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Toxic Couples: The Psychology of Domestic Violence Domestic violence is a major public health concern, affecting millions worldwide. It is underreported, often devastating, and sometimes ends in murder. In Toxic Couples: The Psychology of Domestic Violence, Anna Motz integrates psychological and criminological data with clinical illustrations and discussion of current high-pro(cid:191) le cases. She examines the complex manifestations and multiple causes of intimate partner violence. Motz disentangles the roles played by those involved and examines the addictive nature of these damaging partnerships. The book describes various forms of abuse, including physical, sexual and emotional, and analyses how intimate partner violence can escalate to murder. She explores important factors, including: • the role of addiction; • homelessness and vulnerability; • the intergenerational transmission of abuse; • sadomasochistic relationships; • honour-based violence. The book emphasizes the signi(cid:191) cance of female- as well as male-perpetrated violence and outlines the powerful impact on the children of abusive parents, extending the clinical awareness of professionals working with those affected. Toxic Couples: The Psychology of Domestic Violence is ideal for clinicians working with the victims and perpetrators of intimate partner violence, for students of psychology, gender studies and social care courses, and for anyone interested in the psychological forces behind violence in relationships. Anna Motz is a consultant clinical and forensic psychologist and psychotherapist with extensive experience of the assessment and treatment of victims and perpetrators of violence. She is a former president of the International Association for Forensic Psychotherapy, editor of Managing Self-Harm: Psychological Perspectives (Routledge, 2009) and author of The Psychology of Female Violence: Crimes Against the Body (Routledge, 2000, 2008). ‘This book provides a scholarly and empathic analysis of what the author terms the “addictive force” of relationships in which destructive aggression and intimacy are interwoven. With great integrity, Anna Motz explores the role each partner can play when enmeshed in destructive forms of communication – “a kiss with a (cid:191) st” – and how “the unthinkable” can in turn be acted out against one or more children whose parents have entered a state of malignant fusion. Detailed case discussions include headline cases of children who have evolved from help- less victim to powerful perpetrator in their re-enactment upon vulnerable peers of what they have witnessed but cannot process. Practitioners in the (cid:191) elds of crim- inal justice, forensic mental health, child protection and victim support will (cid:191) nd this important book both illuminating and insightful.’ – Dr Celia Taylor, President, International Association for Forensic Psychotherapy and Clinical Head of Service, Mill(cid:191) elds Unit, UK ‘Toxic Couples is simultaneously dark and enlightening. It is essential reading for any clinician dealing with family con(cid:192) icts since it courageously challenges the traditional view that women are always the victims of male violence. The acknowledgement that women can actively participate in domestic violence is accurately described and clinically proven. Reading this book will help to illuminate complex dynamics within violent partnerships, provide uneasy insights to all those involved in the assessment of domestic violence and prevent future failures in family court proceedings.’ – Dr Estela Welldon, Founder and Honorary Life President, International Association for Forensic Psychotherapy Toxic Couples: The Psychology of Domestic Violence Anna Motz First published 2014 by Routledge 27 Church Road, Hove, East Sussex, BN3 2FA and by Routledge 711 Third Avenue, New York, NY 10017 Routledge is an imprint of the Taylor & Francis Group, an informa business © 2014 Anna Motz The right of Anna Motz to be identi(cid:191) ed as author of this work has been asserted by her in accordance with sections 77 and 78 of the Copyright, Designs and Patents Act 1988. All rights reserved. No part of this book may be reprinted or reproduced or utilised in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers. Trademark notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identi(cid:191) cation and explanation without intent to infringe. British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library Library of Congress Cataloging in Publication Data Motz, Anna, 1964– Toxic couples: the psychology of domestic violence / Anna Motz. – First Edition. pages cm 1. Family violence – Psychological aspects. 2. Spousal abuse. 3. Mental health services. I. Title. HV6626.M68 2014 362.82(cid:397)92019 – dc23 2013039317 ISBN: 978-0-415-58888-1 (hbk) ISBN: 978-0-415-58889-8 (pbk) ISBN: 978-1-315-81799-6 (ebk) Typeset in Times New Roman by Re(cid:191) neCatch Limited, Bungay, Suffolk This book is lovingly dedicated to my remarkable uncles, Herbert and Stefan Edlis. This page intentionally left blank Contents Foreword viii Acknowledgements xi 1 Introduction: kiss with a (cid:191) st 1 2 Russian roulette: the dynamics of violent relationships 24 3 Action replay: the intergenerational transmission of violence 48 4 Beauty and the beast: perversion within the family system 73 5 Murder in the family 95 6 Shelter from the storm: home, homelessness and violence 117 7 Without honour: shame, forced marriage and honour-based violence 138 8 Xanadu: addictive states in violent relationships 156 9 Conclusion: out of the shadows 172 Notes 194 Further reading 198 References 200 Index 211 Foreword Pink, the American singer-songwriter, recently released a song on her album The Truth About Love entitled ‘True Love’, which describes the intense mix of love and hate that can co-exist in intimate relationships. In this sense, the album title and the lyrics both re(cid:192) ect much of the material