and Campbell, T.L., 2026. Emotionally Focused Therapy for Trauma. New York: Guilford Press.
Paivio, S.C. and Pascual-Leone, A., 2010. Emotion-Focused Therapy for Complex Trauma: An Integrative Approach. Washington, DC: American Psychological Association.
Pos, A.E. and Greenberg, L.S., 2006. Emotion-focused therapy: The transforming power of affect. Journal of Contemporary Psychotherapy, 37(1), pp.25‑31.
West, M. and George, C., 1999. Abuse and violence in intimate adult relationships: New perspectives from attachment theory. Attachment & Human Development, 1(2), pp.137‑156.
