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Domestic Violence Against Women: A Literature

Review
Amanda J. Grovert
Pacific University

Recommended Citation
Grovert, Amanda J. (2008). Domestic Violence Against Women: A Literature Review (Master's thesis, Pacific University). Retrieved
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Domestic Violence Against Women: A Literature Review
Abstract
This literature review of research in the past 30 years on domestic violence against women focuses on the cycle
of violence within abusive relationships, why women so frequently stay in abusive relationships, ' and what is
the most helpful in allowing them to leave. Following the review of the literature is a discussion section in
which I examine the usefulness of qualitative research approaches in studying this topic; as well as areas which
need further research, such as women in rural and immigrant populations identifying resources and support in
order to leave abusive relationships and determining which community resources are most useful to women
who are coping with domestic violence situations.

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DOIvrESTIC VIOLENCE AGAINST WO:MEN: A LITERATURE REVIEW

A THESIS

SUBMITTED TO THE FACULTY

OF

SCHOOL OF PROFESSIONAL PSYCHOLOGY

PACIFIC UNIVERSITY

HILLSBORO, OREGON

BY

AMANDA J. GROVERT

IN PARTIAL FULFILLMENT OF THE)

REQUffiEMENTSFORTHEDEGREE

OF

MASTER OF SCIENCE IN CLINICAL PSYCHOLOGY .

JULY125~ 2008

APPROVED: ____~~_____________ ~

Daniel McKitrick, PhD

 Dedication

Toni, it feels like more than a coincidence that I finished this thesis on your birthday.

Knowing you has made writing this more than research to me. Thank you to your family

for allowing me to dedicate this to you to memoralize our friendship, and you. I wish I

could do more.

In loving memory of Antoinette "Toni" Clark. July 14, 1985 - February 17,2008.

ii

- - - - - - - - - - - - - - - - - - - - - - - --------
 ABSTRACT

This literature review of research in the past 30 years on domestic violence

against women focuses on the cycle of violence within abusive relationships, why women

so frequently stay in abusive relationships, 'and what is the most helpful in allowing them

to leave. Following the review of the liter'ature is a discussion sectiori in which I examine

the usefulness of qualitative I~search approaches in studying this t6pic; as well as :~eas

which need further Iesearch, such as women in rural and immigrant popUlations; ?]ii~:~ .

identifying
.
resources and support in order to leave abusive relationships';:and
.
':...dei_l,Iihg
. '.,t; .

which community resources are most useful to women who are coping with dornt::::;ni;;;.

violence situations.

iii

L _ __ _ _ .
 Introduction

Definition

Every year in America, between 1.5 and 3.6 million wonieri are raped or

physically,~ssa,ulted by an intimate partner. With mUltiple assaults perindividual, this ,

adds up to approximately 4 to6 rrrillion intimate ,partner ph)isical and sexual as-saults

every year - and there are many more th~t go,unreported:(Tjad~n & Thoennes, 20gW~
! ~;!;:: ' ' ,' , ,

Matthews, 2004). ':l~f

. . .. ;j ...•
, . S~

For the purposes of this paper, domestic violence is defined as rape,p:gy~ic.,M~;~

A,,,'

assault and stalking perpetuated by current and former dates, spouses 'and cOhabi~g~~r '

p'artners (Tjaden & Thoennes, 2000). This definition can include both sarlle- and

"! opPQsit~-sex couples;' however for the purposes of this review I will fOC\lJs qnly. OIl ",
I~' .

. ,

', oppesite-sex couples~ as'. domestic

.
'vIolence in ,same-sex couples has i~S~,~)~:t?Jf'Q.iql,\f~~~~,. ;", "
. , . , " ~; , , ' . - ".

com.plexities'and attributes;,\yort~y of f'Ulthyptudy (McClle: 2008).~Werstudiesand '.' )'~:j;'t'

tevieWsinclude a broader definition of domestic violence, one that encornp~,sses - .".':

'j'i '
" " psych616gicaland emo~ionalabuse as,well. In tru.:~paper, Iwill focus main!~\i)fl physical
. . . " , ' ,:'j~: ,

I ,. violer..ce, due; to ,the faGtthat :psychological ande:rnotional abuse tend to be'f~~derreported

" , ,~~

a.nd are 'studied less frequent~y than physicai abuse(Kosset aI., 1994; MatthefNS, 2004).

,"" , 'However, nearly all physically abusive relationships include an element Qf emoti'onal and ,
• ; . v ' . • ' . ",' •• • • • .'

. '

psychological, abuse (Weiss, 2000), ther~fore makiIlg it difficult to separate out the

different c9~pon'ents.

-, .- ---- - " ' .. ' --- - --- ---------------------~ ----------

------------ - - - - - - - - - - - -
 Men are frequently victims of domestic violence - anywhere from 80,000 to

800,000 men rep on being physically or sexually ·assaulted.byan intimate partner every

year (Tjaden & Thoennes, 2000; US Census Bureau, 2007). However, for the purposes of

this review; only data from domestic violence against women will be examined. While it

is certainly a worthwhile and much needed endeavor to examine domestic violence as

pertaining to men, it is beyond the scope of this paper to do so. There is much more

research available on domestic violence perpetrated against women, although more is

coming out on domestic violence against men (Turner, 2002; Tjaden and Thonnes, 2000).

Abused men also have a different experience than abused women, in that they stl,iuggle

less with being controlled and being isolated, but more with stigma and discrim!,p ation

(Matthews, 2004; McCue, 2008). Due to these differences and for simplicity's sake; iiI'

this review I will refer to perpetrators of domestic violence as male and the victims; as

female, with the understanding that both sexes commit and experience domestic violence.

Rationale for Review "

In 2001, domestic violence made up twenty percent of all nonfataL violence

against adult women - around 600,000 crimes. In 2000, about 1200 wom~~ were killed

by an intimate partner. This number made up about 33 percent of female murder victims

. (Matthews, 2004).

