Madeeha Syed

Explore the dynamics of why family members take sides in intimacy abuse cases. Meri Sehat provides insights for understanding and support.

Understanding The Dynamics: Why Family Members Take Sides In Sexual Abuse Cases

This article or video has been vetted and verified by Meri Sehat’s specialists. It contains citations and research from validated sources.

How To Practice Safe Sex

Overview

We all think about it, talk about it, partake in it, see it everywhere but not always in the right ways. What makes sex pleasurable is not the next wildly creative idea but perhaps the most basic aspect of being made to feel safe. 
&nbsp;

Practice Safe Sex

Originally, the term was coined to indicate using contraceptive methods or devices in order to reduce the risk of transmitting diseases. It has now been expanded to include practices that prevent pregnancy as well. We call it safer sex or protected sex to highlight the fact that practicing these methods also doesn&rsquo;t completely eradicate the risks that come with this act.&nbsp; 
 
This term first came to light during the <a href="https://merisehat.pk/disease/hiv-61">HIV/AIDs</a> epidemic and is now a crucial part of sex education where the very real risk of sexually transmitted diseases (STD or STI) is a major topic of discussion. Strategies for preventing STIs such as gonorrhea or syphilis had existed long before this too. Locally we don&rsquo;t have much formal education or discussion available on these topics. 
&nbsp;

Abstinence, monogamy, polyfidelity, low-risk sexual behavior, limiting the number of sexual partners, avoiding substances that lead to high-risk behavior, being aware of your partner&rsquo;s sexual history, phone sex/cyber-sex, non-penetrative sex are all valid and useful practices that lead to a reduction of risks associated with sex.&nbsp; 
&nbsp;

Other methods

Some other, more commonly used methods are:

STDs can be passed by exchanging sexual fluids and from skin-to-skin contact as well. This is why barrier methods are so effective. These include condoms, internal condoms (female condoms), dental dams for orals sex and latex or nitrile gloves.&nbsp;

<ul>
	<li>Condoms: This is the most accessible and easy to use option. These are made out of latex. For those with latex allergies there are synthetic non-latex condoms available as well, although they are more prone to breakage. There are female condoms (internal condoms) as well which can be inserted into the vagina or anus to practice safe sex. These come in different styles (ribbed, ultra-thin etc) and flavors as well.&nbsp; 
	 
	It&rsquo;s important to remember that oil-based lubricants degrade the latex material and lead to breakage. This also happens with double gloving which causes friction and tears. Water based or silicone-based lubricants work much better with latex condoms. Remember using lube also makes sex safer as there are fewer chances of getting tears due to too much friction, for example, with anal sex. The effectivity of condoms is no more than 95 percent in preventing STI transmission.&nbsp; 
	&nbsp;</li>
</ul>

<ul>
	<li>Birth Control Pills: Thee are of two types 
	&nbsp;</li>
</ul>

1. Combined Oral Contraceptive (COCP): This has two hormones in it &mdash; oestrogen and progestin. These come in different formulations hence different doses can be prescribed according to personal needs and preferences. For instance, there are pills that give you your period every month as well as pills that can stop your period for 3 months on end. 
 
These work by suppressing ovulation, making the endometrium unsuitable for implantation and thickening cervical mucous which hinders sperm mobility. With typical use, COCPs can be 93-95 percent effective, while with perfect use they are up to 99 percent effective. By perfect use we mean taking it every single day at the exact same time. There is a margin of human error in this hence the lower numbers of effectivity as compared to other methods. 
 
Nausea, breast tenderness, mood swings, bloating, headaches, irregular bleeding are just some of the side effects one experiences on combined hormonal pill. If you still have severe side effects for three months in a row, it means that you need a dose adjustment, but feeling a little nauseous in the first couple months is completely normal. Some non-contraceptive benefits of this are reduced risk of uterine and ovarian cancer, helps manage PCOS, helps with acne and treats endometriosis-related pain, painful periods, menstrual migraines and PMS. 
&nbsp;

&nbsp; &nbsp; &nbsp; &nbsp;2. Progestin-only pill (POP): There are two kinds of progestin-only pills. One is Norethindrone, in which you take a pill pack that is continuous&nbsp; &nbsp; &nbsp; &nbsp; &nbsp;(28 days). And the other is Drospirenone, in which you get hormone free intervals (24 active tablets and 4 inactive tablets) 
&nbsp; &nbsp; &nbsp;&nbsp;This works by two methods; it thickens cervical mucous which makes it harder for sperm to travel and stops ovulation. It&rsquo;s 92-95 percent&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; effective with perfect use and you have to take it at the same time every single day. You get some protective effects such as decreased risk of&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; uterine cancer. Some adverse effects include irregular bleeding, acne, moodiness, weight gain, and increase in follicular ovarian cysts. 
&nbsp;

<ul>
	<li>Depo Provera Shot: This is another form of Progestin-only birth control in which you get injected every three months. Its effectiveness profile is 93-95 percent. You can get unscheduled bleeding with this that might last for more than seven days and is usually the reason why most people don&rsquo;t prefer it. It has a similar side effect profile as the progestin-only pill.&nbsp;</li>
	<li>Nexplanon: This is a tiny (4cm) plastic rod that gets placed between your bicep and triceps muscles. It can stay in for three years and is another progestin-only form of birth control. The biggest reason people don&rsquo;t like it is unscheduled bleeding, along with all of the side effects normally associated with hormonal contraception.&nbsp;</li>
	<li>Hormonal IUD: This also contains progestin and is an intra-uterine device which means it sits inside your uterus. The foreign body effect causes inflammation that is toxic to the sperm while the progestin performs its usual functions. These can be inserted from three to five and up to seven years and come in different doses as well. Its 99 percent effective, rapidly reversible, helps manage heavy painful periods, anaemia and endometriosis-related pain. With this form of IUD, you can either experience prolonged bleeding or your period may stop completely. There is some risk of spotting or unscheduled bleeding as well along with the usual hormonal effects. Device expulsion and IUD perforation (very rare, around 1 in 1,000) may happen.&nbsp;</li>
	<li>Non-Hormonal IUD: Paragard IUD is another intra-uterine contraceptive method which can stay in for up to 10 years and contains no hormones. This may make your periods heavier and longer with worsened cramps but it has a 99 percent effectivity rate. The best part about this option is that you can pull it out anytime if it doesn&rsquo;t suit you.&nbsp;</li>
	<li>Birth Control Ring: This can be inserted into the vagina and kept there for three weeks, once it is removed on week four you can get your period. It has the same benefits as the birth control pill except you don&rsquo;t have to remember taking it every single day. It&rsquo;s 93-96 percent effective and with perfect use, this goes up to 99 percent. Since it contains oestrogen and progestin, it works by similar mechanism as the COCP and has the same benefits and side effects. You might notice an increase in discharge or vaginal infections with this option but it&rsquo;s not very common.&nbsp;</li>
	<li>Birth Control Patch: This falls in the same category as the pill and the ring and contains oestrogen and progestin. It works by similar method as the COCP and is 93-96 percent effective with typical use. Perfect use can raise this number up to 98 percent. It can help with painful periods as well as endometriosis related pain while also decreasing risk of endometrial cancer.</li>
</ul>

It&rsquo;s important to note that it can&rsquo;t be given to patients with a BMI of 30 or more and people with increased risk of blood clots since the amount of oestrogen your body is exposed to by this method is fairly high. Common side effects include irregular bleeding, nausea, moodiness, breast tenderness and skin irritation at the site of application.&nbsp; 
&nbsp;

Ensure safety

Some other ways you can ensure safety of both you and your partners:

Immunization

Making sure you are vaccinated against STIs such as HPV and Hepatitis B is of prime importance. These are more effective when done before the onset of sexual activity. The CDC recommends getting the HPV vaccine for all pre-teens (ages 11 or 12) and people below 26 years of age. It’s not recommended after 26 as most people have been exposed to the virus by then, however, for people 27-45 years of age you can consult your doctor and proceed according to their instructions.&nbsp;

Get tested

If you are someone who regularly engages in sexual activity, make sure you’re also getting regularly tested for STDs. This applies even if you are 100 percent safe every single time.

