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Abuse is not a medical condition, a diagnosis, or an illness that can be treated with medication. Abuse is a deliberate choice, a set of behaviors aimed at controlling, manipulating, or hurting another person. It’s a pattern of actions that go far beyond misunderstandings or arguments—it’s about power, control, and domination.

Too often, society tends to medicalize or psychologize abusive behavior, turning it into something that seems like it could be “treated” or “fixed” with therapy, medication, or some other clinical intervention. This approach not only minimizes the gravity of abuse but also shifts responsibility away from the abuser and onto the idea that they are somehow “sick” or in need of help. Let’s dig deeper into why this way of thinking does a disservice to those who suffer from abuse and how abuse should truly be addressed.

Abuse Is a Choice, Not a Symptom

The root of abuse lies in power and control, not in mental illness. While some abusers may have mental health issues, these issues are not the cause of their abusive behavior. Abuse is a choice that people make to gain power over another person, to manipulate their reality, to dominate their actions, and to undermine their self-worth.

The problem with labeling abuse as a medical or psychological issue is that it treats the behavior as something that just “happens” to the abuser, like an involuntary response or an uncontrollable impulse. This not only removes accountability but also implies that, with the right treatment, the abusive behavior might go away. In reality, abusers often know exactly what they are doing, and they use their tactics deliberately to exert control.

Common Myths That Medicalize Abuse

There are several myths that contribute to the medicalization of abuse, and it’s important to challenge these beliefs:

1. “Abusers have anger management issues.” Abuse is not about losing control; it’s about maintaining control. Many abusers are perfectly capable of managing their anger in other situations—they don’t lash out at work, with friends, or in public settings. Their abuse is often targeted and calculated, directed specifically at their partner or the person they want to dominate.
2. “Mental illness causes abusive behavior.” While some abusers may have mental health conditions, most people with mental illness do not engage in abusive behaviors. Abusers use manipulation, intimidation, threats, and violence to control others, not because they are mentally ill, but because they feel entitled to do so. It is crucial not to excuse or explain away abusive behavior with mental health labels, as it perpetuates harmful stereotypes and undermines the seriousness of the abuse.
3. “Therapy or medication can fix an abuser.” Therapy or medication alone will not stop someone from being abusive because the root cause is not medical but behavioral and attitudinal. For true change to happen, an abuser must make a conscious choice to confront their belief systems, recognize their entitlement and control issues, and take full responsibility for their actions. Many abusers who enter therapy without this commitment often manipulate the therapeutic process to further justify or excuse their behavior.

The Consequences of Medicalizing Abuse

Medicalizing abuse has several damaging consequences:

1. Shifting Blame Away from the Abuser When we treat abuse as a medical condition, we risk absolving the abuser of responsibility for their actions. It sends the message that they are not truly in control of their behavior, which can make the victim feel more obligated to “help” them get better instead of holding them accountable for their choices.
2. Perpetuating the Cycle of Abuse If the focus remains on treating the abuser’s supposed “illness” rather than addressing the abuse itself, there is little chance of stopping the behavior. The cycle of abuse continues, often worsening over time, because the core issues of control and manipulation are never confronted.
3. Undermining the Victim’s Experience When abuse is framed as a mental health problem, it diminishes the experience of the victim, making it seem like their suffering is secondary to the abuser’s need for treatment. It implies that the victim should be more understanding or patient, waiting for the abuser to get better instead of prioritizing their own safety and well-being.

How Abuse Should Be Handled

The proper response to abuse should be grounded in accountability, justice, and support for the victim, not in medical intervention for the abuser. Here are some ways to address abuse more effectively:

1. Hold Abusers Accountable Accountability means recognizing that abuse is a choice and taking responsibility for it. Legal consequences, restraining orders, intervention programs specifically designed for perpetrators of domestic violence, and education about the impacts of abusive behavior are all necessary to address the problem head-on.
2. Empower and Support Victims Victims of abuse need practical support and empowerment, not pressure to help or “fix” their abuser. This includes access to shelters, legal aid, counseling, financial assistance, and social networks that encourage their safety and healing. They need to know that their experience is valid, that they are not to blame, and that their well-being comes first.
3. Education and Prevention It is essential to educate communities about what abuse looks like, its underlying motivations, and the importance of healthy relationship dynamics. By teaching people, especially young individuals, about respect, boundaries, consent, and equality, we can reduce the likelihood of abusive relationships forming in the first place.
4. Address Cultural and Social Norms Society must confront cultural attitudes and social norms that normalize or excuse abusive behavior. This includes challenging gender stereotypes, toxic masculinity, and any ideologies that condone controlling or dominating behavior in relationships. Creating a culture of accountability, respect, and equality is key to reducing abuse.

Final Thoughts

Abuse is not an illness that can be treated with medication; it is a behavior that must be confronted and changed through accountability and a commitment to transformation. Abusers choose their actions, and they must be held responsible for the harm they cause. Victims deserve support, validation, and the knowledge that the abuse they endure is never their fault. It’s time to stop excusing abusive behavior with medical labels and to start treating abuse for what it is: a grave violation of human rights that demands accountability and justice.