3 106-151 s.pdf

6 Uncovering Physical Abuse The LORD is my rock and my fortress and my deliverer, my God, my rock, in whom I take refuge, my shield, and the horn of my salvation, my stronghold and my refuge, my savior; you save me from...

6 Uncovering Physical Abuse The LORD is my rock and my fortress and my deliverer, my God, my rock, in whom I take refuge, my shield, and the horn of my salvation, my stronghold and my refuge, my savior; you save me from violence. (2 Sam. 22:2-3) The last time I had seen Amelia was two months beforehand. Today she sat shaking in my office. Her arms were bruised, and her tears would not stop. Obviously whatever had happened to her over the weekend had been horrific. It was easy to see that it was painful for her to move and even more painful for her to remember. We wept together for a while. As Amelia cried, her makeup ran off her face, revealing two black eyes. Then a new detail emerged as her makeup continued to wash away: little red spots all around her eyes and lacing her cheeks. In an instant, I knew-and it took all that was in me not to gasp. Those little red dots-petechiae-told me that Amelia had been strangled. She was lucky to be alive. Six months beforehand, Amelia had revealed that her husband's arguments with her lasted for hours and that he would not let her leave their home. His outbursts were getting increasingly intense; he had begun exploding over trivial matters, such as where to go out to eat and how their bed was made. Amelia's fear of him grew. She felt that any change she could try to make to their situation, such as asking him to seek counseling, having their pastor talk to him, or temporarily separating from him, would enrage him even more. I asked her if he had ever been physically violent with her, and she said he had hit her only once, years beforehand. As I asked her more questions, I found out that it was common for him to follow her around the house or kick things when he was angry. A month afterward, Amelia told me that Alex had taken her to a restaurant for her birthday dinner. He had become upset as she opened his gift. He felt that her reaction to it and the gratitude she showed were lacking. Alex left the restaurant abruptly, leaving her to cancel their order. His driving on the way home was so erratic that it scared her. Amelia asked him to slow down-and he hit the brakes so hard that she hit her head on the window. When she tried to get out of the car, he locked her in, driving like a maniac while screaming at her.  After she told me about that night, coming to counseling was difficult for Amelia. I would gently express my concern for her safety and ask her if we could consider thinking through some safety measures for her. Her heart was divided. In the same five minutes, she would say that she was too afraid to do anything that would upset Alex and then shift to believing that I was overreacting. One moment she was too paralyzed with fear to talk about a safety plan, and the next moment it was ridiculous to even think about one. Amelia often tried to convince me that Alex was really not that bad. While this was painful and worrisome, it was also familiar, because many victims react similarly. I was not surprised when she stopped coming to see me. Sitting with me meant facing (or at least talking about) the nightmare that she lived in-it was not easy. Amelia's story has stuck with me-and not just because of the intensity of its climax: she had escaped strangulation only because a dog-walking neighbor had heard her cries for help and called the police. What really stands out to me is how quickly Alex had resorted to lethal violence. In the span of ten weeks, he had escalated from behaving aggressively to using deadly force. This is something that we all-both helpers and victims-have to come to terms with: violence is unpredictable and can escalate quickly. We must take every occurrence of it seriously. Is It Physical Abuse? Physical abuse involves intentionally or recklessly using physical force in a way that may result in bodily injury or physical pain. It also includes actions that lead to harm-such as refusing someone sleep or medical care. Physical abuse does not need to cause pain or leave a bruise in order to be considered abusive. A spouse who does anything from throwing things all the way to choking or beating his victim is being physically abusive. Physical abuse can be directed at a spouse, at the children, or at household pets. Amelia's story is a case that involved a particularly alarming intensity of danger, but all occurrences of physical abuse are significant and require immediate attention and care. No amount of violence is acceptable in a marriage. Being married does not require enduring violence or any other form of coercive control. Being married does not mean that a wife should overlook her husband's abuse. God does not want us to value marriage more than we value a wife's life and safety or a husband's repentance. Therefore, a victim should not be made to feel the need to wait until her oppressor's violence intensifies before she responds to it or asks for help. When a husband abuses his wife, he desecrates the image of God in her. This is a severe pattern of sin, and our response to such sin needs to be clear. The Dynamics of Physical Abuse Many people whom I talk with-including even victims-are too quick to dismiss or minimize violence when it occurs in a marriage. Some see physical abuse as episodic and are foolishly relieved when a violent event is over. But physical violence is not merely an event or a series of events; it occurs in marriages in which wives are also being subjected to other forms of abuse. It is just one form of coercive control. What is going on in the heart of a husband who uses violence against his own wife? The most common misconception I hear is that a violent husband becomes so angry that he loses control. However, it is quite the opposite-an oppressor uses violence to maintain control. Think about how we often experience anger ourselves. It feels like an automatic response-usually one that we are quick to justify. Something annoying, inconvenient, or scary happens to us, and we react. I can be surprised by my anger and wonder, "Where did that come from?" It does not feel connected to me-it's far too ugly to be mine. Jeremiah 17:9 reminds us that we are bad interpreters of our own hearts. "The heart is deceitful above all things, and desperately sick; who can understand it?" So we must look to Scripture in order to understand our hearts. Our anger is not automatic. Nor is it provoked as much as it is exposed. Anger is an expression of what lies within a person's heart (see Luke 6:43- 45). We have already talked at length about the attitudes of entitlement that reside within an oppressor's heart and about how the oppressor punishes others in order to maintain power and control (see chapter 3). But so many people misunderstand that I will repeat it: the perpetrator of violence is not "out of control." It is quite the opposite-an oppressor uses violence in order to maintain control. Two examples from the Bible of oppressive leaders showcase how violence can be used to maintain control. The first is Herod. "Herod, when he saw that he had been tricked by the wise men, became furious, and he sent and killed all the male children in Bethlehem and in all that region who were two years old or under, according to the time that he had ascertained from the wise men" (Matt. 2:16). His desire to maintain his power and throne led him to order the mass killing of babies and toddlers. And then there was Haman. When he "saw that Mordecai did not bow down or pay homage to him, Haman was filled with fury. But he disdained to lay hands on Mordecai alone. So, as they had made known to him the people of Mordecai, Haman sought to destroy all the Jews, the people of Mordecai, throughout the whole kingdom of Ahasuerus" (Est. 3:5-6). Haman also called for murder so that he could retain his honor and power. Both these men were willing to kill entire groups of people in order to preserve their power-just as Abimelech did in the parable of the brambles. Physically abusive husbands use violence for the same purpose: to maintain their power and control. Here are three ways that Alex used physical abuse to control Amelia and get his way: If Amelia brought up difficult topics in the car, such as budgeting, Alex would drive aggressively and scare her. She learned not to "stress him out" while they were driving (or anytime, really). If Alex came home and dinner was not ready and waiting, he would go around kicking things-breaking them and creating a mess. He conditioned Amelia to have dinner ready on time. After Amelia hung out with friends, Alex would follow her around the house and demand to know every detail. If he did not like how much money she had spent or who she had been with, he would block the doorway and badger her until she apologized. Amelia stopped seeing friends-it was not worth the stress. Some women experience violence rarely, and others more routinely, but few of them are physically abused daily. Each case will be very different. Remain alert to patterns that unfold over time. Do not assume that the fact that a violent incident has not happened to a victim in the recent past means that other abuses are also not happening to her. Other forms of coercive control are likely present in her marriage. Abuse occurs in many forms- emotional, financial, spiritual, and sexual. As was the case with Amelia, physical abuse is just one way that oppressors control their victims. An oppressor will besiege a victim with a variety of different tactics.  REFLECT 1. 1. Why do you think we tend to believe that people who use violence are out of control? 2. 2. Can you think of a time when displaying your own anger accomplished something for you? It could have been a low-grade expression of anger, such as complaining. (Think of a parenting or work-related example.) 3. 3. The husbands of many wives whom I counsel drive erratically with the intention of scaring them. Even though an oppressor in this situation is not making physical contact with his victim, he is threatening her physical safety by driving in a way that endangers her. If I ask detailed questions about this, victims will tell me that their husbands engage in frightening tailgating or speeding, stop suddenly so that their seatbelt hurts them, or turn too fast so that their head hits the car door window. But victims often fail to voluntarily disclose incidents of abuse that occur in the car. Why do you think victims might struggle to label such actions as physical violence? How might you help a victim to see that the frightening behavior her husband exhibits while driving is accomplishing something for him? The Impact of Physical Abuse When your husband physically attacks you, it changes the whole dynamic of your relationship. No matter how small the aggression is, it is still a violation that does unquantifiable damage. In a few moments, trust dissolves and fear infuses your every interaction. Your marriage and home are supposed to be places in which intimacy flourishes-where you are known and at rest. Neither of those things can happen when you no longer feel safe. Instead, you now live on edge in your own home-even in your own bed. The anticipation of angry outbursts overwhelms your being. Fears multiply. Your body suffers. The impacts of physical abuse usually fall under the seven categories that were discussed in chapter 4-but you will need to pay particular attention to physical anguish in a spouse who is suffering from physical abuse. 