• Intimate Partner Violence: Recognizing Abuse

    IMAGE Anyone can be the victim of intimate partner violence (IPV). Recognizing the characteristics of IPV and having a safety plan in place can save your life.

    Defining IPV

    IPV is a pattern of physically, psychologically, and/or emotionally abusive behavior directed at a current or past intimate partner. It is often used interchangeably with domestic violence and domestic abuse. IPV includes a wide range of behaviors that involves two people who are connected and in touch with one another. This may include those who may be living together or apart, dating, married, separated, or divorced.
    There are 4 main components of IPV that may include one or more of the following:
    • Physical violence—Use of physical force, which may include choking, grabbing, hitting, burning, restraining, or biting someone. It may also include forcing someone to commit these acts on someone else. Although it may not be the intent, physical violence can lead to injury, permanent disability, or death.
    • Psychological aggression—Verbal or non-verbal cues are used to control another person emotionally or coerce them into doing something they do not want to. Examples include monitoring someone's wherabouts, name-calling, using someone's weaknesses against them, and playing mind games. It also includes limiting aspects of their life like money, transportation, friends, or work in order to control them and make them dependent.
    • Sexual violence—There are several categories associated with attempted or completed sexual violence. Sexual violence occurs when e a sexual act is done without consent of the victim or if the victim is unable to give consent because of factors like intoxication, disability, or lack of awareness. Sexual violence may also involve forcing someone to commit these acts on someone else.
    • Stalking—A pattern of repeated and unwanted attention that causes someone to fear for their own safety. Stalking includes spying, showing up in places where the victim may be, damaging the victim's property, or making verbal and non-verbal threats to the victim.

    Who IPV Affects

    IPV cuts across all age, economic, educational, cultural, and religious backgrounds. It is most commonly associated with violence against women committed by men. However, men are also victims of IPV. Relationships include a spectrum of couples that may be homosexual, bisexual, and/or transgender. Children are also at risk of exposure to IPV in the home.

    Characteristics of an Abuser

    Although abusers come from all walks of life, they tend to have some characteristics in common. These include:
    • Being possessive and jealous of any other relationships their partner has
    • Wanting to exert control to keep their partner from leaving
    • Being verbally and/or physically hurtful
    • Blaming others for their problems
    • Sudden mood changes, which may quickly shift between affection and abuse

    Common Signs of Abuse

    Physical Abuse

    Examples of physical abuse include:
    • Hitting, shoving, punching, kicking, choking
    • Throwing or destroying things
    • Blocking you from leaving the room or house
    • Subjecting you to reckless driving
    • Threatening or hurting you with a weapon

    Emotional Abuse

    The abuser does things to make the victim feel scared, worthless, and helpless. Again, this is a pattern of behavior, not just an occasional insult. Examples include:
    • Insulting, blaming, criticizing, name-calling
    • Humiliating you in public
    • Accusing you of having affairs
    • Controlling all the money and making you account for every penny
    • Telling you what to do, where to go, and who you can see
    • Threatening or hurting your children

    Sexual Abuse

    Sexual abuse can be sexual acts, demands, or insults. Examples include:
    • Unwanted touching or sexual comments
    • Calling you sexual names, such as "slut" or "frigid"
    • Forcing you to have sex
    • Attacking your sexual body parts or hurting you during sex
    • Withholding birth control, then coercing an abortion

    Knowing If You or Somone Is Abused

    Ask yourself these questions about your partner:
    • Does your partner shove, hit, shake, or slap you?
    • Does your partner make light of the abuse, insist that it did not happen, or shift the responsibility for his abusive behavior, blaming you for it?
    • Does your partner continually put you down, call you names, or humiliate you?
    • Does your partner intimidate you through looks or actions, destroy your property, or display weapons?
    • Does your partner control what you do, who you see and talk to, and where you go, limiting your involvement outside the relationship?
    • Are you made to feel guilty about the children, or has your partner threatened to take the children away?
    Ask yourself these questions about your friend or family member who may be experiencing abuse:
    • Does she appear anxious, depressed, withdrawn, and reluctant to talk?
    • Does her partner criticize her in front of you, making remarks that make you feel uncomfortable when you are around the two of them?
    • Do you see or hear about repeated bruises, broken bones, or other injuries that reportedly result from "accidents"?
    • Does her partner try to control her every move, make her account for her time, and accuse her of having affairs?
    • Is she often late or absent from work, has she quit a job altogether, or does she leave social engagements early because her partner is waiting for her?

