Book Review: The Myth of Mental Illness by Thomas S. Szasz

pile of sparkling drug capsules scattered on pink surface

IN HIS BOOK The Myth of Mental Illness: Foundation of a Theory of Personal Conduct, psychiatrist Thomas S. Szasz argued that mental and physical maladies are about as similar as apples and oranges. Szasz believed it was erroneous to conflate the impact of environmental stressors on the mind with physical disease. Moreover, he did not believe that the subjective experience of life as problematic was tantamount to having a sickness.

“The notion of mental illness derives its main support from such phenomena as syphilis of the brain or delirious conditions—intoxications, for instance —in which persons are known to manifest various peculiarities or disorders of thinking and behavior.” Szasz explained, “Correctly speaking, however, these are diseases of the brain, not of the mind.” 

The level of rigorous self-examination Szasz applied to his field of study is as edifying as it is exacting. For example, he felt it was inaccurate to presume that minor neurological defects or psycho-chemical factors were at the root of all so-called mental illnesses. He saw this notion as absurd as it bypassed the influence of other factors such as individual needs, standards, aspirations, and value systems. 

It is important to note when reading The Myth of Mental Illness that it was published prior to the development of the magnetic resonance imaging (MRI) and computed tomography (CT) technologies that arrived in the 1970s. Though neuroimaging had existed since the late 1800s, it was primitive and unable to harvest the kind of detailed data available today. For example, current research shows that there are gray matter abnormalities in patients with narcissistic personality disorder and structural and functional differences in antisocial brains. This kind of evidence did not exist when Szasz wrote his book.

“The notion of mental illness thus serves mainly to obscure the everyday fact that life for most people is a continuous struggle.”

Thomas S. Szasz

In absence of the evidence available today, it makes sense that Szasz held that the theoretical concept of mental illness was a metaphor rather than a real malady. He spent much of his career vehemently opposing what he regarded as coercive psychiatry, something that is truly admirable considering that he practiced in an era when it was common for husbands who had grown tired of their wives to label mentally ill and have them institutionalized. Such practices are still widespread today, the most high profile example being the conservatorship of performing artist Britney Spears.

Szasz audaciously argued that the Diagnostic and Statistical Manual of Mental Health Disorders (DSM) was a collection of unsubstantiated diagnoses that could be used to serve systems of oppression. He was determined to hold his profession to the highest standards and demand proof for the theoretical frameworks put forth in the DSM, which are constantly evolving. In the absence of proof, Szasz argued that the idea of mental illness was a superstition invented in a feeble attempt to understand people who were “disabled by living” as opposed to diseased. 

“The role of all these belief systems [is] to act as social tranquilizers.”

Thomas S. Szasz

“The notion of mental illness thus serves mainly to obscure the everyday fact that life for most people is a continuous struggle,” Szasz writes, “Not for biological survival, but for a ‘place in the sun,’ ‘peace of mind,’ or some other human value.”

Szasz believed that psychiatry was as dogmatic as any theology. He held that psychiatry is to democracy as religion is to theocracy, pointing to involuntary, court-ordered mental health treatments as a social scourge. Instead, Szasz advocated for informed consent so that mental health treatment could function as a partnership instead of an expression of might.

Szasz believed that, “…the notion of mental illness has outlived whatever usefulness it might have had […] it now functions merely as a convenient myth.” He described it as the “true heir to religious myths in general, and to the belief in witchcraft in particular.”

He issued a stern warning, “the role of all these belief systems [is] to act as social tranquilizers, thus encouraging the hope that mastery of certain specific problems may be achieved by means of substitutive (symbolic-magical) operations.”

If society is to improve and evolve it needs curmudgeons like Szasz to turn a jaundiced eye on its practices and exercise critical thinking to challenge the status quo. He had no illusions about the reality that the concept of mental illness is lucrative for pharmaceutical companies and neither should we.

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What Is Extreme Narcissism?