1 Signs of an Injured Signs of an Overwhelmed Body  Body bruises and contusions muscle tension broken and fractured involuntary shaking bones sprains and dislocations fatigue and headaches scratches changes in sleeping and eating patterns burns menstrual-cycle and fertility issues head and facial injuries flashbacks Seeing the Effects Even though many of these effects of physical abuse are visible, you will not always see them. When victims are not ready to come forward, they will conceal physical injuries with clothing, sunglasses, makeup, and hats. Oppressors often land injuries on parts of their victims' bodies that can be covered up: their upper arms, the middle of their backs, and their shins. This is just another indicator that oppressors are in control while appearing to be frighteningly out of control. Victims may even offer up false explanations for their injuries. Remember that they are likely afraid that their husbands will be angry if anyone finds out, so they may hide the horrors that they face. Even after victims begin revealing physical abuse, they often forget events and details from week to week. I see two primary reasons for this. First, usually by the time that we meet a victim, either she is buying in to her husband's manipulations (his minimization, denial, false contrition, or blame- shifting), which have reinterpreted events for her, or she believes that the abuse is her fault (and feels guilt and shame). Consequently, she does not feel the proper outrage when her husband harms her. This will feel confusing to you, since you will be moved and disturbed by the violence that has happened to her. The second reason is that her abuse overwhelms her, and so her mind and heart have shut down. When I ask how their previous week was or whether there were any occurrences of physical abuse, victims often fail to recall what has happened. To help them to remember abuses, I have women journal or email me after an event occurs so that we can review the incident together. The Lasting Impact of Violence One more thing to consider is that it is not uncommon for a violent episode in the past to have conditioned a wife to avoid more violent events. Tricia was one such counselee of mine. Her husband beat her severely early on in their marriage. Going forward, he needed only to signal to her with a clenched fist in order to exhibit control over her. Jane's husband threatened to shoot her during an argument in their first year of marriage and later claimed he had just been joking, but when things were tense between them, he would walk around the house with his sidearm tucked into his belt buckle while refusing to speak to her. One occurrence of physical abuse can establish a permanent sense of fear that enables domination. I call this conditioning violence. Conditioning violence happens at lower intensity levels as well. If Patty talked on long car rides, Peter would drive aggressively and frighten her. Cindy's husband had shoved her only once during their five years of marriage, but if he got upset, he would often say, "Don't make me pop you one!" Therefore, it is crucial for us to discover violent abuses from the past and to consider how they are currently exerting control in a relationship. REFLECT 1. 1. Imagine, for a moment, living with someone whom you feared would hurt you physically. How would living in a state of hyperarousal affect your body and mind? 2. 2. Conditioning violence, even if it has occurred only one time, has a powerful and lasting effect. Why do you think most people fail to see the control that it establishes? Helping the Physically Oppressed When you encounter a victim of physical abuse, you will need to have two things in mind: her heart and her safety. At many points you will feel tension between the two. The presence of physical abuse in a relationship introduces a risk of severe injury and lethality, yet you will still need to honor the victim's heart and move at her pace as you collaborate with her. If you do not have expertise in this area, you will want to consult with experts or help a victim to connect with a trained counselor. Honor your own level of comfort as you care for victims. Seek out people to help you when you need support or have questions. 2 Ask Questions That Uncover Physical Abuse When you start talking to someone whom you suspect may be experiencing abuse, it is essential for you to do a physical abuse screening. You need to uncover not just current abuses but also any history of violence in the marriage. The specific questions that you ask matter. If you ask, "Have you been physically abused by your spouse?" many women will say no- because they do not consider the treatment that they endure to rise to the level of physical abuse or violence. It is important to ask questions that victims can relate to. They should be detailed and concrete. I have provided you with a physical abuse inventory at the end of this chapter that will assist you. As you use the questionnaire, ask for detailed examples of occurrences. Go through the inventory twice. The first time, look for simple yes or no answers. This way, you can quickly assess the overall landscape without overburdening a victim. No one wants to talk about some of the worst moments of her life all at once. This will also allow victims to establish trust with you before you ask them about painful details. But, most importantly, by gathering this snapshot you can uncover dangerous violence in a timely fashion, which will let you see where you need to focus. At another time, you will want to go through these questions again. As you revisit any questions that prompted the victim to disclose abuse, go much more slowly. Gather details about occurrences while also discovering how the victim interpreted them. Your goal is to draw out individual stories. Doing so serves several purposes-you will help the victim to make key connections, to come to understand that what she is enduring is not her fault, and to be able to accurately assess her situation. This second run-through may happen over a period of weeks, but its pace will ultimately depend on the urgency of the victim's situation. Make Sense of What You Hear Focus on content, not on presentation. Many of the wives I work with are so traumatized that they do not recall individual events-let alone how those events have played out in the relationship over time. This is true of most trauma victims. Think of someone who is shaken up by a car accident-they do not initially remember all the details about what happened, nor do they share what happened to them from a logical perspective or in an orderly fashion. Their stories are often scrambled, and it takes time for them to sort out what happened. This does not mean that the victim is not credible; it means that she is traumatized. Seek to stay focused on what she is saying, and help her to sort through it. Over time, victims will begin to recall more abuses. As you engage them, they will start to make new connections. Since they are now in a safe relationship, they can reflect on and remember their past. Do not think of a woman's story as changing but as being filled out. You will first hear the abridged version; then new layers of detail and side plots will fill it out later. Take careful notes. Many of my counselees have later minimized some of the things that they initially shared with me. There are many reasons for this: we all forget the intensity of our pain, an oppressor may have recently been on his best behavior, acknowledging abuse can be overwhelming and requires action, and memories simply fade. When we take notes, we help victims to remain clear about what happened to them. Recording these events will also help victims to recognize their oppressors' patterns of abusive behavior. You can help churches by documenting abuses as well. This can be especially helpful if any discipline process may take place. (Documentation might also be needed for any legal or judicial proceedings. 3) Even if you are in the role of an informal helper, consider making dated notes or encouraging the victim to journal about instances of violence and to share them with you. Guard yourself against making wrong assumptions. In no way are victims responsible for the violence that they suffer. The violence that comes out of a man comes from within him (see Prov. 13:2). But some victims employ strategies to limit the effects of the violence they experience or to manage its timing when possible. Think about Pharaoh's demand that the Hebrew midwives kill all the newborn boys (see Ex. 1:17-21). When he confronted them about their failure to follow his order and kill the newborns, the midwives claimed that the Hebrew women gave birth too quickly and were finished before they could get there. Here we see the midwives resisting his violent order. They used a strategy-telling a falsehood-to protect the vulnerable. When we work with victims, we need to remember that they are like the midwives-they too are living under an oppressive ruler. Sometimes the tactics they use to resist this oppression can be disorienting for us to witness. We can mistake their resistance as a cause of the abuse. It easy for us to be wrongly focused on their response and to forget that victims are trying to resist being coercively controlled. Here's an example: Tina's husband, Vic, has been more critical lately- consistently snapping at her, slamming doors, and yelling at the dog. She knows it is a matter of time until Vic punches her in the back one night while she is sleeping. Next week is her son's birthday. That night at dinner, when Vic criticizes her cooking, Tina responds by calmly saying, "If I am such a bad cook, maybe you should cook your own dinner next time." That night, she awakens to a vicious punch in the back. Tina is not relieved-she is crushed and in pain-but by the time her son's birthday party arrives, Vic is no longer stewing in rage. In this example, Tina did nothing that justified her husband's sin against her. Even if she were rude, Vic's violence was without excuse. Tina did not "provoke" his vicious attack against her. Domestic violence is not about cause and effect; it is about control. Understand that if Tina's actions were purposeful, they were done in order to resist violence, not to provoke it. Help Victims to See That the Violence Is Purposeful Ask questions. Many wives need help in order to see that their husbands' violence is strategically timed and placed. They mistake their husbands' use of force for a tantrum and will say things like "My husband will throw things at me or break things-he just gets so frustrated with me." But when I ask, "Does your husband scream or yell at the cashier when the line is lagging, or in a small group when he is interrupted?" they begin to realize that even though he gets frustrated in places outside his home, he does not display his anger publicly. When a man is selective about when, where, and to whom he is physically abusive, his problem is not that he loses control but that he uses anger in order to control. Another way to help a wife to see the purposefulness of this violent anger is to ask, "What things are broken during an argument?" A wife almost always reports that her husband breaks her belongings. For one of my counselees, Terri, this was a devastating realization. Terri began recounting all the things that her husband had broken over the years. The list included many of her family heirlooms and her children's mementos. This simple inquiry allowed her to begin to see that her husband's anger was purposeful and being directed at punishing her.  