Intimate partner violence (IPV) is one of the least understood types of abuse and types of violence that someone might experience.
Be aware of what is being described as violence. EXAMPLE: If you look through the elder abuse literature and read about domestic violence and domestic abuse, it’s often talking about abuse by any family member . This is different from the term domestic violence in other types of studies and other types of research literature, where it’s talking about intimate partner abuse . So just be mindful that the terms are sometimes used interchangeably and sometimes they are not. IPV can cross the life-span; it can start as early as the first relationship and last until the time of death. IPV can happen with former or current partners; stalking can occur by a former partner that didn’t want to end the relationship, and this can sometimes lead to death. Abuse can be child, elder, partner, animal abuse, etc. Its when one person uses power or desires over another person; they use fear as a tactic to gain that power; this is abuse.
Emotional abuse is when you play mind games and use tactics without physically touching someone to scare/harm them; this can be more damaging than physical abuse.
Although it can affect anyone, the bulk of this issue affects women; they are 10 times more likely to be killed than men. Of the 1 in 3 women that are abused, 1 in 3 of the abused ones will have injuries that require medical treatment.
“ Uncontrolled ” anger means the person has no control over their power and can beat the victim to death; but the person stops beating the victim at some point, and so this proves that the person has some control over their anger, otherwise they wouldn’t stop until their victim was dead. A person can say as many bad things as they want to you, but nothing they say should make you assault/hit them; so we mainly focus on the victim as they are not at fault. IPV occurs over and over again, so if you didn’t mean to do something, you wouldn’t have done it again; so it’s not an isolated incidence . Substance abusers have a choice to clean themselves up and go through substance abuse treatment; so they cannot used the excuse that they were under substance abuse. Same with mental illness ; some people may actually be mentally ill, but the majority of abusers use mental illness as an excuse when they are not mentally ill. IPV is not a genetic issue; abusive parents can create abusive children, but these children have the ability to prevent or unlearn the abuse from their parents; it is their choice to not become abusive like their parents; so becoming abusive is definitely avoidable, but becoming a victim of abuse is definitely unavoidable ; can happen to anyone (age, sex, race, gender, culture, etc.)
Anything that can be done to prevent IPV or stop it at an earlier process will result it lots of savings.
Dentists can see certain areas of the patient’s body prone to abuse that others might not see (scalp, behind the ears, inside collar area, etc.).
This study/survey, done in California over the phone, is really good because it asks people about their lifetime exposure to abuse , and not just a specific type of abuse in a specific time period of their life.
Each category is found in a greater percentage in women who have had some form of abuse or violence when compared to women who have had no form of abuse or violence.
Shows that not only are abuse victims more likely to have healthcare issues, but they are less likely to have access to healthcare that they need.
Any health condition you can think of has been shown through research to be connected to partner violence or could easily be understood to have some impact. 1/3 of women murdered in the US are murdered by their partner; men are more likely to be murdered by a stranger while women are more likely to be murdered by someone they are or have been involved with. Any of the things in the non-fatal column can become fatal (mental illness can lead to suicide). In Massachusetts, homicide is the leading cause of death for pregnant women; if your patient is pregnant, they are in a much higher risk group in terms of partner abuse; keep a note of that!!! Lots of women have abusers that overpower them; don’t allow them to have protection during sexual intercourse; can lead to HIV or STD infections; be aware of this.
Difficulty eating – can be physical difficulty or psychological/emotional eating disorders. Dependency on pain medication – substance abuse; addictions; used to cope with certain traumatic experiences. Patient may seem like being non-compliant by missing appointments or not getting prescriptions filled; but in fact, their abuser may be controlling them and not allowing these things to happen. Be aware of that. Dental fear can result from trauma, including sexual trauma.
Sexual abuse is the most harmful in terms of health issues.
If you say something to your patient and they are not afraid of you, they will interpret it differently than if you say the same thing to your patient but this time, they are afraid of you. You’re saying the same thing but its having a different meaning on the patient, and it may be due to trauma they have had. EXAMPLE: You give a lecture with another person. First case: that person suddenly walks out the room and slams the door. Second case: that person tells you not to talk about a particular topic during the lecture, but you talk about it anyways; than they walk out of the room and slam the door. In first case, person might have to go to the bathroom or whatever, but in case two, you know person slammed the door because they were mad at you and that you are now in trouble. So… important to keep in mind what the purpose of a certain behavior was and what the impact is on the person that that behavior is being acted towards.
Tension usually builds up to the point where the abuser hits the victim or does some type of violent behavior to them; afterwards they usually apologize (if they care) and say it won’t happen again. Everyone goes through this cycle. What is different in abuse is that these cycles keep happening over and over, and they gradually tend to get worse over time, get closer together, and happen more frequently. This goes back to the point that violence/abuse is not an isolated incident; its not a one-time thing. It happens in cycles and it often changes over time (get worse, occur more often, etc.).
The relief period may sometimes last and things get better; but it will never last if you’re in an abusive relationship; the cycle starts back up again. So when looking at patient with abuse, you must know what has happened before and what is happening now because of the cycle they may have been going through.
The reason to talk about marriage is that these sort of spikes in the violence happen at key points in the relationship. They often happen when the couple might move in together, when they get married, when they get pregnant, when they have a second child; these are all significant points in time considering how committed the relationship is and what the options for leaving are. So you see spikes because those means of control change over time and the need for that control changes over time.
Happens in all cultures. The only things that may differ are tactics used by the abusers, resources/information the victims may have, or options available to the victims. EXAMPLE: Some cultures a woman can’t get a divorce, so they are stuck with their abuser; in the US, women can get a divorce, but then they face other problems (being a single mom, facing stereotyping and discrimination, etc.).
Most of the legal protection that abuse victims have depends on the abuser deciding not to assault the victim anymore. Our society has not found a good way to protect victims. Massachusetts will have a 300% higher rate of homicide at the end of this year than compared to 2 years ago; women are being killed at higher rates than in the past. Things are getting worse instead of better.
One of the biggest things that keep victims trapped is victim blaming .
