How Covert Abusers Weaponize Mental Health: Explained by WomenSV Founder Ruth Darlene

I’m Ruth Darlene, Founder and Executive Director of WomenSV, a nonprofit organization dedicated to education and awareness around covert abuse and coercive control. Over the past 14+ years, I’ve had the honor and heartbreak of hearing countless stories from brave survivors. Many of them describe the same insidious pattern: a partner who attempts to shame, discredit, and silence them by accusing them of having “mental health issues”. Let’s talk about how covert abusers weaponize mental health. 

As isolating as this experience might feel, if it’s happened to you, you are far from alone!

May is Mental Health Awareness Month. There’s no better time to expose this covert abuse tactic and start a powerful, open conversation about the intersection between domestic violence and mental health.

The mental health consequences of coercive control

Coercive control is a form of domestic abuse that subjects survivors to a pattern of threatening, controlling, isolating behaviors that threaten their safety, deprive them of their freedom and force them to live in fear. It can, but does not necessarily, involve physical and sexual violence in addition to emotional, financial, technological, legal and other forms of abuse that can be difficult to identify. With or without a history of physical abuse, relationships involving coercive control can pose dangerous and life-threatening consequences that have a lasting impact on survivors’ mental health.

Research shows that domestic violence survivors face a higher risk for mental health challenges including depression, anxiety, addiction, Post-Traumatic Stress Disorder (PTSD) and even suicide, when they lose all hope in response to ongoing abuse and begin to believe that death may be their only way out. According to the Veterans’ Administration:

When individuals face violence from someone they trust and love, it creates an environment of isolation, fear and despair. The emotional toll of an abusive relationship often leads to feelings of hopelessness, shame and a perceived lack of escape, all of which can significantly elevate the risk of suicide.

Studies also indicate a strong link between coercive control and increased rates of mental health disorders.

Surviving coercive control and other forms of domestic abuse is undeniably traumatic. Healing is possible, but it often takes plenty of time and support. Survivors deserve to be treated with understanding and compassion for what they have been through – instead of being discredited, shamed, blamed, shunned, silenced or worse, all of which were common occurrences not so long ago.

Mental health as a means of controlling, shaming and silencing women: a brief history

The mid-20th century saw a disturbing convergence of psychiatry, patriarchal control, and social conformity, particularly in the treatment of women. Mental health institutions and practitioners often acted as enforcers of rigid gender roles, using their authority not merely to treat but to discipline women who defied societal expectations.

The medicalization of female nonconformity

In the 1950s, psychiatry was still deeply embedded in a patriarchal framework. Deviations from traditional gender norms – assertiveness, sexual agency, resistance to domestic roles – were often pathologized. Women who strayed from the expected roles of dutiful wife, mother, or virgin daughter risked being labeled with vague psychiatric diagnoses like "hysteria," "neurasthenia," or later, "borderline personality disorder."

As Elaine Showalter wrote in The Female Malady (1985), psychiatry often treated women's emotional and behavioral struggles as symptoms of deviance rather than as legitimate responses to oppression. "Madness" in women was interpreted not as a sign of distress but as a failure to conform. The solution, then, was correction, not compassion.

Lobotomy: The surgical silencing of women

The lobotomy – developed in the 1930s and popularized in the U.S. by Dr. Walter Freeman – was used disproportionately on women. It involved severing connections in the brain’s prefrontal cortex to "tame" what were deemed emotional or behavioral disturbances. Freeman's records indicate that over 60% of lobotomy patients were women, even though mental illness diagnoses were relatively evenly distributed across genders (El-Hai, The Lobotomist, 2005).

A chilling example is Rosemary Kennedy, sister of President John F. Kennedy. Developmentally delayed and prone to mood swings and sexual curiosity – traits seen as dangerously deviant for a woman of her class – Rosemary was lobotomized at the age of 23. The result was catastrophic: she was left disabled, largely nonverbal, and institutionalized for the rest of her life. Her fate was kept secret for decades, highlighting the stigma not just of mental illness, but of a woman who didn’t fit the mold.