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EXTREME NARCISSISM refers to an antagonistic variant of this personality trait that exists at the far end of the narcissism continuum. It is a defensive ego structure that generates a false self to protect the failed development of a true self. It is used to describe the maladaptive, socially destructive strains of narcissism. It is synonymous pathological narcissism.

An Intersection of Two Disorders

Social psychologist Erich Fromm described the most extreme form of narcissism as malignant and placed it at the intersection of narcissistic personality disorder and anti-social personality disorder. He called it “the most severe pathology” and “the quintessence of evil”.

These intersecting personality disorders include the malevolent traits that comprise the dark triad, vulnerable dark triad, or dark tetrad.

The Dark Triad

  • Narcissism –  grandiosity, arrogance, megalomania and low empathy.
  • Psychopathy – antisocial behavior, ruthlessness, impulsiveness, selfishness, absence of conscience and emotionally frigid.
  • Machiavellianism – manipulativeness, amorality, callousness, and self-centeredness.

The Dark Tetrad

  • Narcissism –  grandiosity, arrogance, megalomania and low empathy.
  • Psychopathy – antisocial behavior, ruthlessness, impulsiveness, selfishness, absence of conscience and emotionally frigid.
  • Machiavellianism – manipulativeness, amorality, callousness, and self-centeredness.
  • Sadism – cruelty, mercilessness.

The Vulnerable Dark Triad

  • Vulnerable narcissism – introverted grandiosity
  • Sociopathy – Feeble conscience, absence of psychosis, and emotionally volatile. Also known as secondary psychopathy.
  • Borderline personality disorder – Distorted sense of self, chronic emotional dysregulation, splitting, self-destructiveness, emptiness, rapidly shifting moods, and anger management issues.

Why Does Extreme Narcissism Develop?

Extreme expressions of narcissism are a post-traumatic stress adaptation. It can be thought of as a kind of scar tissue that develops to protect the psyche from unhealed trauma and the failure to generate a true self. Its function is to dull, hardened, and desensitize the mind, to severe consciousness from a state of constant fragility, dread, and hyper-vigilance. It limits an individual’s capacity to form true bonds with others, as it is largely removed from empathy.

Extreme narcissism separates the psyche from painful feelings connected to highly stressful or traumatic experiences. Overwhelming feelings of shame and humiliation are buried deep in the subconscious mind, where a false self is formed to keep feelings of vulnerability emotions at bay.

Characteristics of Extreme Narcissism?

This variant shares the same characteristics as malignant narcissism. Both are:

  • Harmful to self and others
  • Loves self to the exclusion of others
  • Rigid, and 
  • Compromises mental health of self and others.

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What is Narcissism?

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WHAT DOES NARCISSISM MEAN in the context of psychology? Narcissism is self-idealization. It is a personality trait all people possess that exists on a continuum. However, the degree to which people are narcissistic varies. In and of itself, narcissism is neither good nor bad. It is simply a necessary component of the human personality structure. In fact, a normal or healthy degree of narcissism has a range of health benefits. Narcissism becomes problematic only when there are aberrations.

The words narcissism and narcotic both originate from the Greek narkao which means “I numb myself”. In other words, narcissism has a similarly soothing affect on our senses as a narcotic. Holding a slightly flattering view ourselves serves to dull the impact of otherwise painful existential realities.

12 Signs of Normal or Healthy Narcissism?

Clinical psychologist Michael Kinsey, PhD, an expert in personality dynamics, breaks down some of the most prominent characteristics of healthy narcissism as the ability to:

  1. Admire others and accept admiration from them.
  2. Believe in the importance of our contributions.
  3. Experience gratitude and appreciation.
  4. Empathize with others, while prioritizing self.
  5. Embody self-efficacy, persistence and resilience.
  6. Respect self in health habits and boundaries.
  7. Feel confident about being seen.
  8. Tolerate others disapproval.
  9. Set goals and pursue them with desire.
  10. Be attentive to the external world.
  11. Be aware of emotions.

As a trait, narcissism is very different from its subtypes in a number of ways. It is flexible and can change over time. Most importantly normal or healthy narcissism helps us develop a positive self concept and helps form healthy relationships with others as healthy narcissism helps us extend our love to others.


