Physical Abuse

More Than the Injuries You Can See - and More Treatable Than You Think

If You Are in Immediate Danger

If you or someone you know is in immediate physical danger right now, please call 911.

For confidential, 24-hour support, safety planning, shelter, and advocacy:

If you are concerned that someone may be monitoring your device, these resources can be reached from a public computer, a library, a trusted friend’s phone, or directly by calling 911 from any phone. Hotline advocates can help you think through digital safety as part of any conversation.

What This Page Is For

This page is for anyone whose life has been affected by physical abuse - people currently living with it, people who have recently left it, people carrying the impact of abuse that ended years or decades ago, parents and caregivers concerned about a child, family members trying to support someone they love, and people who are not sure what to call what is happening to them but know that something is wrong. All of you are welcome here. All of you deserve support.

At Behavioral Medical Center in Troy, MI, we treat the psychological and emotional impact of physical abuse as what it is: a serious clinical concern that responds to thoughtful, evidence-based care. Our licensed therapists work with adults, adolescents, and children whose lives have been affected by physical abuse - in current relationships, in past relationships, in childhood homes, in extended family systems, and in other contexts where one person has used physical force or the threat of it to control, harm, or frighten another.

We also want to be honest about something important: clinical mental health care is one piece of a larger picture, not the whole picture. For people in current or recent abuse situations, the most critical resources are usually domestic violence agencies, safety planning, legal advocacy, and access to shelter and protective services. Our role at BMC Troy is to work alongside those resources, not to replace them. The advocates at HAVEN and other domestic violence agencies do work that we are not equipped to do, and we refer to and coordinate with them regularly. If you are looking for free mental health services in the Greater Detroit area, we can help point you in the right direction as well.

What Physical Abuse Actually Is

Physical abuse is the use of physical force - or the threat of it - to harm, control, intimidate, or coerce another person. It includes hitting, slapping, pushing, choking, grabbing, restraining, throwing objects at a person, blocking someone from leaving a room, hair-pulling, kicking, biting, burning, and any other contact intended to cause pain, injury, or fear. It also includes acts that may not leave visible marks but are no less harmful - choking, suffocation, threats with weapons, throwing objects near rather than at someone, punching walls in someone’s presence, harming pets, or any act calculated to communicate that physical harm is possible.

What separates physical abuse from a single incident of violence is, in most cases, the pattern of control and intimidation that surrounds the physical acts themselves. Physical abuse rarely exists in isolation. It typically operates alongside emotional, verbal, financial, sexual, or psychological abuse, and the physical violence is often the most visible expression of a broader system in which one person is trying to control another. Many survivors describe the non-physical components - the constant criticism, the isolation from family and friends, the monitoring of their movements, the financial coercion - as harder to recover from than the physical injuries themselves.

It is also important to name that physical abuse is not always a partner. It can be a parent, a stepparent, an adult child, a sibling, a roommate, a caregiver, an in-law, or any other person in a position of proximity or power. Children can be physically abused by the adults responsible for their care. Older adults can be physically abused by family members, caregivers, or facility staff. Adolescents can be physically abused by dating partners. The dynamics differ in important ways across these contexts, but the underlying clinical concern - the impact on the person being harmed - is real in all of them.

What Physical Abuse Is Not

We are also being clear about what physical abuse is not: it is not deserved, it is not provoked, it is not caused by the person being harmed, and it is not a normal feature of any relationship. People in abusive situations often hear - from the person harming them, from family members, sometimes from themselves - that the abuse is their fault, that they could prevent it if they tried harder, or that what is happening is somehow ordinary. None of that is true. The responsibility for abuse lies with the person who is choosing to use violence. Full stop.

How the Impact of Physical Abuse Shows Up

The psychological impact of physical abuse is significant, persistent, and often long-lasting. It can show up immediately after the events themselves, or it can surface years or decades later when the person is finally in a safe enough situation for the impact to be felt. Both timelines are normal, and both deserve care.

Common ways the impact of physical abuse shows up clinically include:

  • Symptoms of trauma and PTSD - including flashbacks, intrusive memories, nightmares, and intense reactions to reminders of the abuse
  • Hypervigilance - constantly scanning for threat, struggling to feel safe even in safe environments, difficulty relaxing
  • Exaggerated startle response - flinching at unexpected sounds, movements, or touch
  • Difficulty trusting others, including in relationships where trust has not been broken
  • Difficulty with closeness and physical intimacy, including with safe partners
  • Sleep disturbances - difficulty falling asleep, difficulty staying asleep, nightmares
  • Anxiety, panic attacks, and chronic worry about safety
  • Depression, including persistent sadness, hopelessness, and loss of interest in things that used to matter
  • Feelings of shame, guilt, or self-blame about the abuse - even though the abuse was not the survivor’s responsibility
  • A pervasive sense of being damaged, broken, or fundamentally different from other people
  • Difficulty making decisions, particularly when other people are involved or might react strongly
  • Difficulty recognizing your own needs, preferences, or emotions after years of focusing on someone else’s
  • Patterns of relational difficulty - including the experience of repeatedly ending up in similar dynamics
  • Difficulty leaving abusive relationships, including the complicated mix of love, fear, hope, and entanglement that often surrounds the decision
  • Difficulty being in safe relationships after abusive ones, because safety itself can feel unfamiliar
  • Dissociation - feeling disconnected from your body, your surroundings, or your own experience
  • Chronic physical symptoms - headaches, digestive issues, chronic pain, autoimmune flare-ups
  • Substance use that developed as a way to cope with the abuse or its aftermath
  • Disordered eating and difficulties with body image, particularly when the body was a target
  • Suicidal thoughts or self-harm
  • For survivors of childhood abuse, developmental impacts that have shaped identity, relationships, and self-concept across the lifespan