Electroconvulsive therapy (ECT): A tool of control

Electroconvulsive therapy, introduced in the 1930s and widely used in the 1940s and 50s, was frequently administered without informed consent. While it can be effective for severe depression, in that era it was often used more broadly – and sometimes punitively – on women who were seen as unruly or resistant to authority. The image of a "hysterical housewife" being restrained and shocked into submission wasn't just film noir drama – it was reality for many women in psychiatric wards.

As Phyllis Chesler observed in Women and Madness (1972), ECT and other psychiatric tools were not simply medical treatments – they were instruments of social enforcement. Women who expressed anger, refused domesticity, or sought autonomy were often "treated" until they became docile, compliant, and therefore, "well."

Drugging and commitment: Chemical and physical restraints

With the advent of psychotropic drugs in the 1950s, including Thorazine (chlorpromazine), a new method of control emerged: chemical sedation. Women were frequently prescribed tranquilizers like Miltown or Valium – earning Valium the nickname "Mother’s Little Helper." These drugs were marketed specifically to women to dull anxiety, restlessness, and depression – often symptoms of oppressive domestic roles, not mental illness.

Long-term institutionalization was also common, and disproportionately impacted women. According to a 1955 U.S. government report, women made up the majority of residents in public mental hospitals – many committed by husbands or fathers, sometimes without due process.

In 1960, Elizabeth Packard was committed to an asylum for defying “all domestic control”, which simply meant being too opinionated and independent for her husband’s liking; she simply insisted that she had a right to have opinions that differ from her husband’s. Her story reflects the experience of countless other women who were able to be committed at the husband’s request.

Psychiatry as patriarchy in practice

The psychiatric system functioned as an extension of patriarchal power, punishing women who threatened the gender order. It’s no accident that many of the women confined, drugged, shocked, or lobotomized were those who sought sexual freedom, rejected domestic life, or expressed anger at their social circumstances.

Women’s emotions – especially negative ones – were often framed as illnesses requiring correction, not valid responses to their sociopolitical realities; that their role in society, their raison d’être was to serve their husbands. And God help those who grew restless and began to express frustration with the gilded cage of their existence with such observations as, “putting brownies in the oven was not a peak experience.”

The legacy of silenced resistance

The use of psychiatry in the mid-1900s to control and punish women reveals a dark chapter in mental health history – one where treatment became indistinguishable from social coercion. From Rosemary Kennedy’s tragic lobotomy to the countless women sedated into submission or shocked into silence, mental health "care" was often a euphemism for control. 

Before there was a term for coercive control, under patriarchal rule, it was standard operating procedure in the medical and psychiatric community as a means to coerce, control, entrap, isolate, intimidate and silence women who caused trouble. And society was complicit for centuries, since any who rebelled against this practice, risked suffering the same fate.

Have we come a long way since then?

Have you read or seen The Handmaid’s Tale? 

Author Margaret Atwood based the story on real occurrences throughout history, serving as a stark reminder that the erosion of women's rights, freedom and very identity can recur if society becomes indifferent. It’s not just our past, it’s our future, if we stop paying attention.

There are signs of it even today, particularly in how female trauma is misunderstood, minimized, or misdiagnosed. Survivors of coercive control, for example, are still too often labeled as "paranoid," "borderline," or "overreacting"—modern iterations of a system that once institutionalized nonconformity under the guise of medicine.

Psychological impacts of gaslighting and emotional manipulation

Now that women have become “liberated,” and the tactics used to control them are no longer socially sanctioned, they have become less public, more private. Today covert abuse operates in the shadows, using subtle and underhanded tactics that are difficult to recognize until they escalate dangerously. Emotional abuse and psychological manipulation are used to entrap survivors in a web of lies that can be hard to explain, let alone escape.