To combat a wife's misconceptions about violence, help her to see what purpose the violence serves. Ask questions to help her to understand what her husband's abuse is accomplishing. What did your husband get (or get out of) from being angry? What did you do differently after the incident? What are you likely to do (or not do) as a result of his explosion? What did your husband gain from making you afraid? Once she can make connections, invite her to think about the other, nonviolent ways that her spouse uses coercive control. Having her expand on her new insights will help her to gain a greater understanding of the functional dynamics that are at work in her marriage and, hopefully, to retain them. Unearth excuses. Many women make excuses for their husbands' anger. Be alert to how they interpret their husbands' behavior. Pay attention to ways in which they blame themselves. In order for victims to know how to respond wisely, they will need to come to understand that physical abuse is purposefully domineering. Listen for how they often explain what is at the root of this abuse: "It is my fault. I pushed him too far." "It was late, and he'd had too much to drink." "He is so insecure. He was afraid I was having an affair." "He's going through a stressful time at work." "I deserved it." "He seems so sad and apologetic. I don't think he meant it to happen." "It is not that bad; it could be worse." "He wasn't always like this. I know I can work harder to help him to get better." "He was abused as a child-it's all he knows." "I think he may be bipolar; he can't help it." "I am too sensitive-I'm overreacting." Be careful to highlight the purposefulness gently. It may be tempting for you to counter a victim's interpretations with strong assessments that vilify the oppressor, because what he is doing is evil. But your goal is to help her to see what you see, and this takes time because she loves and cares for her oppressor. It is more natural for wives to see their husbands as sufferers, so it will take time for their perception to change. Be Alert after Incidents of Physical Violence After episodes of physical violence, there may be a period when no more violence occurs. Do not think that the abuse has stopped-abuse is always happening. It has probably just taken another form of coercive control. Sometimes it even shows up in the form of self-pity that we mistake as sorrow. Oppressors can act and even be remorseful. But they are often sorry only for how their actions will affect them. Their pride senses that they have made fools of themselves or that others think they have done something reprehensible. Watch Out for False Repentance Help victims to assess their abusers' contrition. When control is masked as contrition, victims will need our help with discerning the difference between godly and worldly regret. After a husband hits his wife, he may offer a well- worded apology, give her gifts, or attempt to make her feel sorry for him in order to deflect what he has done. Many women report being moved by tearful apologies. It is a sad state of affairs when even "apologies" are manipulative. We must discern whether perpetrators of violence are feeling worldly regret, grief for themselves, or godly regret. Godly regret is always focused on how sin offends God and harms others. For godly grief produces a repentance that leads to salvation without regret, whereas worldly grief produces death. For see what earnestness this godly grief has produced in you, but also what eagerness to clear yourselves, what indignation, what fear, what longing, what zeal, what punishment! At every point you have proved yourselves innocent in the matter. (2 Cor. 7:10-11) The test of godly regret is repentance that works toward restoration. Is the oppressor zealous about casting off his sin and willing to do whatever it takes to fight against his sin? Or is his "repentance" centered around him feeling sorry for himself? Unless a husband is truly repentant, he typically demonstrates a self- centered sorrow that lures his victim back into his arms by making her feel sorry for him or responsible for his behavior. Such demonstrations are about getting his world back to the way that he wants it. Often oppressors use apologies to avoid the consequences of their behavior. Some oppressors will be on their best behavior as a way to push to be reconciled with their spouses -so great care needs to be taken to determine whether an oppressor is genuinely changing or merely performing. It seems harsh for me to say it, but it needs to be said: the tears and apologies of an oppressive husband are usually meant to exert further control. Resist the temptation to fall for false repentance yourself. Sadly, I have heard too many stories like this one: A pastor witnesses a husband crying and appearing genuinely remorseful for hurting his wife. The pastor then says, "Your husband seemed sincerely sorry and promised that he would not do it again. I do not think you should call the police; it could cost him everything." The pastor missed the manipulation and failed to see that the purpose of the apology was to avoid the police and other consequences. We all do this. We want to believe that people are exhibiting real sorrow, and we are moved by displays of emotion. So we need to look for repentance that goes deeper than an emotional expression or future promises and is instead supported by evidence. When an oppressor genuinely repents, he will be alarmed by his behavior. He will publicly confess it and commit to seeking expert help instead of trying to escape consequences. He will be afraid of his own capacity for evil and will weep for the damage that he has done-not for what he might lose (see Matt. 18:8-9). He will do whatever it takes to make his wife comfortable. He will be eager to make amends and will refrain from pressuring his wife to forgive him. Both helpers and victims need to be careful not to fall for pseudo- repentance. Instead, they both need to look for an oppressor to be willing to give up control and learn new, healthy behaviors for a sustained period. See chapter 12 for a longer discussion of evidences of repentance. REFLECT 1. 1. Both victims and helpers are prone to believe that confessions of sin are sincere. We accept a perpetrator's words as true. Why do you think that is? Why do you think we struggle with this even after we clearly see an oppressor using his words to manipulate people? 2. 2. Matthew 3:8 states that we should "bear fruit in keeping with  repentance." When you are assessing violent people, what are some fruits of repentance that you hope to see? Assess the Severity of the Abuse We need to be wise stewards when we are helping people. As you evaluate how severe a victim's abuse is, be open to involving experts who can help you to offer her appropriate care. As you work through the questions at the end of this chapter, you may discover the need for a safety plan. You will find one in appendix A. Monitor the level of violence. Once you have uncovered physical violence, you will need to monitor it. As our hearts harden, we become numb to the destruction that our sin causes, and we increasingly feel that our participation in it is justified. When someone is unrepentantly committing violence, it is safe to assume that it will escalate. If a victim chooses to stay with her husband, you should check in periodically to see where his violence falls on the following scale. But remember that her phone and her emails are likely monitored, so invite her to get in touch with you safely if things are worsening.  Once an oppressor makes the jump to a higher level of intensity, his violence most commonly will pick up where it left off the next time an episode occurs. For instance, if he moves from shoving a victim to kicking her, each ensuing incident of violence will likely result in the victim being kicked again-or worse. This fact is a frightening reality-but it can also help us to coach a victim who is reluctant to flee for safety. Start by explaining the progression of violence, and ask her to locate the intensity level that she currently faces. Using the diagram, ask her to go back in time and recount different periods of her relationship in order to trace the escalation of the violence. Then ask her to draw a line on the diagram that marks the type of violence that she will no longer accept. I cannot tell you how effective this has been for the victims I counsel. Many women come into my office after an escalation and say to me, "Well, I said if he ever pinned me down, I would have to make plans to flee. It happened-and now I need help getting out." I believe that this works for two reasons. First, it restores a victim's agency -she makes a choice about what she will no longer accept. I am not the one telling her to make a change; she makes a decision about how much she will endure. She decides whether to stop the violence now or when future incidents occur. Second, looking at this progression in black and white is alarming. It helps a victim to open her eyes to where everything may lead, which helps her to be realistic about her situation. Violence can escalate dramatically. While the chart in this chapter shows the way that it escalates overall, most progressions do not happen in a step- by-step fashion. Several victims whom I worked with were never hit or beaten, but their physical abuse began at the level of choking. One counselee of mine never experienced a physical incident until her husband pulled a gun on her. In other words, do not be comforted by what is not happening- remain vigilant and address essential matters of safety whenever coercive control takes place. Watch for predictors of lethal violence. Violence does not always progress step-by-step or exhibit a predictable pattern, but there are predictors of lethal violence. Dr. Jacquelyn Campbell has done extensive research at Johns Hopkins University that found that women were twenty times more likely to be killed by their partners if their partners had threatened to use a weapon on them or had hurt them with a weapon, nearly fifteen times more likely to be killed if their partners had threatened to kill them, and nearly ten times more likely to be killed if their partners had ever tried to choke them. 4 From her research, Campbell developed the Danger Assessment Instrument, which determines how lethal a domestic violence situation has the potential to be. A modified version of this instrument is included with the inventory at the end of this chapter. As you work with victims, there is much for you to assess and consider. Remember what the Lord promises to you-he says, "I, the LORD your God, hold your right hand; it is I who say to you, 'Fear not, I am the one who helps you.'" (Isa. 41:13). Remember that the One who holds your hand and guides you also guides the victim whom you care about. You are not alone in this work. We can look to God for wisdom and help.  