How broken relationships affect well-being by using the Te Whare Tapa Wha model

In this essay, I will discuss how broken relationships affect well-being by using the Te Whare Tapa Wha model.

Safe Shores (October 30, 2020) defined Domestic Violence as “the continual pattern of one person in a relationship using power and control over another in an intimate relationship.” Safety is important because the victim/survivor of trauma was exposed to an unsafe and insecure environment in an abusive relationship which creates their vulnerability (Briere, Scott, 2004; Foa et al,2013;Herman, 1992 ). Wright (2003, as cited in Panchuk, 2018) emphasized, “In a broad sense, a traumatic experience is ‘any event that shatters your safe world so that it is no longer a place of refuge.”

Te Whare Tapa Wha model is one of the tools to see a client’s needs with a holistic view. Ministry of Health (2017) explained:

With its strong foundations and four equal sides, the symbol of the wharenui illustrates the four dimensions of Māori well-being. Should one of the four dimensions be missing or in some way damaged, a person, or a collective may become ‘unbalanced’ and subsequently unwell.

Herman (1992) pointed,” All the structure of the self- the image of the body, the internalized images of others, and the values and ideals that lend a sense of coherence and purpose- are invaded and systematically broken down” (p.385). It means that survivors’ Whare may already be broken down by the volatility in the broken relationship. However, I will analyse each dimension from here.

Firstly, when I saw the Te Whare Tapa Wha model, I wondered how Taha Hinengaro (Mental health) was affected?

Foa et al (2013) answered, “if we are to have faith that the treatment is safe and useful in alleviating the symptoms that are targeted”(p.6).

 In addition, Foa et al (2013) added:

It is also important to note that many psychological problems other than PTSD can develop after a traumatic experience. There is evidence that trauma survivors experience a range of psychiatric disorders, including mood and anxiety disorders (Blanchard, Hickling, Taylor, & Loos, 1995; Bryant et al., 2010; O'Donnell, Creamer, Pattison, & Atkin, 2004; Shalev et al.,1998; Zatzick, Russo, & Katon, 2003). These conditions can occur with and without PTSD (p.5).

The survivor may develop mental health conditions in the context of a broken relationship which means that we clinicians have to be mindful to keep them safe from risk factors.

Mass General Brigham McLean (2023) found, “According to the American Psychiatric Association (APA), 20% of survivors develop mental health conditions. These include: Major depressive disorder, Generalized anxiety disorder, Post-traumatic stress disorder and Substance use disorders”.

Mass General Brigham McLean (2023) continued,

Mental health professionals who treat survivors of violence use a trauma-informed approach. When counseling patients, they consider the distress the patient experienced and how it shapes the person’s beliefs and behavior. This approach focuses on creating a sense of safety and empowerment for patients.Therapists target treatment toward the mental health conditions a patient presents with, such as PTSD or depression. In treatment, patients can strengthen communication, learn stress management, and reduce feelings of isolation. Such skills may protect against future incidences of domestic violence.

Secondly, how was Taha Wairua (spiritual) affected?

Wiesel (1960, as cited in Herman 1992) answered, “The majority experiences the bitterness of forsaken by man and God”. They may be spiritually abused by their partner and a spiritually safe space should be created for them, too.

Vawnet (2021) explained:

Faith and spirituality can be instrumental in supporting the grieving and healing processes of domestic violence survivors. Research and practice alike have shed light on the ways in which faith and spirituality may help survivors rise above their suffering and/or view their trauma and life purpose in a new light. Many survivors report finding hope and healing in the spiritual practices of their ancestors.

Mending the Sacred Hoop (n.d., cited in Vawnet, 2021) added, “Based on the understanding that “reconnection between one’s self and a higher power builds a strong foundation for a balanced life and purpose”.

Thirdly, how was Taha Tinana (physical body) affected?

Including both mental health and physical health perspective, Gerlock (1999, as cited in Alejo,2014) found

63% of the batterers had between 1 and 20 health care visits in the previous six months for physical health problems and 90% for mental health problems; 29% believed their health problems were related to their domestic violence. They were diagnosed with a plethora of long-term health problems: 50% were diagnosed with musculoskeletal issues, 8% pulmonary, 10% dermatological, 13% gastrointestinal, 14% cardiovascular, 10% neurological, 27% with mood disorders, 42% anxiety, 2% psychosis, 2% with personality disorders, and 45% with substance abuse.

Research suggests a correlation between domestic violence victimization and cervical cancer (Alejo, 2014; Bagwell-Gray & Ramaswamy,2022; Urquhart, et al, 2023).

Fourthly, how was Taha whānau (family health) affected?

Ministry of Health, (2017) answered

The capacity to belong, to care and to share where individuals are part of wider social systems.Whānau provides us with the strength to be who we are. This is the link to our ancestors, our ties with the past, the present and the future.Understanding the importance of whānau and how whānau (family) can contribute to illness and assist in curing illness is fundamental to understanding Māori health issues.

According to Safe Shore (2020), “One of the signs of domestic violence in a relationship is your friend or family member is becoming more withdrawn and you hardly ever see or talk with them anymore”.

Family abuse intervention programs (2017) describes the isolation in their power and control wheel. The survivor may distance themselves from their whanau in the abusive relationship.

