Making Sense of Abuse: Why Clear Definitions Matter in Families and Healthcare

Abuse in the context of family relationships does not always look the way we have been taught to expect. It is not limited to what happens between romantic partners or to children. It also occurs between siblings, adult children, and parents, and across generations in directions that challenge cultural expectations. Yet there is a troubling lack of clarity and consistency in how these experiences are defined, understood, and treated, especially in healthcare settings.

At Indigo Path Collective, we know that the language we use shapes the care people receive. That is why we are highlighting new research by Dr. Jeremy Henderson-Teelucksingh, who proposes a unified framework to define six major abuse categories. These include physical, emotional, psychological, sexual, financial, and technical abuse. While widely referenced in the literature, the terminology used to describe them varies. That inconsistency leaves victims unseen and unsupported and allows healthcare providers to miss significant opportunities to help.

Unified Framework to Standardize Abuse Descriptions

• Physical abuse involves the perpetrator's power over and control of the victim’s body through actual or threatened physical harm and can often take the form of hitting, scratching, pushing, pinching, burning, kicking, pulling, poisoning, forced ingestion, biting, choking, weapon use, throwing items, forced restraint, and denying medical care (Domestic violence, 2022; Types of abuse, 2020).

• Emotional abuse involves the perpetrator’s power over and control of the victim’s self-worth and emotional regulation through sustained harmful verbalizations and can often take the non-physical form of name-calling, fault-finding, insults, belittling, emotional withholding, humiliation, yelling, blaming, gaslighting, and vilification (Domestic violence, 2022; Types of abuse, 2020; United Nations, n.d.).

• Psychological abuse involves the perpetrator’s power and control over the victim’s psychological safety and can often take the form of intimidation, threats targeted at family or friends or self, harming pets, unwarranted accusations, pressure to isolate from friends and family members, or withdrawal from work and school, and stalking (Domestic violence, 2022; United Nations, n.d.).

• Sexual abuse involves the perpetrator’s power over and control of the victim’s right to consent to sexual activity and can often take the form of coercion, rape, unwanted kissing or touching, or aggression, ignoring feelings about sexual interaction, shaming, forcing reproductive health choices, and inviting unwelcomed others to participate sexually (Domestic violence, 2022; Types of abuse, 2020; United Nations, n.d.).

• Financial abuse involves the perpetrator’s power and control over the victim’s financial security and autonomy and can often take the form of control over spending and savings, withholding access to money or credit or financial information, identity theft or fraud, creating financial dependency, forbidding education or employment, stealing, using unapproved funds, power of attorney exploitation, and irresponsible fiscal guardianship or conservatorship irresponsibility (Domestic violence, 2022; Types of abuse, 2020; United Nations, n.d.).

• Technical abuse, also called digital abuse, involves the perpetrator’s power and control over the victim’s use of technology and digital safety and can often take the form of online emotional abuse, harassment or bullying, mobile tracking or stalking, profile impersonation or deception, exploitation or extortion, denying the use of technology or engaging with others via technology, requiring real-time responses and password sharing, and monitoring the use of the Internet, social media, email, text, and mobile devices (Domestic violence, 2022; Types of abuse, 2020).

The concern is not just about what abuse looks like. It is also about who is harming whom. Abuse in families can move from one sibling to another or from one partner to another. It can move downward from parent to child. It can also move upward from child to parent or from a family member to an elder. This upward movement is rarely acknowledged. Parent abuse, for example, remains one of the most misunderstood and least recognized forms of abuse.

Dr. Henderson-Teelucksingh’s research describes this movement as either lateral, descending, or ascending. Understanding this directional flow is essential in identifying the dynamics and harm that occur within family systems.

Abuse Definitions and Interpersonal Direction and Movement within Family Systems

Abuse Specifier Description Interpersonal Direction Hierarchical Movement Domestic

• Domestic abuse serves as an umbrella term for abuse that occurs by or between members of a family unit, such as parents, children, siblings, and roommates (Walker-Descartes et al., 2021).
  Interpersonal Direction: Unidirectional or bidirectional.
  Hierarchical Movement: Lateral

• Sibling abuse refers to harm between siblings during childhood and into adulthood (Donagh et al., 2023).
  Interpersonal Direction: Unidirectional or bidirectional
  Hierarchical Movement: Lateral

• Spousal or Partner abuse refers to harm by or between current or former romantic partners (Walker-Descartes et al., 2021).
  Interpersonal Direction: Unidirectional or bidirectional
  Hierarchical Movement: Lateral

• Child abuse refers to harm to a minor by a parent or caregiver (CDC, 2025a).
  Interpersonal Direction: Unidirectional
  Hierarchical Movement: Descending

• Parent abuse, also called child-to-parent violence, refers to harm to a parent or caregiver by a minor child (Ibabe, 2019).
  Interpersonal Direction: Unidirectional
  Hierarchical Movement: Ascending

• Elder abuse refers to harm to an adult aged 60 or older by a caregiver or trusted person (CDC, 2025b).
  Interpersonal Direction: Unidirectional
  Hierarchical Movement: Ascending

In a recent study of licensed healthcare providers in the United States, more than 85 percent agreed that consistent terminology would improve providers’ ability to identify and treat patients experiencing abuse. This finding reinforces what many families already know: when language is unclear, care breaks down.

This is not just a healthcare issue. It is a human issue. When abuse is misnamed or minimized, people are left without the words to describe their reality. That absence can deepen shame, increase isolation, and prevent access to help. Naming each form of abuse clearly and mapping how it moves within families helps bring hidden harm into the light.

At Indigo Path Collective, we support clearer language not as a technical fix but as a relational commitment. This clarity helps prevent harm, protect lives, and promote healing. Join us today in standardizing the language we use to describe abuse.

References

• CDC. (2025a). Child Abuse and Neglect Prevention. https://www.cdc.gov/violenceprevention/childabuseandneglect

• CDC. (2025b). Elder Abuse Prevention. https://www.cdc.gov/violenceprevention/elderabuse

• Domestic violence. (2022). U.S. Department of Justice, Office on Violence Against Women. https://www.justice.gov/ovw/domestic-violence

• Donagh, B. et al. (2023).

• Ibabe, I. (2019).

• Types of abuse. (2020). National Domestic Violence Hotline. https://www.thehotline.org/identify-abuse/

• United Nations. (n.d.). UN Women: Ending violence against women. https://www.unwomen.org/en/what-we-do/ending-violence-against-women

• Walker-Descartes, I. et al. (2021).