Domestic Violence: An Overview

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.” 3

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. 9

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. 8

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. 17

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). 8

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

For help in understanding just what abuse is, follow the “What Is…” links below.

What is Emotional Abuse?
What is Physical Abuse?
What is Sexual Abuse?
Domestic Violence Statistics: Prevalence and Trends
It’s Hard to Stop because it’s Hard to Report
Effects of Domestic Violence
Effects of Domestic Violence on Children and Teenagers
Help is Available!
Domestic Violence Shelters: What They Do
Nationwide Crisis and Hotline Directory
Domestic Violence References

Referring to this article:
“Domestic Violence: An Overview” was written by C. J. Newton, MA, Learning Specialist and published in the Find (formerly Mental Health Journal in February, 2001.

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