Chapter 7
Causes, Effects, and Prevention of Domestic Violence

Sociological Theories on the Causes of Domestic Violence
Feminist Theories
Structure of Interpersonal Relationships Theory
Does Substance Abuse Cause Domestic Violence?
Does Pregnancy Exacerbate Domestic Violence?
Experiencing Violence as a Child
Age and Domestic Violence
Why Do Abused Women Stay?
What Can a Woman Do?
Health Effects of Domestic Violence
When Women Kill Their Partners
Prevention of Domestic Violence

Sociological Theories on the Causes of Domestic Violence

Researchers have studied domestic violence for about thirty years. Even though scholars from different intellectual traditions have varying theories on the causes of domestic violence, sociological explanations have gained wide acceptance.

Murray A. Straus explains in “A General Systems Theory Approach to a Theory of Violence between Family Members” (Social Science Information, vol. 12, no. 3, June 1973) that the general systems theory views violence as a system rather than as a result of individual mental disturbance. It describes a system of violence that operates at the individual, family, and societal levels. It views domestic violence as having many causes, including stereotyped family violence imagery learned in childhood and the fact that these stereotyped images are continually reaffirmed through social and cultural interactions. In fact, violent acts might generate positive feedback—in other words, they might achieve the desired results—leading to a perpetuation of violence.

According to the resource theory of domestic violence, the more resources (social, personal, and economic) a person can command, the more power he or she can potentially call on. The individual who is rich in terms of these resources has less need to use force in an open manner. In contrast, a person with little education, low job prestige and income, or poor interpersonal skills may use violence to compensate for a real or perceived lack of resources and to maintain dominance. For example, the 1985 National Family Violence Survey, which surveyed 6,002 households, showed that serious physical acts of wife abuse are more likely to occur in poorer homes. In the survey, families living at or below the poverty level had a rate of marital violence 500% greater than more affluent families. In “Neighborhood Environment, Racial Position, and Domestic Violence Risk: Contextual Analysis” (Public Health Reports, vol. 118, no. 1, January–February 2003), Deborah N. Pearlman et al. of Brown University find a complex but strong relationship between poverty and domestic violence and speculate that one explanation for the increased risk of domestic violence in poorer neighborhoods might be differences in law enforcement availability and practices—that is, economically deprived communities might have less police notification, attention, and documentation.

The subculture of violence theory posits that some groups within society hold values that permit, and even encourage, the use of violence. Offered as an explanation of why some segments of society and some cultures are more violent than others, this theory is perhaps the most widely accepted theory of violence. In fact, some researchers believe attitudes about violence are shaped early in life, long before the first punch is thrown in a relationship. In “The Attitudes towards Violence Scale: A Measure for Adolescents” (Journal of Interpersonal Violence, vol. 14, no. 11, November 1999), Jeanne B. Funk et al. asked junior high and high school students attending an inner-city public school in a midwestern city about their attitudes toward violence. The researchers find that males endorsed more pro-violence attitudes independent of age, grade level, and ethnicity than did those students who identified themselves as victims of violence. African-American teenagers endorsed reactive violence (violence used in response to actual or perceived threats) at higher levels than other groups. Hispanics endorsed culture of violence measures, reflecting a pervasive identification with violence as a valued activity, at slightly higher levels than the teenagers as a group. Culture of violence measures included the belief that the world is a dangerous place where the best way to ensure survival is to be vigilant and prepared to take the offensive. Whites scored lower on measures of reactive violence as well as on total pro-violence attitudes. Funk et al. conclude that a combination of biological, environmental, and social influences are responsible for these findings.

Feminist Theories

Feminist theories of violence against women emphasize that patriarchal structures of gender-based inequalities of power in society are at the root of the problem. That is, the violence, rather than being an individual psychological problem, is instead an expression of male domination of females. Violence against women, in the feminist view, includes a variety of control tactics meant to control women.

Learned Gender Roles

Pointing to history, some feminist researchers see wife abuse as a natural consequence of women's second-class status in society. Among the first to express this viewpoint were R. Emerson Dobash and Russell Dobash in Violence against Wives: A Case against the Patriarchy (1979). The researchers argue that men who assaulted their wives were actually living up to roles and qualities expected and cherished in Western society (aggressiveness, male dominance, and female subordination) and that they used physical force as a means to enforce these roles. Many sociologists and anthropologists believe men are socialized to exert power and control over women. Some men may use both physical and emotional abuse to attain the position of dominance in the spousal relationship. Kristin L. Anderson and Debra Umberson state in “Gendering Violence: Masculinity and Power in Men's Accounts of Domestic Violence” (Gender and Society, vol. 15, no. 3, June 2001), a study of thirty-three male batterers, that “violence is . . . an effective means by which batterers reconstruct men as masculine and women as feminine.”

Donna Chung of the University of South Australia concludes in “Violence, Control, Romance, and Gender Equality: Young Women and Heterosexual Relationships” (Women's Studies International Forum, vol. 28, no. 6, 2005) that patriarchal belief systems combine with heterosexual norms and sometimes result in violence. She examines dating violence with a view to discerning the “structural factors” that influence the violent actions of young people within relationships. She argues that the “micro-practices” of heterosexual relationships embody power relations between the genders. This inequality in power relationships at times results in intimate partner violence.

In “Girlfriend Abuse as a Form of Masculinity Construction among Violent, Marginal Male Youth” (Men and Masculinities, vol. 6, no. 1, July 2003), a study of thirty male adolescents, primarily gang members, Mark Totten of the Youth Services Bureau of Ottawa, Canada, finds another link between patriarchy and violence. He concludes that underprivileged males in society use violence toward women in response to their lack of access to the traditional benefits of patriarchy. Totten posits that the ideals of patriarchy—and the inability of these disenfranchised boys to wield any patriarchal power outside of their gangs or family groups—leads them to be violent toward their girlfriends as one way to define their masculinity. He states that “violence was one of the few resources over which they had control.” However, he also suggests that “men with more resources can commit different, less visible forms of abuse.”

