She stays quiet because of her child, my patient tells me. But despite her passivity, her husband always manages to find something wrong with her. He shouts at ungodly volumes, threatening, "Don't make me do something to you that I'll regret!" Another time, "You're making me angry enough to hit you!" She invariably cowers in terror, shielding the child from him.
"Like a switch, he shuts it off and turns to our son, smiling, comforting him, even when he's just threatened me. I don't understand it," she weeps in my office. "How can he lose control one minute at me, and then be so calm the next?"
"Because he doesn't lose control," I reply. "He knows precisely what he is doing." I show her the Power and Control Wheel, a useful tool in the psychiatry clinic for identifying behaviors consistent with coercive control, and tears pour down her face. "This is my life, and I can't keep going like this."
The couple has been trying for another child for 2 years, and she's suffered repeated miscarriages with little respite in between. The last attempt ended in ectopic pregnancy and emergent salpingectomy (removal of a fallopian tube). She almost died. With these recent revelations of her husband's cruelty, I wonder if she truly wanted to be pregnant again, if "no," was ever really an option for her.
