Introduction
Domestic Violence isn't just hitting,
or fighting, or an occasional mean argument. It's
a chronic abuse of power. The abuser tortures and
controls the victim by calculated threats, intimidation,
and physical violence. Actual physical violence
is often the end result of months or years of intimidation
and control.
In their diagnostic and treatment
guidelines for physicians, The American Medical
Association defines intimate partner abuse as "the
physical, sexual, and/or psychological abuse to
an individual perpetrated by a current or former
intimate partner. While this term is gender-neutral,
women are more likely to experience physical injuries
and incur psychological consequences of intimate
partner abuse."
In a study, published in the Archives
of Family Medicine, designed to measure physician's
attitudes and practices toward victims of domestic
violence, Snugg, et al, defined domestic violence
as "past or present physical and/or sexual
violence between former or current intimate partners,
adult household members, or adult children and a
parent. Abused persons and perpetrators could be
of either sex, and couples could be heterosexual
or homosexual."
Defining the problem: Domestic
violence is violence between adult intimate partners.
Though the definition above seems
simple enough (it is widely accepted in the law
enforcement community as the definition), the application
of the definition varies quite significantly from
organization to organization, state to state, and
country to country. The term "intimate partners"
in some cases refers only to people who are cohabitating
or have cohabited (lived together) whereas at other
times "intimate partners" refers to people
who are dating or who have dated at some time in
the past.
Perhaps a better definition of
domestic violence is emotional abuse, physical abuse,
or sexual abuse between people who have at some
time had an intimate or family relationship.
To understand how the meaning of
"domestic violence" has and is changing,
think about how the term "family" has
changed in the past 50 years. They are both ever-changing,
and a bit controversial.
Many view the above definition
of domestic violence as overly restrictive. They
argue that domestic violence can occur between adult
family members who are not "intimate"
in the traditional sense, such as adult brothers
and sisters, cousins, brothers-in-law, sisters-in-law,
mothers- and fathers-in-law. For example, many consider
elder abuse to be a form of domestic violence.
Though the definition above clearly
states "adult...", there is a recent trend
for states to adopt legal definitions of domestic
violence that include violence toward children (more
than half of states now mention children in their
domestic violence laws). This could broaden the
definition to be violence between any of the following:
husbands, wives, ex-husbands, ex-wives, partners,
ex-partners, brothers, sisters, mothers, fathers,
children, people who have lived together (which
could include cousins, brothers-in-law, sisters-in-law,
and caregivers), and people who are or have dated
in the past.
What is Emotional Abuse?
Emotional abuse is
when an intimate partner has...
- continually criticized you, called you names
or shouted at you
- insulted or driven away your friends or family
- humiliated you in private or public
- kept you from working, controlled your money
or made all the decisions
- refused to work or to share money
- taken car keys or money from you
- regularly threatened to leave or told you to
leave
- threatened to kidnap the children when the
abuser was angry with you
- abused pets to hurt you
- manipulated you with lies and contradictions
What is Physical Abuse?
Physical abuse is when
an intimate partner has...
- pushed or shoved you
- held you to keep you from leaving
- slapped or bitten you
- kicked or choked you
- hit or punched you
- thrown objects at you
- locked you out of the house
- abandoned you in dangerous places
- refused to help you when you were sick, injured
or pregnant
- forced you off the road or driven recklessly
- threatened to hurt you with a weapon
What is Sexual Abuse?
Sexual abuse is when
an intimate partner has...
- minimized the importance of your feelings about
sex
- criticized you sexually
- insisted on unwanted or uncomfortable touching
- withheld sex and affection
- forced sex after physical abuse or when you
were sick
- raped you
- been jealously angry, assuming you would have
sex with anyone
- insisted that you dress in a more sexual way
than you wanted
Domestic Violence Statistics: Prevalence and Trends
"Around the world at least
one woman in every three has been beaten, coerced
into sex, or otherwise abused in her lifetime. Most
often the abuser is a member of her own family."
