DOMESTIC VIOLENCE

Definitions

The term "intimate partner violence" (IPV) is often used synonymously with domestic abuse/domestic violence. Family violence is a broader definition, often used to include child abuse, elder abuse, and other violent acts between family members.^[5] Wife abuse, wife beating, and battering are descriptive terms that have lost popularity recently for at least two reasons:

• Acknowledgment that many victims are not actually married to the abuser, but rather cohabiting or other arrangement.^[6]
• Abuse can take other forms than physical abuse and males are often victims of violence as well. Other forms of abuse may be constantly occurring, while physical abuse happens occasionally.

These other forms of abuse have the potential to lead to mental illness, self-harm, and even attempts at suicide.^[7][8]
Amartya Sen calculated that between 60 million and 107 million women are missing worldwide.^[9]
The U. S. Office on Violence Against Women (OVW) defines domestic violence as a "pattern of abusive behavior in any relationship that is used by one partner to gain or maintain power and control over another intimate partner". The definition adds that domestic violence "can happen to anyone regardless of race, age, sexual orientation, religion, or gender", and that it can take many forms, including physical abuse, sexual abuse, emotional, economic, and psychological abuse.^[10]
The Children and Family Court Advisory and Support Service in the United Kingdom in its "Domestic Violence Policy" uses domestic violence to refer to a range of violent and abusive behaviours, defining it as:

Patterns of behaviour characterised by the misuse of power and control by one person over another who are or have been in an intimate relationship. It can occur in mixed gender relationships and same gender relationships and has profound consequences for the lives of children, individuals, families and communities. It may be physical, sexual, emotional and/or psychological. The latter may include intimidation, harassment, damage to property, threats and financial abuse.^[11]

In Spain, the 2004 Measures of Integral Protection Measures against Gender Violence defined gender violence as a violence that is directed at women for the very fact of being women. The law acknowledges that aggressions against women have a particular incidence in the reality of Spain and that gender violence stands as the most brutal symbol of the inequality persisting in Spain. According to the law, women are considered by their attackers as lacking the basic rights of freedom, respect, and power of decision.^[12]

Classification

All forms of domestic abuse have one purpose: to gain and maintain control over the victim. Abusers use many tactics to exert power over their spouse or partner: dominance, humiliation, isolation, threats, intimidation, denial and blame.^[13]
The form and characteristics of domestic violence and abuse may vary in other ways. Michael P. Johnson argues for three major types of intimate partner violence. The typology is supported by subsequent research and evaluation by Johnson and his colleagues,^{[14][15][16][17]} as well as independent researchers.^[18][19][20]
Distinctions need to be made regarding types of violence, motives of perpetrators, and the social and cultural context. Violence by a person against their intimate partner is often done as a way for controlling "their partner", even if this kind of violence is not the most frequent.^[21] Other types of intimate partner violence also occur, including violence between gay and lesbian couples,^[22] and by women against their male partners.^[23]
Distinctions are not based on single incidents, but rather on patterns across numerous incidents and motives of the perpetrator. Types of violence identified by Johnson:^{[23][24][25][26]}

• Common couple violence (CCV) is not connected to general control behavior, but arises in a single argument where one or both partners physically lash out at the other. Intimate terrorism is one element in a general pattern of control by one partner over the other. Intimate terrorism is more common than common couple violence, more likely to escalate over time, not as likely to be mutual, and more likely to involve serious injury.^[23][25][27]
• Intimate terrorism (IT) may also involve emotional and psychological abuse.^[28][29][30]
• Violent resistance (VR), sometimes thought of as "self-defense", is violence perpetrated by victims against their abusive partners.^{[25][31][32][33][34]}
• Mutual violent control (MVC) is rare type of intimate partner violence occurs when both partners act in a violent manner, battling for control.^[23][35]

Another type is situational couple violence, which arises out of conflicts that escalate to arguments and then to violence. It is not connected to a general pattern of control. Although it occurs less frequently in relationships and is less serious than intimate terrorism, in some cases it can be frequent and/or quite serious, even life-threatening. This is probably the most common type of intimate partner violence and dominates general surveys, student samples, and even marriage counseling samples.
Types of male batterers identified by Holtzworth-Munroe and Stuart (1994) include "family-only", which primarily fall into the CCV type, who are generally less violent and less likely to perpetrate psychological and sexual abuse. IT batterers include two types: "Generally-violent-antisocial" and "dysphoric-borderline". The first type includes men with general psychopathic and violent tendencies. The second type are men who are emotionally dependent on the relationship.^[23][34][36] Support for this typology has been found in subsequent evaluations.^[37][38]
Others, such as the US Centers for Disease Control, divide domestic violence into two types: reciprocal violence, in which both partners are violent, and non-reciprocal violence, in which one partner is violent.

Physical abuse is abuse involving contact intended to cause feelings of intimidation, pain, injury, or other physical suffering or bodily harm.
Physical abuse includes hitting, slapping, punching, choking, pushing, and other types of contact that result in physical injury to the victim. Physical abuse can also include behaviors such as denying the victim of medical care when needed, depriving the victim of sleep or other functions necessary to live, or forcing the victim to engage in drug/alcohol use against his/her will.^[39] It can also include inflicting physical injury onto other targets, such as children or pets, in order to cause psychological harm to the victim.^[40]

Sexual abuse is any situation in which force is used to obtain participation in unwanted sexual activity. Forced sex, even by a spouse or intimate partner with whom consensual sex has occurred, is an act of aggression and violence.
Categories of sexual abuse include:

1. Use of physical force to compel a person to engage in a sexual act against his or her will, whether or not the act is completed;
2. Attempted or completed sex act involving a person who is unable to understand the nature or condition of the act, unable to decline participation, or unable to communicate unwillingness to engage in the sexual act, e.g., because of underage immaturity, illness, disability, or the influence of alcohol or other drugs, or because of intimidation or pressure.