covered in Toxic Couples. Both convey, for instance, the often confusing continuum of emotions experienced in familial and romantic relationships (that is, from love and caring on one end, to violence, abuse and control, on the other) and how those emotions can ultimately lead to abuse and violence. Although it can often be dif(cid:191) cult for outside observers to understand why a person would remain in a relationship coloured by psychological, emotional, (cid:191) nancial, physical and/or sexual abuse, much less profess their love and desire for their tormentor, research demonstrates that these are not simple decisions. My own work in this area suggests that even highly volatile and violent relationships can often be punctuated by periods of calm and tenderness; most victims simply want the abuse to end while retain- ing the relationship (Nicholls, Hilterman and Tengstrom, 2010). Motz unravels these mysteries again and again for the reader through dozens of captivating case studies. She offers us insights rarely available to non-clinicians, revealing the process of malignant attachment and childhood adversity that is so often at the foundation of domestic violence and intimate partner abuse. A particular strength of this book is the consideration given to diverse relationships and multiple forms of abuse and trauma. Coverage extends from neonaticide and infanticide, to familicide and honour-based violence. The exploration of the clinical cases depicts male and female perpetrated violence alike, as well as giving consideration to the issues of gender symmetry and mutuality in abusive romantic relationships. Importantly, Motz has actively avoided the commonly conveyed reductionist perspective that all domestic violence and intimate partner abuse re(cid:192) ects male patriarchy in isolation of the many other relevant risk factors that can in(cid:192) uence one partner to in(cid:192) ict abuse and violence onto the other. She conveys respect and understanding for perpetrators and victims simultaneously, without dismissing the need for anyone who perpetrates violence to be held accountable. The author also rightly re(cid:192) ects on the importance of self-care, consultation and insight by therapists who work with these dif(cid:191) cult clients and the trauma that can be experienced as an observer to the client’s often extremely painful life history. Foreword ix Motz reminds us of the importance of looking beyond an individual’s current behaviours and the need to place a client’s current circumstances and behaviours within the context of their personal history. In particular, the intergenerational transmission of violence occupies a central position in the book, as it should in any discussion of domestic violence, mental health, substance abuse, crime and violence. The Adverse Childhood Experiences (ACE) research conducted in the United States (http://www.cdc.gov/ace/) is one of the largest and most well- respected studies of traumatic stressors to date; the results illustrate many of the issues covered by Motz. First, the ACE (cid:191) ndings demonstrated that adverse events experienced in childhood (e.g. neglect; physical and sexual abuse; witnessing intimate partner violence between one’s parents; and other family dysfunction) are common. Nearly two-thirds of the more than 17,000 study participants reported at least one ACE, and more than one of (cid:191) ve reported three or more ACE. Second, the study revealed that these adverse events can lead to social, emotional, and cogni- tive impairments and that those de(cid:191) cits and challenges have long-term implications for the individual’s health and well-being. For instance, ACE can lead to an individual adopting risky behaviours (e.g. illicit drug use, alcohol abuse, early initiation of sexual activity) and exhibiting health-related problems (e.g. depres- sion, chronic obstructive pulmonary disease, early and unintended pregnancies). Third, the study also illustrated that the more stress an individual is exposed to in childhood, the greater the health and social implications. It is important to note, however, that although adversity and trauma in childhood is common in the general population (e.g. one in three people have been physically abused), subse- quent research revealed that populations who come into con(cid:192) ict with the law and who suffer from mental health problems carry a disproportionate burden of childhood adversity. For instance, a study of female American prisoners (N = 491; Messina and Grella, 2006) matched their design to the ACE study and found that whereas the community sample had amassed around 0–1 exposures to ACE (55.5%), 67.6% of prisoners reported exposure to two or more ACE; with one-third of the sample reporting exposure to (cid:191) ve or more adverse childhood experiences. The evidence from the ACE study (reported in >50 publications) taken in combination with thousands of other studies which have been available since as early as the 1980s (http://pubpages.unh.edu/~mas2/) demonstrates the ubiquity of violence in the home and the associated public health burden. Motz offers readers a richly interwoven tapestry of theory, research (cid:191) ndings and clinical wisdom. This book is likely to appeal to the lay public as well as seasoned practitioners and novice clinical graduate students, alike. Although this is a ‘heavy topic’ and the case illustrations can certainly be heart wrenching, I was left with a feeling of hopefulness. Motz tackles some of the most dif(cid:191) - cult forensic mental health cases and does an exceptional job of peeling back the layers to reveal what underlies seemingly un-interpretable dysfunction. She exposes domestic violence for what it is: an urgent public health priority that is well within our grasps to alleviate. Eradicating child abuse, intimate partner violence and diverse forms of family dysfunction is a challenge that every reader can take a part in achieving – be it through getting mental health services to