"Physical violence is estimated
to occur in 4 to 6 million intimate relationships
each year in the United States."
"Nearly one in every three
adult women experiences at least one physical assault
by a partner during adulthood. Approximately four
million American women experience a serious assault
by an intimate partner during a 12-month period."
"It is estimated that 2 million
to 4 million US women are assaulted by a domestic
partner every year. Twelve million women (25% of
the female population) will be abused in their lifetime.
Up to 35% of women and 22% of men presenting to
the emergency department have experienced domestic
violence."
The precise incidence of domestic
violence in America is difficult to determine for
several reasons: it often goes unreported, even
on surveys; there is no nationwide organization
that gathers information from local police departments
about the number of substantiated reports and calls;
and there is disagreement about what should be included
in the definition of domestic violence. "One
study estimated that more than 3% (approximately
1.8 million) of women were severely assaulted by
male partners or cohabitants over the course of
a year, while other studies indicate the percentage
of women experiencing dating violence, including
sexual assault, physical violence, or verbal and
emotional abuse, ranges as high as 65%."
However, the U.S. Department of
Justice Bureau of Justice Statistics published a
report in May, 2000 which sheds some light on part
of domestic violence. Their report is based on their
own surveys (National Crime Victimization Survey),
and on data from the FBI (homicide data). In their
report they define domestic violence as violent
crimes by current or former spouses, boyfriends,
and girlfriends. Violent crimes include lethal (homicide)
and nonlethal (rape, sexual assault, robbery, aggravated
assault, and simple assault) offenses. From their
data, we can say that in 1998, women experienced
at least 900,000 violent offences at the hands of
an intimate, and men were victims of at least 160,000
violent crimes by an intimate partner. Their report
did not mention emotional abuse, harassment or stalking.
So, more than 1 million violent crimes were committed
against persons by their current or former spouses,
boyfriends, or girlfriends. To view the report,
go to Intimate Partner Violence.
Fred C. Pampel and Kirk R. Williams
warn, however, that "researchers using this
database must address the problem of missing data,
which typically is the result of the failure to
file, inconsistent filing of reports to the FBI
by local police agencies, or incomplete records
about the characteristics of specific incidents
of homicide (particularly, missing information about
perpetrators), even when reports are filed."
Even though we don't know how frequently
domestic violence occurs (and some estimates suggest
that it is as much as 10 times more prevalent than
reported by the Bureau of Justice Statistics), the
report does help with identifying very interesting
trends. The rates of domestic violence vary along
several lines, including race, gender, economic
and educational status, and geographical location.
Gender trends: Women make up 3/4
of the victims of homicide by an intimate partner.
Actually, 33% of all women murdered (of course,
only cases which are solved are included) are murdered
by an intimate partner. Women make up about 85%
of the victims of non-lethal domestic violence.
In all, women are victims of intimate partner violence
at a rate about 5 times that of males.
Racial and Ethnic trends: Black
women and men suffer from the highest rates of domestic
violence. "Black females experienced domestic
violence at a rate 35% higher than that of white
females, and about 22 times the rate of women of
other races. Black males experienced domestic violence
at a rate about 62% higher than that of white males
and about 22 times the rate of men of other races."
Age trends: Domestic violence is
most prominent among women aged 16 to 24.
Economic Trends: Poorer women experience
significantly more domestic violence than higher
income women. 16
Marital status: For both men and
women, divorced or separated persons were subjected
to the highest rates of intimate partner victimization,
followed by never- married persons.
Reporting to police: The rates
at which individuals report domestic violence to
police vary along racial and gender lines. Hispanic
and black women report domestic violence at the
highest rate (approximately 65% to 67% of abuse
is reported). For white females, only about 50%
of the abuse is reported.
It's Hard to Stop Because
It's Hard to Report.