Physical Abuse Inventory When we suspect that any type of oppression is present in a marriage, it is wise for us to screen for physical abuse. Many victims I work with do not recognize signs of physical abuse, so it is not enough to ask, "Does your spouse physically abuse you?" You need to screen for specific behaviors. Refrain from making assumptions. It is better to ask about the details. It can feel awkward to ask a person about extreme abuse-especially if it has not been disclosed. Let this inventory help you. Instead of making you feel like you're the one who is generating questions, the inventory will lead the process and give both you and the victim the sense that you are using a resource together. This should eliminate the victim's inclination to wonder, "Why would you ask me that?"-or your own uncertainty: "Do I really need to ask about that?" When victims answer these questions in the affirmative, gently express how sad and wrong the behaviors that they describe are. Sometimes I just say, "That is not okay" or "Hearing this hurts my heart for you." Give them space to share, and validate how brave they are for bringing these things into the light. Yet, even though you are showing them concern, they might not be at a place to match your level of distress. Remember, it might take them time to sense the seriousness of their oppression. If that is the case, focus on gathering facts. Do not venture into assigning motives to their oppressors or trying to convince them that they are oppressed. Has your husband ever pushed, shoved, or grabbed you? Has your husband ever spit on you? Has your husband slapped you? With an open or closed hand? Has your husband scratched you? Has your husband ever driven in a way that frightens you? Has your husband spanked you? Is domestic discipline something that your church teaches? Has your husband twisted or bent your arm? Has your husband pulled your hair? Has your husband punched you?  Has your husband thrown objects at you? Did your husband ever hurt your pets? Has your husband hit you with an object? What was it? Has your husband bitten you? Has your husband kicked you? Have you been beaten? Has your husband ever prevented you from obtaining basic needs like sleep, medicine, or food? Has your husband cut or burned you? Attempted to drown you? Did you need to see a doctor for any wounds? Has your husband thrown you? Or slammed your body against a wall, a car, a bed, or the ground? Has your husband ever dragged you? Pushed you on the stairs? Has your husband ever blocked your way? Has your husband ever locked you in a room or in the car? Has your husband kicked you out of a car? Has your husband threatened to use a weapon on you? What type? Has your husband pinned you down? Has your husband strangled or choked you? Has your husband used a weapon to hurt you? Assessing for the Potential of Deadly Violence If a victim answers yes to any of the questions on this next list, then she is at risk for deadly violence. 5 That is the point when we need to become more directive in our counsel. This does not mean that victims will take our direction; we still need to move at their pace. But in these situations, I will say things like "I am afraid for you," "I think it is important that we seek to plan for your safety right away," "Even if you do not feel ready to enact a plan, I think we need to start to work on one; what I am hearing is very concerning," or "Let's do an online danger assessment or call a hotline together. I want to make sure you understand the level of danger you are in." Remember-victims need to be educated and given options, but they get to choose how they will respond. It is not uncommon for me to have this conversation a dozen or more times before a victim is ready to take action. At this point, preferably with the victim, it would be wise for you to reach out to your local shelter or a domestic violence advocate for assistance with safety planning immediately. A victim is in the most danger when she is fleeing abuse, and she should not do so without a safety plan in place. The need for planning is essential, because "75% of domestic violence related homicides occur upon separation and there is a 75% increase of violence upon separation for at least two years." 6 See appendix A for resources to help you with making a plan. Has your husband ever used a weapon against you or threatened you with a weapon? Has he ever threatened to kill you or your children? Do you think he might try to kill you? If so, does he have a gun, or can he get one easily? Has he ever tried to choke you? Is your husband violently or constantly jealous? Does he control most of your daily activities? Has his violence increased in frequency or intensity in the last year? Has your husband ever threatened or tried to kill himself? Has your husband forced you to have sex when you did not want to? Does your husband follow you, spy on you, or leave you threatening messages?  Connecting Cries to Scripture Many women who suffer at the hands of their spouses struggle to put the cries of their hearts into words. Without words, we all struggle to speak to God. Without prayer, feelings of isolation and abandonment settle in. God has given us the Psalms as a means to help us to talk to him and be connected to him and his promises. David Powlison taught me that by personalizing a psalm, we can bring our hearts deeper into Scripture and closer to the Lord. 7 But most victims I work with struggle with knowing where to start. They fumble as they try to find words that capture their experience. They wonder, "Is it okay to express raw and doubt-filled thoughts?" Here is my attempt to help you to get them started. I have reworked Psalm 27 as a prayer of the oppressed. You will find it below. Read Psalm 27 in your Bible first, then read my reinterpretation. It would be an excellent exercise to have each woman whom you are walking with choose a psalm that resonates with her heart and write it in her own words. Encourage her to rework the psalm again and again until it captures the cries of her heart. (Psalms 31, 34, 52, 140, 141, and 142 are other great psalms that plead for protection.) 1 The Lord is my light and my salvation; I know whom I fear-I fear the man I call mine. The Lord is the stronghold of my life; So why am I filled with fear? 2 When he, the flesh of my own flesh, attacks me, his words ravage my heart. He is my adversary and my enemy? I am still in shock. How can it be that the one who devours me... is my own? Help me to remember that you, God, promise me That his evil ways will not prevail. 3 When his control encircles me and seeks to strangle me, Lord, help my heart not to fear. When he tears at my soul, ravaging me with spite and hate, help me to be confident in your love for me. 4 Lord, I ask of you only this one thing- yet from where I sit, it seems near impossible for anyone, even you, to grant it- I want to find peace and rest. Bring my heart close to yours! I want to spend my days dwelling upon your beauty and majesty; I want to know what it is like to be protected by you. 5 My home is filled with trouble and danger; Be my shelter as the storm rages within its walls. Tuck me in under cover of your righteousness, For I cannot stand under his accusations. The bedrock of my home trembles and threatens to give way; please anchor me into your foundation. Secure me. Hide me; keep me. Help me to escape. 6 My enemy encircles me both day and night; there is no escape. Lift my eyes to see past him, past the place where I am trapped-to see only you. Shift my gaze, so that I may see you at work. My heart rejoices when I know that you are looking after me, working to set me free. 7 Hear me, Lord! My face is flooded with tears and my words garbled with sobs; Show me your amazing grace and answer me. In my misery, I cannot bear your silence! 8 I have sought to be faithful to you-to seek after you. Lord, it is you I wish to know; quiet my fears and make me more sure of you. I am looking to you alone. Tell me what to do. My heart is weary in the seeking, heavy in the asking. 9 Please, Lord, make yourself and your way known. I am desperate; I need you to see me. I fear that you have turned away from me, leaving me to dwell in a place of constant terror. But I know that you have promised to be my help and guide. Forget me not! I know that only you can save me. 10 I have no one, not anyone, to turn to- but you, Lord, will take me in. Your Word is filled with promises reminding me that you are my refuge. 11 Help me to figure out what to do, O Lord. All the ways before me seem treacherous and frightening; There is not a choice before me that does not bring anguish to my heart. 12 Protect my heart from all the lies-especially his lies, when he tells me I am worthless and unworthy of your help and rescue. Help me to resist his controlling and dominating ways. His words are so powerful that they crush and break me. 13 I believe that you, Lord, are good and faithful; help me to focus my eyes on your goodness and faithfulness. My home feels like a place of death, but you, O Lord-your kingdom is one of life and freedom. It is where I want to dwell. 14 I pray day and night for you to deliver me. As I wait for you, make my heart strong; fill it with courage. Come, Lord, please! I await you and your wisdom.  7 Uncovering Sexual Abuse When you pass through the waters, I will be with you; and through the rivers, they shall not overwhelm you; when you walk through fire you shall not be burned, and the flame shall not consume you. For I am the LORD your God, the Holy One of Israel, your Savior. (Isa. 43:2-3) I had been counseling Robin for about two years before she even began to allude to her hatred of sex. She had initially come to me for panic attacks, which were intense and occurred almost every evening. We eventually traced this anxiety back to her husband's indifference to her and the children. He would come and go as he pleased, interacting little with his family. There was much for her to grieve-and that was before she began speaking of his cruelty. One day she had found pornography on his phone and was horrified at what she had seen-not merely because it was pornography that was open in the room where their children were gathered but because she realized that the images on his phone captured many of the things he had asked of her. She was sickened and could not stop shaking and crying for days. Even after having experienced such a shock, she was not able to share her story with me all at once. It eked out of her slowly. First she asked me theoretical questions about men and porn, followed by questions about what was normal for men to desire. She had lots and lots of questions. Weeks passed before she told me about what she had seen, and finally she was brave enough to tell me how those things played out in their bedroom. She felt dehumanized-like a prop in a play. The only part of her that her husband ever seemed to have an interest in was forever infected by his sin. We spent hours and hours talking about what she had experienced. It was grueling. But she needed to know what was normal and what was sin. She needed to know what God thinks about sex and what he thinks when it is corrupted. She needed to know what to do, who to tell (if anyone), and what to say to her husband. She needed to know that these