From here, I will discuss the possible meaning of belonging (Turangawawae) and attachment with Whanau.

Brison (2002, cited in Panchuk, 2018) discussed,“Many survivors describe this experience as a fragmentation of the self—an inability to integrate past and present into a coherent narrative, to fully inhabit one’s body, to cope with world, or to imagine a future that includes oneself.

I have heard from my clients at the domestic violence centre, “I forgot who I am. I was confused about my identity in the co-dependent relationship. I do not know if I am him or he was me.”, “I believe I am the rubbish, crazy and idiot that he described.” and “I have no- friends and family. I have no attachment or sense of belonging. I am lonely.”

In fact, Panchuk, (2018) said:

In the case of restriction of range of affect, a survivor may emotionally flat line and feel almost nothing at all, regardless of the circumstance. We might call this a global incapacitation. We will say that an individual is globally incapacitated with respect to activity a at time t only if they lack the physical or psychological ability to engage in activity a in all salient circumstances at time t (p.511).

It can be said that some survivors may not have a sense of turanawaeae (belonging), self, or attachment with their whanau after leaving the abusive relationship because some persecutor took survivors’ original identity (pre-traumatized self), turangawaewae, sense of self, self-esteem and relationship with their whanau to control them.

According to Durie and colleagues (1996, as cited in Groot, et al, 2010), “Highlight a number of important conventional markers of Māori identity—self-identification, ancestry, marae participation, involvement with extended family, access to ancestral land, contacts with Māori people and ability in the Māori language.”

Carlson et al (2002, as cited in Crawford et al, 2009).said, “Research has suggested that protective characteristics within women, such as a sense of hope, their relationships with others and social support, can buffer the adverse effects of domestic abuse.”

I am wondering if survivors could gain their resilience to be able to re-establish their sense of belonging and attachment because “Resilience has been defined as the ability to succeed in the face of adversity (Werner-Wilson, Zimmerman & Whalen, 2000, as cited in Crawford et al, 2009).

However, how can survivors gain their resilience while having affection in the abusive relationship, especially in the context of reduced ability to work?

Herman (1992) said, “As the victim is isolated, she becomes increasingly dependent upon the perpetrator, not only for survival and basic bodily needs, but also for information and even for emotional sustenance” (p.384).

It shows how it is for survivors to leave the persecutor but also explains how resilience and support, attachment, and belongings within their turangawaewae whanau are important.

When I recall my over twenty-five years of work experience, I have heard from survivors, “I got the amazing message from my ancestor during my meditation, I felt I can heal from the domestic violence.”, “I felt Jesus hold my hands and I was crying with his love.” And similar words regarding their spirituality helped them to grow their resilience.

According to Anderson et al (2012):

Spirituality and corresponding religious beliefs played an important role in participants’ recovery by giving them the strength to prevail, uncovering the benefits of their suffering, and giving their lives purpose. In addition, until they were strong enough to support themselves, participants found it necessary to seek and accept informal and formal support from others. These women identified how in rebuilding their lives they experienced growth in their self-awareness, faith, and interpersonal relationships (p.1289).

Actually, Anderson et al (2012) continued:

Participants described the importance of a spiritual relationship to help them view their trauma and life purpose in a different light. Instead of thinking one’s lot in life was to be abused, they were able to appreciate what they had learned from their struggles, such as increased strength, wisdom, and compassion (p. 1289).

Anderson et al (2012) also say, “For the women in this study, their lives did improve as a result of the many internal and external resources they were able to access and develop” (p.1294-1295). Their study shows the importance of turanagwaewae and attachment to their whanau.

In this essay, I discussed how broken relationships affect survivors’ well-being by using the Te Whare Tapa Wha model.

I realized the difficulty of re-starting living without the persecutor because of their abnormal, unhealthy attachment and belonging within the power and control relationship. In addition, I have found the difficulty of creating their new identity (or getting their pre-traumatized self) by ignoring persecutors’ negative voices against them because they have a huge affection for their well-being.

Dutton & Painter (1993) say, “Battered women experienced three aspects of the battered woman syndrome: high rates of trauma symptoms, lowered self-esteem, and heightened "paradoxical attachment" to the batterer” (p.620).

At this point, I am wondering what survivors expect from their therapist to help heal and recover from their broken relationship.

Herman, J. (2015) pointed, “Good therapists were those who really validated my experience and helped me to control my behavior rather than trying to control me” (p.133). The reason is that they do not need to be controlled by therapists after leaving a system of power and control. I always remind myself to build an equal relationship within the therapeutic relationship by using the equal wheel.

I also believe that a survivor has to go through at least two stages to be able to restart their new life with their new post traumatic identity according to the PTG concept. One is the recovery from the affection of broken relationships. To achieve this goal, I refer to psychoeducation in terms of domestic violence, PTSD mechanisms, transactional analysis concept, boundary concept and teaching other tools such as anxiety management skills, mindfulness and self-care skills after providing them assessments. During the sessions, my clients review the relationship by talking or using art creative therapy to express their emotions and thoughts. Psychoeducation helps my clients normalize their hardships and empowers them to start moving forward from their past relationships. Another stage is their healing process because healing is fundamental for them to be able to restart their life. I believe healing would happen when they accept their past relationship and find the meaning of being in there. I also believe healing gives survivors hope and new dreams to make their new future.

References

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