The Relationship Between Stockholm Syndrome and Post-Traumatic Stress Disorder in Battered Women

Every year, 10-50% of women suffer intimate partner violence (Bargai, Ben-Shakhar, & Shalev, 2007). It is important to understand what conditions affect these battered women and how any resultant conditions interact with each other in order to help abused women work through the aftermath of their trauma. Two of the more common resultant conditions of abuse are Posttraumatic Stress Disorder (PTSD) and Stockholm Syndrome (Graham, Rawlings, & Rimini, 1988; Hughes & Jones, 2000).

In 1995, the National Research Council fulfilled a congressional request to investigate causes, consequences, and prevention of violence against women (Crowell & Burgess, 1996). The panel determined that PTSD is the most common disorder among survivors of domestic violence. The prevalence and treatment of PTSD was further explored by Hughes and Jones (2000) in a survey of California public programs for battered women. The survey included questions on the availability of support for survivors in the public programs’ facilities as well as the knowledge and information base the support programs utilized. The researchers found that although the programs were aware that the survivors were likely to suffer from PTSD, few programs actually provided support for PTSD. Only 50% of the domestic violence crisis centers provided support groups while less than 40% offered individual and group treatment for PTSD.  This statistic indicates that although the existence of PTSD is acknowledged, in most cases support for symptoms of PTSD is nonexistent. The programs also have no basis for support for conditions other than PTSD. There is also the possibility that PTSD symptoms may be moderated by co-morbid conditions such as depression or the coping strategies utilized by survivors, one of which may be Stockholm Syndrome (Hughes & Jones, 2000).

Astin, Lawrence and Foy (1993) also examined the effect of PTSD on battered women.  The study emphasized the risk and resiliency factors for PTSD with a self-report survey to assess violence, PTSD symptomatology, social support, intercurrent life events, religiosity, and demographics. The researchers found that PTSD was found in survivors of abuse and PTSD was also highly correlated with the severity of the abuse. Women who declared higher levels of social support and religiosity than the mean experienced fewer PTSD symptoms than those declaring lower levels of social support. The study supports the theory that PTSD is influenced by the situation in which the women find themselves. The exploration of PTSD and Stockholm Syndrome and their interactions may lead to valuable information about the relationships other conditions may have on PTSD which in turn benefits the assistance of survivors.

Stockholm Syndrome is the term for a condition that evolves between an aggressor and the victims in situations such as hostage negotiations, kidnapping, and abuse (Auerbach, Kiesler, Strentz, Schmidt, & Serio, 1994; Graham et al., 1988). The main symptom of Stockholm Syndrome is the development of positive feelings on the part of the hostages for their captors or abusers. Other symptoms may include reciprocal feelings from the aggressors or negative feelings on the part of the victim towards the authorities or outside influences (Auerbach et al., 1994). Stockholm Syndrome is a named after a bank heist in Stockholm, Sweden in which the hostages began to identify with their hostage-takers. During this event, one hostage became engaged to one of the aggressors (Kuleshnyk, 1984). Stockholm Syndrome results from a rather specific set of circumstances, namely the power imbalances contained in hostage-taking, kidnapping, and abusive relationships. Therefore, it is difficult to find a large number of people who experience Stockholm Syndrome to conduct studies with any sort of power. This makes it hard to determine trends in the development and effects of the condition.

However, Auerback, Kiesler, Strentz, Schmidt, and Serio (1994) empirically recreated a hostage situation which resulted in the formation of Stockholm Syndrome symptoms. Six FBI agents acted as terrorists and held several airline employees for four days. Stockholm Syndrome was observed in several of the airline employees. The researchers were also able to determine that Stockholm Syndrome was caused by the dynamic interplay of domination (the aggressors’ control of their hostages) and affiliation (the victims’ identification with the aggressors). The researchers concluded Stockholm Syndrome was a combination of defensive self-delusion and an effort to “get along” with their captors which is similar to some forms of coping such as wishful thinking or avoidance coping.

One problem with the Auerbach, et al. study (1994) is the morality of inducing Stockholm Syndrome in the participants. However, the participants all gave informed consent for a study to investigate the effectiveness of the training the airline workers had received about hostage situations. Stringent measures were also in place to ensure that participants were never physically harmed. The participants were also provided with extensive debriefing after the experiment. However, the Auerbach et al. study (1994) has been invaluable in observing the actual genesis of Stockholm Syndrome and has provided excellent data on what factors in hostage and kidnapping situations trigger the affiliation of the victims with the aggressors.

Kuleshnyk (1984) stated that any person who found themselves in a hostage situation was best served by fostering Stockholm Syndrome. Doing so allowed the hostages to better identify with the attackers and survive the encounter by working with the aggressors rather than against them. From this, it can be argued that Stockholm Syndrome is another method of coping with the stress and danger of the hostage situation while simultaneously allowing the victim to avoid the inherently dangerous option of resisting their captors by identifying with them. Stockholm Syndrome is similar to some forms of coping in that the participants do not directly address the problem but find a way to cope with the situation by identifying with the aggressor. Coping mechanisms such as these can have a large impact on PTSD. 

There are several studies which have explored various aspects of PTSD and its relationship to coping mechanisms in women who had experienced sexual assault or domestic abuse. Walker (1991) surveyed over 200 victims of sexual and nonsexual assault (physical attacks or psychological abuse) on symptoms of PTSD and the effect of coping strategies. To measure the amount of PTSD symptoms and coping strategies, the participants completed self-report measures of PTSD and several coping mechanism measures. Walker found that the PTSD symptoms declined over time. However, the coping strategies, which consisted of Mobilizing Support (informing friends and family of the assault and requesting their support) and Positive Distancing (believing the trauma is past and it is time to move on), had no relationship to severity of symptoms.

However, Wishful Thinking (wishing the trauma had not happened, trying to determine their own responsibility for the trauma, or pretending the trauma had not occurred) was positively associated with severity of PTSD symptoms. This indicates that the fantasies of the Wishful Thinking coping strategy were related to the increased severity of PTSD symptoms. The Wishful Thinking form of coping may, in fact, be related to Stockholm Syndrome because Stockholm Syndrome includes a significant amount of self-delusion on the part of abused individuals. This indicates that Stockholm Syndrome may be a form of “wishful thinking” coping. However, Wishful Thinking is not the only form of coping which may relate to Stockholm Syndrome.Continued on Next Page »