CONTENTS

About This Course

Table of Contents

1. Introduction to the Issues
2. Understanding Alcohol Abuse
3. Understanding Violence Against Women
4. Alcohol and Domestic Violence
5. Alcohol, Sexual Assault, and Rape
6. Prevention and Early Intervention
7. Screening and Assessment
8. Diagnosis and Treatment
9. Legal and Ethical Issues

Supplements
Fact Sheets
Videos
Resources

Silence Hurts
Alcohol Abuse and Violence Against Women

The Grieving Process

In Elizabeth Kubler-Ross' landmark book on grieving, she describes five stages of grief: denial, anger, bargaining, depression, and acceptance. Anyone who suffers any loss (not just someone dying) may experience these stages of grief. A person will feel each stage in her own order and can sometimes be in more than one stage at the same time.

As you work through these stages with your client, she may also present with feelings of disorganization, despair, and fear. You must apply a persistently motivating influence while still allowing the victim to move through the stages at her own pace.

• Denial. In this first stage, the woman cannot acknowledge the loss created by the trauma. She is in shock and cannot yet understand fully what has happened to her. Especially if the abuser was someone she knew, she might still be in disbelief that he could do something like that to her.
• Anger. Once the denial subsides, the woman will feel angry about what has happened to her. She may be angry at the man who attacked her, at her faith for letting this happen, and/or at herself for not being able to see it coming or for not leaving sooner.
• Bargaining. In this stage, the woman will go over in her mind the "what ifs." She will blame herself irrationally. At this stage, she needs help sorting out her feelings.
• Depression. Although there are many kinds of depression, the depression here is usually temporary, though still intense and painful. A woman may show some signs of clinical depression, such as low self-esteem, changes in her eating or sleeping patterns, lethargy, feelings of hopelessness, or various physical pains like backaches, headaches, or vomiting. She will not seem as engaged with others during this phase, and tends not to participate in activities that she used to enjoy.
• Acceptance. This final stage allows the woman to come to her own understanding of the event. She accepts the ways in which she, her family, and/or her friends have been affected by the violence. She does not have to be happy, but she will need to recognize her own limitations and try to move on. She eventually learns to be as loving to herself as she would a child. Gentle encouragement toward the routines of normal life can be effective once the victim has reached this stage.

References

1. 1. Matsakis, A.(1996). I can't get over it: A handbook for trauma survivors. Oakland, CA: New Harbinger Publications.