Dr. Safia Mehmood

AL SHIFA CLINIC KARACHI

Syed Intisar Hussain

Domestic Violence And Its Impact On The Child

Introduction

Two words: domestic violence. In all probabilities, the first person to spring to our minds and the focus of the entirety of the thought process that follows is the victim. Were they physically attacked? Did they suffer any injury? In more extreme cases, did they survive? A handful of us would consider if they suffered psychologically or emotionally.&nbsp; 
&nbsp;

But most of us would overlook the single most important person in the whole scenario - the child(ren) who are witnessing those two adults, people they are close to; one engaged in an act of violence, with the other at the receiving end, cowering or simply motionless. We don&rsquo;t take into account the kind of injury these kids receive, how they&rsquo;re scarred physically and mentally. 
&nbsp;

Before diving deep into the topic about the <a href="https://merisehat.pk/article/how-does-familial-conflict-or-domestic-violence-affect-children">impact of domestic violence on a child</a> we should first understand what domestic violence really is.&nbsp;

&nbsp;

Domestic violence is also known as &#39;intimate partner violence&#39; and it can be defined as a set of behavior in a relationship that is used to assert control and power over a close partner or spouse.&nbsp; 
&nbsp;

Domestic violence comes in many forms &ndash; physical, psychological, sexual, economic, and/or emotional &ndash; and the aim of such acts is to dominate over one&#39;s partner and to threaten them<a href="#accordion">[1]</a>. 
&nbsp;

The individual (male or female) who initiates violence does so by threatening, abusing, frightening, humiliating, terrorizing, or injuring their partner. The least it does is to rob the victim of their self-esteem and confidence.&nbsp; 
&nbsp;

<h5>What It&rsquo;s Not</h5>

Apologizing afterwards does not absolve the perpetrator of the crime. Abuse in any form is NOT love.&nbsp;

&nbsp;

Understanding The Impact Of Domestic Violence On Children

There is no denying that the primary victim is the one tremendously at risk of the negative consequences of the violence, but these abusive episodes negatively impact the children too, who share the same environment.&nbsp; 
&nbsp;

Caregivers, whether it&rsquo;s the mother or the father who endure domestic violence, become unavailable and distant from their kids. Their unresponsiveness to the child&#39;s demands paves way to a range of unresolved emotions in the young one who starts to feel neglected.

&nbsp;

<ul>
	<li>Serious psychological aftermath in children who are exposed to it.</li>
	<li>The place these children call home, the place meant to nurture them with affection, love, and care along with providing safety, becomes a breeding ground of insecurity and fear as a consequence of domestic violence.&nbsp;</li>
	<li>It leaves a lasting impact on their mind and personalities; the events get imprinted on their memories and stress becomes a core component of their lives.&nbsp;</li>
	<li>Children who live in an environment where domestic violence is common develop a certain set of traits such as being short-tempered, becoming habitual at lying, being frustrated, and being emotionally distracted<a href="#accordion">[2]</a>.&nbsp;</li>
	<li>When these children become adults, all their life choices including relationships are greatly influenced by this past trauma. Their beliefs stem from the fear of abandonment, sadness, excessive worry, guilt, and lack of empathy they experienced in their childhood. 
	&nbsp;</li>
</ul>

Hence, when children witness violence at home, they are not merely passive onlookers; rather, they are a part of the equation, the indirect (and perhaps unintentional) victims of it. And this &lsquo;past&rsquo; continues to haunt them throughout their lives. So, the physical and mental health of children living in such households is as much a matter of concern as that of the primary victim.

According to the Centers for Disease Control and Prevention (CDC), where domestic violence is a norm, there are 40% &ndash; 60% chances of children also receiving abuse. It&rsquo;s important to mention here that these rates are 15 times higher than the average<a href="#accordion">[2]</a>.&nbsp;

It is estimated that roughly 10 million people in the United States are affected by domestic violence. A study revealed that 1 in 15 children were exposed to domestic violence, and 1 out 3 experienced the act of violence themselves<a href="#accordion">[3]</a>. In Pakistan, around 70-90% of women experience domestic violence, which is a significant number<a href="#accordion">[4]</a>.

&nbsp;

Kids who witness intimate partner violence at their homes exhibit a range of symptoms:&nbsp; 
&nbsp;

<ul>
	<li>Increased episodes of insomnia&nbsp;</li>
	<li>Bed wetting</li>
	<li>Verbal, cognitive, and motor issues</li>
	<li>Indulgence in activities of self-harm&nbsp;</li>
	<li>Experience learning difficulties&nbsp;</li>
	<li>Aggressive behavior&nbsp;</li>
	<li>Antisocial behavior</li>
	<li>Experience depression and anxiety&nbsp; 
	&nbsp;</li>
</ul>

Children of different age groups react differently to such tense situations. 
&nbsp;

<ul>
	<li>Preschool Children: When these kids experience domestic violence, they revert to a few years and adopt activities that they did when they were younger. For instance, they start thumb-sucking, bed-wetting, crying, and whining.&nbsp;</li>
</ul>

They may also present with symptoms of separation anxiety such that they may have difficulty sleeping and wake up startled from their sleep<a href="#accordion">[5]</a>. 
&nbsp;

<ul>
	<li>School-Going Children: These children often feel deeply ashamed and guilty of the circumstances at home, because they blame themselves for the domestic violence. They have low self-esteem and frequently experience headaches and stomachaches.</li>
</ul>

Children in this age group don&#39;t participate in the class actively. They also lag behind in studies because of their inability to concentrate<a href="#accordion">[5]</a>.&nbsp; 
&nbsp;

<ul>
	<li>Teenagers: Teens who witness domestic violence react in a plethora of negative ways. They miss school and fight with family members. They also have trouble making friends, and suffer from very low self-esteem.&nbsp;</li>
</ul>

Affected teens tend to get involved in risky activities, such as using drug or alcohol, and having unprotected sex. They get involved in fighting and bullying, which puts them at risk of getting caught by the law. Teen boys are more likely to get involved in this kind of behavior, as they react more outwardly to the domestic violence at home. Whereas, teenage girls often become socially withdrawn and experience depression by keeping their feelings to themselves<a href="#accordion">[5]</a>.

