The Substance Abuse and Mental Health Services Administration (SAMHSA) cautions that trauma, violence and abuse of women is more common that you may think. One frightening statistic is that nearly one-fourth of all women are raped or physically abused at some point in their lives.
The effect of this trauma may appear right away or take a long time to surface after the initial crisis is over. These effects may affect how women act with their family and friends and be a major factor in how they raise their children. Trauma, violence and abuse can also lead to substance abuse, depression, panic disorder and post-traumatic stress syndrome (PTSD).
The neighbor you know may be a batterer who drinks
How well do we really know our neighbors? Hidden behind closed doors, all kinds of physical and emotional abuse occur at the hands of spouses or partners, parents and others living in the home. Most often, it’s the wife and children who suffer the consequences of a spouse and father (or male residing with them).
While substance abuse does not cause domestic violence, say the experts, there is a statistical correlation between the two issues. What studies of domestic violence have found is that there is frequent high incidence of alcohol and other drug use by perpetrators during domestic abuse. The reality is that not only do batterers tend to abuse drugs and alcohol, but the probability that victims of domestic violence will turn to alcohol and drugs to cope with the abuse increases as well.
The facts about domestic violence and substance abuse
Delving into what’s known about the two issues — domestic violence and substance abuse — can shed some light on the problem that affects so many in the U.S.
- Regular alcohol abuse is one of the leading risk factors for partner violence (between spouses or partners).
- When there is a battering incident coupled with alcohol abuse, the battering may be more severe and result in greater injury to the victim or victims.
- Studies of alcoholic women indicate that they are more likely to report they’ve had childhood physical and emotional abuse than women who are nonalcoholic.
- In fact, women who have been abused are 15 times more likely to abuse alcohol and nine times more likely to abuse drugs than women who have not been abused.
- Relative to the type of childhood abuse suffered, the National Center on Addiction and Substance Abuse found that 69% of women being treated for substance abuse reported they were sexually abused as children.
- Treatment for alcoholism does not cure abusive behavior.
- The Department of Justice found in 2002 that 36% of victims in domestic violence programs also had problems with substance abuse.
- According to a majority of domestic violence program directors (51%), a woman’s use of alcohol can be a barrier to her being able to leave a violent relationship with a spouse or partner.
- An even greater percentage (87%) of domestic violence program directors agree with the statement that the risk of intimate partner violence increases when both partners abuse drugs or alcohol.
Domestic violence — What it is
Domestic violence is the intentional use of physical, emotional, psychological, or sexual force by one family member — or intimate partner — to control another.
The form domestic violence takes includes acts of:
- Intimidation — physical, emotional and verbal
- Forced sex
- Killing or maiming pets
- Destruction of family members’ property or possessions
- Slapping, punching, choking, kicking, burning, stabbing victims
- Killing victims
Targets of domestic violence include spouses, intimate partners, parents, stepparents, children, stepchildren, siblings, and elderly relatives.
In the United States, a woman is beaten every 15 seconds. Thirty percent of trauma patients (excluding victim of traffic accidents) are victims of domestic violence. The medical costs associated with treating women who have been victims of domestic violence at the hands of their partners is $44 million each year.
In eight to 13% of all marriages, severe physical assaults of women occur. The assaults reoccur in two-thirds of those relationships.
Similar to the patterns of substance abuse, domestic violence tends to increase in frequency and severity over time.
Men as batterers
Men are generally considered to be the stronger sex, particularly in terms of physical strength. But this also often means they inflict profound and lasting emotional damage on their spouses and children.
Batterers who abuse alcohol and are living with women often try to justify their violent actions as a way to control their victims when they are drunk. They also use alcohol as an excuse for the violence, blaming what they’ve done on alcohol. This way, they avoid taking responsibility for their actions. At least, they attempt to rid themselves of the onus by making statements like this: “I didn’t do it – it was the alcohol! I’d never hurt you, you know that.”
When batterers cause substantial injury to their victims and wind up in jail, some of the statistics revealed can be shocking.
The U.S. Department of Justice (DOJ) found that 61% of domestic violence offenders also have substance abuse problems. An early (1994) study on murder in families conducted by the DOJ found that more than half of the defendants accused of murdering their spouses were drinking alcohol at the time of the violent incident.