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6 Signs of Love Bombing with Dr. Steve Sultanoff

Signs of Love Bombing with Steve Sultanoff, PhD

LOVE BOMBING is a manipulation technique used by one person to gaslight another in order to control and dominate them. It is commonly used by highly narcissistic people and people with narcissistic personality disorder (NPD), but it can be used by other types of manipulators as well. The aim is to give the perpetrator an advantage over the recipient of the abuse. This is accomplished using a schedule of intermittent reinforcement that alternates between love bombing and devaluation to deliberately induce, escalate, and then soothe anxiety in the victim-survivor. One of the dangers of love bombing is that it feels so good it can be difficult to recognize it for the psycho-emotional abuse that it is. Today, we’re going to highlight 6 Signs of Love Bombing with clinical psychologist Steven M. Sultanoff, PhD

For more than thirty years, Dr. Sultanoff has been a professor at Pepperdine University’s Graduate School of Education and Psychology. He’s also served as a clinical supervisor and spent twelve years as clinical director of a psychology training network. In 2012, he received the Lifetime Achievement Award in therapeutic humor from the Association for Applied and Therapeutic Humor.

Narcissistic Abuse Rehab: What is something most people don’t understand about love bombing?

Dr. Steven Sultanoff: The extreme narcissist is a “big game hunter.” He is stalking his prey, and the thrill is in the hunt and capture of the prey. In order to capture the prey, the narcissist will go to almost any length to achieve that goal. The result is self-congratulatory: “Look what major feat I accomplished!” In other words, “I made you fall for me.”

Narcissistic Abuse Rehab: What you are describing it sounds more like entrapment than love.

Dr. Steven Sultanoff: He is on a quest to “do” whatever it takes to achieve the goal: capturing a “love” connection or perhaps more accurately capturing the object of his desire. Nothing will stand in the way. Whatever it takes (behaviorally) he will do. He will shower the “love object” with whatever might be pleasing including gifts, flowers, romantic getaways, etcetera.

Narcissistic Abuse Rehab: This is an excellent analogy because it illustrates how little a narcissist’s behavior has to do with the person they are pursuing and everything to do with their self-image. What’s the pay off for the narcissist?

Dr. Steven Sultanoff: Once the goal is achieved, he will feel “full,” valued, worthy, etcetera until the moment of the accomplishment wears off.

Narcissistic Abuse Rehab: So, they obtain narcissistic supply through success in pursuit and conquest of someone they regard as “prey”. It gratifies their ego and fills them with a sense of pride in their ability to manipulate the person they targeted. What is the first major red flag that people should look out for?

Dr. Steven Sultanoff: One tell-tale sign is over the top extreme behavior that, of course, feels like being nurtured and loved.

Narcissistic Abuse Rehab: But in reality it’s neither of those things because the narcissist is using the capture and conquest of their “prey” to feed their ego. Dr. Sultanoff, you have been practicing for over thirty years. Please share something you’ve observed about narcissists in your clinical experience.

Dr. Steven Sultanoff: Most narcissists are men, although women are not immune to the disorder.

Narcissistic Abuse Rehab: Indeed, that’s consistent with the research. Can you please share some other signs you think might help people recognize when they are being love bombed?

Dr. Steven Sultanoff: Narcissists are frequently absolutely charming and they make a great appearance. For example, they are often coiffed meticulously. They are usually generous with money and material things, showering the object of their affection with an assortment of gifts mostly of monetary value but not necessarily. Depending on their style and expertise, they may offer more personal gifts such as poetry, writing songs, sunsets on the beach, looking at the stars, etcetera for their partner. They make a major effort to be in contact with their partner and may frequently text or email with lots of emojis or other endearing extras.

Narcissistic Abuse Rehab: It’s often said that narcissists target people who have one or several blind spots. Can you talk a bit about this?

Dr. Steven Sultanoff: One sign that is often overlooked is the partner’s reaction to the love bomb. If you feel enamored, giddy, or enthralled especially to the point of discussing all the gifts with others then you may want to examine the relationship. It is easy for the partner to be “sucked into” the love bomb since it “feels” so good to be loved at such an extreme level.