Among adult African-American women (aged 15-59), assault by an intimate

partner is the leading cause of premature death (US Department of Justice, 1998). Among

Native American and Alaska Native communities, 19% of female homicide victims were

- ... --- - -- -- --. --------~

killed by family members (Matthews, 2004). Among Asian Americans, there was a 300%

increase between 1995 and 1999 in the number of individuals provided with services by

the Asian Task Force Against Domestic Violence (Matthews, 2004). In Latino culture,

34% of Latinas reported experiencing domestic violence in either their country of origin

or in the United States. Clearly, domestic violence is prevalent across subcultures in the

U.S. It is also important to note that domestic violence rates are five times higher among

families below poverty levels, and also twice as likely to be committed by unemployed

men than by men who are working full time (Matthews, 2004, US Department of Justice,

1998). However, without controlling for socio-economic status, domestic violence occurs

equally in urban, suburban, and rural areas (McCue, 2008).

In terms of lost productivity, women who are currently involved in or have

recently left a violent relationship are 33% less likely than those in nonviolent

relationships to maintain stable employment (Wettersten, et.al., 2004). Estimated medical

expenses from domestic violence range from $3 to $5 billion annually. This does not

include the $100 million lost by businesses from sick leave, lost ~~ges, non-productivity

and absenteeism due to domestic violence (Matthews, 2004).

Because of the widespread prevalence across cultures, subcultures;: 'and socio-

economic status, effect on the economy, and severity of the crimes, the intricacies of

domestic violence and violent relationships must be better understood by mental health

professionals in order to provide more helpful and relevant services, and improve access

to those services, for those who seek them. Since around 1980, more and more people are

becoming aware of domestic violence, more literature is being published, and some of the

