Wednesday, April 27, 2011

The Sky Is The Limit: Researching New Ideas in Recovery of Intimate Partner Violence

              I’m tired of watching rampant demons destroy my new dreams slowly. can you explain the red-hot blackness of your soul that encompasses my skin, even today, remembering how you held me through the tears, and begrudged the blood like it was all my fault?
‘who knew she bruised so easily?’
I’m tired of listening and pretending like it’s gonna go away. I’m tired of lies and yet the most awful stinging pain in my core tonight is because being alone is somehow more terrifying than the memories of what you’ve done to me. to ruin me. to stand and live and bleed through me as though you had any further right to my soul. Please leave …
(Ramsey, 2011)
This poem was written by a survivor of intimate partner violence as she fights for recovery from abuse, and works through her many issues and mental conditions resulting from the trauma. But this poem was not written in the weeks following her being removed from danger, nor was it written on the one year anniversary of her journey into a new life without her abuser. This poem was written close to 3 years post-trauma. It is my experience that the effects of intimate partner violence are more long-lasting than most of society could ever realize. It is my experience, because this is my poem, and I am suffering emotionally as much today, as I have every day over the last 3 years.
There is an incredible need for social change in the realm of support services offered to victims of intimate partner violence. There are many agencies devoted to removing the victim into a safe environment, many shelters dedicated to helping victims get back on their feet emotionally, physically and socially. However, once that magical first year of recovery from trauma is reached, survivors find themselves on their own in a new world. It is my hypothesis that further study into the needs of these survivors, from the one year anniversary forward, must be done and these findings used to create a long-term recovery program for all victims to reach a level of living happily that we seek, and that we deserve. This idea, though truly selfish as it may be, is beginning to be apparent to researchers as well.
Given the absence of violence exposure post-shelter and the appreciable levels of satisfaction reported for most life domains, the results for depression and trauma symptoms are noteworthy. These “cream of the crop” domestic violence survivors reported symptoms of depression and trauma warranting clinical attention.
…continuing efforts ought to be made to assist women post-shelter in meeting their long-term needs and to examine the provision of specialized treatment, both in shelter and community, regarding depression and PTSD symptoms, such as intrusive memories of abuse experiences.
                                                                                            (Ham-Rowbottom, et al, 2005, p.118,120)
So far, it is evident that almost no help is offered, or readily available, to victims of intimate partner violence after the one year mark, post-trauma. Brilliantly helpful agencies such as The Refuge House in Tallahassee, Florida and the Florida Coalition Against Domestic Violence (FCADV) offer almost no guidance to this long-term idea of care (Refuge House, 2010). While the FCADV champions the Survivor Listening Project, an avenue for survivors to “remain central to, and continue to inform the work of” the coalition (FCADV, 2010), there is no avenue to aid in the continued recovery of these survivors. Compounding the problem are the multiple levels of disadvantage and co-occurring disorders that are frequently ignored by support services for intimate partner violence because these programs lack the integrated services to assist in other related conditions such as mental illness and substance use. This issue will be covered thoroughly in a later section.
So, just why is it that victims of intimate partner violence face such a long road of recovery? The research of DeMaris and Kaukinen (2008) seek to explain this further. A frightening fact produced by their research findings shows that help-seeking behaviors, such as seeking aid from shelters, contacting family and friends, reaching out to therapy, etc. are not necessarily a buffer to decrease psychological trauma. It seems evident that the psychological traumas suffered by the survivors are severe and long lasting (DeMaris & Kaukinen, 2008). Getting to the bottom of this question feels more like peeling an onion than simply finding an answer. With continued research, I am hopelessly hopeful that we can create a plan of action to better aid our abused and broken women.
Clearly, the topic of intimate partner violence is one of specific relation to gender oppression. According to the U.S. Department of Justice, 84% of spouse abuse victims were females, and 86% of victims of dating partner abuse were also female (Durose, 2005). For the purposes of this research paper, only the findings and research as they relate to the gender oppression of women will be discussed. The social relevance of this issue is best described by the work of Dobash & Dobash who state: “it is the battered-women's movement, with the support of the media, who have put the issues of the physical and sexual abuse of women and girls firmly on the social agenda” (1992, p.2)
It is the opinion of Michelle VanNatta that domestic violence shelters, constrained by beaurecratic hierarchies, financial limitations, and the idea of the “normal” battered woman, are failing to provide enough intensive, long-term help to all women, especially those with existing social disadvantages (2005, p.439). We need to look into all aspects of the recovering victim and seek to align a productive recovery model for women victims post-trauma. Poole et al state that 42% of women in domestic violence shelters are substance users, and therefore “the need has been identified for more integrated services for women who use substances and experience violence in their lives” (2008, p.1130).
This layer of disadvantage should not be ignored by support services. The co-morbidity of substance abuse and intimate partner violence is of real concern, though frequently unaddressed by support services. Kail, a social worker looking to address the techniques used in therapies for victims of intimate partner violence and substance abuse, finds that “little attention is given to screening for the presence of IPV” when women are seen for substance abuse issues (Kail, 2010), though the likelihood of related events is common. In fact, Bennett & O’Brien have found that substance abuse “is one of the strongest predictors of intimate partner violence” (2010), and the vast majority of women with substance abuse problems have also been victims of IPV at some point in their lives (Bennett & O’Brien, 2010). So why are support services so clueless? Vast research has been done on the correlation of substance use and violence in intimate relationships, as well as research on the resulting mental health issues of depression and post-traumatic stress disorder and intimate partner violence. The big issue, however, is that “few studies have investigated the prevalence of substance-use-related problems among women who experience domestic violence” (Poole, et al, 2008, p.1130). So the question should be how to best treat victims of IPV by also including substance abuse treatment techniques, aid and support. It seems likely that a long-term program of aid will be necessary and helpful to both issues.

