POST-TRAUMATIC STRESS DISORDER,
RAPE TRAUMA SYNDROME AND
BATTERING
Powerlessness is a political condition, while passivity is a strategy adopted by the powerless to survive...The process of victimization consists of (1) first putting the victim in a position of powerlessness relative to the victimizer, and then (2) repeatedly impressing the victim with his or her powerlessness, including the powerlessness to escape, until the victim adopts passive and compliant behavior to stay alive.
Anne Jones
Trauma and Post Traumatic Stress Disorder
In her book, Trauma and Recovery, Judith Herman (1992) reminds us that the ordinary response to the horrors that occur in our lives is to expel them from our consciousness. There are certain violations that are unspeakable. While they are unspeakable, they refuse to be buried because there is an equal but opposite conviction that denial does not work. Herman tells us "remembering and telling the truth about terrible events are prerequisites both for the restoration of the social order and for the healing of individual victims." However, since atrocities are frequently shrouded in secrecy, evidence of a traumatic event initially appears as a symptom, not a story.
The distress symptoms of traumatized people concurrently call attention to the existence of an unspeakable secret while deflecting attention from it. We see this clearly in the way people who experienced a trauma alternate between feeling numb and reliving the event. Mental health professionals call this dissociation.
"People who have endured horrible events suffer predictable psychological harm. There is a spectrum of traumatic disorders, ranging from the effects of a single overwhelming event to the more complicated effects of prolonged and repeated abuse. Established diagnostic concepts, especially the severe personality disorders commonly diagnosed in women, have generally failed to recognize the impact of victimization" (Herman, 1992, p. 3).
Traumatic syndromes as well as the recovery processes have basic features. The primary stages of recovery are:
The challenge is to help survivors reconnect the pieces, rebuild history and make meaning of their current symptoms in the light of prior events. The traditional sphere in which this occurs for women is within the experiences of domestic and sexual life; while for men it is within the experiences of war and political life.
Studying psychological trauma means coming face to face with human vulnerability to natural acts or disasters and the evil deeds of humans. We witness horrible events. When the events are natural disasters, witnesses are readily inclined to sympathize with the victim. Conversely, when the traumatic events are of human creation, witnesses are caught in the struggle between victim and perpetrator. Morally, it is impossible to remain impartial. Witnesses take sides. The side that many choose is the side of the perpetrator because all that the perpetrator asks is for witnesses or society to do nothing. To side with a victim, requires the witnesses to share the burden of the victim's pain.
Ask Vietnam veterans if people want to know what really happened during the war, and they will say "no." Society, without individuals or groups willing to hear and report the pain, prefers to look the other way. It happens even more frequently when the victim is already devalued by society (a woman, a child). Devalued individuals find that the most traumatic events of their lives take place outside the range of socially validated reality. Their experiences are unspeakable.
In the field of psychological trauma, there has been debate about whether individuals with post-traumatic conditions should be treated with care or contempt. Are they genuinely suffering or are their stories products of their imagination? Despite the literature documenting the occurrence of psychological trauma, debate still centers on the basic question of whether these incidents are credible and real. Those who spend too much time treating victims of traumatic events are viewed with suspicion by many of their colleagues.
There have been three periods during the past century when a particular form of psychological trauma has become a public concern. Each time, the study of trauma has flourished in association with a political movement. The first of these was hysteria, the archetypal psychological disorder of women. Its study grew out of a political movement of the late nineteenth century in France. The second was shell shock. Its study began in England and the United States after World War I and reached its peak after the Vietnam War. The political setting was the disillusionment with the Vietnam war and the growth of an antiwar movement. The last and most recent traumas to come to public awareness are sexual and domestic violence. The feminist movement brought them to public view. Today's understanding of psychological trauma is built upon a synthesis of these three areas of inquiry.
Not until the women's liberation movement of the 1970's was it recognized that women in civilian life had post-traumatic disorders. The real but private conditions of women's lives were hidden. The privacy created powerful obstacles to consciousness and made women's reality practically invisible. Those who spoke about sexual or domestic abuses were subject to public humiliation, ridicule and disbelief. Women remained silent out of fear and shame, and silence permitted sexual and domestic exploitation.
This confirmed what Freud had dismissed as fantasies. Sexual assaults against women and children were pervasive. A survey conducted in the early 1980's by Dianna E. H. Russell, a sociologist and human rights activist, concluded one woman in four had been raped and one woman in three had been sexually abused in childhood.
For the first time, women designated rape as an atrocity. Feminists redefined rape as a crime of violence - of power and control - rather than a sexual act. Feminists also redefined rape as a method of political control, forcing the subordination of women through terror.
In 1980, psychological trauma became a "real" diagnosis for the first time. In that year the American Psychiatric Association included in its official manual of mental disorders a new category called Post Traumatic Stress Disorder (PTSD). PTSD occurs in war and peace, as the result of natural disasters or planned attacks, in single or repeated episodes and at the hands of strangers and loved ones.
| Diagnostic Criteria for Post Traumatic Stress Disorder* |
A. The person has been exposed to a traumatic event in which both of the following were present:
1. The person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others.
2. The person's response involved intense fear, helplessness, or horror. Note: In children, this may be expressed instead by disorganized or agitated behavior.
