Domestic Violence: Recognizing Abuse
It is estimated that more than 1.8 million women have been assaulted by an intimate partner in the preceding twelve months. Anyone can be the victim of domestic violence. Recognizing the characteristics of an abuser and having a safety plan in place can save your life.
Shortly after their wedding, Bill began to criticize and insult his wife, Ann. Over the next few years his comments became almost constant. He then began making fun of her in public and hitting her at home. Sometimes he'd physically force her to have sex. When she wouldn't do what he wanted, he'd threaten to hurt their young daughter and son.
Although she tried to please him, Ann could not stop Bill's abusive behavior. Sometimes she felt like a prisoner who wanted to escape. But other times Bill acted very loving, so she'd stay, hoping that this time he would stop hurting her. After Bill threatened her with a knife, Ann finally decided it was time to leave—for good.
What Is Domestic Violence?
Domestic violence is violent or controlling behavior directed by a person toward a current or past intimate partner. Intimate partners can be any two people that are dating or living together, married, separated, or divorced. Domestic violence is also referred to as battering or partner violence. The abuse can be physical, emotional, and/or sexual, and may occur occasionally or often.
Domestic violence is a pattern of behavior in which the abuser is trying to gain and maintain power and control over the victim. According to Elaine Alpert, MD, MPH, associate professor of public health and medicine at the Boston University School of Medicine in Boston, "Many victims of domestic violence have been led to believe that the problems they see in their relationship are their fault. They think it is their responsibility to change themselves and/or their partner so that the abuse will end. However, the abuse is NOT the victim's fault. It occurs no matter what the victim does."
Over time, domestic violence usually occurs more frequently and worsens. It often follows a three-stage cycle:
- Stage 1—Tension builds. The abuser may criticize and threaten the victim.
- Stage 2— The abuser becomes physically violent and/or emotionally abusive.
- Stage 3— The abuser apologizes, promises to change, and may seem very loving. Although the apologies and apparent acts of love may offer hope that things will change, the cycle of violence almost always starts again. It does not end until the abuser seeks help and makes a concerted effort to change or the victim leaves.
Who Is Affected?
Domestic violence affects millions of people. It cuts across all ages and all economic, educational, cultural, and religious backgrounds. Although 95% of the victims are women abused by men, domestic violence is also committed by women against men and in gay and lesbian relationships. More than three million American children are at risk of exposure to domestic violence each year.
What Are the Characteristics of an Abuser?
Although abusers come from all walks of life, they tend to have some characteristics in common, such as:
- Being possessive and jealous of any other relationships their partner has
- Wanting to exert control to keep their partner from leaving
- Being verbally and/or physically hurtful
- Blaming others for their problems
- Being moody and explosive (eg, quickly moving between abusive and loving)
What Are the Common Signs of Abuse?
Examples of physical abuse include:
- Hitting, shoving, punching, kicking, choking
- Throwing or destroying things
- Blocking you from leaving the room or house
- Subjecting you to reckless driving
- Threatening or hurting you with a weapon
The abuser does things to make the victim feel scared, worthless, and helpless. Again, this is a pattern of behavior, not just an occasional insult. Examples include:
- Insulting, blaming, criticizing, name-calling
- Humiliating you in public
- Accusing you of having affairs
- Controlling all the money and making you account for every penny
- Telling you what to do, where to go, and who you can see
- Threatening or hurting your children
Sexual abuse can be sexual acts, demands, or insults. Examples include:
- Unwanted touching or sexual comments
- Calling you sexual names, such as "slut" or "frigid"
- Forcing you to have sex
- Attacking your sexual body parts or hurting you during sex
Are You or Is Someone You Know Being Abused?
Ask yourself these questions about your partner:
- Does your partner shove, hit, shake, or slap you?
- Does your partner make light of the abuse, insist that it did not happen, or shift the responsibility for his abusive behavior, blaming you for it?
