Health Library Domestic AbuseFrom Healthwise

Everyone gets angry from time to time. Anger and arguments are normal parts of healthy relationships. But anger that leads to threats, hitting, or hurting someone is not normal or healthy. This is a form of abuse. Physical, verbal, or sexual abuse is not okay in any relationship. When it occurs between spouses, partners, or in a dating relationship, it is called domestic abuse or domestic violence.

Domestic abuse is also called intimate partner abuse. It is not the same as an occasional argument. It is a pattern of abuse used by one person to control another. Abuse includes:

• Hitting, beating, pushing, shoving, shaking, slapping, kicking, pinching, choking, or burning, or threats to hurt you, your children, or pets. Drugging you with medicine, tying you up, and physical punishment of any kind also are kinds of abuse.
• Controlling behavior, such as limiting contact with your family or friends, or limiting you access to money.
• Not trusting you or spying on you, such as repeatedly calling, text messaging or e-mailing, or checking up on you for no good reason.
• Name-calling, insults, threats, or putting you down in front of others.
• Preventing you from using birth control or from protecting yourself from sexually transmitted diseases (STDs).
• Forcing you to have sex or do other sexual acts. This can range from unwanted touching to rape, sodomy, forced nudity, forcing you to watch pornography, or forcing you to act out pornography.

Domestic abuse is a common form of violence and is a major problem. About 25% of women and 8% of men in the United States have been physically or sexually abused by a partner.¹ It can happen to anyone, at any age, no matter what race or religion they are, no matter what their level of education is or how much money they make.

• Teens may experience dating abuse.
• Older adults can be targets of both domestic abuse and elder abuse.
• Men can be abused in relationships.

Abuse can cause lasting health problems and emotional pain. You are more likely to have long-term health problems if you have an abusive partner. Women who are sexually abused by their partners have more sexually transmitted diseases and unwanted pregnancies.

During pregnancy, abuse can cause problems such as poor weight gain, infections, and bleeding. It may increase your baby's chance of low birth weight, premature birth, and death.

Abusers often blame the victim for the abuse. They may say "you made me do it." This is not true. Every person is responsible for his or her actions. They may say they are sorry and tell you it will never happen, even though it already has.

Once abuse starts, it usually gets worse if steps are not taken to stop it. If you are in an abusive relationship, ask for help. This may be hard, but know you are not alone. Your family, friends, fellow church members, employer, doctor, or your local YMCA, YWCA, police department, hospital, or clinic can help you. These national hotlines can help you find resources in your area. Call:

• The National Domestic Violence Hotline toll-free 1-800-799-7233.
• The National Teen Dating Abuse Hotline toll-free 1-866-331-9474.

Use the Check Your Symptoms section to decide if and when you should see a doctor or get other help.

Once abuse starts, it usually gets worse if steps are not taken to stop it. If you are in an abusive relationship, ask for help. This may be hard, but know you are not alone. Help is available. Call:

• The National Domestic Violence Hotline toll-free 1-800-799-7233.
• The National Teen Dating Abuse Hotline toll-free 1-866-331-9474.

If you feel threatened, it is very important to develop a plan for dealing with a threatening situation. If your partner has threatened to harm you or your child, seek help.

• Anytime you are in danger, call 911 .
• If you do not have a safe place to stay, tell a friend, a religious counselor, or your doctor. Do not feel that you have to hide what is happening.
• Have a plan for how to leave your house, where to go, and where to stay in case you need to get out quickly (safety plan). Do not tell your partner about your plan. For help in developing your plan, call:
  • The National Domestic Violence Hotline toll-free at 1-800-799-7233. They can help you find resources in your area.
  • Your local YMCA, YWCA, police department, hospital, or clinic for the local crisis line for names of shelters and safe homes near you.
• Teach your children how to call for help in an emergency.
• Be alert to warning signs, such as threats or drinking. This can help you avoid danger.
• If you can, make sure that there are no guns or other weapons in your home.
• If you are working, contact your human resources department or employee assistance program to find out what help is available to you.
• If you are seeing a counselor, be sure to go to all appointments.