Narcissistic Abuse Rehab: That’s a very astute and helpful tip! Dr. Sultanoff, do you have any final thoughts you’d like to share on this topic?

Dr. Steven Sultanoff: Bottom line, if he is too good to be true, he likely is too good to be true. Look for the signs of excessively loving behaviors, look for feeling immersed in his love, look for constant actions of his love and desire to be with you, and finally look beyond his loving actions and ask yourself, “What is the substance behind the actions. Is he who I can love if all these loving actions were not present?”

Dr. Sultanoff’s 6 Signs of Love Bombing

To summarize, Dr. Sultanoff highlighted six signs of love bombing and they are:

  1. Too good to be true
  2. Charm
  3. Flamboyance
  4. Generosity
  5. Excessive Attention
  6. Euphoria

Visit Dr. Sultanoff’s website humormatters.com to learn about therapeutic humor.


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What Narcissists Look For in A Partner with Dr. Rick Patterson

what narcissists look for in a partner

DR. RICK PATTERSON spoke candidly with me about what narcissists look for in a partner. He is the author of Shame Unmasked: Disarming the Hidden Driver Behind Our Destructive Decisions, an insightful book about the inner thoughts associated with extreme narcissism. In his work, Dr. Patterson underscores that toxic shame is the driving force of narcissistic aggression.

He explains “A person with internalized shame believes he is inherently flawed, inferior and defective. Such a feeling is so painful that defending scripts (or strategies) are developed to cover it up. These scripts are the roots of violence, criminality, war, and all forms of addiction.”

The role of narcissism in toxic relationships

Narcissistic Abuse Rehab: Dr. Patterson, what is something most people don’t know about love bombing?

Dr. Rick Patterson: As a reforming narcissist myself, I’ve seen this play out in all types of venues. Love bombing isn’t just a romantic thing. It can happen in any relationship anywhere, including the workplace or where you worship. 

Narcissistic Abuse Rehab: As a recovering narcissist, could you share your thoughts on what qualities a narcissistic person or NPD looks for in someone they think will be susceptible to the love bombing tactic?

Dr. Rick Patternson: A narcissist can sense someone’s need and their openness to being manipulated.

Narcissistic Abuse Rehab: Your mention of need is interesting because it’s a word associated with being impoverished, lacking, or hungry. Could you explain a bit more about what you mean when you say that someone is open to being manipulated?

Dr. Rick Patterson: Someone experiencing love myredbook sacramento bombing is thinking that this attention doesn’t make sense combined with a feeling of needing it to make sense.

Narcissistic Abuse Rehab: In your opinion, what drives the need to make the absurd make sense?

Dr. Rick Patterson: Ironically, someone’s need for attention from a narcissist comes from their own narcissism.

Narcissistic Abuse Rehab: Given that narcissism is a trait that exists on a continuum that we all have, it makes sense that a highly narcissistic person or someone with narcissistic personality disorder would excel at recognizing and appealing to narcissism in others. What exactly does a narcissist see when they set their sights on someone?

Dr. Rick Patterson: They see the narcissism of the person they target presenting as neediness, which opens them up to a person whose narcissism presents as manipulative. Both individuals have complementary and codependent forms of the same shame-based malady.

Narcissistic Abuse Rehab: One is the yin to the other’s yang.

What drives narcissists to manipulate others?

Narcissistic Abuse Rehab: Let’s talk about what motivates a narcissistic person to love bomb someone. What drives this behavior?

Dr. Rick Patterson: There is something in it for the narcissist.

Narcissistic Abuse Rehab: So, it’s avarice. The narcissist is seeking to benefit from the person or people they love bomb.

Dr. Rick Patterson: This happens in volunteer organizations and the workplace all the time. Volunteer organizations need people to work for free. The best way to make that happen is through compliments. There is nothing wrong with donating to a cause – just do it for the cause and not the person showering you with attention. Your workplace has also learned that they can pay employees less when they give more compliments. They describe it as “worker retention”, but it helps “retain” workers when they can’t pay as much.