common myths are being dispelled (McCue, 2008; Matthews, 2004). The last decade in

~~~~- --~------~--------------~--- -~~~~~-~--------~~~

 particular has seen a surge of newfound awareness and PJogr1tPls·Jor domestic violence.

, Theirnplications pf"Jhis research and:'the logical next steps must be integrated and

discussed in order to provide the best possible treatments, services, assessments and

preventionsior
.
victims of. domestic
,-
violence.
~ ,' "

, Literature Review

Procedure and Outline

Th,is literature.review will cover book ch~pters, books,andarticles,primalhY from

"
, " ' . ~,

1979 to the present. There hasbeenlittle 'resear:ch on domestic

,
vioienctl, Gon:g.tl~ti~:~I>i;ior
, , ~

, ' . ~ . ' '. ,." ';'.,': .' ji!;i

'to the fuid-1980's, although occ~sionany at} earlie,i articiewilLbe in6hided'tQ;;p&':vtE1:€!La.'

histodcal perspective: The articles utilized were found on the PsycIrifo, Psyc]3o(}M!ii; ,

I.exisN:exis, 'Criminal JJlstice :Periqdic~ls, ~nd Contemporary Women i,E! Issu~s ~18:f~!i[;1ases

using the keywords "domestic vi01ence'~ "family violence" ,and "irttintat¢ par:tner..;;<;. , '!.,
. '!; . ', . "
'-_ , ."

-'" 1::

,', violenc6:" rfhese tennl~ are used,interchangeably in the literature,_:fJsousedis the more ~' -*;jii.
. ., :', -',!o,
.~ -::

! ~ '. " ', .' outdated ternl of "wife beating." for the saJ<e. of simplicity, the te/:m dome§tic
, ' :':'
violence
.. ' .. ' . . . . . . . ... ", . ' .rM
,"
" . , ~. " " ~, , will be used throtlghoilt this :tevi~w . F'urfhenno:J,\@;most domestic vi()lenc~dvocates
.". ..' ' . ,. ' "..'. :' .. ', ~i~:
,"' prefer
.
to ,use. the terntlifamily
" : .
viof¢:nce.
' .
irl'reteren;ce to situations in which ~ldren
' . ' ·;:'i.:'
or
. .: . ~f~.:··;·
, . , ." 'eldel:s are:being:abused instead
, .
ofl)riri
.
addi,tibn to romantic partners
.
(RepJ:W,cci,
" . Woolard
&'Fried"i999). Ad~:Htional stati~tics',wereobtained from St~tisiicalAbstr~cts of the
United States;. 2007anothe United States Dep(,lnment of Justice;. TextbOc)KS 'andbook

chapters wery also used to provide definiti6rts of key terms.

4
 This literature review will be divided into three sub-sections. In the first sub-

section I will discuss the cycle of violence that occurs within the relationship. Violent

relationships tend to follow a cyclical pattern, containing "honeymoon," tension building,

and serious battering phases, then repeating (Matthews, 2004).

In the second sub-section I will discuss the tendency of many abused partners to

stay in and return to the abusive relationship, and possible reasons why that might be.

The most often cited reason is economic dependency (Matthews, 2004; Wettersten, et aI,

2004; Repucci, Woolard & Fried, 1999; Rothman et al., 2007; Bomstein, 2006) ..Other

reasons have been the presence of children, threats made upon leaving or upon bfoaching

the subject of leaving, and a lack of resources to tum to, such as shelters, couns~ling, or

legal services (Suilivap. et al., 1994; Matthews,2004; Weiss, 2000).

In the third sub-section I will discuss what motivates or allows abused parf.ners to

1ea"e abusive relationships permanently, and what protective factors· are available to help

them remain independent. There are resources available such as shelters and non-profit

organizations, as welJ:i:ls the legal system, social workers, religiou~ or spiritual

cOrnInunities, arid law enforcement. The efficacy and availability of these resources will

also be discussed.

Following this literature review will be a discussion section in which the research

will be integrated, highlighting themes and major issues, and directions for clinical

application and for future research will be presented.

5
 Cycle of Violence

Abusive relationships tend to follow a cyclical pattern (Matthews, 2004, Walker,

1979, Weiss, 2000). The changes between the various stages presented are subtle, and

vary depending on the relationship and the nature of the abuse.

In the beginning phase of the abusive relationship, some type of abuse occurs.

This can be physical, sexual, or emotional, however, most often it is subtle and in the

form of verbal insults or accusations (Walker, 1979; Weiss, 2000). Sometimes, though,

the initial incident is physical. After the first episode of physical abuse, an abuse;rmay

not have to beat his partner to gain or maintain control. The threat of violence rp.,ay.be

enough, because his partner knows he is capable of following through on his threats

, (Salber and Taliaferro, 1995).

,
Following this initial incident there is a tension building phase (Walker, 1979;

Matthews, 2004). The abuse continues in this phase, and while it might be physical, it

continues to be more subtle. Weiss (2000) describes a woman who was boiling a pot of

soup when her husband walked by and knocked her forward with his elbow, causing her

to fall forward, burning her hand severely in the boiling liquid. Later on, he denied being

in the kitchen at all. In this second phase, the abused partner may feel the need to keep

the abuser calm, and she may feel as if she is constantly "walking on eggshells" (Weiss,

2000, Walker, 1979). She may also feel that she is at fault for the abuse, and begin to

believe that if she were only a "better partner" the abuse would stop. For example, the

abused woman may start to imagine ifshe dressed differently, was a better cook, or was

6
more agreeable her partner would treat her better (Weiss, 2000; Salber and Taliaferro,

1995; McCue, 2008).

Building an abusive relationship takes time - if the abuse started occurring on the

first date, far fewer women would stay in the relationships as long as they do. Survivors

of domestic violence describe a "brainwas1,1ing" that occurs, which is difficult to quantify

in empirical studies. Weiss (2000) describes interviews with women in which they say

the tension-building phase happened so gradually they almost did not realize it. They

describe abusers who picked at their self-worth by making off-hand comments about their

food intake, or their merit as a wife or a girlfriend, most being careful to temper .t,hese

remarks by saying they were only looking out for their partner's well-being. Ev~ntual1y

the women begin to believe that their partners must be right in their critiques - after all,

he was only looking out for their best interests (Weiss, 2000).

The next stage is referred to as the explosion, and after the slow progression of the

tension building stag~ it may not come as a shock (Turner, 2002; Matthews, 2004). In this

stage; the abuse reaches a crescendo. Weiss (2000) reports storiesJ;f rom women whose

partners have attempted to push them from moving cars, brutally raped them, broken

their noses, deliberately twisted their legs after painful knee surgery, or otherwise hurt

them severely. One woman noted that, as severe as the beatings were, her partner always

made sure to leave bruises on her arms, legs, and torso rather than her face, so that the

marks could be hidden by clothing.

In the making-up stage, the abuser may apologize for the abuse. He may promise

that it will never happen again, or blame the abused partner for forcing him to hurt her

: (Walker, 1979). Other common themes in.this stage are the abuser claiming his victim is

7
exaggerating the abuse, or everi claiming that it never happened, as in the case of the man

who pushed his wife toward the boiling soup.

Often in this stage, the abusers apologize profusely and swear that they will

change (Weiss, 2000; Walker, 1979). The abused partner, whether or not she believes this

claim, may be so relieved that the abuse has stopped for the time being that she accepts

him saying he will change and stay with him. More possible reasons why abused women

stay,in violent relationships will be discussed in the next section.

Finally comes the calm, or honeymoon stage (Matthews, 2004; Weiss, 2000;

Walker, 1979). In this stage, the abused partner may begin 'to hope that her partner really

meant it when he said it would never happen again. The abuser may give gifts tp his

partner, and treat her kindly for a period ranging anywhere from a few days to severaf

months (Matthews, 2004; Weiss, 2000). Inevitably, the situation will again decline-into

tension building, explosion, and so on.

The specifics of these stages are as unique as the women that live them. As such,