B. The traumatic event is persistently re-experienced in one (or more) of the following ways:
1. Recurrent and intrusive distressing recollections of the event, including images, thoughts, or perceptions. Note: In young children, repetitive play may occur in which themes or aspects of the trauma are expressed.
2. Recurrent distressing dreams of the event. Note: In children, there may be frightening dreams without recognizable content.
3. Acting or feeling as if the traumatic event were recurring (includes a sense of reliving the experience, illusions, hallucinations, and dissociative flashback episodes, including those that occur on awakening or when intoxicated). Note: In young children, trauma-specific reenactment may occur.
4. Intense psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event.
5. Physiological reactivity on exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event.
C. Persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness (not present before the trauma), as indicated by three (or more) of the following:
1. Efforts to avoid thoughts, feelings, or conversations associated with the trauma
2. Efforts to avoid activities, places, or people that arouse recollections of the trauma
3. Inability to recall an important aspect of the trauma
4. Markedly diminished interest or participation in significant activities
5. Feeling of detachment or estrangement from others
6. Restricted range of affect (e.g., unable to have loving feelings)
7. Sense of a foreshortened future (e.g., does not expect to have a career, marriage, children, or a normal life span)
D. Persistent symptoms of increased arousal (not present before the trauma), as indicated by two (or more) of the following:
1. Difficulty falling or staying asleep
2. Irritability or outbursts of anger
3. Difficulty concentrating
4. Hyper-vigilance
5. Exaggerated startle response
E. Duration of the disturbance (symptoms in Criteria B, C and D) is more than one month.
F. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
Acute: if duration of symptoms is less than 3 months
Chronic: if duration of symptoms is 3 months or more
With Delayed Onset: if onset of symptoms is at least 6 months after the stressor
* from Desk Reference to the Diagnostic Criteria from DSM-IV, American Psychiatric Association
At the moment, the study of psychological trauma seems to be firmly established as a legitimate field of inquiry. Twenty years ago, the literature consisted of a few out-of-print volumes. Now there are new books, new research findings and new discussions every month.
Traumatic events are extraordinary, not because they are rare, but rather because they overpower normal human adaptations to life. Unlike ordinary misfortunes, traumatic events generally involve threats or perceived threats to life. Victims encounter feelings of helplessness and terror.
Long after danger is over, victims experience the event as though it were continually recurring in the present. They are unable to return to "normal," for the trauma repeatedly intrudes. It is as if time stops at the moment of trauma. The traumatic moment breaks into consciousness in the form of flashbacks and nightmares. Small, seemingly insignificant reminders can trigger these memories, which return with the vividness and emotional force of the original event. As a result even normally safe encounters may feel dangerous.
Traumatized people who cannot spontaneously dissociate may attempt to produce similar numbing effects by using alcohol or narcotics. It has become clear that traumatized people run a high risk of compounding their difficulties by developing dependence on alcohol or other drugs.
Although dissociation, or even intoxication, may be adaptive defense mechanisms at the moment of total helplessness, they cease to be once the danger is past. They prevent the integration necessary for healing. Unfortunately, dissociation, like other symptoms of the post-traumatic stress syndrome, is persistent.
Traumatic events place enormous stress on basic human relationships. They can sever ties of family, friendship, love and community. They can shatter the self image that is formed and sustained in relation to others. They can undermine belief systems. They can violate the victim's faith in a natural or divine order and cast the victim into a state of crisis. Traumatic events destroy victims' fundamental assumptions about the safety of the world, the positive value of the self and the meaningful order of creation.
The damage to relational life is not a secondary effect of trauma. Traumatic events destroy victims fundamental assumptions about the safety of the world, the positive value of the self, and the meaningful order of creation.
Support from other people may temper the impact of the event, while blame or a hostile response may compound the damage and intensify the traumatic syndrome. After traumatic life events, survivors are highly vulnerable. Their sense of self is shattered. That sense can be rebuilt only as it was built initially, in connection with others.
Sharing the traumatic experience with others is an element of recovery. In this process, the survivors seek assistance not only from those closest to them but also from their communities. The response of these communities has a powerful influence on the ultimate resolution of the trauma. Re-establishing the bonds between the traumatized person and their communities depends upon public acknowledgment of the traumatic event and some form of community action. Once communities acknowledge that a person has been harmed, they must assign responsibility for the harm and repair the injury. These two responses - recognition and restitution - are necessary to rebuild the survivor's sense of order and justice.
