1. There is a misinterpretation in society: Drinking problem (or substance use problem) versus the
Abusive problem
In domestic violence situations, alcohol abuse is associated with distorted views of masculinity.
Heavy drinking among men has been shown to represent toughness, risk taking, viritlity, and
sexual prowess in American culture. Substance use among women is often a response to sedation,
depression, trauma and to an abusive relationship. This is an educational guide and a work through
study in understand the relationship between substance use, unhealthy relationships, and the
physical as well emotional consequences of domestic violence in the recovery process.
DOMESTIC VIOLENCE AND SUBSTANCE USE

2. The World Health Organization (2016) cites that intimate partner and sexual violence are
mostly perpetrated by men against women. Child sexual abuse affects both boys and
girls. International studies reveal that approximately 20% of women and 5–10% of men
report being victims of sexual violence as children. Violence among young people,
including dating violence, is also a major problem
 Violence against women - particularly intimate partner violence and sexual violence -
are major public health problems and violations of women's human rights.
 Recent global prevalence figures indicate that about 1 in 3 (35%) of women
worldwide have experienced either physical and/or sexual intimate partner violence or
non-partner sexual violence in their lifetime.
 Most of this violence is intimate partner violence. Worldwide, almost one third (30%)
of women who have been in a relationship report that they have experienced some form
of physical and/or sexual violence by their intimate partner.
 Globally, as many as 38% of murders of women are committed by an intimate partner.
 Violence can negatively affect women’s physical, mental, sexual and reproductive
health, and may increase vulnerability to HIV.
 Factors associated with increased risk of perpetration of violence include low
education, child maltreatment or exposure to violence in the family, harmful use of
alcohol, attitudes accepting of violence and gender inequality.
 Factors associated with increased risk of experiencing intimate partner and sexual
violence include low education, exposure to violence between parents, abuse during
childhood, attitudes accepting violence and gender inequality.
RATES OF VIOLENCE AND INTIMATE VIOLENCE

3. Factors associated with intimate partner and sexual violence occur at individual, family, community and
wider society levels. Some factors are associated with being a perpetrator of violence, some are
associated with experiencing violence and some are associated with both. Risk factors for both intimate
partner and sexual violence include
 lower levels of education (perpetration of sexual violence and experience of sexual violence)
 exposure to child maltreatment (perpetration and experience)
 witnessing family violence (perpetration and experience)
 antisocial personality disorder (perpetration)
 harmful use of alcohol (perpetration and experience)
 having multiple partners or suspected by their partners of infidelity (perpetration)
 Attitudes that are accepting of violence and gender inequality (perpetration and experience)
Factors specifically associated with intimate partner violence include:
 past history of violence
 marital discord and dissatisfaction
 Difficulties in communicating between partners
Factors specifically associated with sexual violence perpetration include:
 beliefs in family honour and sexual purity
 ideologies of male sexual entitlement
 weak legal sanctions for sexual violence.
RISK FACTORS

4. Did you perpetrate (caused it) , experienced it (where you a victim of it),
or both?
Lower levels of education
Perpetrator of sexual violence _________
Experienced sexual violence________
Exposure to child maltreatment
Perpetrator ___________ Experienced ___________
Witnessing family violence
Perpetrator ____________ Experienced __________
Antisocial personality disorder
Perpetrator ____________
Harmful use of alcohol
Perpetrator __________ Experienced ___________
Having multiple partners or suspected by their partners of infidelity
Perpetrator ___________
Attitudes that are accepting of violence and gender inequality
Perpetrator __________ Experienced ______________
WHAT ARE YOUR RISK FACTORS? CHECK ALL THAT APPLY

5. There are unique personal and emotional factors associated with intimate partner and sexual violence
which can place any individual at greater risk. It is important for you to understand which these are so
you can acquire greater insight to understand the effect of these relationships to your personal and
relationship well-being. These are only to help you understand where you fall in this relationship
dynamic. Place a check next to the individual risk factor which applies to you:
Low self-esteem ___________
Low income ___________
Low academic achievement ___________
Young age ___________
Aggressive or delinquent behavior as a youth ___________
Heavy alcohol and drug use ___________
Depression ___________
Anger and hostility ___________
Antisocial personality traits ___________
Borderline personality traits ___________
Prior history of being physically abusive ___________
Having few friends and being isolated from other people ___________
Unemployment ___________
Emotional dependence and insecurity ___________
Belief in strict gender roles (e.g., male dominance and aggression in relationships) ___________
Desire for power and control in relationships ___________
Perpetrating psychological aggression ___________
Being the victim of physical or psychological abuse ___________
History of experiencing poor parenting as a child ___________
History of experiencing physical discipline as a child ___________
Count the number of check marks and write your score ___________
A score of 10 or greater makes your more vulnerable to intimate partner violence.
INDIVIDUAL RISK FACTORS

6. Interpersonal factors occur within the context of your relationships with others. This
does not imply fault it’s your fault. This is to highlight situations and circumstances
which can increase the incidence of violence.
Marital conflict-fights, tension, and other struggles
Marital instability-divorces or separations
Dominance and control of the relationship by one partner over the other
Economic stress
Unhealthy family relationships and interactions
Other facts to know:
 The average age of the 3.5 million victims of family violence is 34.
 For victims victimized by their spouses, the average age is 35.
 The average age of violence against boyfriend or girlfriend is 27.
 The average age of violence perpetrated by a friend and/or acquaintances is 27
 The average age for victims of stranger violence is 30.
 Adult ages 55 and older are the least likely to be victims of family violence.
 Children who grow up in families where there’s violence suffer a range of behavioral and emotional
disturbances, which can also be associated with perpetrating or experiencing violence later in life.
 There are higher rates of infant and child mortality and morbidity due to intimate partner violence
 Associated with history of child neglect and abuse
 Women who experience abuse in childhood are 6 times more likely to experience adult physical and
sexual abuse.
Of victims of family violence, the offender may have tried to inflict physical harm but did not
succeed because the victim was able to flee. The perpetrator may have verbally threatened to
hurt the victim but did not actually do anything that resulted in physical harm.
INTERPERSONAL/RELATIONSHIP RISK FACTORS