there are few academic studies examining what specifically these$tages look like. The

details come from the voices of the women who have lived these stories, and survived

them.

Some women report their relationships being wonderful until they got married, at

which point the tension began building, sometimes slowly, sometimes quickly (Weiss,

2000). In the early stages of the relationship, many women report this tension building

stage as their partner's efforts to gain control over their lives (Matthews, 2004; Bornstein,

2006). The abusers will attempt to isolate their partners from their family, friends, and

careers (Sullivan et al., 2004; Bowker, 1983). One womari reported that her husband did

8
not tell her parents when she gave birth to their first grandchild, although he told his wife

he had and that they did not care enough to visit. He continued to create situations like

this throughout their marriage, effectively separating her from her family. Another

woman reported that her husband told her landlord and a social worker who lived nearby

that his wife was addicted to alcohol and painkillers, which meant they did not think as

much of it when they heard yelling coming from the apartment 0Neiss, 2000).
In the early stages of an abusive relationship, the escalating tension can be

implied rather than overt violence. The abusive partner may hit, kick; or break fu,miture

or other inanimate objects, while the abused partner watches. Displays of violenge such

as this are prophetic - the woman watching knows that even though the violenc.~. is

directed at a piece of furniture this time, it may be her next time (Salber & Taliaferro,

1995; Matthews, 2004; Tjaden & Thoennes, 2001). The abuser may also threaten or harm

the family pets as well (Weiss, 2000).

In some relationships, the tension building stage does not appear to be present at

all. Weiss (2000) describes a woman whose husband would physiCally abuse her

seemingly out of the blue. In the course of his apologies, he would also twist the incident

around until she believed it was somehow her fault, subtly conveying that ,s he had pushed

his buttons until he had no choice but to explode. This woman described her situation as

follows:

The first time there is violence, Andrea reflects, we don't believe it. Next, we
explain it away. Then we do whatever we c;:an to cope. With no prior experience
of abuse, no way to make sense of what was happening to her, Andrea coped by
putting herself into a state of suspended animation. She still wentto work at the
hospital every day. She still wrote prescriptions and made careful notes in medical
charts .... But she felt nothing. She deliberately made herself numb. (p. 139)

9
 It is not uncommon for women, after leaving a violent relationship, to wonder

how they had believed they were somehow at fault for the abuse they endured. It is

important to note, however, that even if this tension building stage does not appear to be

present, it almost always is. It may come, as mentioned previously, in the form of

comments about appearance, cooking, temperament, or others, in the guise of "just trying

to help." The quotation above is an example of how one abused woman who was made to

believe the violence was her fault explained what was happening to her (Weiss , 2000).

In other situations, the tension building stage is more overt, but still subtl,e. It may

not involve the sort of physical violence mentioned earlier, directed at the woman, pets,

or inanimat~ objects (Weiss, 2000; McCue, 2008). Instead it can be more verbal; .

emotional, or covert. For example, the abuser may accuse his partner of having am affair,

which can serve as a means to later "punish" her (Matthews, 2004; Weiss, 2000) ..

Violent relationships can be broken down in this cyclical nature, but as the'

interviews from Weiss (2000) illustrate, no violent relationship is;ithe same as any other,

despite surface similarities. Each woman's relationship is unique, as are the reasons they

stay in them or return to them.

The reference by Weiss (2000), used frequently in this review, is pne of the only

references found that allows survivors of domesic violence to be heard in their own

words. As I stated above, it can be difficult to quantify the details of what happens in

violent relationships, particularly ilJ the stages leading up to the actual physical violence,

which is why books like Weiss' are so important. Weiss interviewed women who had

experienced domestic viplence and had escaped the relationship. After each interview she

10
provided her own thoughts on what had been said in light of her own experiences as a

survivor of domestic violence and in telIDS of the research she had done, consolidating

the interviews into themes, while allowing each woman a forum to tell her story. This

source is largely a discussion of anecdotal examples, but essential for getting the feeling

of what goes on in the minds of abused women, something that will be discussed further

later in this review.

Reasons to Stay

The review of the research yielded a myriad of reasons why abused wOIp.en stay

in abusive relationships, or return to them. The most pressing of these reasons was safety.

A woman who has been abused may fear retaliation from her abuser if she leaves,the

abusive environment or makes efforts to improve her situation (Turner, 2002). The abuser

in the situation may have made specific threats, stating that if the abused partner leaves,

he will hurt or kill her, her children, or himself (Matthews, 2004)~i Statistically, the most

dangerous time for a woman in an abusive relationship is just prior to leaving that

relationship (Turner, 2002; Salber & Taliaferro, 1995). In fact, women who are divorced

or separated are 14 times more likely to repOlt being the victim of violence by a spouse or

ex-spouse. Separated and divorced women make up 10 percent of American women, yet

they report 75 percent of intimate partner violence (US Department of Justice, 1998;

McCue, 2008). It is possible that women who are separated or divorced are more likely to

report violence from their partner, when in fact it could have occurred while they were

married as well. Regardless, these statistics speak to the danger that comes with leaving a

11
 violent relationship, and why some women may choose to stay and survive day to day

rather than make an escape (McCue, 2008).

Women who have limited support from friends, family, or their communities may

find it more difficult to leave abusive relationships (Sullivan et.al, 1994). Women who

have received help and support from family and friends report it as being very important

in allowing them to leave their abusers (Bowker, 1983). Support can come in both

tangible and intangible forms. Close friends and family can provide emotional support in

stressful times, which can help reduce the risk of falling ill due to great amounts pf stress

(Sullivan, et aI., 1994). These friends and family members can also provide safeplaces

for women and children to stay, store belongings, and be available to assist abu$ed

women in rebuilding their lives after leaving an abuser (Bowker, 1983). Women who 'do

not have that support face even greater obstacles than those who do.

Social isolation has been shown to be associated with domestic violence. Severely

abused women tend to be extremely socially isolated, and have no one in their limited

social network who can provide the types of support listed above.,(Levendosky, Bogat,

Theran, Trotter, von Eye, & Davidson, 2004). Additionally, women who are educated are

less likely than those who are notto return to an abusive partner. It was hypothesized that

higher education can contribute to the presence of social networks (Schutte, Malouff, &

Doyle, 1988).

In abusive relationships, the abuser will often slowly work to isolate the abused

partner socially by not allowing her to work,not allowing her to have a car, or not

allowing her to leave the home (Matthews, 2004). Abusers may also prevent their

,i, partners from maintaining relationships with friends and family, via phone, letters,

12

- - - -- - - - - -- - - - --- -_ ._ - -
Internet or community activities, such as church services, as a way of maintaining control

(Turner, 2002, Levendosky, et al., 2004). This may explain part of the correlation

