There’s an exercise I sometimes do with my patients to help them understand the difference between healthy and unhealthy relationships.

I hang a piece of butcher paper on the wall and ask them to write examples of how people might behave in a healthy relationship. Typically, they can’t think of more than three or four examples.

Then I hang a new piece of paper, and ask them to write about behaviors in an unhealthy relationship. They run out of room on the page.

At the Mount Sinai Adolescent Health Center, I work with many teenagers and young adults who have experienced domestic violence in their homes. This problem is extremely common. Every year, over three million children are exposed to domestic violence, typically against their mothers. And when young people’s first, best model of love includes violence, they risk becoming perpetrators or victims themselves. This is called the intergenerational cycle of violence, and it has to end.

Children who grow up in abusive homes often see violence as a normal part of a relationship.

A young boy will learn that it’s normal to feel jealous of his partner’s friends and that if a girl loves him, she should spend all of her spare time with him. This boy will see that it’s ok to blame his girlfriend if he’s in a bad mood, and when he’s angry, it’s acceptable to hit, threaten, or call her names.

On the other hand, a girl growing up in an abusive home will learn that jealousy is a sign of love, and that if she likes someone, she should want to be with him all the time. She will learn that she is supposed to be sexually available to her boyfriend, and that his feelings are her responsibility.

When young people learn that these things are acceptable, they risk entering abusive relationships.

Of course, witnessing domestic violence does not automatically mean a person will have an abusive relationship. Many people who witness abuse go on to have healthy, happy relationships. It’s also worth noting that there are plenty of other ways for boys to learn that violence is just a part of being a man, and girls to associate femininity with submission. Transgender, gay, lesbian, and bisexual youth may find that the impacts of witnessing domestic violence manifest differently in their relationships.

Teens aren’t naïve or oblivious.

Most of them don’t want to repeat this unhealthy model in their own lives. But they don’t know what a healthy relationship looks like.

That’s where I come in. My colleagues and I help our patients understand the characteristics of a healthy relationship, so that their own experiences of partnership and love are healthy and non-violent. In this way, we can break the intergenerational cycle of abuse for the patients that come through our doors.

But the 10,000 young people the Center serves every year are a drop in the bucket compared to the millions of young people who witness domestic violence — and when young people don’t receive compassionate education on healthy relationships, they risk finding themselves in an abusive situation.

That’s why we need comprehensive health and sexuality education that emphasizes and models healthy relationships.

These relationships require skills that young people — particularly those who witness domestic violence at home — often don’t have the opportunity to learn. Teens need to learn about positive communication and conflict management—as well as what healthy and unhealthy behaviors look like—in order to form successful relationships in adolescence and adulthood. But without intervention such as the counseling my colleagues and I provide, and without education about healthy expressions of love, the intergenerational cycle of violence will continue.

This post was originally published on our Medium page.

Rachel Colon, LCSW, is a primary care social worker at the Center and has over 10 years of experience working with survivors of domestic violence.

The Mount Sinai Adolescent Health Center is located in New York City. It provides comprehensive, confidential, judgment free health care at no charge to over 10,000 young people every year. This column is not intended to provide medical advice, professional diagnosis, opinion, treatment or services to you or to any other individual, only general information for education purposes only.