violations were not her fault. She needed to know if God could heal her from the violations. Is It Sexual Abuse? God designed a married couple's physical relationship to express their emotional and spiritual intimacy. And more deeply than that, a couple's love for each other is meant to be a picture of how Jesus loves us-his church. Jesus's love is patient, kind, faithful, self-sacrificing, accepting, honoring, honest, and caring. By God's design, this type of love should characterize a marriage relationship-including a couple's sexual intimacy. Sadly, as we look at marriages that involve sexual abuse, we encounter something very different. We see sex being corrupted by those who lust to fulfill their own desires at any cost. In too many marriages, sex is not a picture of loving mutuality and intimacy but is tainted by domination and manipulation. Marital sexual abuse is a broad term that can encompass many heinous and exploitive acts. The worst violations occur when sex is demanded, required, or taken by force-as in instances of rape or forced sex acts. Other abusive acts include the unwanted intrusion of pornography or implements into sex, undesired sexual activities, peeking, or spying. Sexual abuse can be manipulative and coercive. In such cases, an oppressor uses unrelenting pressure or threats to leverage a sexual encounter even after a victim expresses discomfort or refusal. It is essential for us to also clarify what marital sexual abuse is not. Many couples struggle with differences in their sexual appetites and comfort levels. In a healthy relationship, couples can discuss, and even debate, their differing physical desires without pressure, fear, or rejection. Spouses should be able to express different preferences without either of them imposing their desires on the other in the form of a demand. Such conversations are good and healthy. Something else I want to clarify is that not all usage of pornography is abusive. Both the use and the creation of pornography is always sinful, but it is not abusive unless it is undesired. Mutually agreed upon evil behaviors are simply wrong-not abusive. Remember that abuse requires coercion. The Dynamics of Sexual Abuse We saw in chapter 3 that abuse is fueled by entitlement. Entitlement says, "My needs and desires are the priority; it is your job to make me happy." Abusive entitlement says, "If you fail to fulfill my desires, I will hurt you." Sexually abusive oppressors believe that they are entitled to sex. They love themselves and their own pleasure to such an extent that they are willing to harm another person in order to be satisfied.  Coming to terms with the level of depravity that is involved in marital sexual abuse is difficult. Years ago, I came across a study that helped me to better understand what goes on inside an oppressor's heart. The study asked rapists-of both partners and strangers-why they raped. It found that whether a man rapes a stranger, his wife, or his partner, he does so for the same reasons: power, anger, retaliation, sexual arousal from causing pain and fear, a preference for coercive over consensual sex, and a deep sense of entitlement. 1 This was eye-opening for me because it exposed the fact that sexual abuse in marriage is driven by a desire to dominate-by delight in another's pain. The only difference the study noted between partner rape and stranger rape is that partner rape carries longer-lasting and graver effects for a victim. Another study found that the act of rape causes the highest degree of physical injury when it is perpetrated by an intimate partner and that victims of partner rape are likely to have been raped multiple times. 2 While these studies focused on the extreme end of the sexual-abuse continuum-rape- they helped me to see that sexually abusive husbands operate the same way that sex offenders do. They are purposeful sinners. Their goal is sex the way they want it when they want it. While such research highlights for us the depth of depravity that is involved in sexual abuse, and maybe even turns our stomachs, we should not need a research study to tell us what the Bible already does. Second Timothy 3:2-5 captures not just the breadth and depth of sin but also its grotesque and deceptive nature. For people will be lovers of self, lovers of money, proud, arrogant, abusive, disobedient to their parents, ungrateful, unholy, heartless, unappeasable, slanderous, without self-control, brutal, not loving good, treacherous, reckless, swollen with conceit, lovers of pleasure rather than lovers of God, having the appearance of godliness, but denying its power. Avoid such people. While this passage is not speaking about sexual abuse, the way it describes the actively sinful and self-seeking heart is a profound help to us by identifying why one person sins against another in a self-fulfilling way. Husbands do not sexually abuse their wives because sex is a biological need for them that their wives are failing to provide. They do not do it, as many have claimed, to keep from sinning-from straying from the marriage bed. They do it because they love themselves and their own pleasure to such an extent that they have no self-control. They are willing to be reckless, treacherous, brutal, and heartless. Their love for themselves knows no bounds. We need to be aware of this and not be fooled by excuses or appearances. If we are to be wise helpers, we need to fully acknowledge the destructive root of sexual sin. As is the case with any sinful behavior, there tend to be patterns within sexual abuse that can be observed over time. Becoming familiar with common characteristics of sexual abuse will help us to make sense of the information that we hear. This is especially important because women typically disclose marital sexual abuse in bits and pieces-and so we need to be alert to what may lie beneath the information that they tell us. Familiarity with the characteristics that follow will help you to identify abuses. The stories that accompany the different characteristics are glimpses into the dark world of sexual abuse in Christian marriage. They are stories from Christian women who are married to professing Christian men. Unrelenting Pressure Most couples need to work out differences within their sexual desires and preferences. This is normal, and it is healthy for spouses to communicate with each other. But it is unhealthy and harmful when a husband pleads for or demands sex with pressure that is unrelenting. Women tell me stories of being lectured (sometimes for hours), told that they will be shown no affection unless it culminates in sex, or made to feel responsible for their husbands' use of pornography. Sex on demand has become an expectation or a "right" for the husband. My husband never seems to be satisfied. He always wants sex. I feel guilty all the time. He tells me that it is my fault, on the few days that we do not have sex, if he looks at porn; so sometimes I will give in just to protect him from sinning. Other nights, he will wake me up in the middle of the night and beg me for sex. I do it, but I am just so tired that it is hard to enjoy-so then he gets upset with me for not enjoying it enough. Morning comes, and he insists that we try again. It is important to him that I show lots of excitement. But I am exhausted. I am not sure if there is something wrong with me. -Tina Callous Disregard There are many occasions when sex is neither desired nor reasonable: after an illness, a new baby, a particularly difficult day, or an abusive rant, when there is a house full of guests, or during a painful menstrual cycle. But instead of yielding his own desires and caring for his wife in a situation like this, an oppressive husband will commonly expect or demand that sex proceed as usual.  One time, after my gallbladder surgery, we had not had sex for two weeks-and when I went to check out at the grocery store, there was no money on our bank card. Later he told me that I had been neglecting him and that I needed to know what it was like to not get what I needed. -Jen Unwanted Acts When a wife has made it clear that she is uncomfortable with a particular sex act or implement, an abusive husband insists on it and disregards her comfort. Other examples of this characteristic are when a husband does not stop after his wife says that something hurts or when he films her without her consent while they are engaging in sexual activity. In some marriages, a wife may be too frightened to even give voice to her preferences. A few weeks ago, he started showing me porn clips and asked me to reenact things in them with him. I try to do it, but it makes me feel dirty-and some of them are painful. I try to tell him that this stuff is not God-honoring, but he says, "You are a prude. God gave me the most frigid, unloving wife on the planet. And if you are not careful, I will leave you for someone who knows how to love me and fulfill her duty with joy." -Karen Coercion While a majority of abusers use coercive tactics, coercion is also a particular type of abuse. Sexual coercion happens when a victim is pressured, tricked, threatened, or forced in a nonphysical way to engage in any sexual activity that is unwanted. An abuser uses either implied or actual threats of future punishment to gain compliance with his sexual demands. For instance, a husband may indicate or state that he will get violent, leave, find another woman, expose his wife in some way, or punish their children. The threats do not have to be spoken; oftentimes wives experience punishments without explanation. For instance, some wives get the silent treatment after they turn down sex. In most cases of this, their husbands do not say, "I am not talking to you because you did not give me sex." They simply stop talking to them. Coercive sexual abuse can be very confusing, because after being bullied by her husband, a wife may give her consent to sex. The victimized wife is left wondering, "Was I sexually assaulted, or did I agree to it?" Bob wants lots of sex. If ever I refuse to be intimate with him, he is rotten to the kids the next day. He becomes so irritable and loud that even our dog cowers. I try to interject and tell him not to be so harsh and punishing. He just barks at me, "If you want me to be in a good mood, it is your job to put me in one." Many nights I will provide him sex just to spare the children from being hurt. -Anne Degradation Many women report that their bodies or their sexual performance are a subject of constant and brutal criticism. This criticism can happen privately or publicly-and it is usually purposeful. It can be used to justify the use of pornography. Or a husband may degrade his wife in an attempt to achieve an outcome that he desires. For example, "If you want me to stay faithful, get a tummy tuck-your 'baby bag' turns me off." My husband tells me that I need to loosen up and that sex with me is boring. He says that ever since I gave birth he is no longer turned on by me-that if I loved him I would work harder to spice things up and stay sexy. I have bought lingerie and tried new things, and even went on a strict diet, but he is never happy. He thinks I should get work done on my breasts to make them better for him. Should I make myself do these things for him to keep him happy? I do not know what I'd do with our four kids if he left. -Sally Accusations of Affairs Another form of