between lack of social support and severe abuse. This also limits the woman's access to

all resources, both practical and social, which makes her less likely to eventually leave

the abusive partner.

Among communities made up of primarily of immigrants, the component of

social isolation is intensified. In many situations a woman's greatest barrier to getting

help is the inability to speak or understand English (McCue, 2008; Matthews, 2004).

Female immigrants tend to have a poorer command of English than do their husb.ands or

children, since children can learn English in school, and the men may need to h~ye a

rudimentary command of the language in order to get a job (McCue, 2008). ThIs .

language barrier can mean that an abused immigrant woman does not know her legal

options or rights, and can also mean that if she does manage to call someone for help,

there is a chance that no one will be able to understand her.

The social isolation component can also be intensified fOI;,,;women living in rural

areas. There is a belief that domestic violence occurs more often in urban areas than rural,

and the reason for this is that violence among rural women is vastly unde~Teported. There

are fewer resources, such as shelters and social service programs, availabl~. Access to

everyday resources can be limited too: there may be fewer job opportunities, quality child

care, housing opportunities and health care, and access to what resources are available

can be confounded by distance or poor roads. Responses to domestic violence by law

enforcement and medical services can be slow or inadequate (McCue, 2008). Most

women experiencing domestic violence deal with isolation across all areas, but for

13

- - -- ---- ---- - -- -- - -- - -- - ._-- - -- - -- -- --

 women in rural areas being isolated geographically makes it even worse. They may not

have neighbors for miles, which means there is no chance of a neighbor or passerby

suspecting trouble and calling for help. It may be more difficult for a rural abused woman

to reach safety, be that a shelter or the home of a friend or family member. McCue (2008)

specifically mentions Native American women as potentially lacking phone service or

access to any sort of transportation. For example, in many areas of the Navajo Nation,

located in the Four Comers region of the United States, there is no cell phone service. A

woman isolated by domestic violence, then, can be further isolated by geographY1.lack of

resources, and lack of communication with people outside her household (McCu~, 2008).

Shame or guilt about abuse may represent another reason abused wome~ ·do not

have adequate social support, and thus may indirectly influence their inability to leave

their abusers (Levendosky, et aI., 2004). This shame may come from a lack of public

awareness about the causes and effects of domestic violence (Matthews, 2004, Tumer,

2002, Sullivan, 1994). For example, around half of abused women seek help from their

. religious leader (Gordon, 1996). However, members of the clerRwmay also know the

abuser in the relationship, and may be sympathetic to him. Additionally, clergy may be

committed to maintaining a marriage, even an abusive one, and advise the' women against

leaving their abusive partners. About 15% of women who confided in their religious

leader reported it to be helpful (Gordon, 1996).

Some women are raised to believe that their husbands or male partners are in

charge, and so are hesitant to report abuse (Weiss, 2000; Matthews, 2004). A woman's

abuser may also be her main source of affection when he is not being abusive, which is

particularly dangerous when she is socially isolated (Salber & Taliaferro, 1995). Many

14

- - -- - - ... _-_.....- - - -_ ... - ._--

women interviewed in Weiss (2000) mentioned growing up in a household where divorce

was not only frowned upon, it was absolutely not an option. These particular women

tended to be the ones who mentioned the belief that they were the ones at fault for their

partners' abuse, believing that if they were better wives to them, the abuse would stop.

Immigrant women face unique challenges in this realm as well. They may experience

extreme pressure to remain silent for fear of the family "losing face" in the community.

Reporting domestic violence has the potential to cut the abused woman off from her

community completely (McCue, 2008).

Abusive partners may also use a woman's children to coerce her into stay,ing in

the relationship. The abusive prutner may threaten to harm the children, take the.m.away,

or physically hurt the children in front of their mother in order to maintain control of the

her (Salber & Taliaferro, 1995).

A 1992 study reported that half of the pruticipants in their sample of abused

women were dissatisfied with the police response to their assailants (Sullivan,Basta, Tan,

& Davidson, 1992). The criminal justice system (defined as law. enforcement officers,

lawyers, and judges) is used more often by abused women than any other community

service (Gordon, 1996). However, police officers were as frequently unhelpful as they

were helpful (Sullivan, et aI., 1992; Hamilton & Coates, 1993). Police reportedly would

frequently question the abused partner's story, criticize her for staying in the relationship,

or fail to inform her of other agencies that may help her (Hamilton & Coates, 1993). It

has also been reported that police presence has caused violence to increase (Sullivan et

aI., 1992; Gordon, 1996).

15
 Economic reasons were the most often reported for why women stay in abusive

relationships. If a woman is cut off socially and not allowed to work, her partner may be

her only means of financial support (Matthews, 2004; Salber & Taliaferro, 1995). Rural

women were mentioned above as facing unique challenges in accessing resources and

leaving their abusers. In terms of economic reasons for staying in abusive relationships,

rural farm families are often one-income families, most or all of their income coming

from the farm. A woman whose family finances are tied up in land and equipment may

face the choice of staying in an abusive relationship or leaving with no means of income

- or leaving her partner with no means ofincome, since she may be a key part of;the

farming business. She may also have strong emotional ties to the farm animals!;md land,

and fear that the animals may be neglected or harmed in some way if she leaves them

(McCue, 2008; Salber & Taliaferro, 1995). Additionally, restraining orders against

abusers are less viable for women living on rural farms because the abusive prutners

.cannot be kept away from the family farm if it is their only source of income (McCue,

2008):

A 1981 study found that when an abused woman leaves her abuser, there is a 50%

chance her standard of living will drop below the poverty line. The women who were

most likely to return to the abusive relationship were those who had been. married the

longest or had fewer skills or less work expedence than those who were less likely to

return home (Martin, 1981).

Bornstein (2006) descdbes economic dependency as "the degree to which one

person relies on another for financial support, and is used to describe situations in which

one member of a dyad has exclusive ... control over financial resources" (p. 598).

16
Economic dependency can occur if one person is the sole provider in the family and

denies his partner access to resources, but also when one person ust\\s threat or

intimidation to take control of finances. Women receiving welfare or in low-income

occupations are significantly less likely than other women to terminate abusive

relationships (Woffordt et al., 1994). Economic dependency can also be influenced by the

presence of children, availability of alternate housing, and access to financial resources

beyond job income (Bornste~n, 2006). Additionally, anywhere from 37% to 96% of

women in abusive relationships have reported being impacted at work as a result .of the

abuse (Wettersten et al., 2004). They have a hard time keeping ajob or getting r

promotions, may miss work due to abuse related hospital visits, or may not be aHo.w ed to

work by their abusers.

Bomstein (2006) points out that it is important to realize that links between

economic dependency and abuse are bi-directional. High economic dependency may lead