Structure of Interpersonal Relationships Theory

As seen in the previous discussion, many theories about the cause of domestic violence overlap somewhat. According to Joseph H. Michalski of the University of Western Ontario, in “Making Sociological Sense out of Trends in Intimate Partner Violence” (Violence against Women, vol. 10, no. 6, June 2004), many of the insights of other theories need to be integrated into a more comprehensive theory of the impact of the structure of relationships on domestic violence. He suggests that key risk factors of domestic violence include:

• Social isolation of the couple
• Separate peer support networks
• Inequality between partners
• Lack of relational distance, or a high degree of intimacy within a couple
• The centralization of authority—in other words, patriarchal dominance within a family
• Exposure to violence and violent networks

In “Explaining Intimate Partner Violence: The Sociological Limitations of Victimization Studies” (Sociological Forum, vol. 20, no. 4, December 2005), Michalski argues that distinctions need to be drawn between different types of violence in relationships. He indicates that there is a predatory type of violence, including what he calls “intimate terrorism,” which may in fact be a type of male violence meant to control women. He also identifies “situational couple violence,” which is violence that is in response to a particular conflict within a couple that has a fairly egalitarian relationship. The causes for each of these types of violence, he states, are very different.

Does Substance Abuse Cause Domestic Violence?

The role of alcohol and drug abuse in family violence is documented in many studies, and it is a factor in physical violence and stalking, according to researchers such as Pam Wilson et al., in “Severity of Violence against Women by Intimate Partners and Associated Use of Alcohol and/or Illicit Drugs by the Perpetrator” (Journal of Interpersonal Violence, vol. 15, no. 9, 2000). Even though researchers generally do not consider alcohol and drug use to be the cause of violence, they find that it can contribute to, accelerate, or increase aggression. A variety

of data sources establish a correlation (a complementary or parallel relationship) between substance abuse and violence, but a correlation does not establish a causation. In theory, and possibly even in practice, substance abuse may promote or provoke domestic violence, but both may also be influenced by other factors, such as environmental, biological, and situational stressors. Based on available research, it remains unclear whether substance abuse is a key factor in most domestic violence incidents.

In 2005, 14.1% of victims of violent assaults believed the offender had been using alcohol, 7% believed the offender had been using drugs, and 4.6% believed the offender had been under the influence of both. (See Table 7.1.) Another 1.6% thought the offender was under the influence of either drugs or alcohol. Only 23.4% of victims believed the offender had not used any drugs or alcohol, whereas another 49.2% reported they did not know.

According to Shannan Catalano of the Bureau of Justice Statistics, in Intimate Partner Violence in the United States (December 2007, http://www.ojp.usdoj.gov/bjs/intimate/ipv.htm#contents), 42.1% of victims of intimate partner violence stated the perpetrator had used alcohol or drugs. (See Figure 7.1.) Because these victims knew the perpetrator intimately, the proportion of victims who answered they did not know if the perpetrator was under the influence was smaller, at 22.9%. A third (35%) said the perpetrator had not used alcohol or drugs. Even though anecdotal evidence suggests that alcohol and drugs appear to be linked to violence and abuse, in controlled studies the connection is not as clear. In Alcohol and Intimate Partner Violence (March 2005, http://pubs.niaaa.nih.gov/publications/Social/Module8IntimatePartner Violence/Module8.html), the National Institute on Alcohol

Abuse and Alcoholism states that “alcohol is not a clearly identified direct cause of [intimate partner violence], though it clearly is a correlate and may be a contributing factor.”

Richard J. Gelles and Mary M. Cavanaugh suggest in “Association Is Not Causation: Alcohol and Other Drugs Do Not Cause Violence” (Donileen R. Loseke, Richard J. Gelles, and Mary M. Cavanaugh, eds., Current Controversies on Family Violence, 2005) that substance abuse is not a cause of family violence—rather, it is often used as an excuse for family violence. Gelles and Cavanaugh argue that even though substantial evidence has linked alcohol and drug use to violence, there is little scientific evidence that alcohol or other drugs, such as cocaine, have pharmacological properties that produce violent and abusive behavior. The researchers maintain that alcoholism may be associated with intimate violence, but it is not a primary cause of the violence. They cite experiments using college students as subjects that have found that when the students thought they were consuming alcohol, they acted more aggressively than if they were told they had been given nonalcoholic drinks. According to Gelles and Cavanaugh, it is the expectation of the effects of alcohol that influences behavior, not the actual liquor consumed.

In “Risky Mix: Drinking, Drug Use, and Homicide” (National Institute of Justice Journal, no. 250, November 2003), a study of patterns of alcohol and drug use in murders and attempted murders of women by their partners, Phyllis Sharps et al. show a relationship between substance use and violence. They find that in the year before the violent incident, female victims used alcohol and drugs less frequently and consumed smaller amounts than did their male partners. Sharps et al. also note that during the homicide or attempted homicide, 31.3% of perpetrators consumed alcohol, 12.6% used drugs, and 26.2% used both. Less than one out of three (29.9%) of perpetrators used neither alcohol nor drugs. In contrast, perpetrators who abused their partners without attempting to kill them consumed alcohol 21% of the time, drugs 6.7% of the time, and both 5.8% of the time. Nearly two-thirds (65.8%) of perpetrators used neither alcohol nor drugs. Sharps et al. conclude that increased substance use results in more serious violence. Martie P. Thompson and J. B. Kingree of Clemson University agree. They find in “The Roles of Victim and Perpetrator Alcohol Use in Intimate Partner Violence Outcomes” (Journal of Interpersonal Violence, vol. 21, no. 2, 2006) that alcohol use among male batterers led to a significant increase in the likelihood that their partners would suffer injury in a violent incident.

Does Treatment Help?

According to Gregory L. Stuart et al., in “Reductions in Marital Violence Following Treatment for Alcohol Dependence” (Journal of Interpersonal Violence, vol. 18, no. 10, October 2003), after intensive inpatient treatment of male batterers for alcoholism, both alcohol consumption and levels of violence within families decreased. Not only did the frequency of husband-to-wife physical and psychological abuse decrease but also the frequency of wife-to-husband marital violence decreased significantly.

Gregory L. Stuart of Brown Medical School reviews in “Improving Violence Intervention Outcomes by Integrating Alcohol Treatment” (Journal of Interpersonal Violence, vol. 20, no. 4, April 2005) empirical and theoretical evidence to conclude that not only do most men in batterer intervention programs have problems with abusing alcohol but also that these men are at high risk for continuing to batter their intimate partners. He argues that combining alcohol treatment with batterer intervention programs would significantly improve recidivism rates.