7. Intimate partner and sexual violence have serious short- and long-term physical, mental,
sexual and reproductive health problems for survivors and for their children, and lead to
high social and economic costs. This section is to help you understand how interpersonal
violence affects you emotionally and physically and help you identify these so that you can
begin in self-care.
HEALTH CONSEQUENCES OF IPV

8.  Violence against women can have fatal results like homicide or suicide.
 It can lead to injuries, with 42% of women who experience intimate partner violence reporting an
injury as a consequence of this violence.
 Intimate partner violence and sexual violence can lead to unintended pregnancies, induced abortions,
gynecological problems, and sexually transmitted infections, including HIV.
 The 2013 analysis found that women who had been physically or sexually abused were 1.5 times
more likely to have a sexually transmitted infection and, in some regions, HIV, compared to women who
had not experienced partner violence. They are also twice as likely to have an abortion.
 Intimate partner violence in pregnancy also increases the likelihood of miscarriage, stillbirth, pre-
term delivery and low birth weight babies.
 These forms of violence can lead to depression, post-traumatic stress disorder, sleep difficulties,
eating disorders, emotional distress and suicide attempts.
 Women who have experienced intimate partner violence were almost twice as likely to experience
depression and problem drinking. The rate was even higher for women who had experienced non partner
sexual violence.
 Health effects can also include headaches, back pain, abdominal pain, fibromyalgia, gastrointestinal
disorders, limited mobility and poor overall health.
 Sexual violence, particularly during childhood, can lead to increased smoking, drug and alcohol
misuse, and risky sexual behavior in later life.
 Sexual violence is also associated with perpetration of violence (for males) and being a victim of
violence (for females)
HEALTH CONSEQUENCES

9. As a result of your experience with intimate violence, have you experienced and/or suffered any of the
following health consequences. Check all that apply:
Physical Injuries (i.e. broken limbs, bruises, cuts, burns) _________
Unintended pregnancies _________
Gynecological problems _________
Sexually Transmitted Infections (including HIV) _________
Miscarriages/ stillbirths/ Induced Abortions _________
Pre-Term deliveries or Low Birth Weight Babies _________
Depression _________
Sleeping Difficulties _________
Emotional Distress _________
Suicide attempts _________
Self-harm behaviors (i.e. self-cutting, self burning, self-hitting) _________
Eating Disorders (i.e. anorexia, bulimia, binging and purging) _________
Back pain _________
Fibromyalgia _________
Gastrointestinal disorders (i.e. stomach pains, acid reflux disease) _________
HEALTH CONSEQUENCES

10. Post Traumatic Stress Disorder (PTSD) is an anxiety disorder and a diagnosis defined by the DSM Vas
experiencing the following symptoms: The exposure in which a person directly experiences a traumatic
event, witnesses a traumatic event in person, learns that traumatic event occurred to a close family
member or close friend (which the actual threat or death being violent or accidental), and experiencing
first hand repeated or extreme exposure to aversive details of the traumatic event.
In domestic violence, the repeated negative events and triggers over a long period of time can cause
severe emotional and mental stress. Repeatedly living in a fearful situation, “walking on eggshells,”
repeated instances of experiencing violence or watching violence and/or threats of violence or harm can
create a “war like” scenario.
As the human brain is an very intelligent organ, it attempts to make sense of what has happened so it
can store it away in its long term memory bank and make peace with it. Unfortunately, sometimes
people cannot make sense of what has happened to them or why and live in a perpetual state of fear,
constantly being reminded of the event, sometimes dreaming of the event, “reliving” the event, and
always watchful and vigilant to avoid the same negative situation to ever happen again. In Post
Traumatic Stress Disorder, this is called “avoidance,” “flashbacks,” nightmares, “hypervigilance,” fear,
and withdrawal.
A typical reaction to domestic violence as a form of Post Traumatic Stress Disorder is the belief that
your life is pre-shortened and a lack of faith of seeing a long term future. A person with PTSD may
avoid relationships, people, places, and things who remind them of the negative event, become
explosive when reminded or believe that they are in fear of an attack, and may withdraw as a form of
safety and feel in control again of an event that felt uncontrollable and unsafe. The person may
experience insomnia (a condition where a person is unable to sleep) and may have nightmares which
contributes to insomnia. This is also often followed by feelings of isolation, recreating isolation,
feelings of worthless and sadness, and in extreme situations, suicidal ideation—a thought and desire to
take away one’s life with or without plan.
The most important factor in treating PTSD is to acquire treatment—and the sooner the better after a
traumatic event. Very often, people who experience trauma do not seek help which places them at a
greater risk for onset of PTSD and re-traumatization. With proper treatment, PTSD is manageable and
treatable. The important thing to remember is that not everyone is the same and that there are a lot of
compassionate people in the world to know that the world is not always a fearful and dark place.
HEALTH CONSEQUENCE: WHAT IS POST TRAUMATIC STRESS
DISORDER?