Emotional abuse (also called psychological abuse or mental abuse) can include humiliating the victim privately or publicly, controlling what the victim can and cannot do, withholding information from the victim, deliberately doing something to make the victim feel diminished or embarrassed, isolating the victim from friends and family, implicitly blackmailing the victim by harming others when the victim expresses independence or happiness, or denying the victim access to money or other basic resources and necessities.
Emotional/verbal abuse is defined as any behavior that threatens, intimidates, undermines the victim’s self-worth or self-esteem, or controls the victim’s freedom.^[41] This can include threatening the victim with injury or harm, telling the victim that they will be killed if they ever leave the relationship, and public humiliation. Constant criticism, name-calling, and making statements that damage the victim’s self-esteem are also common forms of emotional abuse. Often perpetrators will use children to engage in emotional abuse by teaching them to harshly criticize the victim as well.^[42] Emotional abuse includes conflicting actions or statements which are designed to confuse and create insecurity in the victim. These behaviors also lead the victim to question themselves, causing them to believe that they are making up the abuse or that the abuse is their fault.^[40]
Emotional abuse includes forceful efforts to isolate the victim, keeping them from contacting friends or family. This is intended to eliminate those who might try to help the victim leave the relationship and to create a lack of resources for them to rely on if they were to leave. Isolation results in damaging the victim’s sense of internal strength, leaving them feeling helpless and unable to escape from the situation.^[42]
People who are being emotionally abused often feel as if they do not own themselves; rather, they may feel that their significant other has nearly total control over them. Women or men undergoing emotional abuse often suffer from depression, which puts them at increased risk for suicide, eating disorders, and drug and alcohol abuse.^[43]

Verbal abuse is a form of abusive behavior involving the use of language. It is a form of profanity that can occur with or without the use of expletives.
Abusers may ignore, ridicule, disrespect, and criticize others consistently; manipulate words; purposefully humiliate; falsely accuse; manipulate people to submit to undesirable behavior; make others feel unwanted and unloved; threaten economically; place the blame and cause of the abuse on others; isolate victims from support systems; harass; demonstrate Jekyll and Hyde behaviors, either in terms of sudden rages or behavioral changes, or where there is a very different "face" shown to the outside world vs. with victim.
While oral communication is the most common form of verbal abuse, it includes abusive words in written form.

Economic abuse is when the abuser has control over the victim's money and other economic resources. In its extreme (and usual) form, this involves putting the victim on a strict "allowance", withholding money at will and forcing the victim to beg for the money until the abuser gives them some money. It is common for the victim to receive less money as the abuse continues. This also includes (but is not limited to) preventing the victim from finishing education or obtaining employment, or intentionally squandering or misusing communal resources.^[44]

Effects

Physical

Bruises, broken bones, head injuries, lacerations, and internal bleeding are some of the acute effects of a domestic violence incident that require medical attention and hospitalization.^[45] Some chronic health conditions that have been linked to victims of domestic violence are arthritis, irritable bowel syndrome, chronic pain, pelvic pain, ulcers, and migraines.^[46] Victims who are pregnant during a domestic violence relationship experience greater risk of miscarriage, pre-term labor, and injury to or death of the fetus.^[45]

Psychological

Among victims who are still living with their perpetrators, high amounts of stress, fear, and anxiety are commonly reported. Depression is also common, as victims are made to feel guilty for ‘provoking’ the abuse and are constantly subjected to intense criticism. It is reported that 60% of victims meet the diagnostic criteria for depression, either during or after termination of the relationship, and have a greatly increased risk of suicidality.^[47] In addition to depression, victims of domestic violence also commonly experience long-term anxiety and panic, and are likely to meet the diagnostic criteria for Generalized Anxiety Disorder and Panic Disorder. The most commonly referenced psychological effect of domestic violence is Post-Traumatic Stress Disorder (PTSD). PTSD (as experienced by victims) is characterized by flashbacks, intrusive images, exaggerated startle response, nightmares, and avoidance of triggers that are associated with the abuse.^[48] These symptoms are generally experienced for a long span of time after the victim has left the dangerous situation. Many researchers state that PTSD is possibly the best diagnosis for those suffering from psychological effects of domestic violence, as it accounts for the variety of symptoms commonly experienced by victims of trauma.

Financial

Once victims leave their perpetrator, they can be stunned with the reality of the extent to which the abuse has taken away their autonomy. Due to economic abuse and isolation, the victim usually has very little money of their own and few people on whom they can rely when seeking help. This has been shown to be one of the greatest obstacles facing victims of DV, and the strongest factor that can discourage them from leaving their perpetrators. ^[49] In addition to lacking financial resources, victims of DV often lack specialized skills, education, and training that are necessary to find gainful employment, and also may have several children to support. In 2003, thirty-six major US cities cited DV as one of the primary causes of homelessness in their areas.^[50] It has also been reported that one out of every three homeless women are homeless due to having left a DV relationship. If a victim is able to secure rental housing, it is likely that her apartment complex will have “zero tolerance” policies for crime; these policies can cause them to face eviction even if they are the victim (not the perpetrator) of violence.^[50] While the number of shelters and community resources available to DV victims has grown tremendously, these agencies often have few employees and hundreds of victims seeking assistance which causes many victims to remain without the assistance they need.^[49]

Long-term

Domestic violence can trigger many different responses in victims, all of which are very relevant for any professional working with a victim. Major consequences of domestic violence victimization include psychological/mental health issues and chronic physical health problems. A victim’s overwhelming lack of resources can lead to homelessness and poverty.