Intimate Partner Violence

Question 1

What is the cycle of abuse? (according to presentation)

Answer 1

Honeymoon > Tension > Explosion > Apologies > Back to honeymoon

Question 2

What are the two key elements of abuse?

Answer 2

Power and control

Question 3

Describe the honeymoon part of the abuse cycle:

Answer 3

• Communication is open
• Security
• Selflessness
• Doing things together
• If it has happened before, may belief this is the “true” self (manipulative kindness)
• Promises that it will “never happen again”
• Victim finally experiencing the relationship in a positive way and thus it becomes increasingly difficult to leave it
• After victim has been through the cycle of number of times, self-esteem begins to wither; they understand they are trading physical and psychological safety for brief periods of ‘peace and happiness’
• This phase occurs less frequently over time as tension building becomes the norm

Question 4

Describe the tension part of the abuse cycle:

Answer 4

• Manipulation
• Communication impaired (conflict or no talking)
• Segregation/isolation
• If others are involved (ex. kids), becomes uncomfortable

Question 5

Describe the explosion part of the abuse cycle:

Answer 5

• Outburst (physical, verbal, etc.)
• Leaving, disappearing, silent treatment
• Fear
• Finances

Question 6

What are some of the consequences of abuse?

Answer 6

• Insomnia
• Chronic stress
• Self-blame
• Depression
• Disability
• PTSD/anxiety
• Weight fluctuations
• Intellectual disability
• Grief/loss of dreams

Question 7

What are the different types of abuse?

Answer 7

• Emotional
• Intellectual
• Financial
• Pets and property
• Psychological
• Physical
• Verbal
• Sexual
• Spiritual
• Using children
• Social
• Using culture

Question 8

What is attachment?

Answer 8

An emotional bond to another person. When a person has a relationship with an abusive person, their desire to be connected and attached to others in healthy relationships is skewed because of what has been done to them.

Question 9

What does unhealthy attachment result in?

Answer 9

• Paralyzes instead of motivation
• Unhealthy dependence or co-dependence
• Fearful environment
• Insecurity
• Disconnectedness
• Separation is relief

Question 10

How can a child be changed by violence in the home?

Answer 10

• Children denied positive role models
• Abuse can harm mother/child bond
• Negative core beliefs about themselves
• Isolated from helpful supports
• Destroys a child’s view of the world as a safe and predictable place
• Style of coping and survival may become problematic
• May adopt some of the rationalizations for abuse
• Children come to believe that victimization is inevitable or normal
• More likely to display developmental, physical, psychological and health concerns
• Aggressive or delinquent behavior

Question 11

What are the key elements of a power and control belief system?

Answer 11

Central, superior and deserving

Question 12

Compare and contrast a power and control belief system vs. a relationship belief system:

Answer 12

• Central vs. connected
• Superior vs. equal
• Deserving vs. mutual

Question 13

When an abusive partner is in a power and control belief system (central, superior, deserving), how does that affect the victimized partner?

Answer 13

Peripheral, inferior or serving

Question 14

What are the two paths of pain?

Answer 14

• Path of revenge vs. path of grief
• With revenge, an event causes hurt/loss, initiates revenge, which passes on pain and leads to more pain and less peace in the world
• With grief, an event causes hurt/loss, initiates grieving, dealing with pain, and leads to less pain and more peace in the world

Question 15

What are the two types of couple violence?

Answer 15

Common Couple Violence and Patriarchal Terrorism Violence

Question 16

What is common couple violence?

Answer 16

• Caused by dynamics of relationship
• Defined as intermittent response to conflicts of everyday life, motivated by a need to control a specific situation (not necessarily control of relationship)
• Occasional outbursts of violence from either violence, but more often minor and insight into events (“getting out of hand”)
• Less frequent occurrence
• Violence does not escalate over time
• Male/female initiation and reciprocation
• Needs appropriate intervention-type assistance (conflict resolution, anger management)

Question 17

What is Patriarchal Terrorism Violence?