11. Below is a list of problems and complaints that people have in response to stressful life experiences.
Please read each on carefully, put an “X” in the box to indicate how much you have been bothered by
that problem in the last month.
HEALTH CONSEQUENCE: DO YOU HAVE SYMPTOMS OF PTSD?
No Response Not at
All (1)
A little
bit (2)
Moder-
ately (3)
Quite a
bit (4)
Extremely (5)
1 Repeated disturbing memories, thoughts, or images of
a stressful experience from the past?
2 Repeated disturbing dreams of a stressful experience
from the past?
3 Suddenly acting or feeling as if a stressful experience
were happening again (as if you were reliving it)?
4 Feeling very upset when something reminded you of a
stressful experience from the past?
5 Having physical reactions (e.g. heart pounding, trouble
breathing, or sweating) when something reminded you
a stressful experience from the past?
6 Avoid thinking about or talking about a stressful expe-
rience from the past or avoid having feelings related to
it?
7 Avoid activities or situations because they remind you
of a stressful experience from the past?
8 Trouble remembering important parts of a stressful
experience from the past?
9 Loss of interest in things that you used to enjoy?
10 Feeling distant or cut off from other people?
11 Feeling emotionally numb or being unable to have lov-
ing feelings for those close to you?
12 Feeling as if your future will somehow be cut short?
13 Trouble falling or staying asleep?
14 Feeling irritable or having angry outburst?
15 Having difficulty concentrating?
16 Being “super alert” or watchful on guard?
17 Feeling jumpy or easily startled?

12. Major Depressive Disorder (MDD) is a mood disorder and a diagnosis of the DSM V. It can be result
of genetic/biological disposition as well as a response(s) to a stressful life event(s). The predominant
feature of MDD is a period of intense sadness, followed by difficulties in concentration, attention and
memory impairments, changes in appetite, insomnia (lack of sleep) or hypersomnia (too much sleep)
daily for a period of minimum 2 weeks or more. During this period, the person does not experience any
joy, hyperness, happiness but rather is in deep sad state which incorporates loss of motivation, loss of
energy, tiredness, and at times complete slowed of the body. At extreme bouts of depression, the person
can experience feeling of hopelessness, helplessness, and worthless which can contribute to
experiencing suicidal ideation—the thought and/or desire to take one’s life with or without a plan.
Major Depressive Disorder is frequently characterized by style of thinking called “rumination.” It is the
repeated and recurrent pattern of thinking in which a person continues to blame self for events they may
or may not have caused. It is a repeated thought pattern comprised of feelings of guilt and repercussion
for which the person believes he/she is experiencing “punishment.” When this thinking occurs, the
person naturally attributes all of life’s negative experiences to one self and believes he/she to be the
cause of the unhappiness experiencing or created. It is a distorted thinking pattern that can lead to more
unhealthy thoughts as suicidal ideation and death.
Series of life events have been found to cause MDD and these have been noted along the lifespan:
Marriage,
Separation
Divorce
Pregnancy
Birth (usually 1st born)
Geographic changes (moves)
Loss/Change in Employment
Retirement
Loss of Spouse/Family Member (death)
Noteworthy, Major Depressive Disorder is the leading cause of disability worldwide and it is the
costliest of all of the mental health disorders in the world in terms of employment and accidents. It is a
very treatable and manageable disorder which, if addressed quickly and properly, a person can return to
normal and healthy state of function quiet rapidly.
HEALTH CONSEQUENCE: WHAT IS MAJOR DEPRESSIVE DISORDER?

13. The following questions ask about how long you have been feeling over the last 2 weeks. Please put an
“X” in the box which is closest to how you have been feeling
HEALTH CONSEQUENCE: DO YOU HAVE SYMPTOMS OF MDD?
How Much of the time All of the
time (5)
Most of
the time
(4)
More
than half
of the
time (3)
Less than
half of
the time
(2)
Some of
the time
(1)
At no
time
(0)
1 Have you felt in low spirits or sad?
2 Have you lost interest in your daily
activities?
3 Have you felt lacking in energy and
strength?
4 Have you felt less self-confident?
5 Have you had a bad conscience or
feelings of guilt?
6 Have you felt that life wasn’t worth
living?
7 Have you had difficulty concentrat-
ing e.g. when reading the newspa-
per or watching television?
8a Have you felt very restless?
8b Have you felt subdued?
9 Have you had trouble sleeping at
night?
10a Have you suffered from increased
appetite?
10b Have you suffered from reduced
appetite?