some women to tolerate physical abuse, but repeated abuse may lead to economic'

dependence. Women in violent relationships who do work may have trouble

concentrating, be harassed at work by an abusive partner, and have low self-efficacy due

to abuse. The abuse can affect work performance to the point where they may lose their

jobs, Contributing to their economic dependency on their partners (Wettersten et al.,

2004).

One final, somewhat controversial, reason women may stay in violent

relationships is the theory of learned helplessness. This theory is controversial because

some researchers feel it takes a stance of "blaming the victim," (Walker, 1989, McCue,

2008), and implying she .should be abk to somehow control what is happening to her.

17
Walker points out, though, that learned helplessness is not Pfissivity, but rather a

sophisticated set of coping skills (Walker, 1989; McCue, 2008). Abused women may use

defense mechanisms to cope with what is happening in their relationships, such as

minimizing, dissociation, and denial (Walker, 1989).

Every woman who stays in a violent relationship will have her own reasons to do

so. Her abuser could have made threats to her or her children, she could be facing poverty

if she left, she may have been out of the workforce for years and lack skills and

experience necessary to obtain employment, she may be a rural woman with few

resources, or a recent immigrant dealing with a language barrier. She may have ~~eached

out to police or clergy in the past and found them to not be helpful. She may beJocused

on surviving day to day instead of focusing on escape. She may feel ashamed of;wnat she

has endured, or guilty for leaving her partner. Whatever the specific reasons, ther.e is no

universal answer for why women stay in abusive relationships, it may well be fo:p"

multiple reasons, and it is much more complicated that "just leaving."

Motivations to Leave, Protective Factors and Community Resources

The specific reasons individual women give for why they eventually leave their

abusive prutners are as diverse and numerous as the women who give them. Everyone of

them can be summed up in one quotation: " There was no other choice." .

Since the early 1990's, research on preventive interventions for domestic violence

has increased (Repucci, et aI., 1999). As has been demonstrated thus far in this review,

18
 domestic violence is extremely complex, and no single strategy or intervention is going to

eradicate it.

Some of the more effective strategies are interventions for children who have

witnessed abuse. Although this review has focused on female, adult victims of domestic

violence, children experience this violence as well, through actually witnessing the abuse,

hearing but not seeing it, being injured in the "cross-fire" of violence, and being

manipulated by the abuser (Faller, 2003). Around half of children who are exposed in

some way to domestic violence display emotional and behavioral problems, such as

cognitive deficits, post-traumatic stress disorder, and depression (Kot & TyndalbLind,

2005; Faller, 2003). In addition to these; children who have witnessed domestic 'Violence

are more likely to either be the victim or perpetrator of violence in adult relationsfiips

(Faller, 2003; Osofsky, 2003). There are certain protective factors that help lower'these

risks, such as a stable relationship with an adult. This can be a complicated process for

children exposed to violent relationships between one or both of their parents, but

children may have opportunities to receive support from relativesj friends, or even a

sensitive police officer (Osofsky, 2003). Further education of mental health professionals,

educators, law enforcement officers, and others who may come into contact with children

affected by domestic violence will be helpful in recognizing and stopping the ripple .
/ .

effect that so often occurs, and providing support to children when they need it the most

(Faller, 2003; Osofsky, 2003). Kot and Tyndall-Lind (2005) outline an empirically

supported play therapy for child witnesses of domestic violence that emphasizes a

corrective therapeutic relationship based on trust, safety and mutual respect. There is at

it.
this point little research on preventative measures outside of childhood.

19
 At that point, then, it is necessary for reactive resources, which are the resources

most commonly used in response to abuse. The resources abused women most often tum

to are the legal system, mental health professionals, support groups, and shelters.

In 1994, Sullivan recruited women in domestic violence shelters, and randomly

assigned half of the 141 participants to receive the free services of an advocate for the

first 10 weeks following their shelter stay. Sullivan's study was the first to examine the

effects of providing women access to an advocate - prior to this study, most research on

domestic violence had focused on prevalence and factors keeping women in abusive

relati onshi ps.

As I explained earlier in this review, many abused women lack community

resources that would make escaping abusive relationships possible, such as affordable

housing, employment, child care, legal assistance, and social support. The purpose.of the

advocate is to assist victims with accessing these resources. Advocates are a part of most

domestic violence shelter staffs. Sullivan found that a 6-months post-shelter stay, two

thirds of the women were no longer involved with their abusive p;mners, and there were

no differences between the experimental and control groups on this factor. Women who

had worked with advocates reported greater effectiveness in obtaining desired resources,

increased social support, and higher quality of life compared to women in the control

group, although both groups tended to regress toward the mean by the 6 month follow up,

displaying fewer differences than at the lO-week follow up.

Sullivan had a good retention rate for his study - 95% of his original sample was

interviewed at 10 weeks post-intervention, and 93% were interviewed at the 6-month

follow up. Sullivan's study also showed a wide range of diversity within the sample. Of

20
the participants, 45% were Caucasian, 43% were African-American, 8% were Latina, anci

1% were Asian American. At least 78% had one child living with them. At least 60%

lived below the federal poverty line, 82% were unemployed, and 81 % were receiving

some type of government assistance.

Sullivan's sample is representative of many of the women who stay in shelters

(Gordon, 1996; Levendosky et aI., 2004). They tend to be unemployed, many rely on

their partners for financial support, many live below the poverty line. Women who stay at

least one night in a domestic violence shelter, on average, seek help six times from other

community resources, such as the police, mental health professionals, or the cleJ;gy,

before enteting the shelter (Gordon, 1996). These women who come to the shelter after

several unsuccessful attempts to get help elsewhere are likely the ones who are,socially

isolated, who do not have easy access to family, friends, or co-workers, or who may have

a language barrier preventing them from seeking help. For example, women who are

employed outside the home are more likely to contact the police or other social services

than women who do not (Gordon, 1996; McCue, ,2008; Turner, 2(02).

At the beginning of this section I said women who were able to permanently leave

their abusive partners did so because there was no other choice. Weiss (2000), a domestic

violence survivor herself, interviewed women who had been victims of domestic violence

who were able to escape. Her book allowed women to explain their experiences in their

own words, giving voice to the women behind the statistics.

Many times, Weiss said, the actual thing that pushes a woman to leave her

abusive partner is a last straw, that may seem minor. One woman, while out with her

husband, reported that a passerby heard an exchange between the couple and called the

21
abusive partner a rude name. The woman left her husband later that week. Some do not

leave so quickly. They spend months or years planning their escape until that last straw,

the one that leads them to say they have no other choice.

Many women report that it was when they became pregnant that they found the

