MONTREAL -- WARNING: This story contains descriptions of domestic assault

McGill Domestic Violence Clinic, a case history:

One evening last summer, 30-year-old Mark and his partner Jennifer, whose identities CTV News has protected, were at their Montreal home mixing up some cocktails. 

Drinking excessively was not usually their go-to activity, but as the pandemic wore on, the couple had started to imbibe more frequently, and on this night, they both got drunk.

An argument quickly escalated. Mark became violent and attacked Jennifer who fled into another room to call a relative who, in turn, called 911.

But the arguing started up again, and when Montreal police arrived, Mark had his hands around Jennifer’s neck and was choking her. 

According to Audrey Elkeslassy, the social worker who eventually treated the couple, Mark later told clinic staff, he snapped and everything got "black," after Jennifer told him, "I'm done. I'm leaving you."

Police officers arrived in time to intervene before Jennifer was seriously injured and Mark was arrested, said Elkeslassy, referring to her detailed notes on the case.

That Mark’s violent behaviour appears to have been triggered by Jennifer wanting to leave the relationship is not unusual. It’s now been well established that this is a particularly dangerous period between intimate partners when the risk of femicide is the highest.

Since the start of the pandemic, 12 women have been murdered in Quebec, allegedly by intimate partners. Of these women, eight were killed in the past nine weeks.

What happened next to Mark, however, is an example of a domestic violence and femicide prevention strategy where help for the abusive man is made available (and sometimes required) - at the first signs of dangerous behaviour.

The goal is to break a cycle of violence that would only continue and even spiral out of control when a man with aggressive tendencies moves from one relationship to the next without any redirection.

If the dangerous behaviour can be treated therapeutically, violence prevention experts say the lives of the man or boy improves, and critically, so do the lives of everyone around them.


The idea to ensure that men have good access to help is also being highlighted by a member of Quebec’s National Assembly, who will be sitting on a new government committee dedicated to fighting violence against women, and who recently came forward with her own experience of conjugal abuse.

For Isabelle Lecours "and her family, it takes a lot of courage and energy to speak out," her press attache told us in an email, explaining why the CAQ MNA was not up to doing more than two interviews in French right now.

In an interview with Le Journal de Quebec, Lecours alleged that her ex-husband abused her for years, physically, verbally, and psychologically. She said she hoped sharing her story will help other women who live with violence today. 

But Lecours went out of her way to "insist" that she also wants to help the men: "If we don't help the men, the violence will always be there."

It’s a component of violence prevention that needs more emphasis and requires more resources, agree Audrey Elkeslassy and other family violence experts, if lives are to be saved and real social change is to occur.


"Domestic homicides are preventable," said Anuradha Dugal, vice-president of community initiatives at the Canadian Women’s Foundation.

It’s one of the main findings of researchers at the Canadian Femicide Observatory for Justice and Accountability, even though the many approaches to prevention are as complex as the phenomenon of violence against girls and women itself.

Concretely addressing women’s immediate safety concerns and any imminent danger comes first, said Dugal.

She referred to the "many cases where women have said, 'I fear for my safety, he has a gun, I know how he behaves,' and those have been disregarded and downplayed."

"Women need to be protected. Children need to be protected," and advocates’ calls for more funding for women’s shelters, and reviews of police work and the justice system need to be heeded, said Dugal. There need to be serious consequences for crimes committed.

At the same time, if boys and young men can be educated and also get support, even after negative behavioural tendencies have already emerged, sometimes the worst can be prevented, say advocates for change.

"Help needs to come as early as possible, and as soon as they ask for it," though the policy-developer at Canadian Women’s Foundation says therapy isn't always effective.

"I do see cases where after behaviours become entrenched it is really hard to change them," Dugal said.

But Dugal asked the question that so many researchers ask: "What is happening to force men to think that this [violence] is their only recourse, that they have nowhere else to go, that they are in many ways isolated, in many ways suicidal themselves?"


The McGill Domestic Violence Clinic (MDVC) has been around for more than two decades. Affiliated with McGill, it serves as a training ground for graduate students, but is an independently run facility.

Men, who make up to 90 per cent of their clientele, are referred to the clinic by lawyers, the courts, youth protection, CLSCs, and other sources.

"If they’re referred to our clinic, it’s usually because there was police involvement," Elkeslassy said.

A small number seek out the help voluntarily, when they are attuned enough to their own behaviour and decide they want to try and work on the negative feelings and behaviour that rule their lives and harm others.

When a new client signs on, staff first ensure the victims of the violence are safe and any immediate threat has been eliminated.

After social workers conduct a full "intake" as it’s known - a long initial conversation with the new client about his personal history, going back to childhood, Elkeslassy calls the woman, to offer her help, and also to ask for her version of events.

If the man they’ve just screened appears to have a mental illness or an addiction that requires medical attention, they also refer him to the proper health services for help.

Elkeslassy said Mark was a willing participant. Before he took part in about 15 group sessions, he recounted to social workers how as a child, his mother became very distant and unloving with him when she begane going through personal problems of her own.

His father was an alcoholic who would sometimes become so angry he would flip over the kitchen table.

Neither parent showed much patience with him and smacked him if he misbehaved or hit him with a spoon, but Mark never saw his parents’ behaviour as abuse, said Elkeslassy.