&nbsp;

These children are likely to become offenders or victims as adults, repeating the cycle that they were part of.&nbsp;Rarely, they are able to break themselves free from the cycle of abuse and violence. In those rare instances, they adopt a healthy and holistic approach towards life and relationships, because they don't want someone else to go through the terrible phase of domestic violence that they went through as a kid.&nbsp;

The impact of domestic violence on a child is evident in the short as well long term. In the subsequent paragraphs, the article sheds light on what are the challenges faced by these kids.&nbsp; 
&nbsp;

<ul>
	<li>
	<h5>Anxiety&nbsp;</h5>
	</li>
</ul>

Children who have witnessed domestic violence are hypersensitive about their surroundings. They feel like they are living on an edge or walking on eggshells, as they fear that any action of theirs could trigger another episode of domestic violence at home. It is not surprising that these children somehow manage to blame themselves for all the violence. This belief in return bruises their self-esteem and robs them of their self-confidence<a href="#accordion">[3].</a>&nbsp; 
&nbsp;

<ul>
	<li>
	<h5>Depression&nbsp;</h5>
	</li>
</ul>

Staying in a toxic household where domestic violence is common triggers anxiety in children and their mental health deteriorates. The young ones struggle with sadness, low mood, difficulty concentrating, and other symptoms that hint towards depression. As they grow older, these children become depressed adults. This unfortunate situation continues, unless a therapeutic intervention is made by a therapist<a href="#accordion">[3]</a>.&nbsp; 
&nbsp;

<ul>
	<li>
	<h5>Post-Traumatic Stress Disorder&nbsp;</h5>
	</li>
</ul>

One of the most detrimental effects of domestic violence is that children develop post-traumatic stress disorder (PTSD). Just witnessing violence is enough to make them enter a downward spiral of PTSD which includes stress, insomnia, having frequent nightmares, experiencing flashbacks, and being unable to concentrate<a href="#accordion">[3]</a>. 
&nbsp;

<ul>
	<li>
	<h5>Physical Effects&nbsp;</h5>
	</li>
</ul>

Domestic violence has a physical effect on the health of children. These children frequently experience headaches and stomachaches that are linked with episodes of violence at home.&nbsp; 
&nbsp;

<ul>
	<li>
	<h5>Physical Abuse</h5>
	</li>
</ul>

Caregivers, who are either offenders or endurers of domestic violence, are not able to provide their child with the safety they need from his or her parents. In fact, such parents can even hurt their children in multiple ways either emotionally, verbally, or physically. In this way, children become the primary victim of violence. It shatters their personality, and breaks them from within<a href="#accordion">[3]</a>.&nbsp; 
&nbsp;

<ul>
	<li>
	<h5>Aggressive Behavior&nbsp;</h5>
	</li>
</ul>

As mentioned earlier, it is not unexpected that children from violent households become aggressive and are often short tempered. They become reckless and get involved in multiple risky activities like skipping school and getting in trouble with the law.&nbsp; 
&nbsp;

<ul>
	<li>
	<h5>Health Issues</h5>
	</li>
</ul>

As adults, these children develop a myriad of health problems such as obesity, hypertension, diabetes. These health problems are usually linked with chronic stress and abuse, which is the case of children living in an environment where domestic violence is sadly prevalent.&nbsp;

&nbsp;

It is integral to help our children recover if they have been an (in)direct victim of domestic violence<a href="#accordion">[5]</a>:

<ul>
	<li>Leave the abusive relationship for the safety of children.</li>
	<li>Help the children open up about their fears.</li>
	<li>Educate them about healthy relationships, and help them differentiate what is a healthy relationship and what is not.</li>
	<li>Help them learn about boundaries. Teach them that no one is allowed to touch them or make them feel uncomfortable. Similarly, they should not make others feel uncomfortable by doing any unacceptable activity.&nbsp;</li>
	<li>Find a therapist who can be a counsellor and a support system to back the child, and help them navigate through their journey as they unlearn the negative effects that violence had on them.</li>
	<li>Get the affected child cognitive behavioural therapy (CBT), as it is known to be an effective treatment option for people undergoing depression or anxiety due to any cause.&nbsp;</li>
</ul>

&nbsp;

There are multiple organizations that offer services to children who are negatively impacted by violence, abuse, or neglect. These organizations include: 
&nbsp;

<ul>
	<li>Center For Violence And Injury Prevention - Funded by the Centers for Disease Control and Prevention (CDC), this organization aims to promote healthy young adults by advancing violence prevention strategies backed by evidence<a href="#accordion">[6]</a>. 
	&nbsp;</li>
	<li>American Professional Society On The Abuse Of Children - This is a nonprofit organization that offers services to children who receive maltreatment at their homes<a href="#accordion">[7]</a>.&nbsp; 
	&nbsp;</li>
	<li>American Psychological Association - This is for children who have experienced youth violence, abuse, or maltreatment<a href="#accordion">[8]</a>. 
	&nbsp;</li>
	<li>Protection And Help Of Children Against Abuse And Neglect (PAHCHAAN) &ndash; It is a not-for-profit child&#39;s rights and protection organization working to enhance and better the future of several families in Pakistan, by providing family support, provision of necessary training and knowledge for parents and alternative carers<a href="#accordion">[9]</a>.&nbsp; 
	&nbsp;</li>
	<li>Sahil &ndash; This is an Islamabad-based organization working on child protection, especially child sexual abuse, by providing free counselling and legal aid for victims of sexual abuse<a href="#accordion">[10]</a></li>
</ul>

&nbsp;

Conclusion

Domestic violence is a painful dilemma not only for the primary victim but also for the child that witnesses it. To mitigate the mental and physical damage that domestic violence causes to these children, seek help from mental health professionals. They can help children overcome their fears and challenges and enable them to live life as healthy individuals.&nbsp;

&nbsp;

Key Points

<ul>
	<li>Domestic violence is also known as intimate partner violence, and comes in multiple forms. In the setting of domestic violence, one partner threatens and overpowers the other by one or all means: emotional, psychological, sexual, and physical.</li>
	<li>Children coming from a background of domestic violence have disrupted personalities, and their mental health is in a feeble state.</li>
	<li>These children become anxious and depressed. They can also suffer PTSD, and experience physical effects after episodes of violence.</li>
	<li>Children who have been indirect victims of domestic violence find it hard to concentrate and suffer academically.</li>
	<li>These children also become aggressive and get involved in reckless activities.</li>
	<li>Support from caregivers and seeking professional treatment by a therapist are ways to overcome the negative effects of domestic violence.</li>
	<li>There are several national and international organizations that offer services ranging from counselling to legal advice, to children facing these issues.</li>
</ul>

&nbsp;

[1] "What Is Domestic Abuse? - the United Nations."

[2]  Alarming Effects of Children's Exposure to Domestic Violence." 26 Feb. 2019,

[3] "How Witnessing Domestic Violence Affects Children - Verywell Mind." 17 Nov. 2021,

[4] "Review Articles - JPMA - Journal Of Pakistan Medical Association."

[5] "Effects of domestic violence on children - Office on Women's Health." 15 Feb. 2021,

[6] "Organizations Providing Family/Domestic Violence Information."

[7] “American Professional Society on the Abuse of Children.”

[8] “American Psychological Association.”

[9] “PAHCHAAN (Protection and Help of Children Against Abuse and Neglect).”

[10] “Sahil”

Nawal Adnan

A Short Guide To Local Addictions

Drug addiction is defined as &lsquo;a neuropsychological disorder leading to intense and persistent urge to use a substance.&rsquo; It overrides a person&rsquo;s self-control and his or her awareness of harmful effects by altering their brain function.&nbsp; 
Addiction is thus identified as a brain disorder and not a personal failure on the part of the individual. Much of the conversation around drug addictions needs to be remodeled based on these principles.&nbsp; 
When we talk about substance abuse in Pakistan our mind immediately conjures up a very particular image of cachectic men huddled in street corners trying to have their most recent hit. This, however, is not the whole picture.&nbsp; 
&nbsp;

Guide to Local Addictions

In recent years, drugs have become not only much more readily available but also cheaper. The youth of Pakistan from all classes and social strata has found themselves using one thing or another at some point. Those who manage to stay away from it have still been impacted by it in some way. Road accidents, broken <a href="https://merisehat.pk/article/love-in-a-long-term-relationship">relationships</a>, lagging behind in school and sports, overall health suffering as a result of these addictions, are just a few examples. Factors such as gender, age, class etc influence this and so does peer pressure and accessibility.&nbsp; 
 
Some of the most common local addictions we have are as follows, this list however is in no way comprehensive:&nbsp; 
&nbsp;

The most popular, most easily available, and a favorite amongst those who indulge. The psychoactive substance here is THC (tetrahydrocannabinol). Two forms of cannabis are available; hashish (hash) and charas (weed). The difference between both is the form they come in and the concentration of THC.&nbsp;

Hash has a more concentrated form of THC. It&rsquo;s either smoked by rolling in a cigarette or inhaled as a vapor by heating it up in a bong. Bhang is a mixture of cannabis and milk and is also widely consumed. Then there are cannabis teas, capsules, vapes and edibles.