14. Know Your City: New York, New York!
Bronx:
47% of women in intimate partner relationships were the victims of a felony assault by their partner vs. 14% of
male victims of partner intimate violence.
59% of women in intimate partner relationships were the victims of an assault in the 3rd
degree and/or related
offences vs. 12% of men in the same relationship.
33% of women in intimate partner relationships were the victim of a sexual offense vs. 1% of men in the same
relationship.
63% of women in intimate partner relationships had their order of protection violated by their partners vs. 8% of
men in the same relationship.
Brooklyn:
46% of women in intimate partner relationships were the victims of a felony assault by their partner vs. 15% of
male victims in the same relationship.
53% of women in intimate partner relationships were the victims of a victims of an assault in the 3rd
degree and/
or related offense by their partner vs. 12% of male victims in the same relationship.
32% of women in intimate partner relationships were the victims of a sexual offense by a partner vs. 1% of men
in the same relationship.
60% of women in intimate partner relationships had their order of protection violated by their partner vs. 9% of
men in the same relationship.
Queens
45% of women in intimate partner relationship were the victims of a felony assault by their partner vs. 14% of
male victims in the same relationship.
56% of women in intimate partner relationships were the victims of an assault in the 3rd
degree and/or related
offense by their partner vs. 12% of male victims in the same relationship.
46% of women in intimate partner relationships were the victims of a sexual offense by a partner vs. 1% of men
in the same relationship.
64% of women in intimate partner relationship had their order of protection violated by their partner vs. 9% of
men in the same relationship.
Staten Island
39% of women in intimate partner relationship were the victims of a felony assault by their partner vs. 16% of
men in the same relationship.
56% of women in intimate partner relationship were the victims of an assault in the 3rd
degree and/or related of-
fense by their partner vs. 11% of male victims in the same relationship.
39% of women in intimate partner relationships were the victims of a sexual offense by a partner vs. 0% of men
in the same relationship.
64% of women in intimate partner relationship had their order of protection violated by their partner vs. 7% of
men in the same relationship.
New York
42% of women in intimate partner relationship were the victims of a felony assault by their partner vs. 20% of
men in the same relationship.
54% of women in intimate partner relationship were the victims of an assault in the 3rd
degree and/or related of-
fense by their partner vs. 15% of male victims in the same relationship.
39% of women in intimate partner relationships were the victims of a sexual offense by a partner vs. 2% of men
in the same relationship.
62% of women in intimate partner relationship had their order of protection violated by their partner vs. 10% of
men in the same relationship.

15. DOMESTIC VIOLENCE
THE POWER AND CONTROL WHEEL & THE CYCLE
OF ABUSE

16. What is Abuse?
Physical Abuse—It is the use of size, strength, or presence to hurt or control someone else
Types: Pushing, shoving, slapping biting, choking, pinching, grabbing, forced kneeling, kicking,
restraining, burning, abuse of animals, standing or sitting on partner, pinning against the wall, attacking
with an object or weapon, murder, throwing things, driving recklessly, slamming doors, tearing clothes,
punching walls or doors, chasing, stalking, unplugging the phone, taking car keys, taking credit cards,
money or checkbook, locking partner out of the house, standing in doorway to prevent exit, abandoning
partner in a dangerous place, refusing to help partner when sick, injured, or pregnant.
Emotional Abuse—It is the use of any words, voice, action or lack of action
meant to control, hurt, or demean another person.
Types: Threatening to kill, threatening to use violence, making insinuations, accusing partner of
unfaithfulness, calling names like bitch, whore, slut, yelling, being sarcastic, sneering, withholding
approval, appreciation, or affect ion as punishment, ignoring, humiliating, insulting family or friends,
criticizing, threatening or insulting family or friends, being irresponsible with money, displaying intense
jealousy, controlling access to money, checking up on partner, making faces, manipulating with lies,
keeping partner up all night, having affairs, threatening divorce, not working, threatening to take custody
of the children, denying access to the phone, threatening suicide, threatening to harm self
Sexual Abuse—It is any sexual behavior meant to control, manipulate, humiliate, or
demean another person. It is to exert power over the female partner and to further shame
and humiliate her.
Types: Unwanted touching, sexual name calling, unfaithfulness, false accusations, withholding sex as a
punishment, forced sex with a partner, hurtful sex, insisting partner dress in a more sexual way than she
wants, forcing partner to strip when she doesn’t want to, forced sex with someone other than partner,
forcing partner to watch others, rape with object, forced sex with animals, unwanted sadistic sexual acts

17. The Cycle of Abuse
Phase I—The Tension Building Phase
Less Lethal form of perpetrating occurs
Tension is sensed and the person tries to placate the abusive partner to prevent
abuse
Partner minimizes the minor incidents and blames self for partner’s behavior
Partner denies that the tension will escalate to more severe battering although
it may have happened before
Phase II—The Acute Battering Phase
The perpetrator’s rage escalates dramatically
Both the perpetrator and victim accept the myth that he/she can’t control his
anger
Severe injuries occur as a result of the abuse
The partner experiences shock and disbelief that the incident has occurred
Phase III—The Remorseful Phase
The perpetrator expresses contrition over the behavior and makes promises to
change
The perpetrator is charming and loving
The perpetrator offers gifts (flowers, jewelry, perfume, candy) to apologize for
the behavior
The perpetrator begins to elicit feelings of guilt and sympathy from the victim
The perpetrator generates confirmation of loving behavior from others.

18. Describe Your Cycle of Abuse
Phase I—The Tension Building Phase
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
Phase II—The Acute Battering Phase
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
Phase III—The Remorseful Phase
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________

19. Signs of an abusive personality
Jealousy: Questions who you talk to, jealous of time spent with others, accuses
of “flirting” with others, “drop by” unexpectedly to check up on you, refuses to
let you work because you might “meet” someone at work, checks car mileage,
asks others to “watch” you
Controlling Behavior : Questions where you went and with whom, makes
decision of what you wear, the children, or going to church, keeps all the
money or has you ask permission to use the phone
Quick Involvement: Usually living together or engaged for less than 6 months,
claims of “love at first sight,” will pressure to commit
Unrealistic Expectations: Dependent that all needs are met by partner, expects
the “perfect” partner, mother, lover, friend, expected to care for everything
emotionally and in the home
Isolation: If the person is a woman and has female friends, she is a “lesbian.”
If the person is a woman and has male friends, she is a “whore.” If the person
is close to her family, he/she is “tied to the apron strings.” Accuse that others
are getting close to “cause trouble.”
Blames Others for the problems: Accuse others of doing wrong, blames his
work, blames anything that is going wrong on the partner. Minimizes behavior
Blames Others for his/her feelings: Reports that reasons for his/her anger is
because the partner is the reason.
Hypersensitivity: Feels “hurt” when he’s actually really angry, slightest
setbacks as “personal attacks,” rage about injustices that happen that are
actually part of life.
Cruel to Animals or Children: Spank a 2 y.o. for wetting a diaper, maim and/
or kills pets to intimidate

