Health Library Physical AbuseFrom Healthwise

Violence can happen to anyone—males or females, children, teens, adults, older adults, or people with disabilities. You are not to blame. No matter what happened, violence is not okay. Violent people usually have many problems that they find hard to deal with, which can cause them to act out with violence.

Physical abuse includes hitting, pushing, shaking, slapping, kicking, pinching, choking, strangling, and burning. Physical abuse may come from a stranger, acquaintance, or from a close friend or family member. Many victims of abuse know their attacker.

Violent behavior can also hurt you emotionally. You may feel sad or frightened. Feelings of guilt may prevent you from getting help. But it is important for you to seek help and continue to get help for yourself as long as you need it. Talk to your local child or adult protective agency, the police, or a health professional, such as a doctor, nurse, or counselor. You can also call a local mental health clinic. Any of these people can help you deal with your feelings, get medical treatment if needed, and take steps to stop the abuser.

Review the Emergencies and Check Your Symptoms sections to determine if and when you need to see a health professional.

• You think you are in immediate physical danger.
• You or someone else has just been physically abused or sexually assaulted (raped).
• You have been physically hurt and do not have someone who can safely take you to emergency care.

If you answer yes to any of the following questions, click on the "Yes" in front of the question for information about how soon to see a health professional.

Review risk factors that may increase your chance of becoming a victim of violent behavior.

If you have:

• Been abused by your partner: Go to the topic Domestic Abuse.
• Problems with anger or trouble controlling your violent impulses: Go to the topic Anger, Hostility, and Violent Behavior.
• Been sexually abused or assaulted (raped): Go to the topic Sexual Abuse or Rape.

	Yes	Has someone hurt you on purpose?
When to See a Doctor See significance of abuse if you need information to help you answer the question below. Review risk factors that may increase your chance of becoming a victim of violent behavior. Note: In some situations, it may be better to call 911 or the police to get the help you need. Call your health professional immediately if you answer "Yes" to the following question. Yes Do you have an injury from physical abuse? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Has someone in your family been hurt on purpose?
When to See a Doctor See significance of abuse if you need information to help you answer the question below. Review risk factors that may increase your chance of becoming a victim of violent behavior. Note: In some situations, it may be better to call 911 or the police to get the help your family member needs. Call your health professional immediately if you answer "Yes" to the following question. Yes Does a family member have an injury from physical abuse? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.

Other Symptoms to Watch For

Even if there is not a physical injury, it is important to find help if you think abuse or neglect has occurred. If you are concerned about:

• Domestic abuse (intimate partner violence): call the National Domestic Violence Hotline to help you find resources in your area. Call the hotline toll-free: 1-800-799-7233. For more information, see the topic Domestic Violence.
• Child abuse and neglect: Call a local social service or mental health department. Many social service agencies involved with child abuse investigation also offer services to parents who need help with anger and stress. Agencies are listed in the phone book, usually under your state's Department of Social Services, Protective Services, Social and Rehabilitative Services, or Children and Family Services. For more information, see the topic Child Abuse and Neglect or Shaken Baby Syndrome.
• Elder abuse: Call the National Directory of Hotlines and Crisis Intervention Centers for a referral to services offered in your area: 1-800-999-9999 or TDD 1-800-999-9915. For more information, see the topic Elder Abuse.

If you are concerned that a family member, friend, or coworker has a problem with violent behavior: Go to the topic Anger, Hostility, and Violent Behavior.

If a visit to a health professional is not needed immediately, see the Home Treatment section for self-care information.

If you feel threatened, you must have a plan for dealing with a threatening situation. If a family member or someone else has threatened to harm you or your child, seek help:

• If you need immediate help, call 911 .
• Call the National Domestic Violence Hotline (1-800-799-7233) for free, confidential counseling and information about local community resources.
• Tell someone: the police, a trusted friend, a spiritual advisor, or a health professional. If the incident occurred at work, contact your human resources department for help.
• Find local resources that can help in a crisis. Your local YMCA, YWCA, police department, mental health clinic, or hospital has information on shelters and safe homes.
• 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 an exit plan for use in an emergency.
• If a child tells you he or she has been abused, stay calm. Tell the child that you believe him or her and that you will do your best to keep him or her safe. Report the abuse to the local police or child protective services agency. For more information, see the topic Child Abuse and Neglect.