It has been labeled as a gateway drug which means that the individuals indulging in this are open to experimenting with harder drugs in the future.&nbsp;

Locally, several cases have been reported where people (both children and adults) started out with smoking cannabis and ended up with addictions to harder drugs such as heroin and crystal meth.&nbsp;

In some areas the country, it&rsquo;s a part of the local culture, and happy occasions like weddings even call for it.&nbsp;

The main effects of cannabis are a feeling of euphoria and relaxation. Then there might sense of time slowing down, increased appetite, heightened senses and even paranoia and anxiety. All of these vary dramatically depending on the form, method and the person using it.&nbsp; 
&nbsp;

Pakistan has the largest cigarette-smoking populations in the world. In the era of harder drugs being accessible, cigarettes aren&rsquo;t even considered a taboo. People of all ages, genders and social strata partake in this and nicotine addiction is a major issue our population suffers from.&nbsp;

Nicotine is considered to be the culprit when it comes to forming a habit of smoking. However, it has been postulated that it is the unique combination of other chemicals added to cigarettes that may actually be facilitating the process.&nbsp;

Cigarettes contain over 7,000 chemicals and most of them are carcinogenic, what we fail to focus on is the fact that they also contain monoamine oxidase inhibitors (MAOIs). This compound is used in antidepressants and this is what leads to the characteristic &lsquo;smoker&rsquo;s high&rsquo;. A smoker&rsquo;s high is when you have increased serotonin in your brain making you feel happier.

Nicotine has other detrimental effects on the body, such as an increased heart rate and blood pressure, your blood vessels shrinking and of course the very obvious toxins introduced into the lungs. All this works together to wreak havoc on the body of the smoker while making sure that they never stop. Then there is the problem of second-hand smoke (which is very harmful for those inhaling it) which is a whole different beast of its own.&nbsp; 
&nbsp;

This is a sweet or savory mixture of crushed areca nut, tobacco, catcechu, paraffin wax, slaked lime and spices such as turmeric, cardamom, cloves, saffron. This is pretty much casually consumed by people usually belonging to the lower socio-economic classes.&nbsp;

They believe that it helps with digestion and killing germs. It also leads to a sense of euphoria, sweating, salivation, palpitation, feelings of warmth, alertness, tolerance to hunger, and a higher stamina for work.&nbsp;

Apart from the nicotine addiction this causes, gutka is a major cause of cancers of the lip, mouth, tongue, throat and esophagus. Supari is areca nut consumed on its own and is also linked with oral cancers some of which simply don&rsquo;t have a cure, such as oral submucous fibrosis. 
&nbsp;

This is derived from the poppy plant (papaver somniferum). Pakistan is a part of the golden crescent where, along with Afghanistan and Iran, 90 percent of the world&rsquo;s non-pharmaceutical grade opium is produced.&nbsp;

It is then transported through the region which makes it so readily available that can get it for as cheap as Rs10, which is cheaper than getting food here. Pakistan has therefore been called the most heroin-addicted country in the world. The active compound in the drug is morphine which has a soporific effect, hence the name. This is the main ingredient in many opioids, including heroin.&nbsp;

It can be smoked, eaten, taken as a pill or most commonly; injected. Sometimes in desperation and sometimes as a sign of brotherhood, needles are shared among the addicts. Around 92percent of PWID (people who inject drugs) were reported to practice &lsquo;booting&rsquo; or &lsquo;registering&rsquo; where blood is first jerked into the syringe and then this mixture is injected back into the system. These syringes are then shared.&nbsp; 
 
This leads to the rise of blood-borne infections and the main reason behind the HIV/AIDS crisis in the country. Hepatitis B and C are also on the rise and have the same etiology. Practices such as &lsquo;flashblood&rsquo; [khoon bozee] where another&rsquo;s opium laden-blood is injected into the body in times of scarcity, or to share the high, worsen this issue.&nbsp;

 
Harmful on its own, it is also added to marijuana joints and a mixture of marijuana, opium and heroin is also injected by some. People suffering from this particular affliction develop intense physical and psychological dependence on the drug. This has implications far and wide starting from health, work, family and ending with an added burden on the healthcare system.&nbsp; 
 
When brought to hospitals on account of either accidents or poor health requiring pain management, the bodies of these addicts fail to respond to the prescription drugs leading to severe physical and psychological distress. Helpless doctors try everything in their power to mitigate the condition but the only thing that works is what they have gotten used to. 
&nbsp;

Pakistan is one of the top 10 countries in the world where people are addicted to opioid analgesics or narcotics. These are strong prescription drugs used for pain management. Taking these in order to achieve feelings of general relaxation, happiness and a high which makes one feel as if they are weightlessly floating through life is what leads to addictions. 
 
Abusing these drugs can lead to severe adverse effects, however, the least of this is nausea, vomiting, reduced peristalsis hence constipation and the worst being respiratory depression leading to death.&nbsp; 
&nbsp;

This is an illegally brewed alcoholic drink made by fermenting sugar cane or wheat husk. Mostly consumed by teenagers, this is essentially a poison. The process happens in remote fields and has no check and balance. The hazardous effects of this are the usual alcohol-mediated liver damage but what&rsquo;s worse is that it leads to a loss of eye-sight as well.&nbsp; 
&nbsp;

Methamphetamine is a highly addictive nervous system stimulant and a recently growing addiction in a younger, more educated demographic. It can either be smoked, injected, snorted or taken by mouth. The feelings derived from this are your usual sense of euphoria but, most commonly, it leads to irritability and paranoia on the part of the user. 
 
People have reported increased focus and no loss of inhibition on this as well but most of this data is purely anecdotal. We know that this is a highly dangerous compound and can lead to strokes, convulsions and even death. It&rsquo;s also very difficult to treat meth addiction. 
&nbsp;

Bottom Line

Pakistan&rsquo;s Drug Abuse Control Master Plan 2010-14 had the lofty aspiration of making the country drug-free by 2020, this has clearly not been executed. A pragmatic approach is needed.&nbsp;

The Lancet (a weekly peer-reviewed general medical journal) reported a government official saying that the relapse rate in Pakistan is 90 percent. The UN Office of Drugs and Crime (UNODC) published a Technical Summary Report back in 2013 which reported that 6.45 million people (aged 15-64) in Pakistan were using drugs.&nbsp;

Things are much graver now and worsened by the fact that treatment and rehabilitation efforts are underfunded. Treatment centers that are cheap are overburdened, while others charge too much for an everyday man to afford. Tertiary care hospitals with psychiatry wards refuse to admit drug addicts and consider it a waste of time and resources. There is also a lack of training and staff. Much of the responsibility is relegated to the social welfare systems which fail to accommodate the sheer weight of the issue.&nbsp;

The best way to proceed would be a coordinated effort where treatment by the health department and rehabilitation by the social welfare system is provided. However, we are still lacking such efforts. Developing an effective response will require an in-depth understanding of the issue. We must raise awareness, fund efforts, stabilize the socio-economic condition of the region strict border control, conduct studies and surveys to assess the real magnitude of the issue (the last national survey dates back to 2013).&nbsp;