Answer 17

• Systemic patriarchal tradition of men’s right and exclusive entitlement to control women
• Need to have and display continual total relationship control by any and all necessary means because rights, status, etc. do not apply
• Form of terrorist control over women via use of violence, but also economic subordination, threats, isolation, other control tactics, etc.
• More frequent
• Violence almost always escalates over time, sometimes to life-threatening forms
• Almost totally male initiation and reciprocation
• Beyond prevention stage; couple counseling is ineffective and can be dangerous for women
• Development of effective method to confront male power and control belief system and effect change is key

Question 18

Describe abuse in same-sex relationships:

Answer 18

• Under-reporting is a clear obstacle
• Un-informed potential helpers may believe that violence is part of the ‘gay culture’
• Individual may view his or her abusive partner as being central to sexual identify
• Bringing abuse in same sex relationships to light may expose the individual to discrimination based on sexual orientation

Question 19

Describe violence against men by women:

Answer 19

• Many men killed by their partners have record of severe violence against them
• Women kill partners after years of suffering physical violence; having exhausted all available sources of assistance; when they feel trapped;when they fear for other own (or children’s) lives

Question 20

What is the difference between men who killed their spouses and women who killed their spouses?

Answer 20

• Men often hunt down/kill spouses who have left; women hardly ever do
• Men kill wives as part of planned murder-suicides; women almost never do
• Men kill in response to revelations of ‘wifely infidelity’; women almost never do even though their mates are more often adulterous
• Men kill wives after subjecting them to lengthy periods of coercive abuse and insults; women seldom do
• Men perpetrate familial massacres; women do not

Question 21

What is the tension-building phase of the cycle of abuse (power point)?

Answer 21

• Tension builds between the couple. Problems regarding jobs, finances, children, and other stressors that increase the tension.
• Over time, abuse and violence increase and escalate in frequency and severity.
• The woman/man attempts to control the abuse through various coping techniques such as avoidance, placating, or “giving in” (These measures do not work for long, if at all.)
• Once the tension reaches an unbearable level, the acute violent incident occurs.

Question 22

What is the acute abusive/violent incident phase of the cycle of abuse (power point)?

Answer 22

• This is an uncontrollable discharge of built-up tension
• The trigger for this is rarely the victim’s behavior; rather it is usually an external stressor or the internal state of theabuser.
• The type of violence is usually much more serious and intense than what the victim has experienced through day to day interactions with the abuser and the victim may be severely injured.

Question 23

What are the for categories of impact on the victim?

Answer 23

• Physical
• Emotional
• Intellectual
• Spiritual

Question 24

Why do women not report violent attacks?

Answer 24

• Fear of further retaliation by attacker
• Dual Charging – fear of being charged for defending self
• Peace Bonds – fear of further retaliation through imperfect system monitoring of restraining orders
• Lack of Trust in judicial / policing system

Question 25

How do children withstand or oppose the violence they are exposed to?

Answer 25

• Create physical and mental escapes
• Attempt to understand family dynamics
• Build support networks
• Create order within familial chaos
• Develop and execute safety/exit plans
• Intervene with the batterer
• Protect and comfort mother and siblings

Question 26

What might abuse stem from?

Answer 26

• History of male dominance in institutions (churches with paternalistic views, for instance)
• Pornography/sexual violence that portrays gender submission as ‘normal’
• History of poor coping and adaptation

Question 27

What is the role of the nurse in detecting/screening for IPV?

Answer 27

• Nurses are a large group of service providers with:
• Central ethic of caring
• Agenda of early intervention and health promotion
• Assisting role in community and hospitals
• Always consider barriers to disclosing IPA

Question 28

What may be some barriers to disclosing IPA?

Answer 28

• Fear of safety (their and their children)
• Denial or disbelief
• Emotional attachment, commitment or love for partner
• Hope that the behaviour will change
• Shame, embarrassment, depression, stress, isolation
• Lack of faith in others abilities to help
• Belief in value of self-reliance and independence

Question 29

What is the SAFE screening tool?

Answer 29

• How would you describe your SPOUSAL relationship?
• What happens when you ARGUE?
• Do FIGHTS result in your being hit, shoved or hurt?
• Do you have an EMERGENCY PLAN?

Question 30

How do we assess patients suspected to be IPV victims?

Answer 30

• Physical signs or injuries
• Psychological and emotional injuries
• Consider all aspects of what the victim reports (verbal, non-verbal, subtext)
• In our responses, we must demonstrate active listening, communicating belief, validating decision to disclose and emphasizing unacceptability of violence

Question 31

What questions can we ask if we suspect IPV?

Answer 31

• You seem very anxious and nervous. Is everything alright at home?
• When I see injuries like this, I wonder if someone could have hurt you?
• Is there anything else we haven’t talked about that may be contributing to this condition?
• Is there anything else happening that may be affecting your health?

Question 32

What questions do we AVOID if we suspect IPV?

Answer 32

• Is your partner abusing you?
• Why are you still with him/her?
• What could you have done to avoid the situation?
• Why did he hit you?….