20. Signs of an abusive personality
“Playful” Use of Force in Sex: Throw you and hold down while sex (not in
consent), want to act out sexual fantasies where woman is helpless, little to no
concern if partner does not want to have sex, “sulks” or anger to manipulate
into compliance, demand sex when partner is tired.
Verbal Abuse: Degrading comments, cursing, or discounting accomplishment,
call partner “stupid,” and may wake partner to verbally abuse and not allow
her to sleep
Rigid Sex Roles: Expect partner (particularly woman) to serve and obey,
believes woman is inferior to man, believes that woman is not a whole person
without a relationship with a man
Jekyll-And-Hyde Personality: Nice and then explodes, “mood swings,”
everyone knows him/her as a super nice guy and the best friend on the block
but behind close doors he/she is a cruel
Past Abusive Behavior: Past history of having “hit” in the relationship but it
was “because they made me do it.” May hear from relatives of the perpetrator
that person is abusive, minimizing abusive behavior with previous partner and
likely to be violent with current partner
Threats of Violence: Threats of physical force meant to control and excuse it
with “everybody talks like that.”
Breaking or Striking Objects: Break things, beat on tables or walls with fist,
throw objects as a primary function to terrorize into submission
Any Force During an Argument: Holding partner down, physically
restraining person from leaving the room, pushing, or shoving, “You’re going
to listen to me.”

21. Power and Control Wheel

22. Identify that which applies to you from the Power and
Control Wheel:
Emotional Abuse: _______________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
Physical Abuse: ______________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
Sexual Abuse: ________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
Why is there “Power and Control” in the middle of circle?
_____________________________________________________________
_____________________________________________________________
What does Power and Control mean to you in these relationships?
_____________________________________________________________
_____________________________________________________________
What are good things about this type of a relationship? Who do they benefit?
And Why? ___________________________________________
_____________________________________________________________
_____________________________________________________________
What are the bad things about this type of a relationship? Who do they not
benefit? And Why? _____________________________________________
______________________________________________________________

23. “Shoulds” and Expectations
Everybody has expectation and beliefs about how a relationship “should” be.
It is this “should” that keeps people trapped without examining the here and
now. Frequently people say, “He/She wasn’t like that when we met” and
discredit the now, hoping, that the person returns to the person that they
“met.” The reality is that frequently there were warning signs at first glance
and like many of the things described, they have been minimized and/or
blamed on to someone else, about someone else or something else… also by
you.
Key Questions to Change:
What does your “ideal” relationship look like? Is it what you have now?
Is your idea of your ideal relationship realistic?
What does your present relationship “mean” to you? What does it represent?

24. Learn the connection!
SUBSTANCE USE & DOMESTIC
VIOLENCE

25. Special points of interest:
 Rates of IPV are higher for people who use substance
 Use of alcohol and drugs to cope with effects of abuse (i.e.
painkillers, benzodiazepines, sleeping medications, alcohol)
 Coercion of use by an abusive partner who sabotages recov-
ery and threatens to undermine via use of authorities
 Coercion of use by an abusive partner for sexual use leading
to abuse and trafficking
 47% of women entering treatment have experienced IPV
 67% of women entering treatment have experienced physi-
cal violence
 High association between alcohol use, abuse, and heavy
drinking or dependence
 High association between frequent opioid use and IPV
 Women who reported that their partners used substances
were 4x more likely to report IVP

26. Battered Women and Substance Abuse
 While women drink less than men, they are more susceptible to the physical
consequences of drinking
 More likely to develop liver disease with lower alcohol consumption than
men
 Female alcoholics die at rates 50 to 100 times higher than male alcoholics
 Under the influence of alcohol and/or drugs, battered women have a relative
risk of attempting suicide 8 times as great as non-battered women
 About 7-14% of battered women have alcohol abuse problems and some
women use alcohol to self medicate
 Women’s substance abuse problems are frequently viewed as less serious
than men’s and more often misdiagnosed
 More battered women are addicted to drugs that are prescribed by their
healthcare provider from whom they sought help
 Self-medication is an expression of personal control as well as an attempt to
numb the pain of the experience
 Chemically addicted women increase the danger of exposure to danger as
drugs and alcohol make one less aware of, less responsive to cues of forth-
coming violence.
 Less able to escape, more likely to fight back resulting in increasing the like-
lihood of serious injury.
 Many chemically dependent and battered women are initiated to substance
abuse via their chemically dependent patterns who then sabotage their efforts
to quit

27. “He would buy me drugs for me because he said he
like me better when I was stoned. When he got mad at
me, though, he’d flush my dope down the toilet and
threaten to tell my boss I was a junkie.”

28. Self Test
Do you and your partner argue often?
If either of you drink, are your personalities different when drinking? If so,
how?
Does your partner ever lose his or her temper, throw things, or threaten
you? Give examples.
Do arguments ever end in pushing, shoving, or slapping?
Has your partner ever used a fist or weapon against you?
Have you ever been concerned about your safety or your children? Give
reasons.