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

If you know someone who may be a victim of violent behavior

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 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, legal support, support, and needed information and services. To find the nearest program:

• Call the National Domestic Violence Hotline at 1-800-799-7233.
• Call the National Center for Victims of Crime at 1-800-FYI-CALL (1-800-394-2255).
• See the National Coalition Against Domestic Violence's Web site at www.ncadv.org/resources/state.htm.

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.

Violence is learned behavior, so it is especially important to help your children learn that violence is not a healthy way to resolve conflict. Living in a violent environment increases your child's chances of developing behavior problems, depression, anxiety, post-traumatic stress disorder, poor school achievement, and lowered expectations for the future. People who are maltreated as children are more likely to abuse others. If you were ever abused, it is very important to get treatment so that you learn different ways to resolve conflict and use appropriate discipline.

If you have been a victim of abuse and continue to have problems related to the abuse, you may experience mental health problems, such as depression, anxiety, or post-traumatic stress disorder (PTSD). For more information, see the topics Depression, Anxiety, or Post-Traumatic Stress Disorder.

Symptoms to Watch For During Home Treatment

If violence occurs again, use the Emergencies and Check Your Symptoms sections to determine if and when you need to see your doctor.

Prevent violence in your home.

• Learn nonviolent ways to resolve conflicts. Arguing is fine, even healthy, as long as it does not turn violent. For more information on anger control, see the topic Anger, Hostility, and Violent Behavior.

Keep yourself safe from 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 an exit plan for use in an emergency.
• Prevent violence with firearms and other weapons. Do not provide your children or teenagers with unsupervised access to guns or other dangerous weapons.
  • Do not keep loaded firearms in your home.
  • If you must keep firearms in your home, unload them and lock them up. Lock ammunition in a separate place.
  • Do not keep firearms in a home where there is someone who has a drug or alcohol problem, is prone to violent behavior, or has threatened suicide.
  • Make sure that no one in your home will have access to firearms or other weapons unless they know how to use them safely.
• If you are no longer living with a violent person, contact the police to obtain a restraining order if your abuser continues to pursue you and act violently toward you.
• Teach your children that violence is not a solution. Settle arguments without yelling or hitting. Do not use physical discipline, such as spanking, pinching, ear pulling, jabbing, shoving, choking, or strangling. If you need help controlling your children, consider taking a course in parenting skills.
• Limit your child's exposure to TV, movies, and video games to no more than 1 to 2 hours per day.
  • Participate in healthy alternatives, such as sports, interactive play, and reading, with your child.
  • Watch television with your children to discuss or limit violent content.
  • Use a "V-chip" to filter broadcast programming.
  • Do not glamorize weapon carrying or use firearms in play.
• Learn how to recognize signs of violent behavior in your teenager.

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

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

A recent event

• Has someone hit, slapped, kicked, or otherwise physically hurt you on purpose?
• Has someone forced you to have sexual activities?
• What kind of injuries do you have?
• What triggered the abuser's violent behavior?
• 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?
• Is the person who harmed you using any alcohol or illegal drugs?
• Does the person who harmed you have access to guns or other violent weapons?
• Do you have any risk factors that increase your chance of becoming a victim of violent behavior?

If you need immediate help, call 911 .

A history of abusive behavior

• Have you ever been emotionally or physically abused by your partner or someone important to you?
• How long have you felt threatened by the violent behavior of someone else?
• Are you the victim of angry outbursts or violent actions?
• Do another person's violent outbursts occur at regularly spaced time periods?
• Has the abuse increased recently?
• What kind of injuries has the abuse caused? Did you seek health care for the injuries? When and where?
• Does the abuser control most or all your activities every day?
• What triggers the abuser's violent behavior?
• 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?
• Is the person who harmed you using any alcohol or illegal drugs?
• Does the person who harmed you have access to guns or other violent weapons?
• Does your family have a history of violent behavior?
• 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 that increase your chance of becoming a victim of violent behavior?

Another resource for help is the National Domestic Violence Hotline (1-800-799-7233) for free, confidential counseling and information about local community resources.

Organizations

• Alcohol Abuse and Dependence
• Alcohol and Drug Problems
• Anger, Hostility, and Violent Behavior
• Anxiety
• Bullying
• Child Abuse and Neglect
• Domestic Abuse
• Domestic Violence
• Feeling Depressed
• Post-Traumatic Stress Disorder
• Suicidal Thoughts or Threats

Author:	Jan Nissl, RN, BS	Last Updated: January 18, 2008
Medical Review:	William M. Green, MD - Emergency Medicine Brigid McCaw, MD, MS, MPH, FACP - Family Violence Prevention
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