Does Pregnancy Exacerbate Domestic Violence?

Research about intimate partner violence reveals that violence does not stop when women become pregnant. The Division of Reproductive Health at the Centers for Disease Control and Prevention (CDC) gathers data about the health of expectant mothers using its Pregnancy Risk Assessment Monitoring System (PRAMS). An analysis of PRAMS data (February 2006, http://www.cdc.gov/ReproductiveHealth/Products&Pubs/PDFs/Physical%20Violence.pdf) reveals that between 4% and 8% of women report being abused by their husband or partner in the year before they gave birth. Jana L. Jasinski of the University of Central Florida states in “Pregnancy and Domestic Violence: A Review of the Literature” (Trauma, Violence, and Abuse, vol. 5, no. 1, January 2004) that this estimate is too low because PRAMS asks limited questions about domestic violence and asks about abuse rather than about particular behaviors. Still, she argues, pregnancy does not appear to increase the risk of domestic violence, although more research into this question is needed.

Studies such as Julie Gazmararian et al.'s “Prevalence of Violence against Pregnant Women” (International Journal of Gynecology and Obstetrics, vol. 275, no. 24, June 1996) and Gazmararian et al.'s “Violence and Reproductive Health: Current Knowledge and Future Research Directions” (Maternal and Child Health Journal, vol. 4, no. 2, June 2000) estimate that higher rates of abuse of pregnant women—as many as 324,000 women per year and rates as high as 20% of pregnant women—have been reported. According to Gazmararian et al., in “Prevalence of Violence against Pregnant Women,” higher abuse rates were reported later in pregnancy, with 7.4% to 20% of that violence occurring in the third trimester. The lowest rates were reported in a study of women with a higher socio-economic status who were treated in a private clinic. The assailants were mainly intimate or former intimate partners, parents, or other family members. Two studies that also examined violence in the period after birth found that violence was more prevalent after birth than during pregnancy.

Jasinski suggests that violence directed toward pregnant women is usually part of an ongoing pattern of domestic violence. However, some factors do seem to increase the risk of violence for pregnant women. In “Prevalence of Violence against Pregnant Women,” Gazmararian et al. find that women with unwanted pregnancies had 4.1 times the risk of experiencing physical violence by a husband or boyfriend during the months before delivery than did women with desired pregnancies. Loraine Bacchus, Gill Mezey, and Susan Bewley find in “A Qualitative Exploration of the Nature of Domestic Violence in Pregnancy” (Violence against Women, vol. 12, no. 6, June 2006) that abuse of pregnant women centered around financial worries, the woman's inability to be as physically and emotionally available during pregnancy, the lack of support of a male partner, and doubts about paternity. In “Police-Reported Intimate Partner Violence during Pregnancy: Who Is At Risk?” (Violence and Victims, vol. 20, no. 5, 2005), Sherry Lipsky et al. of the University of Washington, Seattle, find that certain factors put pregnant women at risk for police-reported intimate partner violence, including unmarried status, public health program use, smoking or alcohol use while pregnant, and having previously been pregnant or given birth.

According to Phyllis W. Sharps, Kathryn Laughon and Sandra K. Giangrande, in “Intimate Partner Violence and the Childbearing Year: Maternal and Infant Health Consequences” (Trauma, Violence, and Abuse, vol. 8, no. 2, 2007), intimate partner violence during pregnancy is associated with poorer maternal and infant health. Abuse during pregnancy is associated with an increased risk of preterm delivery, low birth-weight infants, and infant death. Abused pregnant women were more likely to experience vaginal bleeding, severe nausea and/or vomiting, dehydration, and kidney infections and/or uterine tract infections.

In “Pregnancy-Associated Violent Deaths: The Role of Intimate Partner Violence” (Trauma, Violence, and Abuse, vol. 8, no. 2, 2007), Sandra L. Martin et al. of the University of North Carolina, Chapel Hill, find that intimate partners are responsible for many, if not most, murders of pregnant women. Research in many U.S. cities indicates that about one out of twenty women killed by intimate partners is pregnant. Unsurprisingly, pregnant women who had previously experienced intimate partner violence were at a much higher risk for fatal violence.

Experiencing Violence as a Child

Research demonstrates a relationship between having been a victim of violence and becoming violent in future relationships. In fact, Shelby A. Kaura and Craig M. Allen of Iowa State University note in “Power and Dating Violence Perpetration by Men and Women” (Journal

of Interpersonal Violence, vol. 19, no. 5, May 2004), a study of 352 male and 296 female undergraduate college students, that witnessing parental violence was the strongest predictor of perpetrating dating violence. Another study of college students found exceedingly high rates of abuse during college, especially of students who had been victimized in childhood or adolescence. During the first year of college, 23% of women who had not been victimized in the past were victimized physically, sexually, or both. However, 32% of students who had been victimized in childhood were abused in their first year of college, 42% of students who had been victimized in adolescence were abused, and 66% of students who were abused during both childhood and adolescence were abused during their first year of college. (See Table 7.2.)

Another study looked at whether adults who experienced sexual abuse or domestic violence had been abused in childhood or adolescence. Over a quarter (28%) of adults who had not been abused before reaching adulthood were sexually abused as adults, whereas 75% of those who had been abused in childhood and adolescence were sexually abused as adults. (See Table 7.3.) Six out of ten women who had not been abused in childhood or adolescence experienced some domestic violence in adulthood, but nearly all (97%) of women who had been sexually abused in childhood and adolescence experienced some domestic violence in adulthood.

Dating Violence in Adolescence

Dating violence encompasses physical, sexual, or psychological violence in a dating relationship. Experiencing dating violence puts victims at a greater risk for engaging in risky sexual behavior, anorexia or bulimia, substance abuse, and suicide. It can also be an indicator that an adolescent is at risk for victimization in intimate relationships in adulthood.