Victims of domestic violence are
reluctant to report abuse. Women very reasonably
fear retaliation against themselves and their children
by the abuser and fear the economic upheaval that
may follow the report. Studies show that the highest
risk for serious injury or death from violence in
an intimate relationship is at the point of separation
or at the time when the decision to separate is
made. 2 "Threats and violence are control strategies
used by the batterer, the woman's leaving may threaten
his sense of power and increase his need to control
the woman and children."
Many times, women's self-esteem
is so low as a result of spouse abuse that they
are unable to see themselves as worthy of seeking
help, or they rationalize the abuse, believing they
caused or deserve it. Police complain that often
when they arrest an abuser, the victims want them
to drop the charges.
For children, the fear is more
than fear of injury or death. Children fear the
destruction of their family - their world. Middle-school
aged children have an awareness of things such as
poverty, foster homes, and homelessness, and may
be unable to cope with the uncertainty that reporting
abuse may cause. Even when adults in the community
such as school personnel or neighbors report the
abuse, children may outright deny it. Children may
experience feelings of shame, guilt, and divided
loyalties to parents making it unlikely that they
will disclose the violence to others.
In an abusive situation, many battered
women will try to solve the problem by talking it
out with the abuser, by fighting back, or by trying
to change their behavior to meet the demands of
the abuser (of course, then the demands change).
When they fail to stop the abuse, women may become
passive, which may reduce the immediate danger,
or may go into a state of emotional withdrawal.
In the end, abuse may push a woman to see only two
options: suicide or homicide.
When women do discuss domestic
violence with an authority, they are most likely
to do so with their physician. Still, in a recent
AMA study of physicians, Rodriguez, et al, found
that only 1% of physicians practicing in health
maintenance organizations screened for domestic
violence. Obstetrician/gynecologists (17%) and physicians
practicing in public clinic settings (37%) were
more likely to screen patients. A recent survey
of physician attitudes found that "45% of clinicians
never or seldom asked about domestic violence when
examining injured patients". The result is
less than 15% of female patients report being asked
about abuse by doctors or telling their doctors
about their abuse.
Recognition rates by physicians
in a variety of settings have been as low as 5 percent
(ie, the physician identifies abuse as a problem
in only one abuse victim in twenty who presents
for care).
Despite physicians being the primary
link to families, many doctor's attitudes toward
domestic violence and their knowledge about it's
prevalence, warning signs and effects are lacking.
In a survey of physician attitudes, it was found
that "fifty percent of clinicians and 70% of
nurses/assistants believed that the prevalence of
domestic violence in their practice was 1% or less"
and "twenty-five percent believed the abused
person's personality led to the violence."
19
Effects of Domestic Violence
Long-term effects of
domestic violence on women who have been abused
may include:
- anxiety
- chronic depression
- chronic pain
- death
- dehydration
- dissociative states
- drug and alcohol dependence
- eating disorders
- emotional "over-reactions" to stimuli
- general emotional numbing
- health problems
- malnutrition
- panic attacks
- poor adherence to medical recommendations
- poverty
- repeated self-injury
- self neglect
- sexual dysfunction
- sleep disorders
- somatization disorders
- strained family relationships
- suicide attempts
- an inability to adequately respond to the needs
of their children.
In a 1999 study from Johns Hopkins, it was reported
that abused women are at higher risk of miscarriages,
stillbirths, and infant deaths, and are more likely
to give birth to low birth weight children, a risk
factor for neonatal and infant deaths. In addition,
children of abused women were more likely to be
malnourished and were more likely to have had a
recent untreated case of diarrhea and less likely
to have been immunized against childhood diseases.
Most battered women take active
steps to protect their children, even if they do
not leave their batterer.
Domestic violence can severely
impair a parent's ability to nurture the development
of their children. Mothers who are abused may be
depressed or preoccupied with the violence. They
may be emotionally withdrawn or numb, irritable
or have feelings of hopelessness. The result can
be a parent who is less emotionally available to
their children or unable to care for their children's
basic needs. Battering fathers are less affectionate,
less available, and less rational in dealing with
their children. Studies even suggest that "battered
women may use more punitive child-rearing strategies
or exhibit aggression toward their children."