A study project organized by the Substance Abuse and Mental Health Services Administration (SAMHSA) sought to find all of these answers and more. The two-phase project enlisted consumer/survivor/recovering women as consultants involved in every phase and level of the study. The importance here is that women who have lived with substance abuse problems, mental illnesses and who have histories of trauma were an integral voice in the 5 year Women, Co-Occurring Disorders and Violence Study (WCDVS). The concept is one of brilliance and hope for survivors. It is the hope that voices just like mine, voices of women who sit in the waiting rooms for health care professionals biting back tears until we reach the safety of the inner office; voices of women who have been desperate, hopeless, and alone in our drinking; voices of women who became so accustomed to the beatings we began to do it to ourselves; voices of women who believe there is no help – will finally be heard.
How else can we as a society begin to be more responsive to the needs of those receiving services than to empower them to be a part of the design and implementation of those services? We need to invite service recipients to sit at the table and speak for themselves instead of allowing anyone else to think that they can speak for them.
(Mockus, et al, 2005, p.525)
The insight gained by SAMHSA is still materializing in the training of professionals in related fields, and through implementation of programs created through the work of this study, although I could find little evidence of an actual plan for either avenue of change.
It is my ultimate goal that the work and research set forth by this paper will become the groundwork for a new recovery support service for survivors of intimate partner violence. I believe the work done here is unique – as unique as each story of horror and survival spoken by the woman who lived through it. Through my research I have learned that we are a vast army, though still disorganized and fearful in our efforts, but we are forming. Mockus, Mars, Ovard, Mazelis, Bjelajac, Grady, LaClair, Livingston, Slavin, Williams and McKinney embody my sentiment perfectly:
Even the best science available has lacked a vital component: the insight and wisdom that can only come through the lived experience of recovery.
(Mockus, et al, 2005, p.515)
It is my hope that a new plan of recovery can be implemented into existing support agencies. Groups like the Substance Abuse and Mental Health Services Administration (SAMHSA) are making huge waves toward integration of violence safety, substance use recovery and mental health services. I plan to eventually enact this new recovery program within the Tallahassee community, but in the end – the sky may be the limit.

Bennett, L. W. and O'Brien, P. (2010) The Effects of Violence Acuity and Door to Service. Journal of Social Work Practice in the Addictions, 10(2), 139 — 157. doi: 10.1080/15332561003769526
DeMaris A., Kaukinen C. (2008). Partner's stake in conformity and abused wives' psychological trauma. Journal of Interpersonal Violence, 23 (10), pp. 1323-1342.
Dobash, R. E., and Dobash, R., Women, Violence, and Social Change (New York: Routledge, 1992).
Durose, M.R., et al., U.S. Department of Justice, NCJ 207846, Bureau of Justice Statistics, Family Violence Statistics: Including Statistics on Strangers and Acquaintances, at 31-32 (2005), available at
Florida Coalition Against Domestic Violence (FCADV) (2010). INVEST Program description. Retrieved from
Florida Coalition Against Domestic Violence (FCADV) (2010). Survivor Listening Project description. Retrieved from
Ham-Rowbottom, K. A., Gordon, E. E., Jarvis, K. L., & Novaco, R. W. (2005). Life Constraints and Psychological Well-Being of Domestic Violence Shelter Graduates. Journal of Family Violence, 20(2), 109-121. doi:10.1007/s10896-005-3174-7
Kail, B. (2010). Motivating Women with Substance Abuse and Intimate Partner Violence. Journal of Social
             Work Practice in the Addictions, 10(1), 25 — 43. doi: 10.1080/15332560903526002
Mockus, S., Cinq Mars, L., Ovard, D., Mazelis, R., Bjelajac, P., Grady, J., & ... McKinney, J. (2005). Developing consumer/ survivor/recovering voice and its impact on services and research: Our experience with the SAMHSA Women, Co-Occurring Disorders and Violence Study. Journal of Community Psychology, 33(4), 513-525. doi:10.1002/jcop.20066
Poole, N., Greaves, L., Jategaonkar, N., McCullough, L., & Chabot, C. (2008). Substance Use by Women Using Domestic Violence Shelters. Substance Use & Misuse, 43(8/9), 1129-1150. doi:10.1080/10826080801914360
Ramsey, C. (2011). Your Opinion Here: A Collection of Journal and Poetry. Publishers.
Refuge House (2010). General website.
VanNatta, M. (2005). Constructing the Battered Woman. Feminist Studies, 31(2), 416-443.

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