A Hidden Hurt

A Hidden Hurt

When Abuse Doesn’t Leave a Bruise You Can See


Words by Dr. Angela Mailis
Photos by Carlos Osorio

It took me a good 28 years—27 in the relationship and one more after the breakup was permanent and legal—to put a name on what I had been going through. Despite my smarts, my successful career as a doctor and pain specialist, and my international reputation as a researcher, I had no clue what had been happening to me until my secretary of many years, Anna, gave me a book from Patricia Evans titled, The Verbally Abusive Relationship: How to Recognize It and How to Respond

As I relate in my own book, Smart, Successful and Abused: The Unspoken Problem of Domestic Violence and High-Achieving Women, I took a quiz in which any two positive answers to seven questions indicated you were a victim of verbal and emotional abuse. I answered yes to five. My discovery blew me away. I ran out of my office, yelling, “Can you believe it, Anna? I just found out that I’ve been verbally and emotionally abused all these years!” 

In fact, she could believe it. The abuse had been obvious to her. 

I began to read about emotional abuse, and what I learned fit perfectly with everything I was hearing and feeling. Examples of ill-treatment on my list included: name-calling, yelling, swearing, interruptions, humiliating remarks or gestures, and insults in front of other people. 

My husband exerted pressure on me through sulking and manipulation, by withholding affections and playing the silent game, and by refusing to help with childcare or housework. He harassed me with unwanted visits and calls that were meant to check up on me. 

He always claimed to be right and blamed me and the world without ever taking responsibility himself. I was to blame for his abusive behavior. I had caused it all. 

He abused my trust, lied and withheld information, cheated repeatedly and bragged about it, while being overly jealous himself. I was always walking on eggshells to not provoke his anger and see another poor fellow suffer a bruised face. 

There was also self-destructive behavior, including self-cutting and threatened suicide. The list goes on. 

In roughly half the cases of emotional abuse, the victim will also be physically abused. My book is dedicated to a bright female doctor, Dr. Elana Fric Shamji, who was killed at the hands of her neurosurgeon husband after 12 years of physical and emotional abuse. I did not know Elana, but her husband, a very talented neurosurgeon, was my colleague and collaborator for four years. 

Emotional abuse often serves as the prelude to physical and other kinds of abuse. It often occurs covertly at home or when there are no witnesses. While it leaves invisible scars in the victim’s brain and soul, it leaves no physical marks and therefore can be difficult to detect, particularly when an abused woman does not fit the stereotypes. 

Unfortunately, we tend to equate abuse with the presence of violence toward a weak, maybe uneducated and financially dependent partner. Given my own story, the most difficult (and unspoken) aspect of abuse relates to women such as Elana and myself: educated, intelligent, high-earning, and self-sufficient—women who run businesses and direct teams but return home and become a different person in the hands of their partner. 

Despite being capable in our professional lives, we are still as vulnerable as any women to what the author Evan Stark calls “coercive control,” a pattern of behavior in which one partner repeatedly makes the other feel dependent, isolated, scared, and compelled to do what he or she wants. Usually it is ‘he’ doing the controlling. Stark sees coercive control as a relatively modern phenomenon, devised by men to offset the erosion of sex-based privilege in a world in which women are increasingly independent and empowered. 

Just as status and absence of physical evidence can hide abuse, so can culture. In my experience as an immigrant woman with deep southern European cultural roots, and speaking to colleagues coming from Asian and South American countries, our roots play a significant role in submitting to or accepting abuse, particularly emotional abuse. 

In less liberal societies with less formal equality between men and women, coercive control can be woven into the fabric of the society, even legitimized by law and custom. In more liberal and individualistic societies such as Canada, the United States, and certain European countries where formal equality exists, coercive control can become prominent in the household, as “men are driven to recreate privilege in personal life.” 

Couples migrating from cultures where subordination is prescribed, to more liberal cultures, can slide into patterns of abuse without recognizing it. One of my PhD trainees from a wealthy South Asian family told me that most of her friends answered Yes on many of the questions about emotional abuse but at the same time did not feel abused, “as this is part of their culture.” 

So, what do you look for if you think a friend or colleague or family member is being abused? Inexplicable physical injuries or repeat injuries should raise red flags. Careful observation will also show signs of “emotional beating,” including depression, lack of concentration, withdrawal, fatigue, and avoidance of communication. 

Unfortunately, many professional women show few signs of abuse, as they make every effort to conceal their shame within the boundaries of their home. They are far too aware that society has no sympathy for women who are educated, successful, financially independent, yet still “accept to be abused.” That is why this serious issue is still swept under the carpet. 

The best advice I can give anyone who suspects someone they know is being abused, whether physically or emotionally, is to simply raise the subject gentlyprovoke discussion. Often, an abused woman simply needs to hear concern from others, to feel she is not alone, and that will provide her with a window of opportunity to start talking. 

Once the silence is broken, there are many resources available online to help victims get the information and support they need to deal with their circumstances. So, don’t be afraid to raise the subject: you might change someone’s life. 

Dr. Angela Mailis is the author of Smart, Successful and Abused: The Unspoken Problem of Domestic Violence and High-Achieving Women, published by Sutherland House in 2019.