29. Self Test
Circle all of the substances you used with partner while in your relation-
ship:
Beer Wine Liquor Malt Liquor Cigarettes
Chewing Tobacco Blunts Marijuana Hashish
K2 Cocaine (sniff) Cocaine (IV) Crack Cocaine
Heroin (sniff) Heroin (IV) Oxycodone Morphine
Oxycotin Percocet Fentanyl Suboxone
Ritalin (sniff) Adderral (sniff) Xanax Klonopin Valium
Seroquel Librium Special K GHB Ecstasy LSD
Mushrooms Methamphetamines Crystal Amphetamines
Whippits Inhalants (glue/paint) Vicodin Cough Medicine

30. Describe the 1st time you and your partner would engage in using or drink-
ing. What where the circumstances? What did you use? How did it feel?
Why did you use?
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
Describe the pattern of your relationship and using after the 1st time. Did it
change from the 1st time? If so, how did it change? How did it feel? Why
did you continue to use?
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
If there was violence, what were you thoughts regarding why it happened?
Do you believe it was a result of the alcohol and using? If so, why?
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________

31. How would you feel to be involved in a relationship without using or drink-
ing? Be honest with yourself! Circle all that apply.
Amazed Foolish Overwhelmed Angry Frustrated
Peaceful Annoyed Furious Proud Anxious
Grieving Relieved Ashamed Happy Resentful
Bitter Hopeful Sad Bored Hurt
Satisfied Scared Comfortable Insecure Inadequate
Content Inspired Self-Conscious Shocked Depressed
Irritated Silly Determined Jealous Stupid
Disdain Joy Suspicious Lonely Disgusted
Tense Eager Terrified Lost Loving
Trapped Worried Embarrassed Nervous Miserable
Energetic Excited Motivated Worthless Uncomfortable

32. How would you rate your sexual life in your relationship without using or
drinking? Be honest with yourself! Circle all that apply.
Amazed Foolish Overwhelmed Angry Frustrated
Peaceful Annoyed Furious Proud Anxious
Grieving Relieved Ashamed Happy Resentful
Bitter Hopeful Sad Bored Hurt
Satisfied Scared Comfortable Insecure Inadequate
Content Inspired Self-Conscious Shocked Depressed
Irritated Silly Determined Jealous Stupid
Disdain Joy Suspicious Lonely Disgusted
Tense Eager Terrified Lost Loving
Trapped Worried Embarrassed Nervous Miserable
Energetic Excited Motivated Worthless Uncomfortable

33. Self Inventory
Why do you believe your used these substances?
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
What was the benefit in using these substances for you?
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
In what ways do you believe these substances did not benefit you? If so,
how and why?
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
How can you make amends with yourself?
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
Are you perfect?

34. Changing The Thinking Process

35. Challenging Unhealthy Thoughts and Behaviors
There is a connection between out thoughts, our emotions, and actions which we use on a daily
basis to “self regulate.” Like all things in our environments, we seek to reach some kind of a
balance—a homestasis— with our surroundings. For example, when we turn the oven on, it
heats up and the whole house gets hot. We open the windows, turn on the fans to cool the
place down until we are done baking, even might get a cold glass of water, and take our shirts
off. Nobody had to tell you to think, “wow, it’s hot in here. What should I do?” It was an
automatic reaction but the thought was there and you responded to it. Somewhere, in the
passage of time, you learned what to do when something got “hot” and it became and
automatic thought with an automatic reaction.
Much like the automatic thought that resulted in an automatic reaction described above,
somewhere you learned in your relationship how to behave in a relationship that is abusive and
it became, in time, acceptable to you—for whatever reason you may have had at that time.
Maybe initially you thought “________________________________________” and learned
that if you didn’t do “__________________________________,” then things got better,
happier, more calm, more peaceful, more something… for a while. It became automatic.
To learn new thoughts and behaviors, you have to identify your automatic thoughts and
challenge them to replace your former automatic thoughts. The brain is an intelligent organ,
so you have to find a replacement thought that makes sense to your brain or it will challenge
and fight you. So, if I want to find a replacement thought for an automatic reaction to cooling
the house when the stove is on, it has to be a new thought that makes sense to my brain. For
example, flooding the kitchen with water, throwing a bucket of water inside the stove, closing
the windows, and opening the door to the public might likely not work as an automatic
thought.
In abusive relationships, people get “stuck” in how they “should” be treated and ignore the
other message being sent to the brain on how they are presently being treated. Rather than
taking step back, they focus on ways to change how the other is thinking or acting despite the
danger this may cause. It’s like throwing a bucket of water in the stove rather and closing the
windows rather than doing something that might make more sense, might be better, and
healthier! Likewise, if you find yourself doing something that does not work and it is causing
you harm, take a step back and ask yourself, “why am I doing that?” You will be amazed to
find that more underlying thoughts sometimes are driving your actions than just meets your
eye. You may have just not yet recognized your automatic thought hidden underneath your
reaction...

