From use to abuse: psychological, neurobiological, and spiritual pathways in relational harm and recovery.

Résumé

This viewpoint examines the distinction between relational "use" and "abuse" through psychological, neurobiological, relational, and spiritual lenses. It conceptualizes use as a form of mutual and ethical interdependence, whereas abuse is understood as a persistent pattern of control that undermines an individual's autonomy and self-worth. The paper highlights the profound impact of chronic emotional abuse on both mind and body, including dysregulation of stress-response systems, alterations in brain functioning, increased inflammation, and accelerated biological aging. It further emphasizes that the experience and impact of abuse vary across gender, age, and sociocultural contexts, often remaining unrecognized due to prevailing cultural norms. Additionally, the paper explores the role of spirituality in recovery, suggesting that it can facilitate meaning-making, enhance emotional regulation, and foster resilience, while acknowledging that its effectiveness is not universal. Ultimately, the paper positions relational abuse as a significant public health concern that requires nuanced, interdisciplinary, and culturally sensitive responses.