His parents divorced when he was a child. He was bullied in school and engaged in high-risk behaviours like drinking and setting fires.

And then, over a short perioud of time, several family members he was closest to all died one after the other. He was left alone and isolated.

Elkeslassy said she has certainly heard of childhoods that were far worse than Mark’s "but the trauma he went through in four years really affected him, so his way of dealing with things is by drinking alcohol, shutting down, and not talking about his emotions because it was too hard to handle," she said.

"His trigger was his fear of abandonment and his girlfriend had her share of issues - it turns out they both had this fear," so when she said she was leaving him, he lost control, said Elkeslassy.


A trauma-informed approach to therapy is one of the therapeutic strategies used at MDVC because often the people they see come from difficult backgrounds.

"The majority, 50-70 per cent of abusers, have witnessed their fathers battering their mothers or were themselves victims of abuse as children. A lot of them have dealt with trauma," Elkeslassy said. The women in the family can also be the perpetrators.

"Maladaptive behaviour typically originates in childhood. As they grew up, they tried to learn how to navigate through relationships and in a sense, these are their survival skills."

In group sessions, the social workers emphasize the emotions the men are feeling rather than their negative behaviour.

The goal is to figure out the root issues: what primary need is not being met in the relationship, and how can the men learn to replace the dysfunctional [aggressive] behaviours and reactions with functional behaviours when the issues crop up.

"The emotion drives the behaviour and meeting the need through appropriate behaviour, will result in diminishing inappropriate behaviour," said Elkeslassy.

If the therapist focuses too much on the behaviour, it will cause shame, she said, which can lead to avoidant tendencies: lying, making excuses, blaming the victim, minimizing the problem. It can also cause rage.

"Shame is toxic. If you have too much shame you don’t have empathy or feel guilt," Elkeslassy said.

But without a real understanding of their own emotions and history, it is hard for people to make lasting changes.

So part of the therapy involves psycho-education about trauma, emotions, attachment and the fight, flight, freeze response.

Importantly, the men also learn about how brain mechanisms work and how violent impulses are set into action when powerful emotions related to childhood trauma are stirred up.

The trauma or difficult history "is not an excuse," but it does help explain “why do I react the way I do," said Elkeslassy, and what can I do differently since "we can’t really control our environment, what we can control is ourselves."


The MDVC is working right now with a McGill University researcher to help them assess their program and determine their rates of success and recidivism.

Though some men who are sent there "try to get through it so they don’t have issues with the courts," Elkeslassy said they’re in the minority.

She said she believes in the clinic’s approach to helping men and women develop emotional intelligence because she sees results.

"The majority of men do say, 'Well, when I came here, I didn’t think I really needed it, but I saw how helpful it was.'"

"By the end of the program they speak very differently. They’re able to talk about their emotions and identify what bothers them, so then you don’t get to a point where you explode," she said.

Mark’s last group session was in October of last year and during his therapy, he was able to work through some key communication issues with Jennifer and build trust, according to Elkeslassy.

"He understood his triggers more," the social worker said, though she can now only hope he will continue to use the skills he acquired and ask for help whenever he needs it.

"I always leave the door open for them to come back and some do, even years later," she said.


Early intervention is the key for all children, said Dugal

"Everybody agrees that violence prevention should happen as young as possible," she said. "It should begin with strong information about sexuality, about consent, and about healthy relationships."

And the conversations need to happen everywhere, from the classroom to the sports clubs - wherever young people gather - because there is a stigma.

Young men in early relationships do sometimes realize they are reacting in ways that are unhelpful and are "harming their partners in ways they never intended," and they don’t know how to stop it, said Dugal.

"There’s a cultural barrier in place about men even asking for help," and they don’t know where to turn, she said.

That’s borne out at the McGill Domestic Violence Clinic when men say in therapy they "are just seen as bad people. They’re scared to show their emotions and share their fears with their partners because they’ve always been told that’s weak, and men need to be strong," said Elkeslassy.

While women across North America advocated for services like shelters and sexual assault centres for themselves, men haven't petitioned for the complementary services they might need "and in very many cases some of the work supporting men has gone down a road of being very anti-women and so we do have to guard against that," said Dugal.

Instead, along with early intervention, what needs to be developed are specialized mental health and psycho-educational programs, and "that’s where we’re a little bit behind," the violence prevention expert said.

"But then I think that’s the place where honestly, we call men in too and say those young men should be able to turn to uncles, fathers, coaches, role see healthy examples of masculinity," said Dugal.

Gender-based violence is also connected to poverty and systemic, collective traumas stemming from racism and colonialism.

"We also find it very easy to criminalize certain groups of men too, so Black men are much more likely to be criminalized. Indigenous men are much more likely to be criminalized for these sorts of behaviours. If we could invest early and show compassion and empathy as a society I think that could change," said Dugal.


McGill Domestic Violence Clinic, for men and women

The clinic is associated with McGill University but is a private entity, and so there is a charge for its services, but on a sliding scale, depending on one’s ability to pay, according to social worker Audrey Elkeslassy.

Montreal’s West-island CIUSSS told CTV they refer men upon request to two organizations mandated in Quebec to offer free services:

PRO-GAM, which describes itself as a therapy program for men who have resorted to violence in their domestic or family relationships.

OPTION, offers services in French to men and women exhibiting violent behaviour in a conjugal or family context