abuse is when husbands consistently and unjustly accuse their wives of having an affair or being flirtatious with other men. One woman relayed that after a two-hour dentist appointment, her cheeks were red because she had her jaw open for so long. Her husband was convinced that she was blushing and accused her of flirting with the dentist. Other women have spouses who check up on them at work, track and monitor their phones, or exhibit paranoia when they have any contact with another male. These accusations, too, can be used as leverage in the sexual relationship-for example, "You must do x to prove that you really love me and not [the dentist, your coworker, or someone else]." When I was out with my church friends, Peter would call me every twenty minutes. Sometimes he would find reasons for me to put one of them on the phone to make sure that I was where I said I was. He was convinced I was keeping a lover. When I would get home, he would insist on oral sex -saying that I needed to prove my devotion to him and help him to handle the "stress of doubt" I was putting him through. -Cindy Using Sex as a Bargaining Chip Some husbands withhold money, resources, affection, or visits with extended family unless their wives provide sex (or a certain type of sex). Both her basic needs and her relational desires are not granted until a wife complies with something sexual or agrees to a specified sex schedule. My husband will not show me any affection unless he knows that it will culminate in sex. If I reach out to hold his hand, he says, "You know what this means." He tells me that he cannot help but be turned on by any physical touch and that it is my job to finish what I start. But there are so many times I wish I could just be close to him without having it lead to sex. I honestly do not know what to do. He refuses to listen to me when I try to talk to him about it. -Rose Technological Abuses Technology has opened up new forms of abuse. The most common of these are taking images or video without consent. Some men even share these intimate images of their wives online with websites that encourage image swapping among members. Other technological abuses include unwanted sexting and exposure to pornography or pornographic images after a wife has made it clear that she does not wish to see them. Many women have told me that their husbands show them pornography or leave pornographic material around in order to communicate a demand: "This is what I would like you to do for me." I would be nursing, and suddenly Chris would inundate my phone with sexting messages. I told him that they disturbed me. He said that he just wanted to help get me in the mood, since after the baby I was not as interested in sex. One time he convinced me to send him some pictures-and now he threatens me with them, saying that he will show my sister what a tramp I am if I cannot keep him happy. -Dee Direct Physical Violations The worst physical violation is rape, through the use of restraining force or physical violence-but there are many types of physical sexual violations. Among them are sexual acts that are performed while someone is sleeping or intoxicated, unwanted sexual touch, someone being forced to engage in an unwanted act in order to avoid another type of abuse, or sex continuing while a husband ignores tears or other expressions of discomfort. Sadly, I have heard many stories of Christian women who were raped on their honeymoons. They were conditioned early on in their marriages to be compliant-or else to be terrorized. 3 More than once I have woken up in the middle of the night with my husband on top of me. I do not remember having initiated sex when this happens, but he has told me that I did. Do you think it is possible that I wouldn't remember that? -Susan One day on our honeymoon I just wanted to go out and have a nice dinner and relax. When we got back, I wanted to talk and cuddle. My new husband kept advancing physically, and I kept putting him off in a playful way. I do not understand what happened next. All of a sudden, he got this odd look in his eye and said, "You cannot disrespect and reject me. I cannot stand for our marriage to start off like this." The next thing I knew, he had pinned me down and was physically forcing himself on me. I could tell he was angry. I was terrified, so I did not resist. I had never seen him like that before. To this day, I cannot understand how he could do that to me while I was crying. Did he not care that he was scaring and hurting me? -Janet These types of abuse are disturbing and have no place in a godly marriage. They shatter all safety, trust, and mutuality in the marriage relationship. Wives who endure sexual abuse in their homes are subjected to a tremendous amount of stress, which often wreaks havoc on their bodies and hearts. This stress is often what brings them to counseling. REFLECT 1. 1. Do you think that sexual activity in a marriage should involve both parties being genuinely willing? What conditions must be met for it to be said that someone has freely engaged in a sexual activity? 2. 2. Victims of abuse are often afraid to disagree with their spouses or to state their preferences about ordinary, everyday things. How do you think this might play out in a couple's sexual relationship? 3. 3. After considering how pornography shapes sexual desires and separates sex from the context of a relationship, can you think of ways that it might fuel an abusive mentality? 4. 4. Now that you have considered the various types of sexual abuse, why do you think it is hard for victims of marital sexual oppression to see themselves as victims? The Impact of Sexual Abuse Sexual abuse has devastating impacts on a person, and those impacts are compounded when the abuse occurs in a marriage. Almost all victims carry all seven of the types of wounds that are discussed in chapter 4. But I want to focus here on two of them-faith struggles and shame-and on how they interplay with each other to leave a victim confused and often silent. Statistics reveal that sexual assault or forced sex occurs in approximately 40 to 45 percent of marriage relationships that have involved verbal or physical violence. 4 Marital rape occurs in 10 to 14 percent of all marriages. 5 These numbers should alarm us. And they should also cause us to ask why, if marital sexual abuse is this prevalent, we do not hear more about it. We do not hear more about it because many of its victims remain silent. Women often do not reveal sexual abuse-not even in counseling. Shame is a contributing factor to this, but victims often also experience confusion about what is happening to them. Over the years, I have had hundreds of conversations with women who are being sexually abused by their husbands but do not realize it. They know that something is wrong but do not know what it is. In my experience, there are two primary sources of confusion related to this area, and together they create a powerful dynamic that can make it difficult for women to understand what is happening to them. This lack of clarity hinders disclosure. Unbiblical Teaching The first source of this confusion is the pervasiveness of unbiblical teaching about sex in marriage. Such teaching places the responsibility for a man's purity on his wife and her ability to provide unlimited sex. But it is not a wife's job to keep her husband from sin; each person is responsible for his or her own sin (see Luke 6:45). Yet church leaders have promoted false beliefs related to this, such as the following: Men need sex. Withholding sex is always a sin. Your spouse has rights to your body, any time and in any way. Imagine how these teachings play out in the mind of a wife who is sexually abused by her husband. God's call for a healthy, willing mutuality is ignored, and sex on demand is made to sound like God's will. These teachings wrongly portray a God who not only is indifferent to a victim's suffering but also sanctions it. This creates a wedge in a wife's relationship with God when she needs him the most. Christians need to be clear about God's design for sex so that we do not add to the chaos that is already occurring in a victim's heart and mind. Manipulative Tactics The second contributor to a wife's confusion is the manipulative tactics that her husband employs. Abusive men want their wives to be off-balance and disoriented. If wives believe that they are responsible for the distress in their marriages, their shame makes them easier to dominate. We have already seen that abusers often use coercion to gain consent to their demands. Though coercion itself is obviously abusive, it still contributes to confusion regarding abuse. For example, if a husband asks for sex repeatedly and his wife knows that he will punish her and her children in some way if she does not comply, she may give in to his demand to avoid an escalating outcome. What is confusing about coercion is that if she acquiesces, she believes that she has agreed to have sex. It is then challenging for her to have clarity about what has happened to her. She may feel defiled but think that it is unreasonable for her to feel this way. Abusers are also adept at finding excuses to avoid taking responsibility for their demanding ways. They blame alcohol, a stressful job, the temptation of pornography, their jealousy-and especially their spouses. As a wife begins to feel sorry for her husband, this adds to her confusion. By claiming to be a tortured sufferer in need of relief, a sexually abusive husband preys upon his wife's kind heart, hoping that she will feel sorry for him and then do what he wants. If that does not work, he may escalate to using threats-while still blaming her. Common threats include the following: "If you do not provide sex, I will turn to porn to meet my needs." "I cannot go on like this! So many other women want me. You leave me no choice but to get my needs met elsewhere." "Your constant rejection of me is torturous. I am better off killing myself than living in this loveless marriage." Finally, a husband may even use his own abuse to make his wife feel like she is to blame for his sexual violation of her, by making comments such as "I did that because I know you like it dirty." "I am just jealous of all the other guys you've been with. I want what they had." "I am helping you not to be so frigid." "You act like a whore in bed. I can't help myself." These two tactics-coercion and blame-shifting-make such men very convincing. They leave their victims paralyzed with shame. Is it any wonder, then, that their wives are vulnerable to confusion about their situation and therefore that they keep it hidden? To help these women to lift their confusion, we must carefully dispel and dismantle the myths that ensnare them. We can help them to identify coercive tactics and to make sense of the emotions they are feeling. We need to refute wrong teaching, expose manipulation, correctly assign blame, and reconnect them to a rescuing God who grieves with them and desires to protect them.  REFLECT 1. 1. What teaching have you heard in Christian circles that may unknowingly be fueling some men's entitlement to sex? Are there passages that leave you confused yourself? How can you find clear teaching on them? 2. 2. What are some ways that oppressors blame their wives for their own sexual sin? Are these things easy and clear for a victim to refute? 3. 