According to Erika L. Lichte and Laura A. McCloskey of Harvard University, in “The Effects of Childhood Exposure to Marital Violence on Adolescent Gender-Role Beliefs and Dating Violence” (Psychology of Women Quarterly, vol. 28, no. 4, 2004), adolescents who were exposed to domestic violence during their childhood were in fact more likely to justify being violent in dating relationships. However, Lichte and McCloskey find that even more important in predicting dating violence was an adolescent's belief in traditional models of male-female relationships and the belief that violence was sometimes justified.

Mireille Cyr, Pierre McDuff, and John Wright of the Universite´ de Montre´ al examined dating violence among a group of adolescent girls who had been sexually abused as children and reported their findings in “Prevalence and Predictors of Dating Violence among Adolescent Female Victims of Child Sexual Abuse” (Journal of Interpersonal Violence, vol. 21, no. 8, 2006). Dating violence was more prevalent among these young women than other studies had found in a general population of female adolescents. Nearly half of the sexual abused teens reported that they had experienced physical violence in a dating relationship in the previous year. Certain characteristics of the abuse the girls had suffered made it even more likely for them to be the victims of physical violence, namely if the sexual abuse included penetration or physical violence. Cyr, McDuff, and Wright argue that difficulties that sexually abused youth have with intimate relationships, including a fear of intimacy and ambivalent attachment, might explain the higher levels of dating violence among this group.

The CDC's Youth Risk Behavior Surveillance system surveys students in grades nine to twelve on their experience of dating violence. Almost one out of ten (9.9%) students said they had been hit, slapped, or physically hurt on purpose by their boyfriend or girlfriend during the past year. (See Table 7.4.) Males were more likely to say they had experienced dating violence than were females, across all race and ethnic groups and age groups. A slightly smaller proportion of students said they had been forced to have sexual intercourse, but it was still an alarming 7.8%. Females were much more likely to say they had been forced to have sexual intercourse than were males across all race and ethnic groups and age groups.

Age and Domestic Violence

Intimate Partner Violence Declines with Increasing Age

Studies show that intimate partner violence declines with advancing age. Analyzing National Crime Victimization Survey data, Catalano finds that in 2004 women aged twenty to twenty-four had 11.5 intimate partner victimizations per 1,000 women, compared to just 1.3 per 1,000 among women aged fifty and older. In “Nonlethal Intimate Partner Violence against Women: A Comparison of Three Age Cohorts” (Violence against Women, vol. 9, no. 12, 2003), Callie Rennison and Michael R. Rand also find lower rates of intimate partner violence in women over age fifty-four. They believe lower rates might be because of several factors, such as homicides of younger women, earlier divorces from abusive partners, or the turning of older perpetrators to other forms of victimization, such as psychological abuse or economic domination.

Effects of Abuse among Older Adults

In “The Nature and Impact of Domestic Violence across Age Cohorts” (Affilia, vol. 20, no. 3, 2005), Dina J. Wilke and Linda Vinton of Florida State University indicate that there were no differences among abused

women of different ages in the severity of the abuse, the kind of injuries received, substance abuse at the time of the incidents, the likelihood that women would report the violence, or the rates of childhood abuse or depression. However, older women, on average, had endured abuse for a longer time. They were also more likely to be currently in violent relationships and to have health and mental health problems than were younger women.

Why Do Abused Women Stay?

One of the most frequently asked questions about abused women is: Why do they stay? Some authors and advocates argue that the relevant questions for battered women themselves are different. They believe this question implies there is something wrong with the woman for staying, rather than placing the blame where it belongs: on the batterer. Ola W. Barnett of Pepperdine University argues in “Why Battered Women Do Not Leave, Part 1” (Trauma, Violence, and Abuse, vol. 1, no. 4, 2000) that better questions might be: “Why does he beat her?” or “Why does society let him get away with it?” or “What can be done to stop him?”

However, not all women stay in abusive relationships. Many leave abusive relationships and situations without turning to the police or support organizations. Even though their number is unknown, most women who leave without asking for help usually have strong personal support systems of friends and family or employment and earnings that enable them to live economically independent of their abusive partner. Yet, there can be little question that a large percentage of women remain with their abuser. There are as many reasons women stay as there are consequences and outcomes of abusive relationships.

Women's Reasons to Stay

Women stay in abusive relationships for a variety of reasons. A major reason women stay is their economic dependency on their batterer. Many women feel they are better off with a violent husband than facing the challenge of raising children on their own. Some harbor deep feelings for their abusive partner and believe that over time they can change their partner's behavior. Others mistakenly interpret their abuser's efforts to control their life as expressions of love. Some frequently reported practical considerations include:

• Most women have at least one dependent child who must be cared for.
• Many are unemployed.
• Their parents are either distant, unable, or unwilling to help.
• The women may fear losing mutual friends and the support of family, especially in-laws.
• Many have no property that is solely their own.
• Some lack access to cash, credit, or any financial resources.
• If the woman leaves, then she risks being charged with desertion and losing her children and joint assets.
• She may face a decline in living standards for herself and her children, and the children, especially older ones, may resent this reduced living standard.
• The woman and/or children may be in poor health.
• The abuser may have threatened or harmed her pets, as noted by Catherine A. Faver and Elizabeth B. Strand in “To Leave or to Stay? Battered Women's Concern for Vulnerable Pets” (Journal of Interpersonal Violence, vol. 18, no. 12, December 2003).

In “‘We Don't Have Time for Social Change’: Cultural Compromise and the Battered Woman Syndrome” (Gender and Society, vol. 17, no. 5, October 2003), Bess Rothenberg of Clemson University argues that women are victimized and coerced into staying in violent relationships by a combination of different forces. According to Rothenberg, women are victimized first and foremost by violent abusers; second, by a society that sanctions the right of men to hit women and socializes women into staying in abusive relationships; third, by representatives of institutions who are in a position to help but who instead ignore the plight of battered women (e.g., doctors, police, the criminal justice system, clergy, and therapists); and fourth, by the everyday realities of being a woman in a patriarchal system that expects women to raise children and denies them access to education, job skills, and good employment.