These responses are not signs of weakness, failure, or being “too sensitive.” They are the predictable ways human beings respond to being physically harmed by someone who was supposed to be safe. They are also treatable.

On Why Leaving Is Not Simple

One of the most damaging misunderstandings about physical abuse is the assumption that people who are being abused should simply leave - and that if they haven’t left, the situation must not be that bad, or they must on some level want to be there. This assumption is wrong, it is harmful, and it contributes to the isolation that makes leaving harder.

Leaving an abusive relationship is one of the most dangerous periods in the relationship. The risk of serious injury or death increases significantly around the time of separation, which is one of many reasons safety planning with a trained advocate matters so much. Beyond physical safety, leaving often involves complex logistics that take time and resources to put in place - housing, financial independence, custody of children, legal protection, access to documents, transportation, and a network of support that may have been systematically dismantled by the person doing the harm. People in abusive situations often also genuinely love the person harming them, share a history with them, hope they will change, are afraid of what they will do, and are navigating an internal terrain that someone outside the relationship cannot easily see.

If you are not in an abusive situation yourself but are trying to support someone who is, the most helpful thing you can do is usually not to push them to leave. It is to stay connected, listen without judgment, believe what they tell you, let them know you are there, and gently make sure they know about the resources available when they are ready. HAVEN and other domestic violence agencies have resources specifically for friends and family members of survivors, and we encourage anyone in this position to reach out.

Who We Work With

Our therapists work with the full range of presentations related to physical abuse, including:

  • Adult survivors of childhood physical abuse - including abuse by parents, stepparents, caregivers, or other adults responsible for the survivor’s safety, and including survivors who are only now, decades later, beginning to make sense of what happened to them
  • Adult survivors of past abuse in adult relationships - including former partners, family members, or other people who used physical violence against the survivor, regardless of how long ago the relationship ended
  • People who have recently left abusive relationships - and are navigating the complicated psychological terrain of safety, freedom, grief, fear, and identity reconstruction that often follows
  • People currently in abusive situations - who are working through their own process, considering their options, and often benefit from clinical support alongside the safety planning and advocacy services that domestic violence agencies provide
  • Children and adolescents - who have experienced or witnessed physical abuse, including children whose parents are or were in abusive relationships
  • Family members and supporters - including parents whose adult children are in abusive situations, partners of survivors, and others working to support someone they love
  • People navigating long-term recovery - who have done significant work already and are addressing the layers of impact that surface across the lifespan

Each of these situations involves different clinical considerations, and our therapists work with you to understand what is most helpful at this stage of your particular path.

Children, Adolescents, and Physical Abuse

Children who have experienced physical abuse - whether directed at them or witnessed in their home - often need specialized clinical support, and our clinicians who work with young people are trained in trauma-focused approaches appropriate to a child’s developmental stage. The impact of physical abuse in childhood can include developmental regression, behavioral difficulties, sleep disruption, attachment disturbances, school difficulties, anxiety, depression, and the broader effects of trauma on a developing nervous system.

Parents and caregivers seeking support for a child affected by abuse - whether their own or that of someone else in the child’s life - are an essential part of treatment. Our clinicians work with families to support the child’s recovery, build the protective relationships that help children heal, and navigate the complicated legal and protective service systems that may be involved. Michigan parents’ rights in teen mental health care can be an important resource for those navigating these systems.

We are mandated reporters under Michigan law. We are required to report suspected child abuse or neglect to Michigan Children’s Protective Services. We are clear about this from the outset, and we work transparently with families to support both the child’s safety and their healing.

How We Approach This Work at BMC Troy

Treatment for the impact of physical abuse at BMC Troy is individualized, clinically informed, and paced carefully. There is no one-size-fits-all protocol. Effective work in this area cannot be rushed, and it cannot be done in a way that ignores either the safety of the person sitting in front of us or the depth of what they are working through. Our therapists take the time to build the stability, safety, and resources that effective trauma work requires before moving into the deeper layers of processing.

