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Dr. Tori Hudson, Portland, Oregon, Blog Healthline Blog

I posted a brief blog in May calling attention to intimate partner violence, but here we are again with some added information.  Intimate partner violence (IPV) is defined as physical and sexual violence, emotional abuse, or stalking by an intimate partner.  I have shared some information below, expanding on this definition.

One in four US women and one in ten men have experienced IPV in their lifetimes. [i]  Throughout the world, IPV is the single leading cause of homicide death in women. [ii]  In the U.S. IPV against women disproportionately affects ethnic minorities.  Other disparities exist as well relating to socioeconomic and foreign-born status which impact the physical and mental health outcomes that result from IPV.  Approximately 42.4 million women in the U.S. experience rape, physical violence, and/or stalking by an intimate partner at some point in their lifetime. [iii]

In the most basic terms, there are three categories of abuse to be aware of: Mental abuse, physical abuse, verbal abuse

Types and Signs of Abuse

  • Physical abuse is intentional bodily injury.
  • Sexual abuse is nonconsensual sexual contact (any unwanted sexual contact).
  • Mental mistreatment or emotional abuse is deliberately causing mental or emotional pain.

 

According to some, there are 6 types (reachma.org; Reach Beyond Domestic Violence in Waltham, MA.  Hotline 1-800-899-4000).  I find it useful to expand the types into those that are described below, as I think financial abuse and cultural/identity abuse are under discussed.

From their website:

The commonly held definition of abuse, which we use in all of our trainings, is “a pattern of behavior used by one person to gain and maintain power and control over another.” One thing to note about that definition is that we are talking about a pattern of behavior, in other words, not just one incident.  These behaviors can take on a number of different forms.  Many people when they hear the word “abuse,” think of physical violence.  It’s important to note that physical force is one means of power and control and it is far from the only one.  It’s often not the first one an abuser will use.  Below are six different types of abuse we discuss in our training.

  1. Physical

This is the type of abuse that many people think of when they hear the word ‘abuse.’ It can include punching, hitting, slapping, kicking, strangling, or physically restraining a partner against their will.  It can also include driving recklessly or invading someone’s physical space, and in any other way making someone feel physically unsafe.

  1. Sexual

While sexual abuse can be a form of physical abuse, we put it in a category by itself because it can include both physical and non-physical components.  It can involve rape or other forced sexual acts, or withholding or using sex as a weapon.  An abusive partner might also use sex as a means to judge their partner and assign a value – in other words, criticizing or saying that someone isn’t good enough at sex, OR that sex is the only thing they’re good for.  Because sex can be so loaded with emotional and cultural implications, there are any number of ways that the feelings around it can be uniquely used for power and control.  It wasn’t until 1993 that marital rape was illegal in all 50 states, so some people may still assume that sex is something a partner is entitled to, and not recognize it as a larger pattern of power and control.

  1. Verbal/Emotional

As one survivor puts it, “My ex-husband used words like weapons; like shards of glass, cutting and slowly draining my life, until I had nearly none left.  I didn’t think I was abused because he didn’t hit me- usually… I had begun to believe his awful lies- how worthless I was, how stupid, how ugly, and how no one would ever want me.” Other survivors have pointed out that while the signs of physical abuse might be noticeable to a friend or family member, the effects of verbal/emotional abuse are harder to spot, and harder to prove.  Emotional scars can often take longer to heal.

  1. Mental/Psychological

Mental or psychological abuse happens when one partner, through a series of actions or words, wears away at the other’s sense of mental wellbeing and health.  It often involves making the victim doubt their own sanity.  We’ve heard stories of abusers deliberately moving car keys (and in one case, the whole car!) or a purse, dimming the lights, and flat-out denying that certain things had taken place.  The result of this, especially over a sustained period of time – and often with the isolation that abusers also tend to use – is that the victim depends on the abuser more and more because they don’t trust their own judgment.  They also hesitate to tell anyone about the abuse they’re experiencing, for fear they won’t be believed.  Angela, a participant in one of our Support Groups, said, “He had called me crazy so many times, I was unsure if anyone would ever believe me about the abuse.”

  1. Financial/Economic

Because abuse is about power and control, an abuser will use any means necessary to maintain that control, and often that includes finances.  Whether it is controlling all of the budgeting in the household and not letting the survivor have access to their own bank accounts or spending money, or opening credit cards and running up debts in the survivor’s name, or simply not letting the survivor have a job and earn their own money, this type of abuse is often a big reason why someone is unable to leave an abusive relationship.  Many of the survivors we work with have problems with their credit, because of an abuser’s past behavior.  A bad credit history can affect your ability to get an apartment, a job, a car loan, and any number of other things necessary for self-sufficiency.  We work with survivors to get these issues resolved, but social safety nets such as food stamps, cash assistance, and health insurance can provide a much-needed bridge in the meantime.

  1. Cultural/Identity

Cultural abuse happens when abusers use aspects of a victim’s particular cultural identity to inflict suffering, or as a means of control.  Not letting someone observe the dietary or dress customs of their faith, using racial slurs, threatening to ‘out’ someone as LGBQ/T if their friends and family don’t know, or isolating someone who doesn’t speak the dominant language where they live – all of these are examples of cultural abuse.

An abusive relationship can include any or all of these types of behaviors, sustained over a period of time and often escalating.  If you or someone you care about is experiencing this and you want to talk to someone about your concerns, REACH’s hotline is available 24 hours a day, 7 days a week, 365 days a year.  Call 1-800-899-4000 to speak with a trained advocate who will listen without judgment.

 

What can we do?

  1. Become educated and aware
  2. Create a safe space for clients, employees, co-workers, friends or family members to discuss
  3. Approach the suspected victim in private if you have concerns/suspicions
  4. Be aware of local resources
  5. Provide small pamphlets as to resources in private or public bathrooms where a woman could see it
  6. National Domestic Violence Hotline: 800-799-7233
  7. Thehotline.org

I wish safety and well-being for all.

 

References:

[i] Smith S, Zhang X, Basile k, et l.  The National Intimate Partner and Sexual Violence Survey: 2015 Data Brief-Updated Release. Atlanta, GA: National Center for Injury Prevention and Control.  Centers for Disease Control and Prevention; 2018.

[ii] Devries K, Mak J, Garcia-Morena C, et al.  Global health.  The global prevalence of intimate partner violence against women.  Science 2013;340:1527-1528.

[iii] Black M, Basile K, Breiding M, et al.  The National Intimate Partner and Sexual Violence Survey: 2010 summary report. Atlanta, GA: National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, 2011.

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