courage to leave. They realized that their partners were not just hurting them anymore,

they were hurting a child too. Some women leave once their baby is born, when the child

becomes a player in the abuse. One woman reported leaving after her partner calmly

threatened their baby daughter with a shotgun.

Another woman decided to leave her husband during a Passover Seder, w,-hen her

family was recounting their people's escape from slavery. Making the connectiollto her

own situation, she resolved that night she would no longer be controlled by anyone:. Yet

another resolved to leave after waking up from a coma that her paltner had put berino

Abuse, Weiss states, is not about anger, but about power and control. This is why

statistically, the most danger to an abused woman comes in the 6 months after leaving her

abuser, because by doing so she sends a clear message saying be uo longer controls her

(Weiss, 2000; McCue, 2008;,Turner, 2002).

Discussion

In this discussion section I will integrate the information presented in the

literature review into coherent main points. As I have discussed above, no two woman

experience the same pattern of domestic violence, meaning that research using qualitative

interviews is imperative to truly understanding the nature of violent relationships.

22
 Second, much of the research in domestic violence has examined women who live in

urban areas, who are employed. However, domestic violence occurs equally among urban

and rural women, many of whom are not employed outside the home (McCue, 2008).

Therefore it is important to begin researching domestic violence in these rural

populations in order to provide necessary services. Women who have recently

immigrated are another group that has been neglected in the research. Third, preliminary

researchers have begun to look at the types of resources that are useful in helping women

leave abusive relationships (Sullivan et al., 1992). The time has come to expand upon this

research so that the legal system, mental health professionals, medical professionals, and

advocacy services are prepared to offer assistance and support to allow woman to leave

abusive relationships. Finally I will discuss the importance of examining which ofthese

community resources are most effective and why .

. Resarch Using Qualitative Interviews

Only one book dealing exclusively with qualitative interviews (Weiss, 2000) was

found in the course of the literature review. Facts, figures, percentages, and ratios are

important in understanding the scope of the problem. Scholarly articles are essential in

examining the broader patterns of domestic violence, such as the general cycle of

relationships, resources that the majority of women find helpful, and so on. In order to

have the greatest chance of understanding what a woman in a violent relationship is going

through, though, the voices of those women must be heard. For example, Weiss presents

information from her interviews about the tension building phase of a relationship. This

23
information is difficult to quantify, as the tension building phase can be anything from

calculated put-downs to explicit verbal threats, damaging furniture to social isolation.

Many of the women interviewed in Weiss' book described a "brainwashing" that occurs

in the initial phases of a violent relationship, which is also difficult to describe in

numbers. These individual stories are the details that are lost in quantitative research,

especially in a topic with as many nuances as domestic violence.

It is easy to become desensitized to numbers so big they seem unreal, such as the

4 to 6 million assaults by intimate partners every year (Tjaden & Thoennes, 2000). It is

not so easy to ignore the compelling voices of the women themselves, and know\that for

everyone who escaped and is able to tell her story, countless others are not. One) third of

female murder victims are killed by an intimate partner (Matthews, 2004). This amounts

to around 1200 women every year (Tjaden & Thoennes, 2000).

There were a few articles like the one by Rothman, Hathaway, Stidsen and.de

Vries (2007), which dealt in structured qualitative interviews. The focus in these articles

was on women's employment and dependency. This research allows for some of the

detail provided in Weiss' (2000) book, but also draws more decisive conclusions than

Weiss is able to, which is a positive step. Rothman and colleagues studied how

employment helps victims of domestic violence. The study was qualitative, and

conducted among employees at an urban hospital over a period of several months. The

sample size was small, 21 women who had recently been physically abused by their

cunent or most recent partner, but yielded some interesting results. Rothman et al. found

that employment helped victims of domestic violence by improving their finances,

promoting physical safety, increasing self-esteem, improving social connectedness,

24

-- - - -- - - --
providing mental respite, and providing motivation. These results are fairly typical of

what one would expect from reviewing the literature, Social isolation is often a huge

component of what causes women to stay so long in violent relationships (Sullivan et al.,
,

1994; Bowker, 1983; Levendosky et al., 2004). Working would relieve that isolation,

and also provide a safe place, particularly in a large workplace setting like the hospital

from which Rothman et al. drew their sample. Most of the women in the Rothman et aI.

sample also had at least some higher education, which has been shown to make women

less likely to return to an' abusive partner (Schutte, Malouff & Doyle, 1988). The benefits

of employment for victims of domestic violence are almost common sense, although

studies like that of Rothman et al. and others are helpful in concretely showing,the link.

The Rothman et al. (2007) article is one of many that examine the way '

employment helps victims of domestic violence. Bomstein (2006) did a literature review

examining the relationship between dependency and domestic violence, Bomstein's

review is useful in that it takes a relatively small area of the complex issue of domestic

violence, that of dependency, and looks in depth at different facets of it. Bomstein uses

studies with three general assessment strategies: self-report scales, structured interviews,

and classification via category membership, such as .enrollment in a treatment program

for abusers or use of emergency medical services. These three assessment strategies are

primarily what are used throughout the literature on domestic violence, with the

exception of the occasional unstructured interview, like Weiss' (2000) interviews.

Bomstein concluded that women's economic dependency is a significant risk factor in

potential abuse, and that emotional dependency, while a risk factor, is less significant.

25
Bomstein found that Depressive Personality Disorder symptoms playa role in abused

women's emotional dependency, but not in abusive men.

Wettersten and colleagues (2004) looked at the impact of employment on women

currently residing in a domestic violence shelter. Like Rothman et al. (2007), Wettersten

et al. used a structured qualitative interview. Wettersten et al. found similar benefits as

Rothman et al. to being employed, but also noted the impact of violent relationships on

women's work performance, discussing how frequent domestic violence related absences

led to lost work oppOltunities and how the women interviewed tended to have difficulty

concentrating. As I said about the Rothman et al. study, it is beneficial to have ,

statistically significant results like this, but the results again are somewhat cOlIll;Ilon

sense. It makes sense that a women living in a violent household would have trouble

concentrating on her work, or that she would frequently miss work. The qualitative

research done in this domain of women's employment and dependency by Wettersten et

al., Rothman et al., Bomstein (2006) and others is certainly important groundwork. The

time has now come to "examine different domains of domestic violence, which may be

harder to look at as conclusively.

Rural Women and Recent Immigrants

One author, and only one author, reviewed in this research talked at length

regarding the unique challenges faced by women attempting to leave violent relationships