This form of psychological warfare can make anyone feel like they’re losing their mind. How could anyone’s mental health NOT be affected after dealing with the sadistic, narcissistic, psychopathic, Machiavellian tactics of a covert abuser?

Survivors are left navigating a storm of lies, threats, emotional abuse, and psychological manipulation. These covert abuse tactics are all designed to destabilize their sense of reality.

You are not the problem!

One of the most harmful lies covert abusers spread is that survivors are "crazy" or "unstable." Unfortunately, survivors of abusive relationships are often made to feel like they are the problem. But the truth is, these symptoms are very normal reactions to the very abnormal experience of being abused. It’s not you. It’s them.

Covert abuse tactics: Weaponizing mental health

Still today, one of the most common tactics abusers use to silence and discredit their victims is to try to get people to believe they are mentally unstable or crazy.

This might look like:

Gaslighting
Gaslighting is a classic covert abuse tactic. Gaslighters lie, distort the truth, and manipulate reality so persistently that victims start to question their own thoughts, memories, and eventually their sanity.

One particularly crazy-making example involves hiding the survivor’s belongings, then accusing the survivor of being forgetful and “losing it”. For example, her car keys might go missing right before an important job interview. After hiding the keys and watching her panic, the abuser might say, “How can you get or keep a job when you can’t even keep track of your keys?”

Planting seeds of doubt
This sneaky covert abuse tactic involves faking “concern” about their partner’s mental health. They start quietly telling friends, family, neighbors, coworkers (and anyone else who will listen) that they’re "worried" about you.

But this “concern” is a calculated move to discredit you, before you even realize what’s happening. These planted seeds of doubt can later be used against you, painting you as irrational, untrustworthy or unstable – and isolating you from your social support network.

DARVO
DARVO (Deny, Attack, Reverse Victim and Offender) is a favorite tactic among covert abusers. Rather than taking accountability for their actions, the abuser will deny their abuse, attack their victim, and reverse the role of victim and offender in their narrative. Often, they will accuse you of the very thing they did to you! Among other things, it makes it easier for them to remember their lies. They just remember what they did and project it onto you. And they are so convincing! One survivor lamented, “He lies so much better than I tell the truth.”

Rewriting history
Covert abusers don’t just deny their abusive behavior, they’ll often completely rewrite history. Even if you clearly witnessed them saying or doing something, they might respond with, “I would never do that” (note the use of the conditional tense). The bolder ones will flat out tell you, “That’s not what I said” or “That’s not what happened.” Following DARVO, the next step is to spin it around on you and accuse you of lying, forgetting or being “crazy”.

Violating privacy
Some abusers will go so far as to share your private medical records or mental health history, spinning a story to paint you as unreliable or dangerous. Even if you voluntarily sought psychiatric help after being abused – maybe for anxiety, depression, or PTSD – they may use that very act of seeking support to shame and "expose" you for having “mental health issues”.

Even more disturbing, they may recruit others to help share or leak your personal health information as part of a broader smear campaign, framing it as public service or genuine concern.

This tactic is often referred to as “astroturfing,” after the artificial grass used to carpet stadiums. It refers to a campaign created by the covert abuser in which he keeps repeating his fabricated story to anyone he has influence over. Eventually it begins to be repeated by multiple sources who serve to bolster the abuser’s story and give it more credence. After all, it’s not just “he said/she said” anymore. It’s “she said, they said.” A lie repeated often enough begins to sound like the truth, especially when it’s repeated by multiple people who have “drunk the kool-aid”, succumbed to the convincing charm of a covert abuser and become what’s known as  “flying monkeys,” after the wicked witch's minions in the Wizard of Oz who did the witch’s bidding in attacking Dorothy.

The engineered 5150
In extreme cases, covert abusers will actually set up their current or former partners to be put on a psychiatric hold, also known as a 5150 in California. 