    How Are Children Affected?

    Abuse often filters down to any children who may be in the home. Child abuse occurs much more often in families where IPV is present. Also, IPV against the mother has been associated with an increased risk of death for the children.
    Whether children are being abused directly or just living with abuse around them, their lives are disrupted. They can experience fear, confusion, and pain. This greatly increases their chance of developing emotional and behavioral problems, such as low self-esteem, withdrawal, self-blame, aggression toward others, and problems in school and relationships. They learn that violence is acceptable, they are at greater risk for committing criminal or self-destructive behavior, and they are more likely to become abusers as adults.

    Finding Help

    If you or someone you know is being abused, seek help. Talk with someone you trust, such as a close friend or relative. Consider calling a domestic violence hotline and talking with a counselor. Some online resources will protect you when using their website by erasing your history and/or closing the browser with the push of a button with your mouse.
    Have an honest talk with your doctor. Because of new recommendations, your doctor may ask questions about your home life and safety. They are also better equipped to put you in the hands of those who can help you with referrals, and educational and prevention information.
    Remember, IPV is not your fault, and no one ever has the right to abuse another person. You have a right to be safe and,help is available.

    Planning for Your Safety

    If you are in an abusive relationship, it is important to have a safety plan. Such a plan can be helpful whether you are trying to stay in or leave the relationship. An IPV counselor can help you develop a plan tailored to your needs. Listed below are some common elements of a safety plan:
    • Set up a signal with your neighbors so they can call the police if you are in danger.
    • Get a restraining order if you need legal protection to keep your abuser away from you.
    • Plan an escape route and a safe place to go, such as to relatives, friends, or a domestic violence shelter.
    Keep items listed below easily accessible for an emergency or if you want to leave. Consider keeping some of them, including copies of important papers, with a trusted relative or friend.
    • Important phone numbers and phone calling card
    • Money, checkbook, ATM, and credit cards
    • Driver's license
    • Keys for home, car, and office
    • Important papers for you and your children, including birth certificates
    • Social security cards, health insurance cards, and medical and school records
    • Restraining order and information—including photographs—that will document past abuse
    • Medications
    • Change of clothes
    • Children's favorite toys/blankets
    If you suspect that you will be leaving the relationship, try and obtain a credit card or debit card in your own name so that your abuser cannot cancel the cards. If you are ever in danger—or feel that you or your children are about to be in danger—call for emergency medical services. In a growing number of cities and towns across the US, law enforcement personnel are trained specifically to handle cases of domestic violence.

    RESOURCES

    Futures without Violence https://www.futureswithoutviolence.org

    The National Domestic Violence Hotline http://www.thehotline.org

    CANADIAN RESOURCES

    Canadian Women's Health Network http://www.cwhn.ca

    Public Health Agency of Canada http://www.phac-aspc.gc.c

    References

    ACOG Committee Opinion No. 518: Intimate partner violence. Obstet Gynecol. 2012;119(2 Pt 1):412-417. Available at: http://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Health-Care-for-Underserved-Women/Intimate-Partner-Violence.

    Ackerson LK, Subramanian SV. Intimate partner violence and death among infants and children in India. Pediatrics. 2009;124(5):e878-e889.

    Dicola D, Spaar E. Intimate partner violence. Am Fam Physician. 2016;94(8):646-651.

    Intimate partner violence: Definitions. Centers for Disease Control and Prevention website. Available at: https://www.cdc.gov/violenceprevention/intimatepartnerviolence/definitions.html. Updated May 3, 2016. Accessed December 20, 2016.

    Understanding domestic abusers. Office for the Prevention of Domestic Violence. New York State website. Available at: http://www.opdv.ny.gov/professionals/abusers/genderandipv.html. Accessed December 20, 2016.

    Violence against women. Office on Women's Health. Available at: https://www.womenshealth.gov/violence-against-women/am-i-being-abused/index.html. Accessed December 20, 2016.

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