Health Needs Of Survivors Of Domestic Violence

Domestic violence is not over when the victim is safe and out of harm’s way It’s not
over until justice has been served Even then, it’s not over It’s not over until the
victim is safe, justice has been served, and the victim is well

Consider these facts:

• Abuse, especially repetitive abuse, leaves a lasting “impression” on the
  health, well-being, and post-abuse functioning of the victim This impact lingers
  long after the bruises fade, the bones mend, and the abuse is over
• Victims of violence seek healthcare more often than non-victims The
  severity of victimization is a powerful predictor of the healthcare costs generated by
  these victims
• Most healthcare visits by victims of domestic violence are not domestic
  violence patients presenting with injuries, but rather medical problems that
  seemingly are not related to current or past injuries

The health effects of violence can reach across the life span Studies have now
shown that adults who were abused in childhood vs those who were not have more:

• Infectious diseases
• Mental health disorders
• Hypertension
• Diabetes
• Dermatitis
• Asthma
• Allergy
• Acne
• Abnormal menstrual bleeding
• More heath-threatening behaviors such as smoking, the use of alcohol,
  driving while intoxicated, avoiding regular gynecological examinations, not wearing
  seat belts, sedentary lifestyle, and high-risk sexual encounters

The abuse sustained in an intimate partner relationship does not have to be physical
to cause poor health Intimate partner violence and abuse (IPVA) can take several
forms: physical abuse, verbal abuse, and forced sex When Dr Ann Coker and her
colleagues looked at domestic violence in a large series
of patients, they found that approximately 14% of domestic violence victims have
only been victimized psychologically, not physically These victims had higher rates
of numerous medical problems that the non-abused do not have Among them:

• Disability that prevented working
• Arthritis
• Chronic pain
• Migraine and other frequent headaches
• Stammering
• Sexually transmitted infections
• Chronic pelvic pain
• Stomach ulcers
• Frequent indigestion, diarrhea, or constipation

These findings pose an interesting question: Do victims of psychological abuse have
fewer or more health problems than victims of physical violence? Dr Coker and her
colleagues found that “psychological IPV was as strongly associated with the
majority of adverse health outcomes as was physical IPV” The old childhood taunt
of “Sticks and stones can break my bones, but words can never hurt me,” is wrong,
wrong, wrong And now we have research to support the idea that it’s wrong

Survivors of domestic violence or IPVA will tell you that life after abuse is never the
same Some experience insomnia, multiple aches and pains, problems with
concentration, intrusive thoughts, fatigue, and irritability Any one of these can
interfere with effective functioning and set the stage for depression and even
despair

Violence and abuse of all forms is complex and the resulting health effects are
interwoven No single approach cures all Medical help for domestic violence victims
and survivors exists but is scattered Appropriate care is often difficult to find and
access, but it can be done Healthcare providers and survivors must learn to work
together to secure the best state of health possible for survivors of domestic
violence

My recent book on using expressive writing to help resolve lingering health issues
offers one way to give aid to survivors and their supporters You can read a
summary about the book at website http://healthaftertrauma/

© Copyright Ellen Taliaferro, MD 2005 All rights reserved You have permission to
publish part or all of this article electronically or in print, in your newsletter, on your
website, or in your e-book, as long you maintain the hyperlinks in the article and
include the following information: “Written by Ellen Taliaferro, MD, author, speaker,
and expert witness Dr T can be contacted through http://wwwhealthaftertraumacom A copy of your reprint or publication would be
appreciated

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