The domestic violence issue came back into the media spotlight when the world was confronted with the video of Ray Rice’s assault on his now-wife Janay Rice while they were dating. In the aftermath, the National Football League faced a backlash from the media and the public with its handling of the former Baltimore Ravens running back. In addition, the uproar sparked a nationwide discussion about intimate partner violence (IPV). That discussion included Meredith Vieira’s courageous decision to share her experience of IPV through social media after she was inspired by the #WhyIStayed movement. The movement sends a simple message: abuse is horrific, but leaving an abusive relationship can be equally difficult. The public shamingof Janay Rice for her decision to marry Ray Rice after assault is an example of one of the most insidious aspects of IPV — the stigmatization and blaming of those who are victims. This stigmatization is damaging, and we must empower the victims of abuse to leave without worsening their plight if they stay.
Twenty-four people per minute are victims of IPV in the United States – more than 12 million women and men per year. In 2011, the Centers for Disease Control released the results of the National Intimate Partner and Sexual Violence Survey (NISVS), which interviewed 16,507 adults (9,086 women and 7,421 men) to evaluate the incidence of IPV. The results were staggering: 35.6 percent of women and 28.5 percent of men in the United States have experienced IPV in their lifetime. As a society we need to heed these numbers, recognize that IPV is a major public health problem and stop stigmatizing victims. No behavior, including a decision to stay in an abusive relationship, condones violent behavior. If anything, the stigma and pressure will worsen the very emotional well-being that is necessary to have the strength to leave abusive relationships.
Even if there were no long-term damages, being assaulted by your partner is reason enough for leaving an abusive relationship. However, IPV does in fact cause lasting serious physical and mental health consequences. One meta-analysis of several studies found that among female victims of IPV, 47.6 percent experienced depression, and 63.8 percent reported post-traumatic stress disorder. According to the NISVS study, men and women who experience IPV in their lifetime are more likely to have both mental health problems and physical health issues, including frequent headaches and chronic pain. In particular, women who had experienced IPV were more likely to have asthma, irritable bowel syndrome and diabetes than women who did not experience these forms of violence. Further, evidence suggests that children who witness domestic violence are more likely to have a range of behavioral and emotional problems.
While a victim of IPV has all these reasons for leaving an abusive relationship, it is not that simple; for those that want to leave, the path to ending an abusive relationship can seem like an endless gauntlet of barriers. To start, the very suffering that is caused by IPV can be what makes leaving an abusive relationship so challenging. The mental health issues facing abuse victims can severely limit functioning; according to the World Health Organization (WHO) and the World Economic Forum (WEF), mental illness represents one of the biggest causes of work disability. Compared to non-victims, victims of IPV are more likely to report lower productivity, higher absentee rates and more frequent tardiness. In fact, victims of IPV often see higher job turnover rates and job losses. Thus, while struggling to function, the added challenge of leaving an abusive relationship often can be too much to bear for abuse victims.
In addition, leaving an abusive relationship does not necessarily remove the threat of violence. Evidence suggests that IPV is not confined to the home. A study by the U.S. Department of Justice that examined IPV among 2,400 employed men and women in three companies across 39 states found that over 18 percent of currently victimized employees reported experiencing some form of IPV carryover onto work premises. Estimates suggest that up to 75 percent of perpetrators harass their intimate partners at work, with 21 percent of offenders reporting that they contacted victims at the workplacein violation of a no-contact order. Perpetrators can also interfere with employees’ work by such acts as refusing to watch children or attempting to cause harm prior to the workday.
The combination of loss of functioning and threat at work can result in even poorer performance at work and often leads to financial stress. One study conducted a retrospective analysis to examine 1,167 women not exposed to IPV and 859 exposed women to determine the long-term effects of health-care costs even after exposure had ended. Compared to women with no IPV history, total health-care costs were significantly higher during IPV exposure and these costs were sustained for three years following the end of exposure. And when leaving an abusive relationship in some cases involves loss of a home, health care and financial support from the abusive partner, the short-term and long-term financial consequences of the abuse can be too overwhelming for abuse victims.
And unfortunately, these incidents of IPV occur in a context in which the violence is rarely discussed, and when it is, the victim is stigmatized or blamed. For example, one survey suggested that the majority of people in the United States have never discussed IPV and a staggering 73 percent have never had a conversation with their under-18 children about IPV. Further, rather than being universally condemned IPV carries varying degrees of acceptability. Victim-blaming can be commonplace, in particular, by the abuser. Research further suggests that we blame victims who stay with their abusers. In a study of 194 participants randomly assigned to a series of hypothetical scenarios, results demonstrated that participants blamed victims who returned to their abusers more than victims about whom there was no such information. Thus, abuse victims are being expected to seek help while being condemned for their situation.
Further, there are additional reasons whereby an abused partner may truly want to stay in the relationship, regardless of the negative consequences. Some victims may still love their abusive partner and/or believe that their partner can change, may feel compelled to stay in an abusive marriage for religious reasons, or stay for reasons related to their children (e.g., want children to grow up with both parents). For any of these reasons, as compelling as it may be to leave an abusive relationship, it may simply be too difficult for some victims at a given time. We need to help victims of IPV get the help they need while understanding all of their reasons for staying and not stigmatize those who have more difficulty getting help.
So what can be done?
The first and most important thing is to make help available for victims in the form of mental health services. To be sure, existing treatments for perpetrators of IPV do not demonstrate strong evidence of success and we know little of the efficacy of existing programs for battered spouses in reducing violence. However, there is initial research suggesting that the mental health consequences of IPV can be improved among victims. We need not only to direct victims to the best resources, but also develop and evaluate programs to prevent IPV and aid its victims.
As financial abuse is a major aspect of IPV, one place where we can make tremendous progress towards this goal is in the workplace. Results from the United States Department of Justice study found that victims who disclosed IPV — in comparison to those who did not — reported feeling more hopeful about their futures, safer, more supported and better able to concentrate. This study also found that when victims felt strong support from their employers, there were positive outcomes, including job satisfaction, organizational commitment and reduction in turnover.
In order to accomplish this goal, businesses need to have a clear, systematic and serious way of managing IPV. Unfortunately, some studies suggest that as many as 70 percent of companies have no official policy on managing IPV. Further, only 4 percent of companies have any type of training for employees to recognize or aid in IPV. Worse, while many corporate executives take IPV seriously, only 12 percent feel that businesses should have a role in managing the problem. This sends a message that IPV is not important. When considering the prevalence of on-site abuse at many companies, there is a tremendous opportunity to show leadership and create a safe space for abuse victims.
To facilitate environments in which victims will disclose IPV, employees, employers and human resources officials need to be educated on the signs and consequences of IPV, as well as the corporate procedures to handle it effectively. Further, clear and firm policies need to be in place to investigate IPV, especially any form of violence or harassment that occurs at the workplace. This includes directives on whom an employee should speak with if managing IPV, as well as strict investigative and legal policies to protect employees. Further, human resources and employee-assistance workers should be trained to detect and provide the proper referrals for care for victims of IPV.
Intimate partner violence is a beast with many heads. The physical violence is often part of an interpersonal and societal context that includes psychological and financial abuse as well as stigmatization. To slay the beast of domestic violence, we need to address all of these issues empower victims to leave, while not stigmatizing them for staying with their abusers.
* This article is from Psychology Today written by Dr. Mike Friedman who is a clinical psychologist in Manhattan and a member of EHE International’s Medical Advisory Board. His thoughts are his own.