3. How might the Bible's teaching on self-control help to lift victims' confusion? For this is the will of God, your sanctification: that you abstain from sexual immorality; that each one of you know how to control his own body in holiness and honor. (1 Thess. 4:3-4) Helping the Sexually Oppressed When I began counseling, I did not realize that I needed to be alert for marital sexual abuse. Now that I see its prevalence, I am deeply concerned about the fact that many in the church remain unaware that sexual abuse even occurs in Christian marriages. Wives often seek counsel for anxiety, for depression, or sometimes even for guilt that they feel about their lack of sexual desire for their husbands. These women are often unaware of what is at the root of their suffering because, as we've seen, they are confused and can't see that what is happening to them is wrong. For this reason, you should use language that potential victims can relate to. Try to capture their experience without using words that ask them to make a firm judgment about the fact that what is happening to them is wrong. Do not start by asking, "Has your husband violated you, raped you, or abused you sexually?" It is often difficult for victims to identify with words like rape, coercion, and abuse. They typically do not make the connection that what they are experiencing rises to the level of matching those labels. Take special note of the word choices that the questions employ that are listed in the inventory at the end of this chapter. I designed them to help a victim to identify and talk about what is happening to her without having to make the connection or assert the fact that she is experiencing violating or abusive acts. I am not suggesting that you ask all of those questions in one conversation; that would be overwhelming for anyone! I am giving you options. Be attuned to a woman's reactions and responses to specific questions-and proceed at a pace that is comfortable for her. As the questions unpack sexual abuse, be alert to the many ways that the abuse affects the woman. You will have gathered many details about what is happening to her, but it is equally important that you ask her how these violations are impacting her. Ask follow-up questions that tend to her heart, her feelings, and her needs. What has this been like for you? What do you fear? How do you cope? How can I help you? The ongoing stress of living with such destructive relational dynamics can result in depression, anxiety, post-traumatic stress disorder (PTSD), eating disorders, a distorted body image, fear of sexual contact, sleep problems, trust issues, and suicidality. This type of abuse can also cause physical injury. Be sure to ask a victim if there has been any physical damage, and see if there is a need to involve medical professionals. As victims share their stories, they will be sorting through the confusion they feel. We need to help them to lift their shame and to offer them restorative teaching about God and his Word. In order to do this, we should learn as much as a woman feels comfortable sharing and wait until she is ready. Sometimes victims are ready only to say yes or no to a question but are not comfortable discussing what happened to them in more detail. Do not press them. Some women I have counseled have taken months or even years to tell me about their darkest violations. Keep in mind that it may take a long time for them to be ready to share certain parts of their stories. It is good to follow up with them and revisit their stories. A very important aspect of healing is for a victim to be able to tell her story-so periodically check in with her and ask if she is ready to talk or if she has questions. As her story emerges, notice the ways in which she wrongly feels responsible. Earlier we saw that feeling a false sense of responsibility is particularly damaging-so be consistent to remind her that she is never responsible for her husband's sin. The reality that her husband is capable of hurting her so deeply for his own selfish gain will be painful for her to acknowledge. She may prefer to minimize the truth, keep it hidden, or blame herself rather than face the brutal reality of what her husband is doing. She may not be ready to see that her husband's behavior is abusive, so be gentle in the way that you remind her who is at fault. It may be too much for her to see the severity of the situation all at once. Gaining clarity about what has happened to her will bring up questions about what she should do about it, which will create terrible internal conflict. Oftentimes, bad teaching sets wives up to believe their husbands' lies that the abuse is their fault. Be alert for ways that the misuse of passages such as 1 Corinthians 7:2-5 (which people interpret as saying that sex is women's "wifely duty") has compounded these wives' guilt and suffering. 6 Help victims to see that marriage does not require them to give consent to unlimited sex or unlimited types of sexual acts. Let victims know, repeatedly, that their abuse is not condoned by Scripture. Never tire of sharing Scripture that speaks to the evils of their violation. I have shared some examples of such Scriptures throughout the points below. Respond to Her Story Share how a victim's story affects you. Sexual abuse is isolating, and it can make a victim feel as if no one-not even God-sees or cares about what is happening. Horrible things have happened to her, and we need to react to them in a way that shows God's heart for her. God hates what is occurring in her marriage and is grieved by it. Share with her what God says about her violation. For example, Deuteronomy 22:25-29 addresses sexual violation and God's concern for the welfare of abused women. Other passages depict the emotional toll that this violation takes (e.g., Gen. 34; Judg. 19; 2 Sam. 13; and Ps. 55). Speak Beautiful Truths Being sexually abused brings a victim a particular sense of shame. This shame can penetrate so deeply that the victim begins to believe horrible lies. She may come to believe that she is repulsive, unlovable, dirty, permanently disgraced, or-even worse-that her story will contaminate you. Remind her that she is God's treasured possession (see Deut. 7:6). She is chosen, holy, and beloved by Christ (see Col. 3:12), is God's child (see 1 John 3:1), and is Jesus's friend (John 15:15). Lament Together  When unspeakable things happen to a person, it is hard for her to find the words to describe them. In order for these women to pray, they need words- words that will help them to connect their hearts to God and to others. Help these women to find the words. Help them speak to God and to other wise helpers about their suffering. Remember the lamenting exercise that we did with Psalm 27 here. Psalms 22, 55, 109, and 140 will also give words to victims' experiences with marital sexual abuse. Pray with them. Pray for them. Give them words that they can bring to God-words that bring light to expose the darkness (see Eph. 5:13). Taking these concerns to God is particularly difficult. We talk to God about many things-but sex is not usually one of them. Sexual violation is difficult to speak about. But what is happening to these victims goes against God's design-and it angers him. He hears their cries as we help them find ways to bring them to him. Connect God to Her Story Scripture tells stories of many victims of rape, incest, prostitution, and oppression and of women who were despised, mistreated, unloved, and violated (see Gen. 16:1-16; 29:17-35; Josh. 2:1-21; 6:25; 2 Sam. 11:1- 12:24; Luke 7:36-50; John 4:1-45; 8:1-11). Through these stories, help women to see similar themes in their own stories. And then show them what God does with these stories. All our sin and suffering gets caught up in Jesus's story. Not only does he see our stories of suffering, he knows what it is like to live through them-"He was despised and rejected by men, a man of sorrows and acquainted with grief.... He was oppressed, and he was afflicted" (Isa. 53:3, 7). On the cross he was stripped naked, exposed, mocked, and murdered. But then the Father raised him from the dead in victory and glory. By coming near to victims and suffering like they do, he has forever changed their stories-and those stories will end in victory and glory as well, because of the victims' connection to Christ. Finding comfort from this will take oppressed spouses gentleness and time, but as you talk with them, help them to see that their stories are not just about what happened to them. They are also about what God is doing for the whole world as he reconciles us to himself. Consider Your Relationship and Responsibility Are you a counselor, a friend, an elder, or a pastor? Each of these roles will have unique implications regarding the level of care you can offer, whom you can involve, and how intimate the details are that you can ask for. Victims need many helpers-some who are professionally trained and others who can offer spiritual, emotional, and practical support. Look for the ways that your connection to a victim can best serve her-in the present as well as in the years to come. Be Mindful of Your Role What will it be like for a victim if you know details about her situation? Which of those details are important for you to know? What is she comfortable with telling you? Questions like these are especially important if you are a pastor or an elder. Depending on a woman's personality and experiences, she may feel exposed before you, which could make future interactions with you more uncomfortable for her. Some women tell me that after sharing certain things with their pastors, they feel awkward taking communion or attending church social events. It is important for you to think ahead-it is usually not wise for a victim to share details with a male unless he is a counselor. But just because you are a male helper does not mean that you should not enter this area of abuse. Victims need to hear from men, and especially men who are in positions of authority, that what has happened to them was wrong. Victims will have questions as they wrestle with certain passages of Scripture. In order for them to recover, they will need solid teachers to help to correct what has been twisted. Sometimes it will be necessary for you to share information about a victim with her elders, her pastor, her advocates, or other care team members. If this becomes the case, get her permission to do so and be clear about whom you will tell and what you will say. To the greatest extent possible, do not expose the sensitive details of a victim's story. Ask her who she would be most comfortable with you telling about her situation. Care for her vulnerability by asking those whom you tell to make an effort to connect with her. Even if it's through a note, they should acknowledge the woman's suffering. I have heard from too many victims that silence from those in church leadership who know their stories is excruciating. It feels like rejection and disgust. Involve the Necessary Authorities Rape within a marriage is a crime-but few women wish to report it, and ultimately that is their choice. While this may leave us feeling fearful for them, we should remember that they are the ones who will have to endure the fallout, and will have to take self-protective measures, if they do make a report. Police know this, and so they usually require that the victim (not the counselor) be the one to make the complaint-unless life-threatening violence is present. In most states, counselors do not have a legal obligation to report domestic violence-but we should communicate to victims the valuable protection that involving the police can make available. 