The battered woman’s reality
A battered woman literally lives in a war zone. She never knows what’s going to trigger a violent outburst from her spouse or partner. There may be subtle signs of an impending abusive incident, but often there are none.
She tries to read her partner for any such indications, watching his every move, facial expression, listens to his tone of voice, trying to interpret what’s going on in his head. Searching for behavior cues and indicators of changing moods takes a lot of time and energy, and she’s not always successful.
Unable to, or afraid that she won’t be able to, support herself and her children on her own, along with constant fear that her spouse will make good on his threats to harm family members, the battered woman stays in the home. As such, she’s likely to fear her batterer will continue to stalk and harass her, possibly even kill her.
In many instances, the batterer also serves as the woman’s supplier of drugs and/or alcohol. This compounds the problem of the woman leaving. Being so dependent on the spouse or partner for financial as well as drug supplies, the woman often becomes so damaged emotionally as well as physically that she simply cannot imagine being able to make it on her own.
What about the children?
Perhaps the most heartbreaking consequence of the dual issues of domestic violence and substance abuse is what happens to the children involved. Instead of being nurtured, children living in abusive homes where drugs and alcohol abuse occur simultaneously are often deprived of more than just the basics of food and shelter. They may face lifelong consequences resulting from parents who abuse substances and resort to violence.
It’s a fact that children of substance abusing parents are more likely to experience physical, emotional, or sexual abuse than children who live in non-substance abusing homes. In a survey conducted by the National Committee to Prevent Child Abuse, the results showed that as many as 80% of child abuse cases were linked with drug and alcohol use.
It is estimated that three million children witness violent acts against their mothers each year. As a result, many of them may come to believe that behaving in a violent manner is an acceptable way of expressing control, anger or frustration.
And violence carried across generations – victims of abuse themselves abusing partners and offspring in the future – is estimated to be 30-40% in the general population. This suggests that up to four in every 10 children who either witness or experience violence in the family unit run an increased risk of becoming involved in a violent relationship when they are adults.
Not only that, but children who experience family violence are also at greater risk for developing alcohol and/or drug problems later in life than children who do not suffer from violence at the hands of family members.
There is also evidence that children who run away to escape violence at home are at risk of developing substance abuse. Again, it’s often a matter of coping with the pain, trying to block out the memories.
What victims of domestic violence and substance abuse need to know
There’s no question that the victims of domestic violence and substance abuse have a difficult situation. Often they don’t know where to turn or are fearful of letting anyone outside the home know of the violence and abuse. If they say anything, they may suffer even worse at the hands of the substance abusing batterer. In the face of such fear, they often continue to suffer in silence.
The batterers often exhibit profound remorse over what they’ve done, promising to never do it again, blaming the alcohol or drugs. But the truth is that domestic violence never just goes away. And it won’t stop just because the person doing the battering stops using alcohol or drugs.
Even when the substance abusing batterer goes into treatment for substance abuse, treatment for that alone will not curtail the abuse. Both need to be treated simultaneously. Unfortunately, too many people believe that it’s just the drugs or alcohol that causes the violence. The tragic result is that the batterer, once rehab is complete, still has the underlying psychological impulse to abuse his (or her) spouse and/or children. Without treatment to overcome those urges, the violence will simply continue. The bottom line is that one problem (substance abuse or domestic violence) cannot be addressed without also dealing with the other.
While it’s understandable that victims of domestic violence and substance abuse would seek a way out of the pain, attempting to cope by using drugs or alcohol can not only defeat the purpose, it can have lasting and profound consequences. It can lead to further problems such as drug and alcohol dependency and the potential for increased vulnerability to violence. Besides alcohol and illicit drugs, abuse of prescription drugs such as tranquilizers, sedatives, stimulants and painkillers can lead to dependency.
There’s not going to be any effective support inside the home for overcoming the dual issues of substance abuse and domestic violence. The barriers to surmount are simply too high and family members – those who are the victims – are not equipped to deal with them. Protection, support, and treatment have to come from outside the family, in almost every instance.
Treatment for the victim who also abuses substances
When a woman goes in for treatment to overcome substance abuse and says that she has been a victim of domestic violence, there are three areas that need to be addressed.
First, the safety of the woman is paramount. Whether she is in treatment on an outpatient or inpatient basis, her physical safety has to be ensured. Security measures need to be implemented if she is an inpatient. As an outpatient, the woman should have a safety plan, which may mean referral to a domestic violence or battered women’s shelter. Confidentiality must be maintained in both cases (inpatient or outpatient).
