Psychological Aggression Psychological aggression is the use of verbal and nonverbal communication with the intent to harm another person mentally or emotionally and/or exert control over them. Psychological aggression includes expressive aggression such as insulting or humiliating someone, coercive control (i.e. limiting access to transportation, money, friends, and family; excessive monitoring of whereabouts), threats of Applying Definitions to Clinical Practice Consistent, up-to-date definitions are important for accurately identifying cases of IPV and monitoring trends in incidence and prevalence. However, healthcare providers should also be aware of important considerations when applying IPV definitions in clinical practice, as these may not fit perfectly in every case. Sometimes, clients may not recognize or relate to the terms being used. For example, many individuals who experience a nonconsensual sexual encounter in a marriage or romantic relationship do not perceive it as rape and therefore a form of IPV (Deosthali et al., 2022) . This can stem from societal and cultural norms that support the notion that sexual violence cannot occur within a marriage and that sex is owed to one’s partner (Gul & Schuster, 2020) . In conversations with patients or clients about IPV, it may be better to use language such as forced or unwanted sex/sexual contact instead of rape . Using validated screening tools to identify IPV in the clinical Power and Control in IPV One of the major dynamics of IPV is the establishment of power over and control of one partner by the other. The Power and Control Wheel reflects some of the ways these dynamics may function in relationships (see Figure 1). Please note that this is not a comprehensive listing of behaviors that may occur in cases of IPV, and that it is also focused on abuse perpetrated against women by men. IPV
physical or sexual violence, reproductive coercion (i.e. birth control sabotage, refusal to use contraception) exploitation of a vulnerability such as immigration status or a disability, gaslighting or denying that a victim’s recall or perception of events is accurate, and/or entrapment (Hamel et al., 2023; Leemis et al., 2022) . setting is another useful strategy for overcoming some of these barriers (Burton & Carlyle, 2020; Graham, Sahay, et al., 2021) . Some of these tools are discussed later in this course. It is also important to remember that IPV occurs on a continuum of frequency and severity. Different types of abuse may occur within the same relationship. Abusive situations may occur once within a particular relationship, they may occur sporadically throughout the relationship, or they may occur frequently or chronically during the relationship. Although all experiences of violence can result in adverse outcomes, victims of repeated or chronic abuse may present differently and with more severe symptoms than do those who experience singular abusive events (Both et al., 2020; Pegram & Abbey, 2019; Stubbs & Szoeke, 2021).
can and does occur in all types of relationships, and both perpetrators and victims can be of any gender or sexual identity (Chen et al., 2020; Cho et al., 2020; Leemis et al., 2022) . With that said, those reporting experiences of IPV are disproportionately identified as women (Leemis et al., 2022) .
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