Similarly, April L. Few and Karen H. Rosen examine in “Victims of Chronic Dating Violence: How Women's Vulnerabilities Link to Their Decisions to Stay” (Family Relations, vol. 54, no. 2, April 2005) why women stay in abusive dating relationships and describe a combination of “relational” and “situational” vulnerabilities that work together to influence a woman's decision to stay. They define relational vulnerabilities as one's beliefs about what behaviors and interactions are normal in an intimate relationship. Situational vulnerabilities refer to the degree to which a woman was experiencing stress at the beginning of the abusive relationship (either as a consequence of life changes or as a consequence of feeling like one is getting too old for marriage or parenthood). Few and Rosen find that an accumulation of vulnerabilities, combined with lacking protective factors such as high self-esteem, a social support system, and healthy coping skills, made it more likely a woman would stay in a chronically abusive dating relationship.

The Role of Self-Blame

Ola W. Barnett, Tomas E. Martinez, and Mae Key-son explain in “The Relationship between Violence, Social Support, and Self-Blame in Battered Women” (Journal of Interpersonal Violence, vol. 11, no. 2, June 1996) that battered women often hold distorted beliefs and perceptions that tend to keep them in abusive relationships. Some women blame themselves for the violence; they believe that they cause the abuse and that they should be able to prevent it by changing their behavior. Others see the abuse as normal and rationalize the violence as “not that bad.”

Escalating levels of violence in a relationship often lead to greater use of violence by the woman as a means of self-defense or retaliation. This can result in still more self-blame, because the woman feels she is at fault for the violence. It may also deter her from seeking help and prompt her to believe no help is available. External sources of support may be less inclined to help a woman who presents the problem as her fault; as a result, the self-blaming woman may receive less assistance from health and social service agencies and organizations. Breaking this vicious cycle requires counselors or advisers who can help the woman shift the blame to her abusive mate. In fact, some researchers, such as Kate Cavanagh of the University of Glasgow in “Understanding Women's Responses to Domestic Violence” (Qualitative Social Work, vol. 2, no. 3, 2003), suggest that even though women may blame themselves when the abuse begins, as the frequency and severity of violence increases, they do eventually begin to assign the blame to the perpetrator.

The Role of Fear

Many women fear that attempting to end an abusive relationship will lead to even worse violence. Research shows this fear of reprisal is well founded. As Lenore E. Walker explains in Terrifying Love: Why Battered Women Kill and How Society Responds (1989), batterers often panic when they think women are going to end the relationship. In the personal stories women told Walker, they repeatedly related that after calling the police or asking for a divorce, their partners’ violence escalated.

Walker observes that in an abusive relationship it is often the man who is desperately dependent on the relationship. Battered women are likely to feel that the batterer's sanity and emotional stability are their responsibility—that they are their partner's only link to the normal world. Walker alleges that almost 10% of abandoned batterers committed suicide when their partners left them.

It appears, however, that more batterers become homicidal than suicidal. Angela Browne, in “When Battered Women Kill,” and Kirk Williams, in “Resource Availability for Women at Risk and Partner Homicide” (both published in Law and Society Review, vol. 23, 1989), find that more than 50% of all female homicide victims were murdered by a former abusive male partner. Barnett emphasizes that evidence consistently demonstrates that after women leave abusive partners they often continue to be assaulted, stalked, and threatened and that leaving provokes some batterers to kill their partners. In “How Can Practitioners Help an Abused Woman Lower Her Risk of Death?” (National Institute of Justice Journal, no. 250, November 2003), Carolyn Rebecca Block of the Illinois Criminal Justice Information Authority concurs that an attempt to leave can escalate domestic violence. She finds that 45% of homicides of a woman by a man were in response to the woman trying to leave her abusive partner.

The Battered Woman Syndrome

In The Battered Woman (1979), Lenore E. Walker claims that abused women suffer from a constellation of symptoms—the so-called battered woman syndrome— that keeps them from leaving abusive partners. She argues that a psychological condition known as learned helplessness plays a significant role in keeping women in abusive relationships. Even though Walker recognizes, as do other multiple-victimization theorists, that women are victims of a patriarchal society and institutions that fail to advocate for abused women, she emphasizes the psychological problems women develop in response to abuse.

The concept of learned helplessness was articulated by Martin E. P. Seligman. In Helplessness: On Depression, Development, and Death (1992), Seligman describes how he conducted an experiment in which he taught dogs to fear the sound of a bell. He did so by restraining a dog, ringing the bell, and then subjecting the dog to a painful (but not dangerous) shock. This process was repeated many times.

Next, to test the effectiveness of the training, Seligman placed the dog in a cage with a floor that could be electrified. One wall of the cage was low enough that the dog could jump over it if it wished. Seligman then rang the bell and administered shocks through the floor. He expected that the dog would jump out of the cage. However, most of the dogs did not. Seligman theorized this was because their earlier experience, where they had been shocked with no possibility of escape, had taught them that they were helpless.

Seligman called this learned helplessness. He and other psychologists theorize that it also occurs in humans, with similar effects. In Battered Woman, Walker contends that battered women have learned through their life experiences that they are helpless to escape or avoid violence. These battered women are conditioned to believe that they cannot predict their safety and that nothing can be done to fundamentally change their situation. They become passive, submissive, depressed, overwhelmingly fearful, and psychologically paralyzed. Walker emphasizes that even though they do not respond with total helplessness, they narrow their choices, choosing the ones that seem to have the greatest likelihood of success.

In “The Battered Woman Syndrome Is a Psychological Consequence of Abuse” (Richard J. Gelles and Donileen R. Loseke, eds., Current Controversies on Family Violence, 1993), Walker claims that battered woman syndrome is common among severely abused women and that it is part of the recognized pattern of psychological symptoms called posttraumatic stress disorder (PTSD). Normally, fear and the responses to fear abate once the feared object or circumstance is removed. People who have suffered a traumatic event, however, often continue to respond to the fear with flashbacks and violent thoughts long after the event has passed. Symptoms of PTSD may include difficulty in thinking clearly and a pessimistic outlook, memory distortions, intrusive memories, sleep and eating disorders, and medical problems associated with persistent high levels of stress. Over time, the more aggressive symptoms diminish and are replaced by more passive, constrictive symptoms, making the affected women appear helpless. The abused woman's outlook often improves, however, when she regains some degree of power and control in her life.