If you are no longer living with a violent partner, contact the police to obtain a restraining order if your abuser continues to pursue you, threaten you, or act violently toward you.

If you have been a victim of abuse and continue to have problems related to the abuse, you may have post-traumatic stress disorder (PTSD). For more information, see the topic Post-Traumatic Stress Disorder.

If you know someone who may be abused

Here are some things you can do to help a friend or family member.

• Let your friend know you are willing to listen whenever she or he wants to talk. Don't confront your friend if she or he is not ready to talk. Encourage your friend to talk with her or his health professional, human resources manager, and supervisor to see what resources might be available.
• Tell your friend that the abuse is not her or his fault and that no one deserves to be abused. Remind your friend that domestic violence is against the law and that help is available. Be understanding if she or he is unable to leave. She or he knows the situation best and when it is safest to leave.
• If your friend has children, gently point out that you are concerned that the violence is affecting them. Many people do not understand that their children are being harmed until someone else talks about this concern.
• Encourage and help your friend develop a safety plan. This plan will help keep your friend and her or his children safe during a violent incident, when preparing to leave, and after leaving.

The most important step is to help your friend contact local domestic violence groups. There are programs across the country that provide options for safety, support, needed information and services, and legal support. To find the nearest program:

• Call the National Domestic Violence Hotline at 1-800-799-7233.
• See the National Coalition Against Domestic Violence's Web site at www.ncadv.org/resources/state.htm.
• Call the National Teen Dating Abuse Hotline toll-free 1-866-331-9474.

The most dangerous time for your friend may be when she or he is leaving the abusive relationship, so any advice about leaving must be informed and practical.

Symptoms to Watch For During Home Treatment

If problems from domestic abuse become more frequent or severe, use the Check Your Symptoms section to determine if and when you need to see your doctor or get other help.

To prevent injury from domestic violence

• Be alert to warning signs, such as threats or drunkenness, so that you can avoid a dangerous situation. If you cannot predict when violence may occur, have a safety plan for use in an emergency.
• If you are no longer living with a violent partner, contact the police to obtain a restraining order if your abuser continues to pursue you, threaten you, or act violently toward you.
• Learn how to recognize signs of teen relationship abuse in your teen.

To prepare for your appointment, see the topic Making the Most of Your Appointment.

If you have made an appointment with your doctor, you may be able to get the most from your visit by being prepared to answer the following questions:

Domestic violence in the past 12 months

• Have you ever been emotionally or physically abused by your partner or someone important to you? When was the last time this happened?
• Have you been hit, slapped, kicked, or otherwise physically hurt by someone? What kind of injuries do you have? Did you seek medical treatment for the injuries? When and where?
• How long have you been afraid or felt threatened by the violent behavior of someone else?
• Has anyone forced you to have sexual activities?
• Does the abuser control most or all your activities every day?
• Has the abuser threatened violence against your children? Is he or she violent toward your children?
• Has the abuser hurt a pet or destroyed things that belong to you?
• Does the abuser use alcohol or legal or illegal drugs? Does the abuse happen when the abuser is drunk or "high"?
• Does the abuser have access to guns or other violent weapons?
• Has the abuser ever been diagnosed with depression or a mental illness, such as bipolar disorder, schizophrenia, or personality disorder?
• Do you have any risk factors?

Book

Organizations

Citations

1. Family Violence Prevention Fund (2004). National Consensus Guidelines on Identifying and Responding to Domestic Violence Victimization in Health Care Settings. Available online: http://endabuse.org/programs/healthcare/files/Consensus.pdf.

Author:	Jan Nissl, RN, BS	Last Updated: May 6, 2008
Medical Review:	Steven L. Schneider, MD - Family Medicine William M. Green, MD - Emergency Medicine Adam Husney, MD - Family Medicine Brigid McCaw, MD, MS, MPH, FACP - Family Violence Prevention
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