Unmasking The Unseen Wounds: How To Recognize Signs Of Emotional Abuse

Emotional abuse is a subtle but devastating form of mistreatment that can leave deep psychological scars. Unlike physical abuse, its wounds are not visible, but its impact can be just as severe. Recognizing signs of emotional abuse is crucial in order to protect oneself or others from its detrimental effects. This article sheds light on the intricacies of emotional abuse, its manifestations, and offers guidance on how to recognize its hidden signs. 
&nbsp;

Understanding Emotional Abuse

Emotional abuse is a pattern of behaviour designed to undermine an individual&#39;s self-esteem, confidence, and sense of self-worth. This type of abuse doesn&#39;t involve physical harm, but it can be just as damaging, if not more so, because its effects are internal and insidious. Perpetrators of emotional abuse often manipulate, belittle, and control their victims, leaving them feeling powerless and trapped. 
&nbsp;

Signs Of Emotional Abuse

<ol>
	<li>Constant Criticism: A hallmark of emotional abuse is relentless criticism. An abuser might criticize every aspect of their victim&#39;s life, from appearance to choices, in an effort to erode self-confidence.</li>
	<li>Isolation: Emotional abusers often isolate their victims from friends and family, making them solely dependent on the abuser for emotional support. This isolation creates an environment where the victim feels trapped and unable to seek help.</li>
	<li>Gaslighting: <a href="https://merisehat.pk/article/how-to-recognise-gaslighting-and-get-help">Gaslighting</a> involves distorting reality to make the victim doubt their perception of events. Abusers may deny their actions, manipulate situations, or even question the victim&#39;s sanity, causing confusion and self-doubt.</li>
	<li>Undermining Achievements: An emotional abuser may belittle their victim&#39;s achievements or downplay their successes. This tactic is used to make the victim feel inadequate and unworthy of recognition.</li>
	<li>Control And Manipulation: Abusers exercise control over their victims by making decisions for them, monitoring their activities, and even dictating their thoughts and emotions. Manipulation is employed to maintain dominance and subjugate the victim&#39;s autonomy.</li>
	<li>Humiliation And Insults: Public humiliation, name-calling, and insults are tactics used to demean the victim and lower their self-esteem. This behaviour reinforces the abuser&#39;s power dynamic.</li>
	<li>Emotional Withdrawal: Abusers may intentionally withhold affection, attention, or emotional support, causing the victim to constantly seek validation and approval.</li>
	<li>Threats And Intimidation: Emotional abusers may use threats, intimidation, or even violence to maintain control. This creates an atmosphere of fear and submission. 
	&nbsp;</li>
</ol>

Recognizing emotional abuse can be challenging due to its subtle nature. Victims may initially dismiss or downplay the signs, attributing them to stress or misunderstandings. However, paying attention to one&#39;s emotional state and seeking external perspective is vital.

<ol>
	<li>Trust Your Instincts: If something doesn&#39;t feel right in a relationship, it&#39;s important to trust your gut feelings. If you find yourself constantly anxious, fearful, or emotionally drained, it might be a sign of emotional abuse.</li>
	<li>Observe Patterns: Look for consistent patterns of behaviour, rather than isolated incidents. Emotional abuse is characterized by repetitive tactics aimed at maintaining control.</li>
	<li>Seek Support: Share your experiences with a trusted friend, family member, therapist, or counsellor. Their outside perspective can help you better understand if you&#39;re in an emotionally abusive situation.</li>
	<li>Document Instances: Maintain a record of instances where you&#39;ve felt belittled, controlled, or manipulated. This documentation can serve as evidence if you decide to seek help or take legal action. 
	&nbsp;</li>
</ol>

Emotional abuse can be incredibly damaging, leaving long-lasting scars on an individual&#39;s self-esteem and mental well-being. Recognizing the signs of emotional abuse is the first step toward breaking free from its cycle and seeking help. Trust your instincts, seek support, and prioritize your emotional well-being. No one deserves to be subjected to emotional abuse, and everyone has the right to live a life free from manipulation, control, and mistreatment.

Umna Salah

This article or video has been recorded by a subject / domain specialists with a proven track record of excellence in their area. 

Re-Victimization Within Families

Survivors of sexual assault often rely on their families for emotional support and understanding during their healing journey. However, it&#39;s important to acknowledge that, at times, family members may unintentionally re-victimize survivors, compounding the trauma they have experienced. This article delves into the various ways in which family members can inadvertently cause harm to survivors and provides guidance on how to foster a more supportive environment. 
&nbsp;

guidance

1. Victim-Blaming Attitudes

Some family members may harbor victim-blaming attitudes, consciously or unconsciously. They may ask questions like, &quot;Why were you there?&quot; or &quot;What were you wearing?&quot; These questions place blame on the survivor rather than on the perpetrator. 
&nbsp;

2. Doubting The Survivor&#39;s Story

Expressing doubt about the survivor&#39;s account of the assault can undermine their sense of credibility and discourage them from seeking help or reporting the incident. Family members should approach the survivor with empathy and belief. 
&nbsp;

<ol>
	<li>Trivializing The Experience: Minimizing the severity of the assault by saying things like, &quot;It could have been worse&quot; or &quot;Just move on&quot; invalidates the survivor&#39;s emotions and can make them feel as though their pain is inconsequential. 
	&nbsp;</li>
	<li>Pressuring The Survivor To Move On Quickly: Recovery from sexual assault is a highly individualized process, and it&#39;s crucial to respect the survivor&#39;s timeline. Pressuring them to &quot;get over it&quot; prematurely can be harmful. 
	&nbsp;</li>
</ol>

1. Invasion Of Personal Space: Family members should always respect the survivor&#39;s boundaries. Invading their personal space, especially without consent, can trigger feelings of vulnerability and fear. 
&nbsp;

2. Sharing The Survivor&#39;s Story Without Permission: Discussing the survivor&#39;s experience with others, even within the family, without their consent can be a breach of trust. The survivor should have control over who knows about their experience. 
&nbsp;

1. Silence And Avoidance: Some family members may avoid discussing the assault altogether, thinking it&#39;s best not to bring it up. However, silence can be interpreted as indifference or a lack of support. 
&nbsp;

2. Failure To Offer Emotional Support: Survivors need a safe space to express their feelings and thoughts. Family members who fail to offer emotional support may inadvertently isolate the survivor, making them feel even more alone in their struggle. 
&nbsp;

Support from family can be a cornerstone of healing for survivors of sexual assault, but it&#39;s essential to be mindful of the potential for unintentional harm. Understanding the ways in which family members can re-victimize survivors is crucial for fostering a more empathetic and supportive environment. Listening, believing, respecting boundaries, and offering unwavering <a href="https://merisehat.pk/article/unmasking-the-unseen-wounds-how-to-recognize-signs-of-emotional-abuse">emotional</a> support are key elements in helping survivors navigate their path to healing and recovery within the familial context.