Second, the treatment staff need to validate and believe the woman — and assure her that she is believed. When the survivor of domestic violence receives such validation, it helps empowers her to participate in immediate problem solving and longer term planning.
Third, treatment staff need to help the woman identify her options, share information on other available options, explore risks associated with each option, and support her in developing a safety plan.
Since she is in treatment for substance abuse, there are other immediate goals that need to be addressed. These include detoxification and stabilization — managing any withdrawal symptoms; evaluation and treatment of any health concerns, including pregnancy; and attendance to any psychological and emotional symptoms that can interfere with treatment, such as acute depression or anxiety. Physical health problems may range from the commonly seen skin abscesses and hepatitis, to cuts and bruises on the face, head, neck, breasts and abdomen. Battered women should also be screened for HIV/AIDS and other sexually transmitted diseases.
During treatment, psychosocial issues have to be addressed as well. The woman should be encouraged to assume responsibility for her addiction, and to dispel any thought that she is to blame for her partner’s behavior. She needs to learn that she cannot control her partner’s behavior, no matter how desperately she wants to or believes that it is necessary for her to do so.
Since her decisionmaking skills are likely to be poor, another aspect of treatment is to empower her by helping her develop, strengthen, focus, or validate her decisionmaking abilities.
Many victims of domestic violence who abuse substances suffer from post traumatic stress syndrome (PTSD). Treatment for PTSD may occur in-house during residential treatment, or the woman can be referred to the appropriate provider for PTSD treatment. One effective treatment for PTSD is eye movement desensitization and reprocessing (EMDR).
Victims of childhood or other trauma may benefit from specific trauma treatment by a therapist specializing in treating victims of childhood abuse.
Treatment for substance-abusing batterers
Similar to individuals seeking treatment for substance abuse, when a person enters treatment for substance abuse who is a batterer, he or she is likely in a crisis state. He may have been referred to the treatment program by the courts after being arrested for drug- or violence-related charges. He may have been left alone by his partner and children after they sought safety from his physical and emotional violence. In any case, the danger of violence erupting is always present.
Fostering accountability is of vital importance in successful treatment. Experts say that the degree to which a batterer begins to assume responsibility for his actions can serve as a barometer for his progress during substance abuse treatment.
Referral to and collaboration with batterer’s intervention programs can help facilitate treatment for substance abuse in batterers. The relationship between substance abuse and violent behavior needs to be examined. Answers to the following questions can help treatment providers prepare an appropriate treatment plan:
- Exactly when, in relation to an instance of substance abuse, does the violence occur?
- How much of the violent behavior occurs when the individual is drinking or using drugs?
- What substances are used before the violent act?
- What feelings precede or accompany the use of drugs or alcohol?
- Is alcohol or drugs used to recover from an incident of violence?
Other areas of treatment typically include bonding with peers and parenting classes. There is also a focus on the matter of ongoing support for the substance-abusing batterers. While there are many national 12 step groups for those in recovery from alcohol, drugs, gambling, compulsive sexual behavior and other disorders, there are no ongoing organizations that support change for men who batter, nor their surviving victims.
There is Batterers Anonymous, although chapters are widely scattered.
Continuing psychiatric counseling may benefit batterers who have undergone treatment for substance abuse.
Bringing the hidden problem to light
Shining a spotlight on domestic violence, the hidden side of substance abuse, isn’t easy. The victims are understandably reticent about coming forward. Fearing for their safety, they may be unwilling or unable to get treatment or help for themselves. Batterers who also abuse substances are unlikely to be forthcoming about their violent behavior. But with the prevalence of domestic violence and substance abuse in today’s society necessitates continued intervention, prevention, treatment and recovery services.
If you are a victim of domestic violence, whether or not you or your batterer abuse substances, the only way out of this situation is to seek help. Safety needs to be your primary concern, both for you and your children. But you need to know that you did not cause the violence and you are not responsible for the batterer’s violent behavior.
There is light at the end of the tunnel. But action needs to be taken. If you have a trusted family member or friend you can turn to, use the opportunity to contact a battered women’s or domestic violence shelter. Find out what your options may be. Seek psychiatric treatment or some form of counseling while you formulate your safety plan.
Above all, don’t settle for a life of violence. It will only result in permanent damage to you and your children.