The role of sociotropy in narcissistic abuse

Narcissistic Abuse Rehab: If a person has been targeted for narcissistic abuse what are three things they need to understand and be mindful of going forward?

Dr. Rick Patterson: Think about these things:

  1. Neediness – Your need and your openness to being manipulated
  2. Resources – There something in it for the narcissist to shower this attention.
  3. Vulnerablity – A willingness to give up your freedoms for praise.

Narcissistic Abuse Rehab: Excellent points. An excessive need for approval and acceptance can cause people to lapse into denial when confronted with red flag behaviors. Sociotropy or people pleasing creates blindspots. It’s a green light for a predatory personalities.

Dr. Patterson: The danger for the recipient of love bombing is the needier you are for the praise you receive – in other words, the more shame drive you have – the less likely you will be to see what’s going on. Find someone you trust to give you some clarity.

Shame Unmasked: Disarming the Hidden Driver Behind Our Destructive Decisions is available for purchase on Amazon.


Confidential support is available 24/7/365 to anyone experiencing abuse.
In the USA call 1-800-799-7233 or log on to thehotline.org.
In the UK call 0808 2000 247 or log on to nationaldahelpline.org.uk.


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Book Review: ‘Unmasking Manipulation’ by Meredith Wesley

Unmasking Manipulation: Maneuvering the Undertow with Shrewdness and Innocence by Meredith Wellesley

MEREDITH WESLEY’s Unmasking Manipulation: Maneuvering the Undertow with Shrewdness and Innocence is the first book I’ve selected to review because it is an excellent self-help resource.

I had the honor of endorsing the book in 2020, the year of its publication after the author sent me an advanced copy. I knew that the focus of the book was psychological manipulation but what came as a pleasant surprise was that Wesley had written a how-to manual for women seeking to untangle themselves from the powerful tentacles of psycho-emotional abuse.

I mentioned that Unmasking Manipulation is written for women, as it uses the feminine gaze and its contents speak directly to anyone who has experienced manipulation in the context of misogyny. Keeping in mind that the women’s rights movement began in 1848 and has been in progress for less than two hundred years, it is essential that women share their stories and perspectives in a world that has historically erased them. 

Perhaps the most valuable part of the book is Wesley’s ability to detail a range of manipulation tactics and teach readers to recognize them in daily life. However, another characteristic of the book I found especially useful is the practical way that it is structured into sections, each one addressing common aspects of the manipulation process. Wesley excels at explaining complex topics in clear and direct language, which is helpful for readers in the early stages of recovery from psycho-emotional abuse who may be struggling with anxiety, depression, or post-traumatic stress.

In Unmasking Manipulation Wesley compares misogynistic abusive power and control to warfare and illustrates why she has come to this conclusion. She effectively articulates the shocking sensation of having one’s face pressed up against the glass of the systemic oppression of women.

Unmasking Manipulation: Maneuvering the Undertow with Shrewdness and Innocence by Meredith Wesley is available on Amazon, Barnes and Noble, and other fine book stores.

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Reproductive Coercion Affects 50% of Women Ages 18-44

crop man covering mouth of woman

A RECENT POLL showed that 50% of women between the ages of 18 and 44 have been targeted for reproductive coercion, in which a person or group influences another person’s right to reproductive freedom and self-determination.

Studies show that women targeted for coercive control and women who have unplanned pregnancies are more likely to be targeted.

There are three main types of reproductive coercion:

  • Pregnancy coercion
  • Birth control sabotage, and 
  • Controlling the outcome of a pregnancy

The practice is also known as coerced reproduction, reproductive control, or reproductive abuse.

The poll, commissioned by BBC News, also showed that:

  • 2/3 women were pressured by a current or former partner or family member not to use contraception. 
  • 1/5 women were forced to have sex without contraception.
  • 1/10 women said their contraception had been intentionally tampered with, hidden, withheld, or deliberately damaged.
  • 1/10 women reported that their partner had removed the condom during sex without their consent.
  • 15% of the women in the survey were pressured to undergo a pregnancy termination against their will.