Staff Writer

Coping With Sexual Violence And Assault: A Guide To Healing And Recovery

<a href="https://merisehat.pk/article/how-sexual-violence-can-impact-your-physical-and-mental-health">Sexual violence</a> and assault are traumatic experiences that can have profound and lasting effects on survivors. Coping with the aftermath of such incidents is an individual journey, but there are valuable strategies and resources available to aid in the process. In this guide, we&#39;ll explore various steps survivors can take to cope with sexual violence and assault and begin the journey towards healing and recovery. 
&nbsp;

Various Steps for survivors

1. Speak To A Trusted Friend Or Family Member

Sharing your experience with someone you trust can be a crucial first step in coping. It allows you to unburden yourself and receive emotional support from those who care about you. 
&nbsp;

2. Seek Professional Help

Consider reaching out to a therapist, counselor, or support group specializing in trauma and sexual assault. Professional guidance can provide you with valuable tools and coping strategies. 
&nbsp;

1. Contact Law Enforcement

Reporting the assault to the police is an essential step in seeking justice and preventing the perpetrator from harming others. Be prepared for a thorough investigation and remember that you have the right to privacy and confidentiality during the process. 
&nbsp;

2. Preserve Evidence

If you choose to report the incident, try to preserve any physical or digital evidence that may be relevant. This may include photographs, messages, or clothing. 
&nbsp;

1. Practice Self-Compassion

It&#39;s essential to treat yourself with kindness and patience during your healing journey. Self-compassion can help counteract feelings of guilt or self-blame. 
&nbsp;

2. Engage In Physical Activity

Regular exercise can be an effective way to reduce stress and boost your mood. It can also help you reconnect with your body in a positive way. 
&nbsp;

1. Trauma-Informed Therapy

Seek therapy with a trauma-informed therapist who specializes in working with survivors of sexual violence. Therapists can help you process your emotions, develop coping strategies, and work towards healing. 
&nbsp;

2. Support Groups

Joining a support group for survivors of sexual violence can provide a sense of community and shared understanding. It allows you to connect with others who have experienced similar trauma. 
&nbsp;

1. Medical Examination

Visit a healthcare professional for a medical examination, even if you don&#39;t plan to report the incident. This can address any physical injuries and assess the risk of sexually transmitted infections. 
&nbsp;

2. Legal Advocacy

Consider seeking legal advice to understand your rights and options, especially if you choose to pursue legal action against the perpetrator. 
&nbsp;

Coping with sexual violence and assault is an arduous journey, but it&#39;s essential to remember that healing and recovery are possible. Seeking support, whether from friends, family, professionals, or support groups, can significantly aid in the process. Prioritizing self-care, self-compassion, and seeking therapy are key steps towards reclaiming your life and finding hope after trauma. Remember, you are not alone, and there is help available to guide you through this difficult journey. 
&nbsp;

How Sexual Violence Can Impact Your Physical And Mental Health

Sexual violence is a harrowing experience that leaves deep scars on survivors. Beyond the immediate trauma, it can have enduring effects on physical and mental health. In this article, we delve into the complex ways in which sexual violence can impact a survivor&#39;s well-being. 
&nbsp;

Impacts of Sexual Violence

<h5>1. Physical Health Consequences</h5>

<ul>
	<li>Physical Injuries: Sexual violence often results in physical injuries, such as bruises, cuts, or fractures. These injuries can range from minor to severe, depending on the nature and intensity of the assault. 
	&nbsp;</li>
	<li>Reproductive Health Issues: Sexual violence can lead to reproductive health problems, including sexually transmitted infections (STIs), unwanted pregnancies, and gynecological issues. Survivors may require medical attention and support to address these concerns. 
	&nbsp;</li>
	<li>Chronic Health Conditions: Survivors of sexual violence may be at an increased risk of developing chronic health conditions, such as chronic pain, gastrointestinal problems, and autoimmune disorders. The chronic stress from the trauma can weaken the immune system and exacerbate existing health issues. 
	&nbsp;</li>
</ul>

<h5>2. Mental Health Implications</h5>

<ul>
	<li>Post-Traumatic Stress Disorder (PTSD): Many survivors experience symptoms of <a href="https://merisehat.pk/disease/ptsd-post-traumatic-stress-disorder">PTSD</a>, including flashbacks, nightmares, and hypervigilance. These symptoms can significantly impact daily life and functioning. 
	&nbsp;</li>
	<li>Depression And Anxiety: Survivors of sexual violence are at a higher risk of developing depression and anxiety disorders. The emotional toll of the trauma, coupled with feelings of shame and guilt, can contribute to these conditions. 
	&nbsp;</li>
	<li>Substance Abuse: Some survivors may turn to substance abuse as a way to cope with the emotional pain and distress caused by the trauma. This can lead to addiction and further complicate recovery. 
	&nbsp;</li>
</ul>

<h5>3. Sexual And Relationship Issues</h5>

<ul>
	<li>Intimacy And Trust: Sexual violence can shatter trust and intimacy in future relationships. Survivors may struggle with forming and maintaining healthy relationships due to fears and triggers related to the trauma. 
	&nbsp;</li>
	<li>Sexual Dysfunction: Survivors may experience sexual dysfunction, including pain during intercourse, loss of libido, or difficulty achieving sexual satisfaction. These issues can affect self-esteem and quality of life. 
	&nbsp;</li>
</ul>

<h5>4. Social And Emotional Impact</h5>

<ul>
	<li>Isolation And Stigmatization: Survivors of sexual violence may face stigma and isolation, as societal misconceptions and victim-blaming attitudes persist. This isolation can hinder healing and recovery. 
	&nbsp;</li>
	<li>Guilt And Shame: Many survivors grapple with feelings of guilt and shame, even though they are not responsible for the assault. These emotions can erode self-worth and hinder the healing process. 
	&nbsp;</li>
</ul>

The physical and mental health impact of sexual violence is significant and multifaceted. It&#39;s essential to recognize the complex challenges survivors face and provide them with the support, empathy, and resources they need to heal. With trauma-informed care, therapy, and a strong support network, survivors can embark on a path towards recovery, reclaim their physical and mental health, and rebuild their lives.

The Role Of Mindfulness In Maintaining Sexual Health

Sexual wellness is an essential aspect of our overall health and well-being. It involves the physical, emotional, and mental aspects of our sexuality, and it can be affected by a variety of factors, including <a href="https://merisehat.pk/disease/stress">stress</a>, <a href="https://merisehat.pk/disease/anxiety">anxiety</a>, and past experiences. One approach that has gained popularity in recent years for improving sexual wellness is mindfulness. 
&nbsp;

Mindfulness is a practice that involves paying attention to the present moment in a non-judgmental way. It is about being aware of your thoughts, feelings, and sensations without becoming overwhelmed by them. Mindfulness has been shown to reduce stress, improve mood, and increase overall well-being. It involves focusing on the present moment and allowing yourself to fully experience each moment without judgment or distraction. 
&nbsp;

Effects of Mindfulness

Mindfulness can have a positive impact on sexual wellness in a variety of ways. Here are some of the benefits of practicing mindfulness for sexual wellness:

<ol>
	<li style="list-style-type:decimal">Increased Sensitivity And Arousal 
	Mindfulness can increase our awareness of our own bodies, allowing us to become more in tune with our physical sensations. This increased awareness can lead to greater sensitivity and arousal during sexual experiences, enhancing the overall experience. 
	&nbsp;</li>
	<li style="list-style-type:decimal">Reduced Anxiety And Stress 
	Anxiety and stress can have a significant impact on sexual wellness. Mindfulness has been shown to reduce anxiety and stress levels, which can help to improve sexual functioning and satisfaction. 
	&nbsp;</li>
	<li style="list-style-type:decimal">Improved Communication 
	Effective communication is critical to maintaining a healthy sexual relationship. Mindfulness can help partners become more present and attentive to each other&#39;s needs, leading to improved communication and a more fulfilling sexual relationship. 
	&nbsp;</li>
	<li style="list-style-type:decimal">Increased Intimacy 
	Mindfulness can help partners connect on a deeper level, leading to increased intimacy and emotional closeness. This increased emotional connection can lead to a more satisfying sexual relationship. 
	&nbsp;</li>
	<li style="list-style-type:decimal">Increased Confidence And Self-Esteem 
	Mindfulness can help to improve self-awareness and self-acceptance, leading to increased confidence and self-esteem. This increased confidence can lead to improved sexual functioning and satisfaction. 
	&nbsp;</li>
</ol>

Practice Mindfulness For Sexual Wellness

There are several ways to practice mindfulness for sexual wellness. Here are some tips to get started:

<ol>
	<li style="list-style-type:decimal">Focus On The Present Moment 
	During sexual experiences, try to focus on the present moment and allow yourself to fully experience each sensation without judgment or distraction. Pay attention to your body and your partner&#39;s body, and try to stay present and in the moment. 
	&nbsp;</li>
	<li style="list-style-type:decimal">Practice Mindful Breathing 
	Mindful breathing involves taking deep, slow breaths and focusing on the sensation of the breath entering and leaving your body. This can help to calm the mind and reduce stress and anxiety levels. 
	&nbsp;</li>
	<li style="list-style-type:decimal">Practice Self-Acceptance 
	Mindfulness involves accepting yourself and your experiences without judgment. Practice self-acceptance by acknowledging your thoughts and feelings without criticism or self-judgment. 
	&nbsp;</li>
	<li style="list-style-type:decimal">Improve Communication 
	Effective communication is critical to maintaining a healthy sexual relationship.Practice active listening and open communication with your partner, and try to be present and attentive to their needs and desires. 
	&nbsp;</li>
	<li style="list-style-type:decimal">Seek Professional Help 
	If you are struggling with sexual wellness, consider seeking professional help. A therapist or counselor can provide guidance and support to help you improve your sexual wellness. 
	In conclusion, mindfulness can have a positive impact on sexual wellness by increasing sensitivity and arousal, reducing anxiety and stress, improving communication, increasing intimacy, and increasing confidence and self-esteem. By practicing mindfulness and focusing on the present moment, practicing mindful breathing, practicing self-acceptance, improving communication, and seeking professional help when necessary, individuals can improve their sexual wellness and enhance their overall well-being. 
	&nbsp;</li>
	<li style="list-style-type:decimal">Incorporate Mindful Touch 
	Incorporating mindful touch can help partners connect on a deeper level during sexual experiences. This involves paying attention to the sensations of touch and focusing on the present moment without distraction. 
	&nbsp;</li>
	<li style="list-style-type:decimal">Practice Mindful Self-Pleasure: Practicing mindful self-pleasure can also help to improve sexual wellness. This involves taking time to focus on the sensations of touch and pleasure without distraction or judgment. 
	&nbsp;</li>
	<li style="list-style-type:decimal">Reduce Distractions: Reducing distractions during sexual experiences can help partners stay present and focused on the moment. This may involve turning off electronic devices, eliminating distractions in the environment, and focusing on each other&#39;s needs and desires.</li>
</ol>

<ol start="9">
	<li style="list-style-type:decimal">Practice Gratitude: Practicing gratitude can help individuals appreciate and savor the positive aspects of their sexual experiences. This involves reflecting on the positive aspects of each sexual experience and expressing gratitude for those moments.</li>
</ol>

<ol start="10">
	<li style="list-style-type:decimal">Cultivate A&nbsp;Positive Mindset: Cultivating a positive mindset can help individuals approach sexual experiences with a sense of openness and positivity. This involves focusing on positive thoughts and feelings and letting go of negative thoughts and judgments. 
	&nbsp;</li>
</ol>

Mindfulness can be a powerful tool for improving sexual wellness. By incorporating mindful practices into sexual experiences and daily life, individuals can increase sensitivity and arousal, reduce anxiety and stress, improve communication and intimacy, and increase confidence and self-esteem. With practice and dedication, mindfulness can help individuals achieve a more fulfilling and satisfying sexual relationship. 
&nbsp;

Rukhsana Rizwan

Unseen Scars: Navigating The Depths Of Emotional Abuse's Impact

Imagine a wound that leaves no visible mark but aches relentlessly, affecting every facet of your life. This is the nature of <a href="https://merisehat.pk/article/unmasking-the-unseen-wounds-how-to-recognize-signs-of-emotional-abuse">emotional abuse</a>. Often underestimated, emotional abuse leaves a profound mark on victims, impacting both their short-term well-being and long-term mental health. In this article, we&#39;ll embark on a journey to uncover the hidden repercussions of emotional abuse, shedding light on its short- and long-term effects with a friendly and engaging tone. 
&nbsp;

Emotional Abuse's Impact

Emotional abuse doesn&#39;t leave bruises, but it leaves an indelible mark on a person&#39;s emotional landscape. The short-term effects are like ripples on a pond, with each one impacting a different area of life.

<ol>
	<li>Low Self-Esteem And Self-Worth: Constant criticism, belittling, and derogatory comments chip away at a person&#39;s self-esteem. Victims often start believing they are unworthy and incompetent, leading to feelings of inadequacy.</li>
	<li>Anxiety And Fear: Living in a state of uncertainty, victims of emotional abuse often become anxious, fearing the next outburst or negative encounter. This constant unease can manifest physically as well, with headaches, nausea, and even panic attacks.</li>
	<li>Isolation And Loneliness: Emotional abusers often isolate their victims from friends and family, leaving them feeling alone and without a support system. This isolation can lead to a deep sense of loneliness and helplessness.</li>
	<li>Depression: The barrage of negative emotions and manipulation can plunge victims into depression. Feelings of sadness, hopelessness, and a loss of interest in things once enjoyed are common.</li>
	<li>Difficulty Trusting: When someone you trust has betrayed that trust, it becomes challenging to believe in the intentions of others. Victims may become overly cautious and skeptical, making it difficult to form new relationships. 
	&nbsp;</li>
</ol>

While the immediate aftermath of emotional abuse is painful, its echoes can be even more distressing. The long-term effects seep into the core of a person&#39;s identity, influencing their choices, relationships, and mental health.

<ol>
	<li>Complex Post-Traumatic Stress Disorder (C-PTSD): Prolonged emotional abuse can lead to C-PTSD, a more intense version of PTSD. Flashbacks, nightmares, and emotional dysregulation are some of its symptoms.</li>
	<li>Poor Self-Image And Self-Sabotage: Long-term emotional abuse can result in a distorted self-image. Victims may engage in self-sabotaging behaviors, often avoiding opportunities due to a lack of belief in their abilities.</li>
	<li>Difficulty Forming Healthy Relationships: Emotional abuse skews the perception of what constitutes a healthy relationship. Victims might struggle to set boundaries, fear vulnerability, and have a skewed sense of love and respect.</li>
	<li>Impact On Parenting: Those who grew up in emotionally abusive households may find it challenging to break the cycle when they become parents themselves. The learned behaviors can affect their parenting style and the way they nurture their own children.</li>
	<li>Negative Coping Mechanisms: Victims might resort to unhealthy coping mechanisms such as substance abuse, self-harm, or excessive eating to numb the emotional pain they carry.</li>
	<li>Impaired Emotional Regulation: Emotional abuse can hinder the development of healthy emotional regulation skills, leading to difficulty managing and expressing emotions in a balanced manner. 
	&nbsp;</li>
</ol>

While the effects of emotional abuse are profound, they don&#39;t have to be permanent. The journey to healing requires patience, self-compassion, and often the support of professionals.

<ol>
	<li>Therapy And Counseling: Engaging in therapy, particularly cognitive-behavioral therapy (CBT) or trauma-focused therapy, can provide tools to address the negative beliefs and emotions stemming from emotional abuse.</li>
	<li>Building A&nbsp;Support System: Surrounding yourself with people who uplift and support you is essential. Building healthy relationships can help reshape your understanding of trust and love.</li>
	<li>Learning Healthy Boundaries: Establishing and maintaining boundaries is crucial. Learning to say no, communicate effectively, and assert your needs can aid in breaking free from the cycle of abuse.</li>
	<li>Self-Care And Self-Compassion: Practicing self-care and showing self-compassion helps in nurturing your emotional well-being. Engage in activities that bring you joy and remind you of your inherent worth.</li>
	<li>Educating Yourself: Educate yourself about healthy relationships, emotional manipulation, and the effects of emotional abuse. Knowledge empowers you to recognize unhealthy dynamics and make informed choices. 
	&nbsp;</li>
</ol>

Emotional abuse is like a stealthy thief that robs you of your emotional well-being and self-worth. Its short-term and long-term effects can cast a shadow over your life. However, you possess the resilience to overcome its impact. By seeking help, fostering supportive relationships, and practicing self-care, you can heal and rebuild a life that&#39;s defined by your own strength, value, and happiness. Remember, the scars may be unseen, but your strength shines through as you embark on the journey to reclaim your emotional freedom.