7 When a victim is ready to make a police report, help her through the process. It will be an extremely difficult experience for her. Go with the victim and remain present with her during the process. A notable exception to this guideline of allowing women to make their own decisions is when the abuse concerns children. Any time children witness sexual abuse (or if they themselves are physically or sexually abused), it is considered child abuse-and we do need to make a report. Keep in mind that doing so will create a dangerous situation for both the mother and the child. The woman needs to know that you are reporting the abuse, and a safety plan 8 should be implemented for her immediately. Connect Her to Resources Women need to know that they are not alone. You are most likely limited as far as what you can do to support a victim. Help her to build a team of caregivers and other helpers-one that includes, for example, a pastor, a counselor, medical care, legal support, another victim, and a trusted friend. Sexual abuse creates damage in many areas. A woman may need to see a doctor for an examination if her abuse resulted in physical injuries. And if her husband's behavior leaves room for even the suspicion of unfaithfulness, she will need to be tested for sexually transmitted diseases. She may need help with building a supportive community. Connect her with people who understand what she has experienced and can wisely care for her. If her oppressor used Scripture to control her sexually, be wise and go slowly as you ask her to engage in church activities. Marriages are particularly difficult to restore when sexual violation has occurred. It causes a large ripple effect when the story comes out. The wife has to face not only the abuse itself but also the potential loss of many things -such as privacy, as church leaders get involved, and the loss of friends who fail to understand. If she separates from her husband, she may experience a loss of income, of her home, or of time with her children. She will need help with navigating the implications of telling her story.  Finally, remember that sexual abuse in marriage is a predictor of future violence. To protect wives and their children, prepare for potential violence by making and following a safety plan. REFLECT 1. 1. Given the relationship you have with the victim, what level of detail do you think you should pursue as she tells you her story? How might you tenderly share your assessment of the victim's situation with her so that she feels loved and protected? 2. 2. Talking about sex can be uncomfortable for us. Consider how you can communicate your care through what you say and don't say and how you follow up with a victim. How might you push through your own uneasiness? Involve others who can help you? Communicate your unease openly and tenderly so that the victim does not misinterpret your awkwardness? How can you pray for God to assist you? 3. 3. I have my students practice talking about this topic. Is there someone you can share parts of this chapter with so that you grow in your ability to speak of evil and awkward things? 4. 4. Do you have remaining questions that may impede your ability to speak clearly with victims? Who can help you to sort through those questions? The Truest Expression of Love Victims need you to help them cut through their confusion and to speak crucial truths to them. Consider Scripture's clear, straightforward description of the way Jesus loves. Love is patient and kind; love does not envy or boast; it is not arrogant or rude. It does not insist on its own way; it is not irritable or resentful; it does not rejoice at wrongdoing, but rejoices with the truth. Love bears all things, believes all things, hopes all things, endures all things. Love never ends. (1 Cor. 13:4-8) This passage is not referring explicitly to physical love, but it captures what love is meant to look like in every situation. Sex should be an expression of love-always. But husbands who abuse express hate, not love. They are impatient and unkind. They are intolerant, cruel, jealous, full of themselves, prideful, and dishonoring. They seek self-pleasure, are easily angered, repeatedly rehearse wrongs, and derive pleasure from evil. They violate, reject, hate, and endanger their spouses. Victims need you to be clear about the violations they have endured-and where better for you to point them than to their Savior?  Sexual Abuse Screening Inventory Some of the questions that follow are general and give you the opportunity to hear how the woman you are talking with experiences or thinks about sex. Others ask about specific behaviors. The goal of these questions is to help a woman to tell her story. Not everyone will be comfortable talking about these things, so you should honor that. Remember that in chapter 1 we talked about how identifying abuse is not always as simple as uncovering events or incidents. Sometimes we need more context to determine whether an incident is abusive. For example, a wife might say that she struggles with physical intimacy, but when we dig deeper we discover that the root of her distress is sexual abuse that she endured as a child. Or perhaps a victim says that she has had sex when she did not want to, but from talking to her further you learn that she was not coerced or forced but rather chose to overcome her own lack of desire. These questions require us to be sensitive when we ask them, and often we will need to learn more about the events they uncover in order to make accurate assessments. Introducing some of them might be delicate, and we might feel uncomfortable asking for clarifying details about them, but they are important for us to ask. I want the women whom I interact with to know that they are not the only ones who suffer in the ways that they do and that I am ready to hear what they are willing to share. To put them at ease, I will often preface these questions by saying, "Many of the women I counsel experience hard and difficult things in their sexual relationships." Have you ever been intimate with your husband when you didn't want to be? Are there ways that you struggle with physical intimacy? Does your spouse ever force you to be intimate? How often does this happen? When did it happen last? Have you ever been intimate with your spouse because you were afraid of him? Are there times when sex is unpleasant? What happens to make it  unpleasant? Do you and your spouse ever have disagreements about sex-for example, about when and how often to have sex? How do you resolve those disagreements? Do you think that you and your spouse enjoy your sexual relationship equally? Has your spouse ever had sex with you when you were unable to consent? Such as when you've had too much alcohol to drink or after you've taken drugs (whether illegal drugs or sleeping or pain pills)? Has your spouse ever said or done sexually degrading things to you? Does your husband use porn? How has it affected your intimacy with him? Has your spouse ever touched you in a sexual way that made you feel uncomfortable? Has your spouse ever pressured you into doing things that you weren't comfortable with? What were they? Has your spouse ever forced you to have a sexual experience by using a weapon, trapping you, or physically hurting you? Have you ever had intercourse with your spouse because he threatened, pressured, forced, or hurt you? What happened? Has your spouse ever had sex with you when you were asleep? Have you ever given in to a sexual encounter with your spouse to avoid fighting with him or being hurt? Have you ever had a sexual encounter because you felt overwhelmed by your spouse's continual arguing and/or pressure? If you discover that sexual abuse has taken place in this person's marriage, here are some follow-up questions to ask her: How long has this behavior been occurring in your relationship? How often does it occur? Have these things ever happened before or after physical abuse? Have you noticed any change in the frequency or severity of these things over time? Can you think of other times when force or pressure has been involved in your sexual relationship? Has your husband ever used Scripture to justify his behavior? Which verses? Have you ever told anyone about these things? Whom did you tell, and what type of response did you receive? Have you noticed any physical changes involving your body? Have you needed to seek medical care?  Entering In When There Is Evil Sexual abuse is prevalent in marriages, and uncovering it is heart- wrenching. God's beautiful intentions for these marriages have been perverted in terrible and devastating ways. But God sees what is happening and, in turn, calls us to see it as well. We are to proclaim the truth about his design for sex and to break through the isolating devastation that is caused when it is abusively corrupted. In short, we are to be like Jesus. His ministry was an intimate one. He did not protect himself from the details of people's suffering. He did not fear being contaminated by others' suffering and sin (see Mark 1:40-41; Luke 13:12-13; John 9:6-7). In Jesus's name and for his sake, we choose to draw near to the sin and suffering of others, as well. And yet we have to be stewards of our own hearts. Keep track of how what you are hearing is affecting you. Are you struggling with any of the following issues? sleeplessness nightmares intrusive images anxiety wanting to be numb hypervigilance irritability faith questions becoming cynical or pessimistic minimizing your own sin feeling vulnerable being overburdened hopelessness preoccupation with a particular story If these symptoms show up, they might be a sign that the gravity of what you are hearing is affecting you. Stories of deep suffering are heavy burdens to carry. If the information you are hearing has been impacting you in these noticeable ways, you might begin to fear being too close, knowing too much, or having to carry stories of devastation around with you. But Jesus came near; he touched the afflicted and invited hurting people to speak. God calls us to do these things as well-but with wisdom and his help. Consider how you can share your own burdens: 1. 1. Are you actively partnering with the True Helper? How are you praying and speaking to the Lord about the evil that you encounter? 2. 2. Is seeing evil challenging your faith? Who can you entrust with your heart and questions? 3. 3. God created us to need community, which can help us to carry our burdens and see our blind spots, can give us wisdom, and can remind us of his faithfulness. Are you able to work in conjunction with the church? How can other Christians be caring for you? Remember that the church is the community that the Lord has wisely given to you-and to your counselees. Invite them to help you. 4. 4. Are you aware of your own strengths and weaknesses? Your limitations-both physical and emotional? What are ways in which you can purposefully steward your physical, emotional, and spiritual health? 5. 5. How can you buttress your own spiritual disciplines? This is a battlefield-be battle ready!