36. Challenging Unhealthy Thoughts and Behaviors
Exercise I: Identifying Your Automatic Thought
Event: ________________________________________________________
Thought: _________________________________________________________
Behavior: _________________________________________________________
Feeling: _________________________________________________________
Exercise II: Identify Your Automatic Behavior
Event: __________________________________________________________
Behavior: __________________________________________________________
Feeling: __________________________________________________________
Thought: __________________________________________________________

37. Challenging Unhealthy Thoughts and Behaviors
Exercise II: Identifying Your Automatic Thought (from Exercise I)
Event: ________________________________________________________
Thought: _________________________________________________________
Behavior: _________________________________________________________
Feeling: _________________________________________________________
Exercise II: Identify Your Replacement (new) Automatic Thought
Event: __________________________________________________________
Behavior: __________________________________________________________
Feeling: __________________________________________________________
Thought: __________________________________________________________

38. Challenging Unhealthy Thoughts and Behaviors
Exercise III: Identifying Your Automatic Behavior (from Exercise II)
Event: ________________________________________________________
Thought: _________________________________________________________
Behavior: _________________________________________________________
Feeling: _________________________________________________________
Exercise III: Identify Your Replacement (new) Automatic Behavior
Event: __________________________________________________________
Behavior: __________________________________________________________
Feeling: __________________________________________________________
Thought: __________________________________________________________

39. Challenging Unhealthy Thoughts and Behaviors
When he use a “should,” “have to,” or “must,” we in essence are creating a set of rules to go
by. Often people will say,
“I can’t go out. I HAVE to clean my house” (as if they are being forced into action)
“I should not have eating the quart of ice cream” (as if something horrible will now happen to
their lives),
“I must do what he tells...”
This “should,” “have to,” or “must,” implies that a set of mental rules are created and people
created these all the time. For example, think of kids playing and the weird rules they come up
with for their imaginary games!
As stated before, in abusive relationships, people get “stuck” in how they “should” be treated
and ignore how they are presently being treated. Rather than taking step back they focus on
ways to change how the other is thinking or acting despite the danger this may cause.
In changing your unhealthy thoughts and behaviors, it is important to examine the “mental
rules” which are affecting your thinking and consequently why it is that you’re staying and/or
using.
Example: Event: He didn’t call or come home last night.
Thought—He should treat me ____________________________________.
Emotion– anger, hurt, rage, shame, embarrassed
Action—Because he should treat me this way and doesn’t, I get high/drunk to
piss him off.
Your Example: Event: __________________________________________________
Thought: ________________________________________________
Emotion: ________________________________________________
Action: __________________________________________________

40. SAFETY PLANNING

41. 1. Make arrangements to go to a place that is safe, either with a trusted friend, relative, or at a hotel.
2. Keep a bag packed and hidden that contains clothes and personal hygiene items. Pack money, extra
checks or checkbook, charge cards, protective orders, birth certificates, marriage certificates, children
immunization, titles to property and cards—and anything that has personal value to you.
3. Hide the bag where it will not be discovered by your partner, i.e. with trusted friends, relatives, or at
work.
4. Hide an extra set of house keys and car keys in a place easily accessible to you.
WHEN PREPARING TO LEAVE

42. 1. Decide who at work you will inform about your situation—supervisor, staff person, security personnel
2. Provide a picture of your perpetrator to the appropriate person
3. Ask for help in screening your telephone calls at work
4. Review your work schedule with your supervisor and ask about changing your hours.
5. Review the parking situation and park close to the building for easy entry and exit.
6. Ask for an escort to and from your vehicle.
7. Use a variety of routes to and from your homes and plan what you would do if something happened while going
home.
8. If you need to leave from work, provide your address/telephone number to a trusted company contact person.
WORKPLACE SAFETY

43. 1. Make safety plan in advance, in case you need to leave your home quickly
2. If an argument is unavoidable, try to have it in a room in which you can easily get away. Stay away
from the kitchen, bathroom, and/or bedrooms.
3. Identify in advance the doors, windows, or stairways that would allow you to get our of your home
quickly and safely.
4. Identify trusted neighbors that you can tell about the violence, and ask that they call the police if they
hear a disturbance coming from your home.
5. Devise a code word to use with your children, trusted family members, friends, and neighbors when
you need them to call the police.
SAFETY DURING A VIOLENT EPISODE

44. The following steps represent my plan for increasing my safety and preparing in advance for the
possibility for further violence. Although I do not have control over my partner’s violence, I do
have a choice about how to respond to him/her and how to best get myself and my children to safety
(Courtesy of SAMSHA)
I can use some or all of the following strategies:
A. If I decide to leave, I will __________________________________. (Practice how to get out safely.
What doors, windows, elevators, stairwells, or fire escapes would you use?)
B. I can keep my purse and car keys ready and put them (place) ________________________ in order to
leave quickly.
C. I can tell ___________________________ about the violence and request that they call the police if
they hear suspicious noises coming from my house.
D. I can also tell ____________________________ about the violence and request that they call the
police if they hear suspicious noises coming from my house.
E. I will use _________________________ as my code word with my children or my friends so they can
call for help.
F. If I have to leave my home, I will go ___________________________. (Decide this even if you don’t
think there will be a next time).
G. I can also teach some of these strategies to some/all of my children.
H. When I expect we are going to have an argument, I will try to move to a space that is lowest risk, such
as _____________________________. (Try to avoid arguments in the bathroom, garage, kitchens,
near weapons or in rooms without access to an outside door).
I. I will use my judgment and intuition. If the situation is very serious, I can give my partner what he/she
wants to calm him/her down. I have to protect myself until I/we are out of danger.
PERSONALIZED SAFETY PLAN