- Does your partner continually put you down, call you names, or humiliate you?
- Does your partner intimidate you through looks or actions, destroy your property, or display weapons?
- Does your partner control what you do, who you see and talk to, and where you go, limiting your involvement outside the relationship?
- Are you made to feel guilty about the children, or has your partner threatened to take the children away?
Ask yourself these questions about your friend or family member who may be experiencing abuse:
- Does she appear anxious, depressed, withdrawn, and reluctant to talk?
- Does her partner criticize her in front of you, making remarks that make you feel uncomfortable when you are around the two of them?
- Do you see or hear about repeated bruises, broken bones, or other injuries that reportedly result from "accidents"?
- Does her partner try to control her every move, make her account for her time, and accuse her of having affairs?
- Is she often late or absent from work, has she quit a job altogether, or does she leave social engagements early because her partner is waiting for her?
How Are Children Affected?
"Children are not just innocent bystanders when there is violence in their home," says Dr. Alpert. "They are often victims themselves." Child abuse occurs much more often in families where there is domestic violence. Also, domestic violence against the mother has been associated with an increased risk of death for the children.
Whether children are being abused directly or just living with abuse around them, their lives are disrupted. They can experience fear, confusion, and pain. This greatly increases their chance of developing emotional and behavioral problems, such as low self-esteem, withdrawal, self-blame, aggression toward others, and problems in school and relationships. They learn that violence is acceptable, they are at greater risk for committing criminal or self-destructive behavior, and they are more likely to become abusers as adults.
What Kinds of Help Are Available?
When Ann decided to leave, she discussed her plans with a friend and a counselor at a domestic violence hotline. After a week of planning, she left home with her two children and stayed at a shelter for battered women. The shelter staff helped her begin the process of building a new life. Several years later, Ann and her children now live in another state near a few cousins. She has a full-time job and her own apartment.
If you or someone you know is being abused, seek help. Talk with someone you trust, such as a close friend or relative or your doctor. Consider calling a domestic violence hotline and talking with a counselor.
Remember, domestic violence is not your fault, and no one ever has the right to abuse another person. You have a right to be safe! And, help is available.
How Do You Plan for Your Safety?
If you are in an abusive relationship, it is important to have a safety plan. Such a plan can be helpful whether you are trying to stay in or leave the relationship. A domestic violence counselor can help you develop a plan tailored to your needs. Listed below are some common elements of a safety plan:
- Set up a signal with your neighbors so they can call the police if you are in danger.
- Get a restraining order if you need legal protection to keep your abuser away from you.
- Plan an escape route and a safe place to go, such as to relatives, friends, or a domestic violence shelter.
Keep items listed below easily accessible for an emergency or if you want to leave. Consider keeping some of them, including copies of important papers, with a trusted relative or friend.
- Important phone numbers and phone calling card
- Money, checkbook, ATM, and credit cards
- Driver's license
- Keys for home, car, and office
- Important papers for you and your children, including birth certificates
- Social security cards, health insurance cards, and medical and school records
- Restraining order and information—including photographs—that will document past abuse
- Change of clothes
- Children's favorite toys/blankets
If you suspect that you will be leaving the relationship, try and obtain a credit card or debit card in your own name so that your abuser cannot cancel the cards. If you are ever in danger—or feel that you or your children are about to be in danger—call 911. In a growing number of cities and towns across the US, law enforcement personnel are trained specifically to handle cases of domestic violence.
Family Violence Prevention Fund
The National Domestic Violence Hotline
Domestic Abuse Must Stop
Rhode Island Coalition Against Domestic Violence. Domestic Violence, The Facts: An Information Handbook. Boston, MA: Peace At Home, Inc.
12/11/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php: Ackerson LK, Subramanian SV. Intimate partner violence and death among infants and children in India. Pediatrics. 2009;124(5):e878-89.
Last reviewed January 2009 by ]]> Theodor B. Rais, MD]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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