If the abuser is a medical professional, therapist, or someone who holds influence over such professionals, they may exploit their credentials by recommending that you be placed under observation for your own safety.

This tactic is used to control, humiliate, silence and discredit you – all under the guise of "helping" you.

It happened to so many of the survivors I’ve advocated for that I coined the term “engineered 5150”. 

If you follow WomenSV on social media, you may have heard me share the story of one survivor whose therapist husband had her put on a psychiatric hold. (And yes, she gave me permission to share this – anonymously of course!)

Her husband had kept her up all night, abusing her, breaking dishes, throwing chairs at her, threatening her and chasing her around the house with a knife. By the morning, she was understandably beside herself in terror. She was finally able to call the police, but he got to them first, meeting them outside on the driveway where he told them, “I’m so glad you’re here. My wife is having another psychotic episode. I’m a therapist and I do believe she needs to be on a psychiatric hold for her own safety and for mine.”

When the police went inside the house, they found the knife on the counter, chairs overturned, broken plates on the floor and the survivor slumped over in a corner, disheveled and crying. She was so upset and traumatized that she couldn’t clearly explain what had happened – and she was terrified to find out what would happen if she spoke up. 

She ended up getting taken to the hospital and placed in a locked unit. The next day, her husband came to visit her. When they were alone, she asked him, “Why did you do that?”

He replied, “Because I can.”

How’s that for an abuse of power?

Covert abusers tell on themselves

Here’s the ironic part: Covert abusers are actually telling on themselves when they try to shame their victims. 

Consider this: Do mentally healthy, kind, caring, compassionate people shame others for seeking support for their mental health? NO!

Mentally healthy, compassionate people don’t point fingers and make cruel accusations about a survivor’s mental health. They respond with empathy, not cruelty.

So in a way, covert abusers call themselves out. 

When an abuser draws attention to someone else’s suffering in an attempt to ridicule them, they expose their own cruelty and lack of empathy. They are actually sharing evidence of just how severely they abused their victim, and how shamelessly committed they are to continuing that abuse.

So when someone tries to discredit you using your mental health history, what they’re really doing is showing everyone who they are. Not you.

The truth always comes out eventually.

Time is the enemy of the covert abuser.

When a covert abuser goes to great lengths to make you look bad, they often end up making themselves look worse. Their obsessive need to control the narrative often exposes the very tactics they’re trying to hide. And they are so convinced they are always the smartest person in any room, they can get careless sometimes and let the mask slip.

But here’s the sad truth: abusers could really use some help with their own mental health, but they refuse to admit that they even have a problem (or are the problem). So instead they will do LITERALLY ANYTHING except go to therapy -- and they'll try to shame you even when you seek support to recover from the damage they have done.

Projection and shame

At the root of this abusive behavior is often deep insecurity. Covert abusers will go to great lengths to avoid ever having their own flaws exposed. So, instead, they seem to project their own negative beliefs about themselves onto others.

When it comes to mental health, they might know deep down that something isn’t quite right within themselves. They might secretly even be terrified that if they were to seek support for their mental health, they might be shamed, discredited or ridiculed. So they act out these beliefs by projecting them onto you.

Being a covert abuser must be exhausting! Imagine if all that effort (devoted to causing pain, fear and trauma, spinning a web of lies and manipulating others for personal gain) went into self-improvement!

Instead of doing the hard inner work of therapy, self-reflection, and accountability, they point fingers. They shame you for doing what they themselves are too afraid to do: look inside themselves, seek help, change and break the cycle of abuse. 

What are they so afraid of finding if they look too close? Many survivors report that their partners experienced abuse growing up and this was one reason why so many survivors kept forgiving, forgetting and trying again. But haven’t many of us experienced abuse in childhood? And some of us go on to become social workers, therapists, advocates, community activists or judges. We do have a choice in the road we go down – we can choose to become what we saw or we can decide we will never inflict the kind of pain we suffered on anyone else. Because we know how much it hurts we resolve to treat others so much better than we were treated and with the help of other healthy role models we encounter, we can learn how to do that. The key is are we willing to change? Or is it easier to blame others?