Women Are Not Helpless

Beginning in the 1980s a number of critics emerged who argued that the emphasis on psychological problems of abuse victims was an inadequate explanation of domestic violence. Lee H. Bowker surmises in “A Battered Woman's Problems Are Social, Not Psychological” (Gelles and Loseke, eds., Current Controversies on Family Violence, 1993) that women remain trapped in violent marriages because of conditions in the social system rather than because they suffer from psychological problems. According to Bowker, battered women are not as passive as they are portrayed in abuse literature and routinely take steps to make their life safer or to escape abuse. Bowker views husbands’ unwillingness to stop being dominant and a lack of support from traditional social institutions as the factors that delay battered women in escaping from abuse.

External Barriers to Leaving

Barnett suggests that battered women face many obstacles to leaving abusive relationships. She states that many of these barriers are external—in other words, not because of an individual or psychological problem with the abused woman. Barnett outlines many external obstacles to an abused woman's quest to leave her partner, including:

• The patriarchal structure of society—when men control all of a family's resources, women may be economically powerless.
• Problems with the criminal justice system—the U.S. criminal justice system is underfunded and tends not to enforce legislation prohibiting the abuse of women. The lack of adequate funding keeps battered women from getting legal assistance. Police decisions to arrest or not arrest batterers tend to be inconsistent; when police do not arrest, it impedes women's attempts to leave and leaves them vulnerable to further abuse. Barnett notes that only a quarter of batterers are arrested, about one-third of those arrested are prosecuted, and only 1% of those prosecuted serve jail time beyond the time served at arrest. Orders of protection are ineffective because most judges will not enforce them.
• Child custody and visitation—women fear losing their children if they report intimate partner violence. A report of domestic violence can trigger an investigation by child protective services. When women do retain custody of their children, judges usually do not take intimate partner violence into account when writing visitation orders. Court-ordered visitation is often used by abusers as an opportunity for further battering.

Internal and Psychological Barriers to Leaving

In “Why Battered Women Do Not Leave, Part 2” (Trauma, Violence, and Abuse, vol. 2, no. 1, 2001), Barnett outlines several internalized socialization beliefs (normal, learned beliefs about how society and relationships work) as well as psychological factors induced by trauma that serve as obstacles to battered women leaving their abuser. Barnett emphasizes that many of these beliefs are detrimental to all women—but battered women are particularly vulnerable. Among them are:

• Gender-role socialization—society values male traits more than female traits and often devalues female gender roles. As girls age into adolescence, they begin to lose self-confidence as they turn to romantic relationships for a sense of self-worth. When an adult woman values her ability to form a relationship with a male partner over other characteristics, losing the relationship may seem worse than staying and enduring the abuse.
• Distorted beliefs and perceptions—as previously mentioned, battered women tend to hold some distorted beliefs that keep them in abusive relationships. Common distorted thought patterns among battered women include a belief that violence is commonplace and not abusive, a belief that they caused the abuse, a lack of recognition that children are harmed more by witnessing intimate partner violence than by living with a single parent, and a belief that they can and should help the abuser to change.
• PTSD—this is a prolonged psychological reaction to a traumatic event. The level of psychological distress abused women experience can keep them from being able to escape the violence.
• Impaired problem-solving abilities—many factors can impede the problem-solving abilities of battered women, including postconcussion syndrome resulting from head injuries and the cognitive distortions of PTSD.
• Prior victimization effects—women who have been abused during their childhood have an increased risk of becoming involved with an abusive intimate partner in adulthood. This may be because these women have difficulty judging how trustworthy people are, or they hold a distorted belief that they cannot escape violence.

What Can a Woman Do?

Cavanagh gathered qualitative data from interviews with the female partners of violent men to illustrate that battered women try to end the violence in their relationships in many ways, even if they stay—complicating the notion of the battered woman as passive and helpless. She finds that women worked to stop the violence by talking with their partner about the violence, developing strategies for avoiding the violence (e.g., being affectionate or feigning agreement with the abuser), challenging the violence (e.g., fighting back, verbally or physically), telling other people about the violence, and leaving (usually temporarily) the relationship. Cavanagh argues that abused women almost always actively fight the abuse: “At some points in time the struggle to change took second place to the struggle to survive but not even women subjected to the extremes of abuse totally ‘gave up.”’

Avoidance

For their landmark book Intimate Violence (1988), Richard J. Gelles and Murray A. Straus interviewed 192 women who suffered minor violence and 140 who suffered severe violence and asked which long-range strategies they used to avoid violence. Fifty-three percent of the minor-violence victims and 69% of the severe-violence victims learned to avoid issues they thought would anger their partner. Others learned to read a change in their partner's facial expressions or body language as one of the first signs of impending abuse. Avoidance worked for about 68% of those women who suffered minor abuse, but this tactic was successful for less than one-third of the more severely abused victims.

Leaving

Some battered women do leave their husband. Gelles and Straus find that 70% had left their spouse in the year preceding the interview. Only about half of those who left, however, reported that this was a “very effective” method of ending the abuse. In fact, for one out of eight women it only made things worse. Batterers put incredible pressure on their partner to return. Often, when the women returned they were abused more severely than before—as revenge or because the men learned that, once again, they could get away with this behavior. Women who returned also risked losing the aid of personal and public support systems, because these people perceived that their help or advice was useless or ignored.

Just Say “No”

Many researchers believe there is real truth to the statement that men abuse because they can. A wife who will not permit herself to be beaten from the first act of minor abuse, such as a slap or push, is the most successful in stopping it. Gelles and Straus note that simply eliciting a promise to stop was by far the most effective strategy women could undertake—especially in cases of minor violence. Threatening to divorce or leave the home worked in about 40% of the minor-abuse cases, but this strategy worked in less than 5% of the severe-abuse situations. Physically fighting back was the most unsuccessful method. It worked in fewer than 2% of the minor-abuse cases and in less than 1% of the severe-abuse cases.

Health Effects of Domestic Violence

There are often urgent and long-term physical and health consequences of domestic violence. Short-term physical consequences include mild to moderate injuries, such as broken bones, bruises, and cuts. More serious medical problems include sexually transmitted diseases, miscarriages, premature labor, and injury to unborn children, as well as damage to the central nervous system sustained as a result of blows to the head, including traumatic brain injuries, chronic headaches, and loss of vision and hearing. The medical consequences of abuse are often unreported or underreported because women are reluctant to disclose abuse as the cause of their injuries, and health professionals are uncomfortable inquiring about it.