Forcing women to have sex without a condom turned out to be the most common type of reproductive coercion.

Non-consensual condom removal is a form of sexual assault in which a man removes or sabotages a condom during sex without the consent of his partner. Colloquially known as stealthing the practice has been on the rise in dating culture since 2017. Non-consensual condom removal is classified as rape under UK law and in some US states.

Why Do Men Practice Reproductive Coercion?

Men who practice reproductive coercion tend to be highly narcissistic. It is an act of abusive power and control driven by desire to dominate, manipulate, and dupe their partner to satisfy the perpetrator’s sense of entitlement.

There are online groups that encourage men to practice this insidious form of sexual assault that is ultimately a manifestation of misogyny.


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3 Effects of Narcissistic Parenting on Minor Children

a sad young girl

TRAUMA IS THE WORD most commonly associated with extreme narcissism – and with good reason. People who have been targeted for narcissistic abuse often scoff when the pathology is described as shame based because they are distracted by the spectacle of the narcissistic person’s formidable defenses. But in reality, narcissistic personality disorder is a post-traumatic stress adaptation. It is usually developed to resolve intense feelings of inferiority and shame often connected with psychological devastation.

Extreme narcissism is a kind of scar tissue that develops to protect unhealed trauma. It numbs, hardens, and desensitizes the mind, eventually severing consciousness from feelings of incessant vulnerability, fear, and hyper-vigilance. It restricts the ability to genuinely bond with others, making empathy an elusive prospect. The deeper the trauma, the more narcissistic people disconnect from their emotions to cope. The overarching feelings of inferiority and shame become submerged in the subconscious mind. There, a false self is generated to serve as a bulwark to keep unbearable, vulnerable emotions at bay. The words narcissist and narcotic originate from the Greek narkao which means “I numb myself”.

Early life wounds fuel the adult fury boiling under the surface of this personality type. It’s what drives the explosive narcissistic rage that detonates with every real or perceived threat to their cherished false self. It feeds their obsessive need for control and it can blind them to the fact that they perpetuate the very trauma that wounded them on others, especially their children.

3 Effects of Narcissistic Parenting on Minor Children

  1. Research shows that children who witness narcissistic abuse suffer the same degree of harm as the parent who is the primary target for the narcissist’s aggression.
  2. Children who witness or experience narcissistic abuse are at risk for long-term physical and mental health consequences.
  3. Some children who witness narcissistic abuse may have an increased propensity to act out the same violence in their own relationships.

“Children learn first and foremost by what they see and what they observe.” explains Clinical Psychologist and parent-child attachment specialist Dr. Michael Kinsey, “There are going to be lasting impacts of trauma in a context where there is emotional and physical abuse.There are things people can do to buffer against the permanent arresting of development that can happen as a result of witnessing or seeing that type of abuse.”


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What Is Coercive Control?

What is Coercive Control?

COERCIVE CONTROL IS AN ACT or a pattern of acts used by one person to harm, punish or frighten another person to secure psycho-emotional dominance. It begins with occasional incidents of strategic aggression that escalate over time to full-scale campaigns of intimate terrorism.

Coercive control was conceptualized by Evan Stark, Ph.D. in his book Coercive Control: How Men Entrap Women in Personal Life. Perpetrators of coercive control also harm their children as part of their wider campaign to isolate the primary recipient of the abuse.