The weaponization of therapy

Since therapists get very little training on domestic violence or coercive control, asking him to go to private counseling will likely just end up reinforcing his worldview that he is the victim here and you are the problem. Going to couples counseling isn’t likely to make things any better either – instead it may just equip him with new ways to make you look like the problem. The reason you are so “cold” in the bedroom? He may tell the therapist he believes it’s because you were raped as a teenager. Wasn’t that your story to tell, not his? And then the next several sessions are spent addressing your childhood wounds.You may be very reluctant to call him out on what he did to you in the bedroom that made you go cold, because covert abusers are very shame sensitive. They also don’t do well with confrontation or the truth. You will likely be punished after any session in which you reveal the truth of who he is and what he has done to you or your children.

If you are fortunate enough to find a trauma-informed therapist who understands coercive control, that can be a lifesaver while you are in an abusive relationship. Here’s where the focus will be on helping you identify the tactics being used on you, how to counter them, how to shore up your inner emotional reserves, maintain your sanity, problem solve and safety plan, how to stay safe (as safe as possible), learn what your options are, what your personal rights are (like living in peace, safety and freedom in your own home) and how to know when or whether you are ready to end the relationship and how to do that as safely as possible, and hopefully with the help of a domestic violence advocate who is also trauma informed where it concerns coercive control and cover abuse. 

Healing from this kind of relationship, this kind of trauma, can’t really begin in earnest until you are safe. That’s when a trauma-informed therapist can help again – work with you to begin that long, hard, beautiful road to recovery after everything you have been through, everything you have suffered, survived and are now in the process of overcoming.

Healing is something to be proud of

If you’ve sought help for PTSD, depression, or anxiety as a result of abuse, that takes tremendous strength and courage. You made the conscious decision to break out of a toxic cycle instead of repeating it. That’s a huge accomplishment, and you deserve respect!

If a covert abuser is trying to expose you for seeking help to heal from the trauma they caused - they’re actually just sharing proof of what they did to you. They’re revealing how broken THEY are! Don’t make the mistake of thinking that this kind of brokenness can be fixed by any intervention short of a personality transplant. It takes the willingness to be honest, authentic and vulnerable. It requires empathy for the person you’ve hurt, remorse for harm done and a sincere desire to change, along with the commitment to do the hard work to make that change and make it stick. 

Have you ever pointed out something your partner did to hurt you, humiliate you or frighten you? 

What was his reaction? 

If he’s a covert abuser, his reaction was likely to deny, deflect, project, or blame you for it – or do even more of what you asked him to stop. This kind of behavior pattern points to a catastrophic failure of character, and the remedy in most cases is not therapy, it’s escape, or at least ongoing safety planning with a focus on protecting yourself and your children as much as possible until you can. 

The key word here is “escape,” because when this kind of relationship ends, that’s when the danger escalates. We are not talking about a regular relationship that has run its course, or even a dysfunctional relationship. We are talking about a dangerous relationship with an individual who views women as resources, property, possessions – and therefore disposable, replaceable. You don’t leave this kind of individual. You escape.

Breaking the cycle

Friendly reminder: We are living in an era that values mental health, openness, healing, and compassion.

Together, we’re building a world where the truth is heard, where survivors are believed, and where cycles of abuse are broken, not repeated.

PTSD and other mental health struggles are not signs of weakness. They are signs of survival. They are testaments to your strength in enduring something you never should have had to.

You deserve support. You deserve safety. You deserve peace.

Ready to overcome abuse and reclaim your story?

Join us for Understanding and Documenting Coercive Control: Executive Summary Workshop. After serving over 1500 survivors of coercive control and covert abuse, I founded this online program to help survivors find their voices, clearly communicate their experiences and get the support and protection they need. In just 90 minutes you’ll learn how to recognize and report domestic abuse using a trauma-informed process that has helped thousands of survivors take their power back.

