IPV Flashcards
What the victim needs from provider
- Respect the patient’s POV
- Be a source of support and resources
- Trust that patients/clients make informed decisions
- Understand that leaving is a process of change
Who Abuses Women
- 25% of women reported Hx of IPV
- Male were abusers 93% of the time
Who Abuses Men
- 8% of men reported Hx of abuse
- Male was abuser 86% of the time
Who is in Greatest Need
- More women (1 in 4) that men report
- Women are more likely than men to be murdered
- Higher rates in African-American women (1 in 3)
- Highest in Indian/Alaskan Native women and men
- Lowest reporting from Asian/Pacific Islander
Consequences of IPV
- Physical injury and illness
- Psychological symptoms & chronic Dz
- Economic costs
- Death
Consequences to children
- Mistrust
- Inability to learn
- Fear of expression
- Crave/need
- Cranky, crabby
- Fear of safety
Intimate Partner Violence
- Coercive control, usually occurring over time, exhibited through:
- Physical violence
- Sexual violence
- Threats of physical or sexual violence
- Psychological or emotional abuse
- “Any violence b/n intimates, including all adult intimate relationships b/n people regardless of sexual preference, marital status, or age.”
- WHO: Behavior within an intimate relationship that causes physical, sexual, or psychological harm including acts of physical aggression, sexual coercion, psychological abuse, and controlling behaviors by current and former partners/spouses
Physical Violence
Intentional use of force, but not limited to :
* Slapping, pushing, shaking, biting, using a weapon, strangulation, scratching, choking, burning, hitting
Emotional/Psychological Abuse
- Intentional infliction of anguish, pain, or distress designed to control the victim:
- Verbal assaults, Insults, Threats, Frightening intimidation, humiliation, harassment.
Ways of Abusing Emotionally in IPV
- Isolating and restricting activity
- Attack self esteem through humiliation and degrading comments
- Withdraw in hostile ways
- Destroy (her) personal property
- Threaten harm
Emotional Abuse
- Less research for emotional vs. physical abuse, but:
- Predicts occurrence of physical abuse
- Occurs in the absence of physical abuse
- Tends to co-occur with physical abuse
- Often perceived by victim as worse than physical abuse
Things that Distinguish IPV From Other Violence
- People have an intimate knowledge of one another
- Perpetrator has ongoing access to victim
- Secret nature of problem, generally happening outside of public view
- Perpetrators ability to avoid being caught
- Perpetrators ability to influence consequences if caught
Definition: Sexual Violence
WHO:
- Any sexual act, attempt to obtain a sexual act, unwanted sexual comments or advances, or acts to traffic or otherwise directed against a person’s sexuality using coercion, by any person regardless of their relationship to the victim, in any setting including but not limited to home and work
Definition: Rape
WHO:
- Physically forced or otherwise coerced penetration of the vulva or anus with a penis, other body part, or object
- Definition varies b/n countries
Types of abusers
- Cycliclally emotional or volatile perpetrators
- Over-controlling perpetrators
- Psychopathic perpetrators
Cycle of Violence
Phase 1) Tension building
Phase 2) Violence erupts
Phase 3) “Honeymoon phase”
Personality/Behaviors Seen in Batterers
- Jealousy
- Controlling
- Quick involvement (married w/in 6mo)
- Unrealistic expectations (perfect wife, mother, friend)
- Isolation
- Blames others for problems/feeling
- Hypersensitive
- Cruel to animals or children
- Playful use of force in sex
- Verbal abuse
- Rigid sex roles
- Dr. Jekyl/Mr. Hyde
- Past battering
- Breaking objects
- Any force during arguments
4 Types of IPV Relationships
- Situational couple violence
- Intimate terrorism
- Violent resistance
- Mutual violence
Situational Couple
- Victims are male or female
- Perpetrators are male or female
- Cause/Pattern:
- Not part of general pattern of control
- Part of escalating couple conflict
- Nature of violence considerable variability
- Population found:
- Not usually in ER
- Not usually severe injury
Mutually Violent Couple
- Both are victims
- Both are perpetrators
Violence Resistant Couple
- Fighting back
- Self protection
Intimate Terrorism
- Victim is female
- Perpetrator is male 97%
- Cause/Pattern: General strategy of power/control
- Nature of violence: considerable variability
- Population found:
- In ER
- Police reports
- Unlikely to participate in surveys
Physical Consequences of IPV
- Physical trauma/disability
- Chronic conditions (Pelvic pain, IBS, HA)
- In pregnancy: Miscarriage, low pregnancy wt. gain, inadequate prenatal care, LBW
- Sexual assault IVP: Unwanted pregnancy, STI, TOP
- Substance abuse
- Homicide
Emotional Consequences of IPV
- Depression
- Diminished self-esteem
- Dissociative disorders
- PTSD
- Fear of future trauma
- ETOH/Drug abuse
- SI
Why Do Victims Stay? (11 F’s)
- Fear
- Finances
- Family
- Failure
- Faith
- Father
- Face
- Fantasy
- Fix
- Familiarity
- Fatigue
Definition: Stockholm Syndrome
Psychological phenomenon is which the hostage or victim of abuse express empathy and sympathy or have positive feelings towards their captors to the point where they might begin to defend them.
Stockholm Syndrome: 5 Powerful Motivations Working Together
- The motivation to survive physically/mentally
- The motivation to avoid pain and fear
- The motivation to find hope and meaning
- The motivation to find significance and security
- The motivation to see acceptance and relationship
Short-Term Trauma Associated with PTSD
- Car accident
- Natural disasters
- Rape
- Chronic Trauma Associated with Complex PTSD
- Concentration camps/POWs
- Prostitution brothels
- Long-term IPV
- Child sexual abuse
- Organized child exploitation rings
Complex PTSD
- Alteration in emotional regulation, consciousness, Perception of perpetrator, and relations with others
- Changes in self-perception and one’s system of meanings
- Avoidance of trauma topics
- Substance abuse
- Self-mutilation
- Recipient of victim blaming
- Misdiagnosis as masochist
- Dependent
Open Window Phase
- Avoidant, dependent, and denial behaviors are absent
- the abused woman:
- Realizes she is a victim and cannot stop violence
- Is most likely to reach out for help
- Will learn if there are alternatives to violence
- Is most receptive to intervention
The Process of Leaving
Stages of Recovery and Change
- Committed to continuing the relationship
- Committed but questioning
- Considers change
- Breaks away or partner curtails abusiveness
- Establishes new life, apart or together
Precontemplation/Binding
- Defines partner behavior as controlling/atypical for him
- Blames self for his abuse
- Views relationship with partner as positive
- Not ready to act, avoids discussion of situation
Contemplation While Enduring
- Perceives partners behavior as occasionally abusive
- Hopeful partner will change behavior
- Concerned more about partner than self
- Perception of relationship mixed/ambivalent
- Not ready to take action but concerned
- Extreme ambivalence and external constraints overwhelm desire to take action
- Secretive and ashamed about situation
Preparing to Leave/Disengage
- Perceives partner’s behavior as abusive and dangerous
- Attributes blame to partner
- Has little hope that he will change
- Concerned more about self than partner
- Perceives relationship as mainly negative but sense of loss is strong
- Shares situation with close confidants
- Plans to act and is considering barriers to action
Taking Action/Disengaging
- Angry with partner, no hope he will change
- Believes that abuse will escalate
- Perceives relationship as very negative
- Has “gone public” and taken actions to promote safety
Maintenance/Recovery
- Taking steps to achieve and maintain autonomy (getting a job, etc.)