When children cannot depend on
their parents or caregivers - for emotional support
and for practical support - their development can
be seriously delayed or, in severe cases, permanently
distorted. Children without an emotionally available
parent may withdraw from relationships and social
activities. Since childhood is the time when social
skills and attitudes are learned, domestic violence
can affect their ability to form relationships for
the rest of their lives.
Parents who have been traumatized
by violence must cope with their own trauma before
they are able to help their children.
Effects of Domestic Violence
on Children and Teenagers
CHILDREN:
Effects of Domestic Violence: academic
problems; agitation - feeling "jumpy";
aggression; avoidance of reminders; behavior problems;
clinginess to caregivers; depression; distractibility;
emotional numbing; emotional changes; fear - feeling
scared; fear of natural exploring; feelings of guilt;
feelings of not belonging; flashbacks; general emotional
distress; increased arousal; intrusive thoughts;
insomnia; irritability; low levels of empathy; low
self-esteem; nightmares; numbing of feelings; obsessive
behaviors; phobias; poor problem-solving skills;
posttraumatic stress disorder; revenge seeking;
social problems; suicidal behaviors; truancy; withdrawal
from activities.
Effects in Adulthood: alcohol abuse;
depression; low self-esteem; violent practices in
the home; criminal behavior; sexual problems; substance
abuse.
Estimates are that more than 3.3
million children are exposed to physical and verbal
spousal abuse each year. 14 Exposure means seeing
or hearing the actual abuse or dealing with the
aftermath of the abuse.
When describing the effects of
domestic violence on children, it is important to
note that domestic violence and child abuse are
often present in the same families. "In homes
where domestic violence occurs, children are physically
abused and neglected at a rate 15 times higher than
the national average. Several studies have shown
that in 60% to 75% of families in which a woman
is battered, children are also battered." In
addition, children living in households where domestic
violence is occurring are at a higher risk for sexual
abuse.
The effects of witnessing or experiencing
violence at home vary tremendously from one child
to another. The attributes that give a child the
greatest chance of surviving unscathed are "average
or above-average intellectual development with good
attention and interpersonal skills. Also feelings
of self-esteem and self-efficacy, attractiveness
to others in both personality and appearance, individual
talents, religious affiliations, socioeconomic advantage,
opportunities for good schooling and employment,
and contact with people and environments that are
positive for development."
Many children in families where
domestic violence has occurred appeared to be "parentified."
They are forced to grow up faster than their peers,
often taking on the responsibility of cooking, cleaning
and caring for younger children. Laura Gillberg,
MSW, is the child and adolescent program director
at Sarah's Inn, an agency in Oak Park, Illinois.
She stated, "Many of these children were not
allowed to have a real childhood. They don't trust
their fathers because of his role as an abuser and
they may have been worried about what to expect
when coming home. They learned at a young age to
be prepared for anything."
Children may also be isolated.
Typical activities such as having friends over to
their house may be impossible due to the chaotic
atmosphere. "Kids aren't going to have their
friends over when mom has a black eye." However,
school performance is not always obviously affected.
Children may respond by being overachievers.
Gillberg noticed that children
in domestic violence tend to be either extremely
introverted or extremely extroverted. Psychosomatic
problems (aches and pains for no apparent reason)
are common; these children's eating and sleeping
patterns tend to be disrupted. Children who witness
domestic violence can develop behavior problems,
including aggression and violent outbursts.
Underlying all these "symptoms"
of domestic violence are children's emotional responses:
i.e. anger - misery - intense terror - fear of dying
- fear of the loss of a parent. Children may feel
rage, guilt, or a sense of responsibility for the
violence, which can stifle emotional and social
development. To learn and grow into a healthy adult,
children must feel confident in the world and in
themselves. Domestic violence can wipe out a child's
confidence and leave them shocked.
INFANTS AND TODDLERS:
Infants and toddlers who witness
violence show excessive irritability, immature behavior,
sleep disturbances, emotional distress, fears of
being alone, and regression in toileting and language.