Click here to sign up for instant, lifetime access.

If you can relate to this article, I want you to know that you are not alone. At WomenSV, we believe you. We see you. And we are here to support you.

Let’s keep having these conversations, supporting one another and shining a light on the shadows where covert abuse hides.

To stay in touch, please connect with us on social media. We’re active on YouTube, TikTok, Instagram, Facebook and Pinterest.

The work of breaking free, reclaiming your narrative, and healing from covert abuse is not easy. But it is possible. And it is worth it. YOU are worth it!

Happy Mental Health Awareness Month. 💜

With love and solidarity,

Ruth Darlene
Founder & Executive Director, WomenSV

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Frequently Asked Questions (FAQs)

1. What is coercive control?

Coercive control is a pattern of controlling, isolating, threatening behavior that entraps an intimate partner. It can, but does not necessarily, include physical and sexual violence as well as stalking, psychological abuse, financial abuse, legal abuse, technological abuse or other forms of domestic abuse. Coercive control can involve overt (obvious) abuse and / or covert (hidden, subtle) abuse. Even without a prior history of physical abuse, coercive control poses a significant lethality risk to survivors.

What is covert abuse?
Covert abuse refers to a wide range of behaviors from emotional manipulation to strangulation. In its more subtle form, this kind of abuse can be difficult to detect, yet still deeply damaging. Covert abuse often includes love bombing (excessive displays of affection and attention designed to create a quick, intense emotional connection to later exploit), emotional abuse (like the “silent treatment’ or “gaslighting”, technological abuse (like putting spyware on her computer), financial abuse (like putting a partner on an allowance or racking up debt secretly in her name), psychological manipulation and veiled threats.

2. What does WomenSV do?
WomenSV (Women of Silicon Valley) is a nonprofit organization founded by Ruth Darlene. Although it originated in Silicon Valley, in the past 14 years, WomenSV has served over 1500 women from all over the country and from many different races, religions, and cultural backgrounds. Their partners tended to be men (and some women) in positions of power and influence – and who weaponized both. WomenSV is dedicated to empowering survivors, providers, advocates and communities in general with education about covert abuse and coercive control. We envision a world in which every adult and child can exercise their fundamental human right to live in peace, safety and freedom in their own home.

Donations to WomenSV help support domestic violence prevention through education. To make a donation, click here.

3. How does mental health relate to domestic violence?
Studies consistently demonstrate a strong link between domestic violence and mental health conditions. Survivors of domestic violence often suffer from mental health impacts like PTSD, depression, and anxiety as a result of the trauma they've endured.

4. What should I do if someone is weaponizing my mental health?
Remember that you are not at fault, and you deserve kindness and compassion. Document the abuse and connect with a healthy support system. A trauma-informed therapist, trusted friends and family members, domestic violence advocates and support groups can help support you as you heal. Take a look at our online Directory of Resources for additional sources of support.

5. Is it normal to feel crazy after covert abuse?
Yes, gaslighting and manipulation are designed to make victims doubt their sanity. These feelings are a natural response to sustained psychological abuse. Healing is possible, but it takes time. Please be patient with yourself. Prioritize safety planning and self-care.

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Disclaimer: The information in this article is intended for informational and educational purposes only. This is not a form of therapy or therapeutic advice. WomenSV does not offer therapy or referrals.

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Citations:

• Showalter, E. (1985). The Female Malady: Women, Madness, and English Culture, 1830-1980. Pantheon.

• El-Hai, J. (2005). The Lobotomist: A Maverick Medical Genius and His Tragic Quest to Rid the World of Mental Illness. Wiley.

• Chesler, P. (1972). Women and Madness. Doubleday.

• U.S. Department of Health, Education, and Welfare. (1955). Mental Health: United States Public Health Service Report.