In “Does Physical Intimate Partner Violence Affect Sexual Health” (Trauma, Violence, and Abuse, vol. 8, no. 2, April 2007), Ann L. Coker of the University of Texas Health Science Center undertook a systematic review of studies that looked at whether domestic violence affected women's sexual health. She found that a causal connection could be made between intimate partner violence and unplanned pregnancies and abortions, sexually transmitted infections, sexual dysfunction, such as lack of sexual pleasure, and sexual risk taking, including failure to use condoms or partner nonmonogamy.

Abused women are also at risk for health problems not directly caused by the abuse. Jacquelyn Campbell et al. compare in “Intimate Partner Violence and Physical Health Consequences” (Archives of Internal Medicine, vol. 162, no. 10, 2002) the physical health problems of abused women to a control group of women who had never suffered abuse. The researchers find that abused women suffered from 50% to 70% more gynecological, central nervous system, and stress-related problems. Examples of stress-related problems included chronic fear, headaches, back pain, gastrointestinal disorders, appetite loss, and increased incidence of viral infections such as colds. Even though women who most recently suffered physical abuse reported the most health problems, Campbell et al. find evidence that abused women remain less healthy over time.

Posttraumatic Stress Disorder

Women who have been abused are at risk for developing PTSD. According to the National Institute of Health, in “Post-Traumatic Stress Disorder” (June 26, 2008, http://www.nimh.nih.gov/health/publications/anxiety-disorders/post-traumatic-stress-disorder.shtml), PTSD symptoms include startling easily, emotional numbness (especially in relationships), irritability or aggressiveness, avoidance of situations that are similar to the traumatic event, and reliving the trauma in flashbacks and nightmares.

The development of PTSD may lead to some of the adverse health outcomes associated with intimate partner violence. Studies such as Mary Ann Dutton et al.'s “Intimate Partner Violence, PTSD, and Adverse Health Outcomes” (Journal of Interpersonal Violence, vol. 21, no. 7, 2006) and Stephanie J. Woods's “Intimate Partner Violence and Post-Traumatic Stress Disorder Symptoms in Women: What We Know and Need to Know” (Journal of Interpersonal Violence, vol. 20, no. 4, 2005) show that victims of intimate partner violence have up to five times a greater likelihood of having or developing PTSD, as well as a host of other mental health problems such as depression and substance abuse. Some researchers estimate that between 31% and 84% of all battered women develop PTSD. The more severe the violence, the higher the likelihood that a woman will develop the disorder.

According to Dutton et al., “PTSD . . . appears to be a linchpin in the relationship between exposure to violence and negative health outcomes.” The researchers postulate that PTSD, which has been shown to lead to negative health behaviors, has consequences on battered women's health. These consequences may result from not adhering to a doctor's instructions or from specific coping strategies to deal with PTSD. In addition, biological responses to PTSD may contribute to an increase in blood pressure or a suppression of the immune system.

When Women Kill Their Partners

James Alan Fox and Marianne W. Zawitz indicate in Homicide Trends in the United States (July 2007, http://www.ojp.usdoj.gov/bjs/homicide/homtrnd.htm#contents) that in 2005, 1,181 women and 329 men were killed by an intimate partner. The researchers note that the number of males killed by intimate partners dropped 74.8% between 1976 and 2005. Researchers and advocates for battered women attribute this dramatic decline to the widespread availability of support services for women, including shelters, crisis counseling, hotlines, and legal measures such as protection and restraining orders. These services offer abused women options for escaping violence and abuse other than taking their partner's life. Other factors that may have contributed to the decline are the increased ease of obtaining divorce and the generally improved economic conditions for women.

Factors That Influence Wives to Murder Their Husbands

In When Battered Women Kill (1987), one of the first studies of wives who murdered their abusive partners, Angela Browne compares forty-two women charged with murdering or seriously injuring their spouse with 205 abused women who had not killed their husband. Browne's findings suggest a link between homicide potential and three things: marital rape, murder and suicide threats, and drug use. In her study, more than 75% of women who had committed homicide claimed they were forced to have sexual intercourse with their husband, compared to 59% in the group of women who had not killed their husband. Some 39% of the former group had been raped more than twenty times, compared to 13% of the latter group. One woman Browne interviewed said, “It was as though he wanted to annihilate me . . . as though he wanted to tear me apart from the inside out and simply leave nothing there.”

In addition, men murdered by their spouse had often threatened to kill their partner. In Browne's study 83% of the men killed by their spouse had threatened to kill their spouse, compared to 59% of the men whose spouse did not kill them. Men killed by their spouse had used guns to frighten their spouse and were sometimes killed with their own weapon. Nearly two-thirds (61%) of this group also threatened to kill themselves. Many of the threats were made when women tried to leave the relationship or when the men were depressed. Browne questioned whether the suicide threats were genuine expressions of wishes to die or whether they were used to manipulate the women in efforts to make them feel guilty and prevent them from leaving.

Legal Defense

In legal cases involving battered women who kill their abuser, the defendants often admit to the murder and reveal a history of physical abuse. The charge is usually first- or second-degree murder, which is murder with malicious intent either with or without premeditation. The outcome of these trials depends on three main issues: self-defense, equal force, and immediate versus imminent danger. Expert witnesses are crucial in an abused woman's trial to explain how these issues are different for cases involving battered women than for other homicide cases.

SELF-DEFENSE. Women often plead that they killed in self-defense, a plea that requires proof that the woman used such force as was necessary to avoid imminent bodily harm. Self-defense was originally intended to cover unexpected attacks by strangers and did not take into account a past history of abuse or a woman's fear of renewed violence. Traditionally applied, a self-defense plea does not exonerate a woman who kills during a lull in the violence, for example, when the drunken abuser passes out.

