History of Domestic Violence According to Martin (2008) domestic violence, also referred to as family violence and intimate partner violence, involves the physical and emotional abuse acted out between intimates. This may include violence between husbands and wives, boyfriends and girlfriends, violence within gay and lesbian relationships, and violence between siblings. Domestic violence can include hitting, punching, slapping, pinching, shoving, and throwing objects at or near the victim.
It is also typically associated with verbal and emotional abuse including name-calling, harassment, taunting, put-downs, and ridiculing. Sometimes emotional and verbal abuse can occur without physical abuse, but rarely does physical abuse occur without emotional or verbal abuse. Statistics have shown the rate in which the incidence of domestic violence occurs is alarming. In 2003 alone roughly 5. 3 million people were the victims of intimate partner violence in the United States, resulting in over 2 million injuries per year and about 1,300 deaths.
Once considered a personal family matter, the public realized in recent generations that domestic violence affects entire communities, both fiscally as well as socially. People with a history of domestic violence report having significantly higher rates of physical health problems. Physical problems from assaults, partner rape, and the stress of living in a violent environment can lead to chronic pain, HIV/AIDS, and other sexually transmitted diseases, gastrointestinal problems, unwanted pregnancy, miscarriage, and premature births. The estimated health costs related to domestic violence is close to $6 million per year and $1. billion in lost productivity including lost time from work, unemployment, and increased dependence on public aid (Martin 2008). When dealing with this issue one has to remember that everyone involved in the relationship is at risk of becoming a victim of the batterer, this includes children and elderly dependents. Studies have shown that children who are raised in homes where domestic violence is practiced are more likely to get involved in juvenile delinquency and become a perpetrator of abuse when they become adults. The Nature of Domestic Violence
Lenore Walker (1979) was the first to coin the phrase the cycle of violence to describe the pattern of interpersonal violence in intimate relationships. This type of abuse usually starts with the abuser telling the victim things to make them trust only them. They also manipulate various situations to make the victim think no one understands them but their abuser. In a short while the victim is wined, dined and complemented. The abuser may tell them various things to make them feel good about themselves all while giving them a false since of security and trust.
One the relationship becomes more comfortable the abuser will more like to show their true nature. In this time the abuser will go through two processes. The first would be when the abuser starts to feel vulnerable because they start to realize their partner’s power within the relationship. This sense of fear may cause the abuser to become jealous, possessive, and or controlling. In response to these threatening feelings of vulnerability and entitlement, innocent partners often become the focus of the batterer’s mistrust, fear, and ultimate rage.
Some partners of batterers will sense the increasing tension brought about by the abuser’s underlying anger that is bubbling to the surface. The abuser might start to ask more questions like “Were you going and what time are you coming back”? They may even make sarcastic comments; ask why two cups are out rather than one, or question why the phone wasn’t answered more quickly when they called. At this time they will typically have a shorter fuse, becoming easily frustrated often without an incident. In relationships like this most victims do their best to walk on eggshells to avoid their abuser’s rage.
In most cases there is no amount of interference or offered reassurances will help this situation because the process is an internal one, occurring within the mind of the abuser. In fact, most abusers have a need to be proven correct in their fear of being hurt and humiliated again because to a batterer, being too trusting is often synonymous with being an unsuspecting fool. At some point a fight occurs despite all peacemaking efforts. Abusive fits can take on several different forms including frightening, screaming, yelling and intimidation.
Physical abuse such as hitting, kicking, scratching, grabbing, slapping, and shoving can also be used. Another form of abuse is the threatening of the victim of other persons in the home (children). Clinical Issues and Intervention Strategies In a study done in San Francisco emergency room, 218 women were interviewed these are the results. We reviewed data from standardized interviews with 218 women who presented to an emergency department with injuries due to domestic violence. Victims ranged in age from 16 to 66 years and constituted a wide range of socioeconomic and ethnic backgrounds.
Domestic violence often resulted in severe injury; 28% of the women interviewed required admission to hospital for injuries, and 13% required major surgical treatment. The typical presentation was injuries to the face, skull, eyes, extremities, and upper torso. A third of the cases involved a weapon, such as a knife, club, or gun. In all, 10% of the victims were pregnant at the time of abuse, and 10% reported that their children had also been abused by the batterer. Most victims (86%) had suffered at least one previous incident of abuse, and about 40% had previously required medical care for abuse. Berrios DC, Grady D 1991) Most intervention efforts are aimed at separating the abused from their batterer. Physical separation from the batterer, however, did not ensure protection for these subjects. A third of the victims in the study were not living with their abusers at the time of the incidents, suggesting that victims of domestic violence need better police and judicial protection after leaving the abusive relationship. When counseling victims of domestic violence one should have specialized training that focuses on the unique dynamics commonly displayed in abusive relationships.
Many of these trainings should relate to the cycle of violence discussed in the previous paragraph. However many remain solely focus on the victim, these include; understanding common personality traits encountered in people who show a pattern of getting romantically involved with abusive partners, as well as identifying traits commonly seen in individuals who will not leave, or those who continue to return to their abusive partners. Another key element of counseling victims of domestic violence is assisting them with making decisions about their future that will not compromise their safety.
While is true a human service professional may not actually tell a client to leave an abusive relationship, they can however lead the abused clients down this path, especially if it is the only way to secure their safety or if the batterer has refused to enter into a structured treatment program. A common clinical issue in helping the client develop new boundaries is the experience of unreasonable guilt. Many victims of domestic violence feel a sort of toxic guilt in response to setting limits with others. They often believing that saying no to someone or upsetting another person is the same as being unkind.
Human service professionals can help clients see the irrationality of this way of thinking. Cognitive Behavioral Therapy (CBT) is a counseling technique commonly used to help victims of domestic violence recognize and change unhealthy relationship styles. Helping victims of domestic violence realize that feelings are not always the best indicators of appropriate action will assist them in setting better boundaries in their relationships and more efficiently recognizing the signs that a partner or potential partner is merely looking for a life scapegoat, rather than a life partner (Martin 2008).
The problem of domestic violence in our society and the severity of the injuries incurred argue strongly for its inclusion as a topic of study in medical school curricula and within our every day society.