Silence Hurts
Alcohol Abuse and Violence Against Women

Supplements

Assessing Psychological Abuse

Have you ever experienced psychological abuse?1

Check off all that apply to your situation. Please use the following codes:

1 = Has not occurred
2 = Threatened
3 = Once
4 = Two to four times
5 = Five or more times, frequently

Isolation

_____ Locked in a house, room, or closet
_____ Tied up with rope, chains, handcuffs, etc.
_____ Forced to live in isolated settings
_____ Frequently change residences
_____ Controlled socialization with family or friends
_____ Monitored use of telephone/mail

Degradation

_____ Cursing or name-calling, such as stupid, worthless etc.
_____ To deprecate
_____ Public humiliation
_____ Private humiliation
_____ Denial of power or competency
_____ Forced prostitution or sex acts with others
_____ Forced pornography
_____ Rejection (emotional, intellectual, social, sexual, affectional)

Denial of Reality

_____ Denial of power or competency
_____ Told or convinced that you are mentally ill
_____ Lying to and manipulating you
_____ Attempting to induce self-doubt through shame, guilt or fear

Induced Physical Distress or Exhaustion

_____ Forced to take on role of servant
_____ Forced to clean house or work excessively long hours
_____ Obsessive needs for cleanliness, such as towels placed just right
_____ Interference with sleep patterns
_____ Interference with meals and nutrition
_____ Not allowed personal or rest time

Alcohol or Drug Administration

_____ Forced to use alcohol or other drugs
_____ Forced to participate in sale/distribution of drugs
_____ Induced dependence upon drugs

Monopolizing of Perceptions

_____ Pathological jealousy
_____ Controlled activities
_____ Economic control
_____ Checking up on where partner is (surveillance)
_____ Forced partner to live up to abuser's expectations
_____ Refuse discussions or negotiations

Threats to kill

_____ Threats to kill partner or children
_____ Threats to kill others
_____ Threats to commit suicide
_____ Threats using weapons
_____ Sham executions
_____ Threats to kidnap or keep children

[1] Created by Dr. Lenore Walker, Domestic Violence Institute, Denver, Colorado.