Domestic violence has traditionally been thought of as physical: someone is struck, injured, or killed. This is certainly one type of domestic violence, but there are many other ways that someone in an intimate relationship can be abused. Domestic violence will be defined in this module as the following:

Domestic violence is physical, sexual and/or psychological abuse committed by someone who is intimately related to the victim.

• Physical abuse: The physical abuse that characterizes domestic violence can involve seemingly minor types of harm such as pushing, pinching, rough touching, etc., or it may involve dangerous and injurious behavior such as slapping, choking, punching, kicking, or physical contact that causes injury or death. Physical abuse can also include forcing a victim to engage in dangerous behavior such as excessive use of alcohol or the use of dangerous and illegal drugs.

• Sexual abuse: Domestic violence that involves sexual abuse can take many forms. It may involve the threat of unwanted or forced sexual contact or intercourse; it may involve sexual contact or intercourse that is humiliating, painful or dangerous, such as unprotected intercourse with someone who has a sexually transmitted disease. In its most severe form it may involve physical harm that occurs during sexual contact or rape.

• Emotional/psychological abuse: Emotional and psychological abuse always accompanies the other forms of domestic violence; it is impossible to suffer physical or sexual abuse without being injured both emotionally and psychologically. But there are millions of cases of domestic violence in which the victim does not suffer physical or sexual harm. An abusive partner may constantly subject the victim to bullying, harassment, or criticism. The victim may be subjected to daily threats or intimidation. The abuser may be overly controlling and prevent the victim from enjoying normal freedom of movement and normal social relationships, and will do so by the use of threats, screaming, or abusive language. The abuser may stalk the victim or make uninvited visits to someone’s home or workplace. The person who is being terrorized may, in the end, find that she/he has become totally dependent on the abuser – which of course is often the abuser’s intent.

The emotional and psychological abuse that each victim experiences are unique to her or his situation. But regardless of how someone is being abused, whether it is physically, sexually, or psychologically, there is one feeling that is common to all abusive situations: fear. The victim of domestic violence lives in a constant state of fear. Fear is the environment in which the victim lives on a daily basis because domestic violence occurs over and over; it is a continuing phenomenon. If someone is being abused, it is rarely an isolated incident.

What is that fear like? One way to know is to look at what women who are being victimized say about their relationships. The Women’s Experience with Battering Scale is an assessment tool that is used to determine if a woman is involved in an abusive relationship. The victim is given a sheet with these statements and asked whether or not they characterize her relationship.

• He makes me feel unsafe even in my own home.
• I feel ashamed of the things he does to me.
• I try not to rock the boat because I am afraid of what he might do.
• I feel like I am programmed to react in a certain way to him.
• I feel like he keeps me prisoner.
• He makes me feel like I have no control over my life, no power, no protection.
• I hide the truth from others because I am afraid not to.
• I feel owned and controlled by him.
• He can scare me without laying a hand on me.
• He has a look that goes straight through me and terrifies me.

It is easy to see that if someone is intimately involved with a partner who through words, actions or both makes him or her feel this way, life would be very, very frightening. Also, it is well known that people in abusive relationships are more likely to suffer from poor health, chronic health problems, chronic psychiatric problems (depression, low self-esteem, etc.) and are more likely to commit suicide. Unfortunately, the level of violence in an abusive relationship often escalates dramatically if a woman or other victim reports the abuse, and the risk of being murdered is the highest when a victim attempts to break off the relationship.

Should You Ask Someone if She/He is Being Abused?

In some health care facilities, it is required to ask someone if there is a problem of domestic violence. Many times this is not done directly. The questions may be very general in nature, such as “Do you feel safe at home?” or “Are there any relationship issues you would like to talk about?” Some emergency rooms simply give each patient a pamphlet or information sheet that briefly discusses domestic violence and has contact numbers. It may also be useful to ask if there are any problems with alcohol or substance abuse in the home, as excessive use of alcohol and/or drugs is associated with an increased risk for domestic violence.

Certainly, you should at least open the subject if there are very strong indications that domestic violence is occurring. The best approach is to follow the guidelines that have been developed by your workplace, and if you are required to ask about abuse do so in a way that is non-confrontational, non-judgmental, and supportive. You should also assess each situation and determine the best way to open the subject. Remember, this is a very sensitive issue. Remember too that you are essentially a stranger asking someone to share intimate information and your relationship with someone who is being abused is temporary, at best. Encourage someone to talk but do not be forceful or intrusive. You may not need to directly ask someone if abuse is occurring and directly intervene, but if you feel there is a possibility that abuse is occurring, even if there are no obvious signs of abuse, you can bring your concerns to a supervisor or a social worker.