Preschool children may develop enuresis and speech
disfluencies, such as stuttering. "Exposure
to trauma, especially family violence, interferes
with a child's normal development of trust and later
exploratory behaviors, which lead to the development
of autonomy." 14
TEENS:
Being a teenager is difficult,
as most of us remember. But being a teenager and
living in a house infected with domestic violence
can have devastating, life-long effects. Teens living
with domestic violence face the unique problem of
trying to fit in with their peers while keeping
their home life a secret. Teens in shelters often
face the problem of having to move and begin school
in a new place, having to make new friends while
feeling the shame of living in a shelter. Needless
to say, their family relationships can be strained
to the breaking point. The result can be teens who
never learn to form trusting, lasting relationships,
or teens who end up in violent relationships themselves.
In addition, teens face the same
issues as younger children in an abusive family,
namely feeling lonely and isolated, growing up too
fast, behavior problems, stress related medical
and mental health problems, and school problems.
Teenagers are also faced with entering into the
dating world for the first time. They are formulating
their own theories about relationships, and some
may not have the best models on which to base a
healthy relationship. They have witnessed the cycle
of violence with the abuse, apologies from the perpetrator,
tensions building and more abuse. Unfortunately,
some teenagers may be faced with a higher risk of
being victims of dating violence and as mentioned
earlier, ending up in violent relationships as adults
either as victims or abusers.
Domestic Violence Shelters:
What They Do
In 1999, the National Coalition
Against Domestic Violence reported that the number
of agencies providing services to battered women
surpassed 2,000.
Shelters often offer temporary
as well as transitional living programs, where women
and their children can live in an agency-owned apartment
for an extended period of time, during which they
receive counseling and assistance. To be accepted
into a program, women are interviewed and must demonstrate
need. The cost is usually on a sliding scale, dependent
on a woman's ability to pay. There is usually a
waiting list for transitional living apartments
because it is a much-needed service.
For children, group and individual
counseling, education and play-therapy services,
along with case management services are often available.
About half of residents in domestic violence shelters
are children.
Domestic Violence agencies and
shelters often offer men's programs in the form
of workshops and group therapy for abusers.
Outpatient services include support
groups, vocational counseling and job training,
outreach to high schools and the community, court
advocacy, and mental health services or referrals.
Many agencies have funding for practical matters
such as locating temporary shelters and, if none
are available, putting women and their children
up at a hotel for a few days.
Conclusions
The effects of domestic violence
on our society are obviously enormous, but are impossible
to measure. Our entire nation suffers. You can see
the effects at bus stations, fast-food restaurants,
and schools. You can see it on television and in
jails. You can see it in people's faces on the street
- hopelessness, pessimism, hard-headedness, meanness.
A person's spirit is priceless, and a broken spirit
costs more than can be measured in dollars.
Still, think about the cost of
domestic violence in terms of just dollars and cents,
and it's devastating. Abuse victims need medical
care. Up to 54% of women seeking emergency services,
up to 66% of women seeking general medical care,
and up to 20% of women seeking prenatal care report
experiencing domestic violence. 17 Victims of abuse
also require mental health care. There is enormous
cost to the state in the form of time spent by law
enforcement officers, courts, lawyers, public health
workers and more. There is cost to social welfare
organizations in the form of money and donated time
to staff and run shelters, counseling services,
hotlines, and more. There is cost to the productivity
of our workhouse in the form of absenteeism, worker
re-training (when a victim is killed), and decreased
productivity. The educational system is required
to provide specialized services to children suffering
from attentional and behavioral problems resulting
from domestic violence.
Now think about the fact that children
growing up in a house with domestic violence will
grow up and require medical care for stress-related
illnesses, mental health care for anxiety, depression,
panic, and shock. They will likely end up costing
the state money in the legal system, will earn less
than their peers because of their academic difficulties
as children and because they may have lost the optimistic
and risk-taking qualities necessary to become successful,
and finally, they will likely raise children who
will in turn continue the cycle.
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