Signs of Coercive Control

1. GaslightingThe perpetrator deliberately distorts the victim-survivors’ reality.
2. IsolationThe perpetrator isolates the victim-survivor from family and friends. 
3. Control of Daily LifeThe perpetrator dictates where the victim-survivor can go, see, wear, and eat.
4. Monitoring timeThe perpetrator oversees where the victim-survivor is, where they are going, and what they are doing at all times
5. Put-DownsThe perpetrator may repeatedly tell the victim-survivor that they are worthless or useless, they may publically humiliate the victim-survivor by calling them degrading names or by criticizing their appearance, intelligence, etc.
6. Monitoring CommunicationThe perpetrator may use spyware to track the victim-survivors’ digital communication.
7. Rules and Regulations The perpetrator creates a set of ever changing rules which they enforce by humiliating, degrading, or dehumanizing the victim-survivor.
8. ThreatsThe perpetrator may threaten to hurt or kill the victim-survivor, their child, family members, friends, or pets; they may threaten to take away their child; they may threaten to reveal private information such as intimate photos or revelations about your sexuality.
9. Deprivation of Basic NeedsThe perpetrator restricts the victim-survivors’ access to healthcare and food.
10. Obstruction of EmploymentThe perpetrator may stop the victim-survivor from obtaining employment, going to work, and earning their own money.
11. Financial AbuseThe perpetrator takes control of the victim-survivors’ finances, making sure they have little access to money so that the victim-survivor is dependent on them.
12. Criminal DamageThe perpetrator may damage or destroy the victim-survivors’ personal property.
13. Assault or RapeThe perpetrator may physically abuse, sexually assault, or rape the victim-survivor.

Confidential support is available 24/7/365 to anyone experiencing abuse.
In the USA call 1-800-799-7233 or log on to thehotline.org.
In the UK call 0808 2000 247 or log on to nationaldahelpline.org.uk.


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What Is Reproductive Coercion?

gray scale photo of a pregnant woman

REPRODUCTIVE COERCION is a kind of abuse in which one person or group controls another person’s right to reproductive freedom and self-determination. Perpetrators of reproductive coercion use manipulation tactics, from psycho-emotional abuse and rape to restricting access to healthcare.

Perpetrators may oscillate between covert and overt expressions of coercive control. They may also use intermittent reinforcement. For this reason, some people impacted by reproductive coercion may not immediately recognize the behavior as dysfunctional or abusive. Moreover, the perpetrator’s aggression may become normalized over time.

A common tactic of reproductive coercion is so-called stealthing, which is the non-consensual removal of a condom during sexual intercourse.

Reproductive coercion includes: 

  • Forced sexual intercourse without the use of contraceptives
  • Stealthing, or the non-consensual removal of a prophylactic during sex
  • Contraceptive sabotage
  • Refusing to use a prophylactic though the woman requests it
  • Lying about having had a vasectomy 
  • Forced continuation of a pregnancy 
  • Forced termination of a pregnancy 

Is reproductive coercion illegal?

Many forms of reproductive coercion do not yet have status in the criminal justice system. However, in the UK stealthing is classified as rape and coercive control has been criminalized since 2015. However, these crimes are seldom prosecuted and convictions are rare due to a lack of evidence.

Forced termination of a pregnancy

Forced termination of a pregnancy, also known as coerced or forced abortion, is illegal in the United States.

Coerced abortion can look like:

  • Pressuring a person to have an abortion against their will
  • Restricting their access to healthcare providers
  • Withholding relevant information

1 of 4 survivors of human sex trafficking have been subjected to forced termination of a pregnancy.

Resources are available at the Center Against Forced Abortions.

References

  • Rosenfeld EA, Miller E, Zhao X, Sileanu FE, Mor MK, Borrero S. Male partner reproductive coercion among women veterans. Am J Obstet Gynecol. 2018 Feb;218(2):239.e1-239.e8. doi: 10.1016/j.ajog.2017.10.015. Epub 2017 Oct 19. PMID: 29056537; PMCID: PMC5807143.
  • Harte, A, Stonehouse R (2022, March 14). Reproductive coercion: ‘I wasn’t allowed to take my pill’ BBC News. Retrieved on March 22, 2022.
  • Lederer, Laura; Wetzel, Christopher A. (2014). “The health consequences of sex trafficking and their implications for identifying victims in healthcare facilities” (PDF). Annals Health. Retrieved March 22, 2022.

Confidential support is available 24/7/365 to anyone experiencing abuse.
In the USA call 1-800-799-7233 or log on to thehotline.org.
In the UK call 0808 2000 247 or log on to nationaldahelpline.org.uk.


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