Psychological abuse – what it is and how to stop it

Psychological abuse is the most common form of abuse of older people.

Top 3 messages about psychological abuse of older people:

1. Psychological abuse is a usually sustained pattern of actions that cause another person pain, distress, anguish or humiliation. It’s the most common form of elder abuse.

2. If you are hurt, upset, humiliated or frightened by someone else’s ongoing behaviour or language towards you, it could be psychological abuse. Help is available.

3. Psychological abuse can be hard to see, so it’s important to take note and ask gentle questions if an older person’s behaviour or demeanour changes.

When other people’s behaviour makes you feel frightened, distressed, unsure of yourself or alone, it’s time to stop and take a closer look. What’s happening may be a form of elder abuse known as ‘psychological abuse’. It causes a lot of harm and can be hard to detect, but it can be stopped.

What is psychological abuse of older people?

Psychological abuse is treatment by other people that causes you emotional pain, anguish or distress or demeans you. It’s also sometimes called ‘emotional abuse’. Abusive behaviour is usually a sustained pattern of repeated acts, although a single but serious event can be harmful and considered abusive.

It often occurs with other types of elder abuse, such as neglect and financial abuse. Even a failure to act – such as the person tormenting you by failing to meet your needs – can constitute psychological elder abuse.

Psychological abuse is the most common form of abuse of older people, accounting for 11.7% of the reported incidents of elder abuse, the Australian Institute of Family Studies found in 2021.[i]

Examples of psychological abuse

• Insulting you or deliberately speaking in ways you find offensive

• Threatening you (even if they don’t follow through on the threat)

• Excluding or ignoring you

• Undermining, humiliating or belittling you

• Preventing your contact with other people

• Denying or limiting your social activities

• Taking away your decision-making freedom

• Denying you access to services or aids that you need

• Gaslighting (making you doubt yourself), controlling or manipulating you

• Withholding affection

The response to ‘no’: Agnes’ story

Agnes’ adult son asked her for financial help in the form of a guarantee on a loan, secured by her property. When she refused, he accused her of ‘blocking him from buying his home’ and started a prolonged campaign of threats, accusations and insults.

Fortunately, Agnes was attending sessions with a counsellor, which helped her recognise that her son’s behaviour was emotionally abusive. Aware of her right to say ‘no’, she was able to stand firm on her decision.

Effects of psychological abuse

Psychological abuse can lead to low self-esteem, social withdrawal, depression, anxiety or other mental health issues, trauma, loss of dignity and reduced independence.

Your physical health can also suffer, especially if you’re prevented from getting medicines, services and aids that you need.

How psychological abuse happens

Psychological abuse often happens in relationships of trust, which typically involve sustained contact. The people who perpetrate this type of abuse are commonly the older person’s adult children, acquaintances and children-in-law, but they may also be their partners, neighbours, grandchildren or in-laws.[ii]

People with low socioeconomic status, disability and high levels of dependency are often at greater risk of experiencing psychological abuse. However, it can happen to anyone.

If you have an Enduring Power of Attorney, you are less likely to experience abuse. That’s because this document is a clear record of your wishes and decisions. It’s harder for people to ignore, dispute or disregard what you want or abuse you for the decisions you make.

Sometimes people who abuse have substance abuse or mental health issues, financial problems or experiences of family violence themselves. Shauna (below) believed this to be a major factor in her experience.

Not the ‘real’ person: Shauna’s story 

Shauna’s only son, Patrick, moved back home after her husband died. However, he had substance abuse issues and was physically and psychologically abusive towards her.

She feels this isn’t the ‘real’ Patrick and that the drugs that are making him behave like this.

Psychological abuse in professional settings

Psychological abuse can occur in professional settings such as aged care services, medical services and care provider relationships.

In 2020, the Royal Commission into Aged Care Quality and Safety estimated that 22.6% of Australian residential aged care consumers had experienced behaviour that was emotionally or psychologically abusive.[iii]

The Aged Care Quality and Safety Commission requires residential aged care providers to report incidents of psychological or emotional abuse. Its Reportable incidents fact sheet sets out examples of what counts and doesn’t count psychological abuse in this setting. For example, if a care provider raises their voice to communicate with a client who has reduced hearing, are they yelling at the client?