According to Diane R. Follingstad et al. of the University of South Carolina, in “The Impact of Elements of Self-Defense and Objective versus Subjective Instructions on Jurors’ Verdicts for Battered Women Defendants” (Journal of Interpersonal Violence, vol. 12, no. 5, October 1997), many observers feel that self-defense law is problematic, inadequate, and/or not appropriate for use in self-defense cases of battered women. Traditionally, self-defense permits an individual to use physical force when he or she reasonably believes it is necessary to counteract imminent or immediate danger of serious bodily harm. Furthermore, a person must use only a reasonable amount of force to stop the attack and cannot be the one who provoked the encounter or initiated the violence. To justify the use of reciprocal deadly force, most jurisdictions require that the defendant reasonably believes the attacker is using or is about to use deadly force.

Advocates for battered women have succeeded in convincing many courts to accept a subjective standard of determining whether a battered woman who killed her husband was protecting her own life. This concession allows the court to judge the circumstances of the crime in relation to the special needs of battered women and not according to the strict definition of self-defense. This looser definition is especially important for women who killed during a lull in the violence, because a strict interpretation of imminent danger does not provide legal justification for their actions.

Gena Rachel Hatcher explains in “The Gendered Nature of Battered Woman Syndrome: Why Gender Neutrality Does Not Mean Equality” (New York University Annual Survey of American Law, vol. 10, no. 27, March 2003) that for this modified definition of self-defense to work, the court must first be subjective in understanding the woman's circumstances. Next, it must be objective in deciding that, given the situation, she truly did act in a reasonable manner. Courts have already accepted the notion that self-defense does not require perfect judgment in a violent situation, only reasonableness. In Brown v. United States (256 U.S. 335 [1921]), Justice Oliver Wendell Holmes (1841–1935) said: “Detached reflection cannot be demanded in the presence of an uplifted knife.” Battered women and their advocates have asked the courts to revise their definitions of imminent danger and appropriate force in cases involving domestic violence.

EQUAL FORCE. Self-defense permits the use of equal force, which is defined as the least amount of force necessary to prevent imminent bodily harm or death. Women, however, who are generally physically weaker than men and who know the kind of physical damage their batterer can inflict, may justifiably feel that they are protecting their life when shooting an unarmed man. In State v. Wanrow (88 Wash.2d 221, 559 P.2d 548 [1977]), the Washington Supreme Court ruled that it was permissible to instruct the jury that the objective standard of self-defense does not always apply.

Yvonne Wanrow was sitting up at night fearful that a male neighbor, who she thought had molested the child in her care, was going to make good on his threats to break into the house where she was staying. When the large, intoxicated man did enter, Wanrow, who was incapacitated with a broken leg, shot him. The court ruled:

The respondent was entitled to have the jury consider her actions in the light of her own perceptions of the situation, including those perceptions which were the product of our nation's “long and unfortunate history of sex discrimination.” Until such time as the effects of that history are eradicated, care must be taken to assure that our self-defense instructions afford women the right to have their conduct judged in light of the individual physical handicaps which are the product of sex discrimination. To fail to do so is to deny the right of the individual woman involved to trial by the same rules which are applicable to male defendants.

IMMEDIATE VERSUS IMMINENT DANGER. Traditionally, self-defense required that the danger be immediate, meaning that the danger was present at the moment the decision to respond was made, to justify the use of force, as noted by Kimberly Kessler Ferzan of Rutgers University in “Defending Imminence: From Battered Women to Iraq” (Arizona Law Review, vol. 46, 2004). Accepting imminent danger, or danger that is about to occur, as justification for action permits the jury to understand the motivations and dynamics of a battered woman's behavior. A history of abuse may explain why a defendant might react to the threat of violence more quickly than a stranger would in the same circumstances. In Wanrow, the Washington Supreme Court found that “it is clear that the jury is entitled to consider all of the circumstances surrounding the incident in determining whether the defendant had reasonable grounds to believe grievous bodily harm was about to be inflicted.”

LEGAL OUTCOMES. Whether a woman will be convicted depends largely on the jury's attitude, or the judge's disposition when it is not a jury trial, and the amount of background and personal history of abuse that the judge or jury is permitted to hear. Juries that have not heard expert witnesses present the battered woman defense are often unsympathetic to women who kill their abusive partner.

In “Jurors’ Decisions in Trials of Battered Women Who Kill: The Role of Prior Beliefs and Expert Testimony” (Journal of Applied Psychology, vol. 24, 1994), Regina Schuller, Vicki L. Smith, and James M. Olson find that jurors who learned about battered woman syndrome from expert testimony were more likely to believe the defendant feared for her life, that she was in danger, and that she was trapped in the abusive relationship. Equipped with knowledge and understanding of battering and its effects, jurors handed down fewer murder convictions than were issued by a control group of jurors who were not given this specialized information.

Prevention of Domestic Violence

Empowerment of Battered Women

Researchers and advocates find that one of the most effective ways to deal with partner violence is by giving the victim the power, encouragement, and support to stop it. In “Estrangement, Interventions, and Male Violence toward Female Partners” (Violence and Victims, vol. 12, no. 1, spring 1997), Desmond Ellis and Lori Wight of York University assert that abused women want the violence to stop and most, if not all, attempt to do something to stop it. They find evidence showing that empowerment of abused women is related to a decrease in the likelihood of further violence. The interventions Ellis and Wight recommend to promote gender equality include:

• Social service agencies such as counselors or shelters to provide information and support
• Mediation to facilitate a woman's control over the process
• Prosecution with an option to drop the charges, which also facilitates control by female victims
• Separation, which indicates the woman's strength in decision making

Ellis and Wight find that separation or divorce is one of the most effective strategies for ending abuse. Levels of violence after separation vary with the type of legal separation or divorce proceedings. Women who participate in mediation before separation are less likely to be harmed, either physically or emotionally, than women whose separation is negotiated by lawyers. Ellis and Wight find that other legal proceedings, such as restraining orders and protection orders, were relatively ineffective in protecting female abuse victims.

In “Survivor Preferences for Response to IPV Disclosure” (Clinical Nursing Research, vol. 14, no. 3, 2005), Jacqueline Dienemann, Nancy Glass, and Rebecca Hyman examine how intimate partner violence survivors want to be treated when disclosing the violence to health care professionals. The researchers find that surveyed survivors want to be treated with respect and concern when disclosing intimate partner violence. They also want health care professionals to document the abuse and provide protection. The women say they want to retain control over their options. They believe health care professionals should listen, present choices, and ultimately leave the decision about what to do up to the victim herself.