Navigating Verbal Abuse: Understanding, Recognizing, And Taking Action

Verbal abuse is a form of emotional mistreatment that uses words to control, demean, and belittle others. Though it doesn&#39;t leave physical scars, its impact can be just as damaging, affecting a person&#39;s mental and emotional well-being. This article delves deep into the world of verbal abuse, shedding light on its nature, helping readers recognize abusive behaviors, and offering guidance on how to take the necessary steps to protect oneself or others. 
&nbsp;

Understanding Verbal Abuse

Verbal abuse is a pattern of behavior where an individual uses derogatory language, insults, threats, and manipulation to exert power and control over another person. It can occur in various settings, including relationships, workplaces, families, and friendships. Verbal abuse takes on many forms and can range from overt aggression to subtle manipulation. 
&nbsp;

<h5>Recognizing Abusive Behaviors</h5>

<ol>
	<li>Name-Calling And Insults: Verbal abusers use derogatory language and insults to demean and belittle the victim, attacking their self-esteem.</li>
	<li>Yelling And Screaming: Raising one&#39;s voice excessively, yelling, or screaming is a way of intimidating and asserting dominance over the victim.</li>
	<li>Threats And Intimidation: Abusers may threaten physical harm, emotional harm, or the end of a relationship to create fear and submission.</li>
	<li>Blame-Shifting: Verbal abusers often deflect responsibility for their actions by blaming the victim for their behavior, making the victim question their actions.</li>
	<li>Gaslighting: Gaslighting involves manipulating the victim&#39;s perception of reality, making them doubt their memories, thoughts, and feelings.</li>
	<li>Withholding Affection: Verbal abusers may use affection as a tool for control, withdrawing it when the victim doesn&#39;t comply with their demands.</li>
	<li>Public Humiliation: Humiliating the victim in front of others is a tactic used to exert power and control while undermining their self-esteem.</li>
	<li>Constant Criticism: Verbal abusers criticize the victim&#39;s appearance, abilities, and choices, eroding their self-confidence. 
	&nbsp;</li>
</ol>

<h5>Recognizing Abusive Relationships</h5>

<ol>
	<li>Feeling Afraid: If you&#39;re afraid of how the other person might react to something you say or do, it&#39;s a sign that the relationship might be verbally abusive.</li>
	<li>Constantly Walking On Eggshells: You find yourself constantly monitoring your behavior to avoid upsetting the other person.</li>
	<li>Feeling Worthless: Verbal abuse often leaves victims feeling worthless, unlovable, and powerless.</li>
	<li>Isolation: Abusers may isolate victims from friends and family, creating an environment where they have full control.</li>
	<li>Inconsistent Behavior: Abusers might alternate between affection and aggression, causing confusion and dependency in the victim. 
	&nbsp;</li>
</ol>

<h5>Taking Action</h5>

<ol>
	<li>Set Boundaries: Establish clear boundaries and communicate them assertively. Let the abuser know what behaviors are unacceptable.</li>
	<li>Seek Support: Reach out to friends, family, or a therapist who can provide emotional support and an external perspective.</li>
	<li>Document Instances: Maintain a record of abusive incidents, including dates, times, and descriptions. This can be helpful if legal action is necessary.</li>
	<li>Create An Exit Plan: If you&#39;re in a dangerous situation, create a plan to leave safely. This might involve seeking shelter or assistance from professionals.</li>
	<li>Contact Authorities: If the abuse becomes physical or you fear for your safety, don&#39;t hesitate to involve law enforcement. 
	&nbsp;</li>
</ol>

<h5>Seeking Healing And Recovery</h5>

<ol>
	<li>Therapy And Counseling: A therapist can help you process the trauma, rebuild self-esteem, and develop healthy coping mechanisms.</li>
	<li>Self-Care: Prioritize self-care activities that nurture your emotional well-being and remind you of your worth.</li>
	<li>Education: Educate yourself about healthy relationships, boundaries, and communication to prevent falling into similar patterns in the future.</li>
	<li>Support Groups: Joining support groups for survivors of abuse can provide a safe space to share experiences and insights. 
	&nbsp;</li>
</ol>

Verbal <a href="https://merisehat.pk/article/unmasking-the-unseen-wounds-how-to-recognize-signs-of-emotional-abuse">abuse</a> is a damaging form of mistreatment that can have long-lasting effects on an individual&#39;s mental and emotional health. Recognizing abusive behaviors, understanding the dynamics of abusive relationships, and taking action to protect yourself or others are crucial steps towards breaking free from the cycle of abuse. Remember, everyone deserves to be treated with respect and kindness. By seeking help, setting boundaries, and prioritizing your well-being, you can pave the way for healing, recovery, and the pursuit of healthy relationships.

<a href="https://merisehat.pk/article/sexual-abuse-vs-assault-whats-the-difference">Sexual abuse</a> within families is a painful and distressing issue that can shatter the very core of a household. One particularly challenging aspect of such cases is the tendency for family members to take sides, often leading to divided loyalties. This article aims to uncover the underlying reasons behind why some family members support the survivor while others side with the perpetrator. 
&nbsp;

supporting factors For survivors

<ol>
	<li>&nbsp;Loyalty To The Perpetrator: Some family members may have a deep-seated loyalty to the perpetrator, making it difficult for them to accept the reality of the abuse. Loyalty may stem from long standing relationships, familial bonds, or a sense of denial to protect the family&#39;s reputation.</li>
	<li>&nbsp;Fear Of Consequences: Family members may fear the consequences of acknowledging the abuse. This includes potential legal actions, public humiliation, or the disruption of the family unit. This fear can drive them to side with the perpetrator as a means of self-preservation. 
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1. Protecting The Family Image: Cognitive dissonance, a psychological phenomenon where individuals hold contradictory beliefs, can play a significant role. Some family members may choose to side with the perpetrator to maintain the illusion of a perfect family, even when faced with evidence of abuse.

2. Self-Justification: Siding with the perpetrator may help family members justify their inaction or ignorance regarding the abuse. It allows them to avoid feelings of guilt or responsibility for failing to protect the survivor. 
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1. Concern For Family Unity: The fear of tearing the family apart can lead some members to take sides. They may believe that supporting the survivor would only deepen the rift within the family, and they may prioritize maintaining harmony over addressing the abuse. 
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1. Emotional Manipulation: Perpetrators of sexual abuse can be skilled manipulators. They may use emotional blackmail, threats, or coercion to sway family members to their side, making it difficult for them to see the truth.

2. Emotional Attachment To The Perpetrator: In some cases, family members may have a strong emotional attachment to the perpetrator, such as a parent or sibling. This attachment can cloud their judgment and lead them to defend the abuser. 
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The dynamics of family members taking sides in cases of sexual abuse are deeply complex and often rooted in a range of psychological and emotional factors. Recognizing these reasons is essential for understanding the challenges that survivors and their advocates face when seeking justice and support within their own families. Breaking the silence and encouraging open dialogue about sexual abuse is a crucial step towards addressing this issue and providing survivors with the help and validation they deserve.