​ Delivering care, hope to victims of ‘intimate partner violence

As part of recognizing the recent National Domestic Violence Awareness Month, Kaiser Permanente South Sacramento emergency physician Dana Rygg, MD, addresses questions about “intimate partner violence” and what providers and staff are doing to support victims.

Q: What is domestic violence?

A: Domestic violence, in the context being discussed here, is a pattern of behavior in any past or present relationship that continues and is used to gain or maintain power and control over an intimate partner. The abuse can be actual or threatened and can take many forms such as physical, sexual, emotional, economic, or psychological.

“Intimate partner violence” or “IPV” is now the preferred term as it better describes the specific behavior between intimate partners, either past or present. The term “domestic violence,” however, suggests it occurs just within a household and could be between any two people within that household. For example, between a parent and child, siblings, or even roommates. That being said, “domestic violence” is still a common term in the community and is currently interchangeable with “intimate partner violence”.

Q: Who is most affected by it?

A: IPV can affect anyone. 1 in 4 women and nearly 1 in 10 men experience some form of IPV during their lifetime. It can occur among people of any gender identity or sexual orientation. It crosses all ethnicities and socioeconomic levels but does tend to occur more frequently when more socioeconomic stressors are present.

Q: Why do victims stay in an abusive relationship?

A: There are many reasons why a victim stays in an abusive relationship. They likely still love their partner and remain hopeful that the abuse will stop. The victim may be dependent on their abuser financially and not have the resources to leave. They may be isolated from family, friends, or other community support. It is also normal for victims to feel responsible for the abuse and, as a result, they feel shame and embarrassment.

Religious or spiritual reasons may also play a role in keeping a victim in the relationship, as well as family pressure. In many cases the abuser has made threats toward the partner, which may include taking the children or hurting someone they love. An abuser may also threaten to kill themselves or the victim if they leave. The most dangerous time for a victim is when they leave their relationship, taking away control from the abuser.

Q: What are the harmful effects of domestic violence?

A: Harmful effects of abuse include physical, emotional, and financial issues that not only impact the victim, but their family and dependents. The harmful effects are often passed on to future generations.

Women experiencing IPV are exceptionally high utilizers of health care due to increased rates of mental health conditions, chronic pain issues, recurrent infections of the genital or urinary tract, miscarriages, and substance abuse. They are 60% more likely to have asthma, 70% more likely to have heart disease, and 80% more likely to have a stroke.

The financial cost of IPV is $3.6 trillion annually, which includes lost income due to days off from work and exponentially higher medical costs.

Q: What should someone do if they are being abused?

A: First, it is important for one to realize it is not their fault and no one, under any circumstance, deserves to be treated in such a way. Leaving an abusive relationship can seem overwhelming and finding the confidence in oneself and the trust in those who want to help can take time.

Know that help is available. Reaching out to your medical provider is a confidential and safe way to get dialogue started. One can also speak with a counselor through their church or even their child’s school. Consider reaching out to family or friends who knew you before you were in the abusive relationship or call the National Domestic Violence Hotline at 1 (800) 799-SAFE (7233) for assistance. And start creating a safety plan to protect you and any children, pets, or other dependents affected.

Q: What should someone do if they know someone who is being abused?

A: Believe them! Many abusers are charming and charismatic and can hide their behavior from friends and family. If you suspect abuse, ask and express concern. Reassure the victim that the abuse is not their fault and let them know they do not deserve to be controlled, manipulated, or abused. Be supportive and listen. Ask them specifically how you can be help. Encourage them to talk to a therapist, seek help from a community agency that specializes in IPV, and encourage them to create a safety plan. Be patient because the person may not be ready to end the relationship; this is a personal choice and can be hard for others to understand.