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Health & Healthcare
April 19, 2008

Domestic Violence: Call for Primary Care Screening and Gender Issues – Part I

By Robert A. Yourell, MA | 4 Comments | Share | Print | Email | Tweet | Like | 1+
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In this article, and some to follow, I will provide a glimpse into controversies and progress in the field of domestic violence (DV). Issues of mental illness, cognitive disabilities, personality disorders, unemployment, poverty, gender, politics, the legal system, and education loom large in DV, calling for a biopsychosocial perspective. What better place than Brain Blogger for a look at the subject? Because it is such a tremendously large and complicated topic, I will write about it through different lenses.

I am not an expert in DV, but I have had my share of exposure in my work with federal probation and pre-trial, in chemical dependence, in family therapy, and in employee assistance programs. The way I put together this snapshot, was by monitoring a major discussion list of experts and practitioners in the field of DV, and doing a survey of DV-related research, particularly that concerned with mental health issues.

I’ll start with a very good reason for primary care providers to screen for DV, and an initial look at gender issues.

The number of women being arrested for DV is increasing. They constitute one-fifth of these arrests. There is concern, though, as to how many of them are women who were fighting back. The concern is amplified by the fact that some batterers are able to manipulate the police and the courts. According to authors such as Jackie Campbell, the batterer who succeeds with such manipulation rebound even bolder with a victim less likely to call for help; the danger is greater.

However, statistics showing that over half of violence in relationships comes from women (not danger or physical harm, there’s a difference) could lead one to say that this might be playing out as much to harm men as it does women, especially since the bias is generally against men, who are presumed to be the perpetrators. An expression of this bias developed in clinical thinking in the form of the idea of learned helplessness, in which, through abusive manipulation, women were believed to become unable to effectively defend themselves through escape, self-advocacy, or other means. Research has not supported the idea that this characterizes most women who experience DV. When police encounter women who are fighting with their men, and who are drunk and surly, they are not prepared very well to respond by this kind of bias.

In any case, the research and advocacy on DV calls for routine screening for DV in primary care settings, including maternity settings. The motive for this is to get early intervention, which will prevent violence, save lives, and get help before the DV dynamic becomes more ingrained. According to Jackie Campbell, nearly half of women killed by their partner are seen in primary care settings prior to their deaths, but only 4% of them were in shelters.

Robert A. Yourell, MA

Mr. Yourell's experience in the mental health and social services fields dates back to 1975. His training includes Ericksonian communication and hypnosis with John Grinder, Eye Movement Desensitization and Reprocessing with Francine Shapiro, Ph.D., Body Integrative Psychotherapy with Jack Rosenberg, Ph.D., and solution-focused psychotherapy. He provides free audio experiences on his site that include bilateral sound and Shimmering.

Related Articles

  • Sex, Violence and The Male Warrior Hypothesis
  • Domestic Violence – Understanding is Getting More Nuanced
  • Screening for Postpartum Depression Not Worth the Time or Money
  • Curb Domestic Violence/Abuse and Slash the Incidence of Mental Disorders
  • Woman Comparable to Men in Domestic Violence: Stereotypes and their Consequences
  • Domestic Violence and Executive Dysfunction
  • A Fatal Lack of Data

4 Responses

  1. Megan from Imaginif says:
    April 19, 2008 at 8:12 pm

    I welcome screening and early intervention.
    Domestic Violence is a child protection issue and if child protection is every body’s business then so it preventing and protecting from domestic violence.

    Looking forward to the series.

    Reply
  2. Mike Calahan says:
    April 14, 2009 at 9:14 am

    You may be interested in our recent publication “Hidden Costs in Healthcare: The Economic Impact of Violence and Abuse now available on our website.

    Reply
  1. Feminism at its Finest: April 2008 | Menstrual Poetry says:
    April 29, 2008 at 10:08 pm

    [...] Lakhan presents Domestic Violence: Call for Primary Care Screening and Gender Issues – Part I, saying: “Nearly half of women killed by their partner are seen in primary care settings [...]

    Reply
  2. Domestic Violence and Executive Dysfunction | Brain Blogger says:
    May 4, 2008 at 7:40 am

    [...] function has big implications for the design of domestic violence programs. It is important to know the subtypes of batterers because different subtypes have [...]

    Reply

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