Most children of abuse don’t know they’re being abused. It’s all they know- it’s seems normal to them. For most of us, the word “abuse” refers to someone else, something worse than what we’ve been through.

A dear friend, who has been a wise and loving mental health counselor for more than three decades, explained that to me several years ago. It stuck with me because it’s true, and it was true in my own life.

I kept thinking about that last week as I read a report published by the American Academy of Pediatrics (AAP).

Emotional abuse, the authors say, is as damaging to a child’s well-being as physical or sexual abuse, but it is likely much more prevalent. Yet, despite its widespread occurrence, emotional (or, more formally, psychological) abuse often remains undetected and untreated.

Authors of the report define psychological mistreatment as:

A repeated pattern of parental behavior that is likely to be interpreted by a child that he or she is unloved, unwanted, or serves only instrumental purposes and/or that severely undermines the child’s development and socialization.

A caregiver who is psychologically abusive may belittle, ridicule or humiliate a child; they may ignore or purposefully withhold care for the child’s physical or emotional needs; they may place a child in chaotic, dangerous or unpredictable situations; or a parent may threaten harm to a child or a loved one.

In contrast to physical and sexual abuse, though, emotional abuse is difficult to quantify. The authors point out that a single instance of any of these behaviors does not make one an abuser; it’s the repetition, the pattern, that does so.

It may be a mother who leaves her infant in a crib alone all day, providing only the basic necessities of food and diaper changes but withholding love and attention. It may be a parent who looks at a teenage daughter with disdain and tells her that she’s fat, and no boys are going to like her unless she loses weight. Or it may be a child who struggles academically, and his father tells him that he’s stupid and he can’t get anything right.

But, it’s very difficult to know what takes place in others’ homes. If you see a mother lose her temper and berate her child in the grocery store, how could you know whether this is an isolated incident or merely the tip of a very ugly iceberg? Physical abuse leaves bruises and scars; those who are emotionally abused bear invisible wounds.

These invisible wounds, though, can cause a lifetime of pain. I know because I am a survivor – one of the walking wounded. As a child, I believed the message that was conveyed to me: you are unlovable, you are unworthy of anything good, and it is all your fault. I didn’t know they were lies, and I didn’t know it was abuse. As I said, most of us believe that abuse is something worse than whatever dysfunction we live in.

As an adult, most days I can recognize those lies that still float about in my mind for what they are. I can name them and dispute their validity. But, my heart aches for those little children who are experiencing these same things, suffering in silence and solitude because they don’t know that it’s supposed to be any different. They don’t know that they deserve to be loved and cherished, protected and celebrated. They don’t know that the ones who’ve been entrusted to care for them are destroying their spirit.

The AAP’s clinical report advocates for pediatricians to become more vigilant about recognizing and responding to psychological abuse occurring in families within their care. While logical and admirable, that somehow just doesn’t seem like enough.

I think it’s all of our responsibility to speak up in the face of injustice, especially in defense of defenseless children. And, while it may be difficult to fully understand the parent/child relationship of someone you pass in the grocery store, that someone has family and friends who do know what goes on in the home. There is someone who has witnessed the ridicule, the neglect or the humiliation the child has endured. There is someone who, if they were brave enough to wade into the deep waters, would discover a child drowning in their midst.

I wish those bystanders would be bystanders no more. I wish they would become soldiers fighting for what’s right. And that means speaking truth to those who perpetrate such acts and speaking the truth of love and acceptance to those who are suffering under such tyranny.

The little girl inside of me wishes someone would’ve done that for her.

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Discuss: The silent scars of emotional abuse


  1. avatar
    Susie Raskin says:
    August 6, 2012 at 2:54 pm

    Courtney- I deeply commend you for writing this piece… You are right… This kind of abuse happens all the time and because there are no visible marks or scars, it is often dismissed by others. People often do turn a blind eye to it, and I agree with you that taking a stand against it would make a difference… It sends a powerful message to the victim AND the caregiver that what’s happening is not ok.

    Thank you for bravely sharing your own story… It makes this post that much more powerful. Your daughter is lucky to have such strong, smart mom!

    • avatar
      Courtney Schmidt, PharmD says:
      August 7, 2012 at 11:09 am

      Thanks, Susie!

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