Therapeutic approaches commonly used in this work include:

  • Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) - an evidence-based approach particularly well-supported for children, adolescents, and adults working through the aftermath of abuse
  • Cognitive Processing Therapy (CPT) - a structured approach that focuses on identifying and revising the abuse-related beliefs that maintain symptoms long after the events have ended
  • Prolonged Exposure Therapy - a structured, paced approach to processing traumatic memories and reducing avoidance of trauma-related cues, used when the person is ready and the foundation is solid
  • EMDR-informed approaches - working with the way trauma is stored in the nervous system to help the brain reprocess experiences that have remained “stuck”
  • Internal Family Systems (IFS) - an approach particularly well-suited to complex trauma, working with the internal parts that carry trauma material and restoring access to the core self
  • Somatic and Body-Based Approaches - working with the physical, nervous-system-level dimensions of abuse that cognitive approaches alone cannot fully address
  • Attachment-Focused Therapy - particularly relevant for survivors of childhood abuse, addressing the patterns of connection, trust, and emotional regulation that developed in early relationships that were not safe
  • Phase-Based Treatment for Complex Trauma - a structured approach that begins with stabilization and skill-building, moves into trauma processing when the person is ready, and ends with reintegration and meaning-making
  • Supportive Psychotherapy with a Trauma-Informed Frame - providing a consistent, non-judgmental space to process what happened, what is happening, and what comes next
  • Coordination with Medication Management - for cases where medication is a helpful part of the overall plan, particularly for sleep disturbance, severe anxiety, PTSD symptoms, or co-occurring depression
  • Coordination with Domestic Violence Agencies, Legal Advocates, and Protective Services - because clinical care is one part of what survivors often need, and the work is most effective when it is connected to the other systems that protect, advocate, and support

Your therapist will work with you to identify the approach - or combination of approaches - most likely to be effective for your particular situation. The work moves at the speed of safety, not at the speed of urgency. You are not asked to revisit anything you are not ready to revisit, and you are not asked to do this work alone.

What Therapy Can and Cannot Do

We want to be honest about this. Therapy can help you understand what has happened to you, process the psychological and emotional impact of abuse, work through trauma symptoms, rebuild your sense of self, address depression and anxiety, rebuild your self-esteem, navigate the complicated emotions that often surround abuse and its aftermath, and build the internal resources and external skills that support healing across the long term.

Therapy alone cannot keep you physically safe from someone who is currently harming you. It cannot get you a protection order, a shelter bed, an emergency relocation, a divorce, or a custody arrangement. It cannot make the person harming you stop. Those needs require advocates, attorneys, law enforcement, protective services, and the network of agencies built specifically to address them - resources that exist in Oakland County and across Michigan, that are free or low-cost, and that we can help you connect with.

Effective recovery for people whose lives have been affected by physical abuse almost always involves multiple kinds of support working together. We see our role as one part of that larger picture.

When to Seek Help

If you are wondering whether what you have experienced - or are experiencing - warrants professional support, the answer is yes. There is no threshold of severity you need to meet. There is no requirement that the abuse be ongoing, or recent, or that you have left the situation, or that you have ever named what happened to you with the word “abuse.” If physical force or the threat of it has been used against you, by someone in a position to do so, and you are wondering whether the impact is worth attention, it is.

You also do not need to be in crisis to reach out. Some of the most important work in this area happens long after the immediate situation has resolved - in the years when the survivor has the safety, stability, and capacity to begin addressing what they could not address while they were still surviving it. If you are unsure where to start, Metro Detroit mental health crisis lines and walk-ins can connect you with support at any hour.

A Note on Confidentiality

Everything discussed in therapy sessions is confidential. Our therapists adhere strictly to HIPAA privacy standards, and nothing shared in session will be disclosed without your explicit written consent.

There are specific, limited exceptions to confidentiality that we want you to know about up front. Under Michigan law, we are mandated reporters in the following situations: suspected child abuse or neglect, suspected abuse of a vulnerable adult, and imminent threats of serious harm to self or others. We are required to report in these specific situations, and we are clear and transparent with our clients about how and when this applies. If you have questions about how confidentiality operates in your particular situation, your therapist will discuss this with you directly.

We also want to be clear that confidentiality protects your right to determine the pace and direction of your own care. The fact that we are mandated reporters in specific situations does not mean we report anything else, share information without consent, or take decisions about your relationship or life out of your hands. The choices about what to do, when, and how are yours.

Both in-person and telehealth sessions are available for this work, and we can discuss with you which format is most appropriate given your situation, including safety considerations around device use, privacy at home, and confidentiality of sessions.

Physical abuse tries to convince you that what happened to you was your fault, that you are alone, and that nothing can really help. None of those things are true. What happened to you was real, the way it has shaped you is real, and the path to healing is also real. You are not alone, and you do not have to figure this out by yourself.

If you are in immediate danger, please call 911 or one of the hotlines listed at the top of this page. If you are ready to talk about clinical support for the impact this has had on your life, call us at (248) 528-9000, Monday through Friday, 9am-5pm, to schedule a confidential assessment. There is a path forward, and there are people ready to walk it with you.