who are recent immigrants or who live in a rural setting, although others mentioned this

topic briefly or cited statistics. The research in this book (McCue, 2008) is presented in

26
this review. A closer look, however, at rural and immigrant populations is certainly

needed before any broader conclusions can be drawn regarding these women. For

example, much research has focused on links between employment and domestic

violence. McCue points out that women in rural farming communities will most often

work on the family farm, meaning that although they may get the sense of purpose or

mental respite gained by women employed outside the home (Rothman et aI., 2007), they

will not have the additional benefits of increased social support, increased safety, and

financial gain, since any earnings would be put back into the family farm.

Many perpetrators of domestic violence, as a means of control, will not allow

their partners to work outside the home at all (Matthews, 2004; Turner, 2002;

Levendosky et aI., 2004). If this is the case, and it frequently is, it will not matt~r how

many benefits there are to employment. Add to this the lack of employment opportunities

in rural areas, and the social isolation that comes from geography alone, and it seems

. clear that women in rural areas have unique challenges that deserve further study in order .

to begin to provide more effective treatments. These population £\re harder to study,

though, which is likely a reason why research has been conducted so much on employed

women in urban settings - it is far simpler to firid participants at a large hospital of

16,000 employees, as Rothman et aI. (2007) did than it is in a small farming community

of 5,000, where domestic violence is underreported anyway (McCue, 2008).

The lack of research concerning domestic violence in immigrant populations is a

similar concern, and one that is also difficult to research. In many recent immigrant

populations, adult women have a poorer command of English than their husbands or

children (McCue, 2008). They may also face more shame or guilt in talking about abuse

27
to someone outside their culture, and may not understand their legal rights (McCue,

2008). However, recent immigrant women face challenges like those of rural women, and

are equally, if not more, overlooked. Rural and immigrant women are in need of services

to help escape domestic violence, as much as urban, English-speaking women, but with

the lack of research concerning their experiences and distinct needs, those services are

difficult to develop and make effective.

Resources for Abused Women

Few questions are asked more often of abused women than, "why didn't you just

leave?" (Weiss, 2000). There is a great deal of research to answer this question, as I have

discussed previously. There is a lack, however, of research surrounding how abused

partners find the resources and support to actually leave. Most of the research on

prevention in this area focuses around interventions with children, which are certainly a

worthwhile area of study, considering the ties between witnessing violence as children

and perpetrating or experiencing it as adults. There is almost no research .o n preventative

interventions for adults. Researchers have demonstrated some success using rape

education programs, showing post-intervention changes in rape (Repucci et al., 1999).

The same sort of changes may be possible for domestic violence. This is a worthwhile

direction for future research. Many colleges already educate incoming students on rape

myths and safe behavior (Repucci et al., 1999). Education surrounding domestic violence

could be incorporated into that as well.

28
 Sullivan (1994), as stated earlier, was the first to examine the effects' of providing

women access to an advocate after staying at a shelter. While it's true that the staff at

most shelters provide advocacy services during the shelter stay, few researchers since.

1994 have examined the efficacy of services either during or after shelter stay. Also,

although Sullivan's sample was representative of women who stay in shelters (Gordon,

1996; Levendosky et aI., 2004), he did not examine, at least overtly, immigrant

populations and n011-English speaking populations. It can be hypothesized that recent

irrrrnigrants, even working with an advocate, may not experience the same gains as the

other women in the study due to language and cultural banlers (McCue, 2008) . .

There is also little research on other community resources and responses to

domestic violence. Sullivan, after examining various social and community supports for

domestic violence survivors, concluded that advocacy services, shelter services, or police

interventions on their own will not significantly reduce the amount of domestic violence

a woman may experience. In fact, women already rate police interventions as particularly

ineffective in comparison with the other resources mentioned (Gordon, 1996). Instead, all

of these services must be part of a larger package designed to work with abused women

(Sullivan, 1994).

As I stated above, there is a great deal of qualitative research concerning issues

like the links between employment and domestic violence (Rothman, et aI., 1997;

Bomstein, 2006; Levendosky, et aI., 2004; Wettersten, et al., 2004). There are books like

Weiss' (2000) collection of interviews, which are invaluable. Research like Sullivan's

1994 study on advocacy intervention is a step in the right direction in terms of providing

more detailed insight to help prevent and treat domestic violence. Gordon (1996)

29

- _._- -- -- - - -- - - -- - - -- - -_ . _ - -- - -
conducted a meta-analysis of 12 studies examining perceived usefulness of services most

frequently utilized by abused women. The studies making up the meta-analysis consisted

mostly questionnaires and structured interviews, allowing for a certain level of detail in

responses. Gordon's findings, that some of the most utilized resources, like the criminal

justice system or the clergy, were some of the lowest rated by abused women, are

startling. Gordon also points out that women in the 12 studies were ones who were not

under such strict control that they do not have the opportunity to respond to surveys,

which lends support to the point that there is an important population of women out there

that is not being heard.

Needfor Research on Resource Effectiveness

The next step, then, in the domestic violence research is an obvious one. More

research should be done on which community resources are effective or not, and why.

Salber and Taliaferro (1995) provide a reference guide for physicians on how to

recognize signs of domestic violence and what to do about it. This reference is useful,

first of all, in that it shows that the medical community is working to dispel myths

surrounding domestic violence, such as misconceptions about who it happens to and why

a woman who has been abused may not readily admit it to a physician. The Salber and

Taliaferro article is also useful for educating providers about broad concepts, and in fact

cites many of the same articles I have used here. Yet women seek help from community

providers an average of six times before coming to a shelter (Gordon, 1996). Why are

these resources not helping? Providers' lack of education in the intricacies of domestic

30
violence is an obvious answer, but examination cannot stop there. Women surveyed

reported that physicians, psychiatrists, psychologists, and in particular, social workers,

are helpful for all types of abuse (Gordon, 1996). This is a start, but it is not enough yet.

What will help people in the legal system, the education system, the mental health field,

gain the expertise needed to help women escape violent relationships without having to

seek services six times before going to a shelter? Finally, what can shelters do to further

assist the women that stay there? These are the questions facing the next group of

researchers, who have information about prevalence and what happens in violent

relationships, but not what helps end them. It is this research yet to come that wiUprovide

the treatments, services, assessments, and methods of prevention for the societal problem

of domestic violence.

31
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33