45. I can use some or all of the following strategies when preparing to leave:
A. I will leave money and an extra set of keys with _______________________ so I can leave quickly.
B. I will keep copies of important documents or keys at ______________________________.
C. I will open a savings account by _____________________ (date), to increase my independence.
D. Other things I can do to increase my independence include: _________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
E. The domestic violence program’s hotline number is _______________________________. I can seek
shelter by calling this hotline.
F. I can keep change for phone calls on me at all times. I understand that if I use my telephone credit
card, the following month the telephone bill will tell my perpetrator those numbers that I called after I
left. To keep my telephone communications confidential, I must either use coins or I might get a
friend to permit me to use their telephone credit card for a limited time when I first leave.
G. I will check with ____________________ and _______________________ to see who would be able
to let me stay with them or lend some money.
H. I can leave extra clothes with _____________________________________.
I. I will sit down and review my safety plan every ___________________________ in order to plan the
safest way to leave the residence. ___________________________ (domestic violence advocate or
friend) has agreed to help me review this plan.
J. I will rehearse my escape plan and, as appropriate, practice it with my children.
PERSONALIZED SAFETY PLAN

46. I can use some or all of the following strategies seeking safety in my own residence:
A. I can change the locks on my doors and windows as soon as possible.
B. I can replace wooden doors with steel/metal doors.
C. I can install security system including additional locks, window bars, poles to wedge against doors,
and electronic systems, etc.
D. I can purchase rope ladders to be used for escape from second floor windows.
E. I can install smoke detectors and purchase fire extinguishers for each floor in my house/apartment.
F. I can install an outside lighting system that lights up when a person is coming close to my house.
G. I will teach my children how to use the telephone to make a collect call to me and to (friend/minister/
other) in the event that my partner takes the children.
H. I will tell people who take care of my children which people have permission to pick up my children
and that my partner is not permitted to do so. The people I will inform about pick up permission
include:
__________________________________________________________ (school)
__________________________________________________________ (day care staff)
__________________________________________________________ (babysitter)
__________________________________________________________ (Sunday school teacher)
__________________________________________________________ (teacher)
__________________________________________________________ and (others)
J. I can inform ___________________ (neighbor), ______________________ (pastor), and
__________________ (friend) that my partner no longer resides with me and they should call 911 if he
is observed near my residence.
PERSONALIZED SAFETY PLAN

47. I can use some or all of the following strategies seeking safety in my own residence:
A. If my partner violates the protection order, I can call the police and report a violation, contact my
attorney, call my advocate, and/or advise the court of the violation.
B. If the police do not help, I can contact my advocate or attorney and will file a complaint with the
chief of the police department.
C. I can also file a private criminal complaint with the district justice in the jurisdiction where the
violation occurred or with the district attorney. I can charge my perpetrator with a violation of the
protection order and all the crimes that he commits in violating the order. I can call the domestic
violence advocate to help me with this.
I might do any or all of the following to increase my safety on the job and in public:
D. I can inform my boss, the security supervisor and ___________________________ at work of my
situation.
E. I can ask _________________________ to help screen my telephone call at work.
F. When leaving work, I can ____________________________________.
G. When driving home if problems occur, I can ________________________________.
H. If I use public transit, I can _________________________________________.
I. I can use different grocery stores and shopping malls to conduct my business and shop at hours that
are different than those when residing with my perpetrator.
J. I can use a different bank and take care of my banking at hours different from those I used when
residing with my perpetrator.
K. I can also ___________________________________________.
PERSONALIZED SAFETY PLAN

48. Using alcohol and/or drugs can be very hard on victims of interpersonal violence, may hurt your
relationship with your children, and put you at a disadvantage with your perpetrator. You should
carefully consider the cost of not sober living. Use of any alcohol or drug can reduce your awareness
and ability to act quickly to protect yourself from your perpetrator. The use of alcohol and/or drugs
by the perpetrator may provide an excuse to use violence.
If drugs or alcohol use has occurred in my relationship with the perpetrator, I can enhance my
safety by some or all of the following:
A. If my perpetrator is using, I can _________________________________.
B. I might also _____________________________________________.
C. To safeguard my children, I might ______________________________ and ____________________.
The process of building a new life for myself takes courage and incredible energy:
A. If I feel down and ready to return to a potentially abusive situation, I can
____________________________________________.
B. When I have to communicate with my partner in person or by telephone, I can
________________________________________________.
C. I can try to use, “I can….” statements with myself to be assertive with others.
D. I can tell myself, “ ________________________________” whenever I feel others are trying to
control or abuse me.
E. I can read _______________________________ to help me feel stronger.
F. I can call _______________________, _________________________, and __________________ as
other resources to be of support of me.
G. I can attend workshops and support groups at the domestic violence program or
____________________________ to gain support and strengthen my relationship with other people.
PERSONALIZED SAFETY PLAN

49. When leaving, it is important to take certain items with you. Items with an asterisks are the most
important to take. If there is time, the other items might be taken or stored outside the home. When I
leave I should take:
 Identification for myself
 My birth certificate
 School and vaccination records
 Checkbook, ATM (Automatic Teller Machine) card, Benefits Card
 Keys—house/car/office
 Medications
Work permits
Passport(s)
Medical records—for all family members
Bank books
Small saleable objects
Pictures
Children’s favorite toys and/or blankets
PERSONALIZED SAFETY PLAN

50. Telephone Numbers I Need to Know:
Police department—home ________________________
Police department—work ________________________
County registry of protection orders ________________________
Supervisor’s home number ________________________
Other ________________________
Hotlines
National Domestic Violence Hotline Rape, Abuse, and Incest Network (RAINN)
1.800.799. SAFE 1.800.656.4673
1.800.787.3224 (TDD)
Childhelp USA/National Child Abuse Hotline National Coalition Against Domestic Violence
1.800.4A-CHILD 303.839.1852
New York City Domestic Violence Hotline
1.800.621. HOPE
PERSONALIZED SAFETY PLAN