Why psychological elder abuse may stay hidden

There are many factors that may contribute to psychological elder abuse remaining hidden.

• Behind closed doors: Psychological abuse often happens within a relationship of trust, such as a marriage, de facto partnership or parent–child relationship. The behaviour may not be visible to other people, or it may even seem normal within the family dynamic.

• Isolation: If the older person is being socially isolated, there is less opportunity for outsiders to see what’s happening.

• Lack of awareness: Not everyone who experiences psychological abuse recognises it as abuse, so they don’t speak up about it happening. This can be due to family loyalties, past experiences of violence or abuse (which may normalise the treatment), or diminished self-esteem. Also, changes in societal or cultural expectations of behaviour over time can make it harder for a person to decide what’s acceptable and what’s not.

• Fear: The abused older person may feel too scared to speak up or may not know who to turn to for help.

• Invisibility: Unlike physical abuse, psychological abuse leaves few visible effects.

• Quiet resolution: Sometimes, older people who take action do so by speaking directly to the person causing the abuse, rather than seeking outside help. As a result, other people don’t hear about it happening.

Common signs of psychological abuse in older people

For all those reasons, it’s important that we are aware of psychological abuse of older people and look out for warning signs. We might be watching out for ourselves, or for other people we know.

Listen and look for signs and changes such as:

• new or increased levels of depression, anxiety or distress

• unexplained reduced physical health

• withdrawal from social activities or relationships

• decreased self-esteem and confidence

• increased confusion or indecisiveness

• unexplained fear or agitation

• sudden changes in behaviour or unusual compliance expressions of feeling controlled or manipulated.

How to respond to possible psychological abuse

If you are experiencing abuse

• Write down the details of what’s happening: dates, behaviours, what was said to you, how you felt. This can help you see the behaviour clearly and talk about it.

• If you feel safe doing so, try talking directly to the person harming you. Tell them their behaviour is abusive, that it is affecting you and that you want it to stop now.

• Break contact with the person, if you can and you feel safe doing so. Remember that you do not have to let them into your home or answer their phone calls if you don’t want to.

• Maintain or re-establish your social networks as much as you can. More contact with other people can bring clarity to your situation as well as avenues of help.

• Tell someone you trust what’s happening, if you have access to other people, so they can help you think through your options.

• Call a support service – see Where to get help, below.

• Consider family mediation, if the situation involves a family member. A support service may be able to help you decide if mediation is appropriate.

If someone else may be experiencing abuse

• Write down why you suspect psychological abuse may be happening. What changed behaviour have you noticed? What seems wrong?

• Find a private moment to ask the person gently whether they are okay. Mention what you’ve seen and invite them to talk to you.

• If they describe or hint at behaviour that could be abusive, help them contact a support service – or make contact on their behalf. See Where to get help, below.

• If they say, ‘Everything is okay’, keep gently checking in with them. Perhaps they are okay, but they could also be too scared, ashamed or confused to talk.

• Never confront the person suspected of abusive behaviour yourself. This could make things worse for the older person. Instead, contact a support service for advice.

• If the older person is in an aged care setting, you can report concerns anonymously to the Aged Care Quality and Safety Commission (call 1800 951 822).

Where to get help

• 1800ELDERHelp, the National Elder Abuse phone line: call 1800 353 374

• ACT – Older Persons ACT Legal Service (OPALS): call 1800 353 374 or visit the website

• New South Wales – Ageing and Disability Abuse Helpline: call 1800 628 221

• Northern Territory – Older Persons’ Abuse Information Line: call 1800 307 072

• Queensland – Elder Abuse Helpline: call 1300 651 192 or visit the website

• South Australia – Adult Safeguarding Unit: call 1800 372 310

• Tasmania – Elder Abuse Helpline: call 1800 441 169 or visit the website

• Victoria – Seniors Rights Victoria: call 1300 368 821 or visit the website

• Western Australia – Elder Abuse Helpline: call 1300 742 679

Find out more

On Compass :

• Recognising elder abuse – article

• The five types of elder abuse – webinar

• The damaging effects of impatience – article

• Technology-facilitated coercive control – article