Rape-Related Post-Traumatic Stress
from Rape in America: A Report to the Nation, National Victims Center, 1992.
| Rape Trauma |
An acute and long-term emotional reorganization process that occurs as a result of completed or attempted rape, and lasts for months or years after the actual rape has occurred.
| Stages |
A. Acute/Impact Reaction
1. Immediately and several days after the rape
2. Ways of showing anger
a. Expressed style - fear, crying, smiling, restlessness, tenseness
b. Controlled style - feelings hidden by calm, composed attitude
3. Somatic Reactions
a. Physical: soreness and bruising from the physical attack, irritation and throat infections for women forced into oral sex
b. Skeletal muscle tension: inability to sleep or restlessness while asleep, edgy and jumpy over minor incidents
c. Gastrointestinal Irritability: stomach pains, appetite affected, nausea
d. Genital Disturbances: vaginal discharge, an itchy, burning sensation on urination, chronic vaginal infections, rectal bleeding/pain
4. Emotional Reactions
a. Fear of: how friends will react, not being believed, rapist retaliation
b. Shock/disbelief
c. Agitation/anger
d. Shame/self-blame
e. Confusion/bewilderment
f. Extreme sense of guilt
5. Her needs
a. Someone to believe her
b. Emotional support/acceptance
c. Reassurance about how she handled the attack
6. Additional needs
a. Examination by physician even if it is several days after the attack
b. Aid in reporting the crime
B. Outward Adjustment Phase
1. Lasts from weeks to months
2. Emotional reactions
a. Intense fear: pregnancy, V.D., physical violence or death, crowds, being approached from behind, intercourse, fear of the unexpected (because the rape may have been unexpected)
b. Anxiety: anticipating medical exams, court hearing in which she'll face the rapist, prospect of losing partner
c. Denial - refusing to believe the rape happened
d. Lost sense of security
1. Nightmares in which
a. Victim is in danger and wants to do something but wakes before acting
b. Victim succeeds in fighting off assailant
c. Humiliation, embarrassment
d. Self-blame
e. Feelings of wanting revenge
f. Fear of sexual things
g. All problems become intensified
3. Physical signs
a. Antipregnancy medicine - causes nausea. Consist of 25-50 mg. of diethylstilbestrol (DES) administered per day for five days
b. Anti-venereal disease medicine - causes nausea. Consists of 4.8 million units of aqueous procaine penicillin administered intramuscularly
c. Burning sensation when urinating and itching or burning discharge from vagina
d. Tension headaches
4. Her needs
a. Counselor to be patient as she retells her story; time and time again, if necessary
b. Aid in approaching family and friends
c. Counseling with partner about her fear of sexual intercourse
d. Meet with other rape victims so she won't feel as isolated and helpless
C. Depression Phase
1. Lasts days to months
2. Her emotions
a. Loss of self-esteem as her defenses break down
b. Obsessive memories
c. Uncertain about being able to control her life and environment
3. Her needs
a. Support through the sentencing of her rapist and any possible end to intimate relationship
b. Overcome her guilt feelings
c. Help in re-establishing intimate relationships
D. Integration and Resolution Phase
1. Lasts months to years
2. Her emotions
a. Lack of trust in men
b. Anxious and depressed when something reminds her of the rape
3. Her needs
a. Support and someone to listen
b. Guidance in steps to make her feel more safe
1. Obtain unlisted phone number
2. Move to another location
3. Extended vacation to get away for a awhile
|
Reactions Above and Beyond Rape-Related PTSD That May Require
Different Kinds of Intervention
|
Ten Warning Signs of Mental Illness*
2 2. Inability to cope with problems and daily activities.
3. Strange or grandiose ideas.
4. Excessive anxieties.
5. Prolonged depression and apathy.
6. Marked changes in eating or sleeping patterns.
7. Thinking or talking about suicide.
8. Extreme highs and lows.
9. Abuse of alcohol or drugs.
10. Excessive anger, hostility or violent behavior.
* from the American Psychiatric Association
A person displaying one or more of these warning signs may have a mental illness and should be evaluated by a mental health professional as soon as possible. If the individual has experienced trauma due to crime or abuse, the behavior may be a normal response to an abnormal event.
Depression
The most common complaints that patients tell their physicians are the common symptoms of depression. In 1990, the American Psychological Association reported that depression annually afflicts about 7 million American women and is responsible for 30,000 suicides. This is twice the rate of depression found in American men. The rate of depression and victimization in women may be linked.
| Symptoms |
A common feature of depression includes the tendency to over generalize the meaning of events. Instead of dealing with adversities as isolated incidents, people with depression see incidents as part of a larger pattern. They are inclined to see things as black or white. For example, a mother trying to solve family problems, realizes that some solutions will work well while others will not. But the mother who is depressed tends to feel there are no solutions.
| Recovery |
Depression can often be successfully treated. Depression can be caused by sudden changes in brain chemistry (endogenous) or by personal tragedy or trauma (exogenous) which trigger chemical changes. Serotonin and norepinephrine are chemicals that affect mood. When confronted with trauma or tragedy, a person may become depressed. The amounts of serotonin and norepinephrine in the brain plummet. After about three weeks, the levels of the chemicals usually rise and the person begins to feel better. For some people, the levels of serotonin and norepinephrine do not return to normal. With low levels of the chemicals, the person may feel continually "blue." But if the quantity drops further, it could lead to clinical depression.
There are drugs which can restore the levels of serotonin and norepinephrine. In the last few years several drugs have been approved by the FDA for the treatment of depression that have fewer side effects and begin to work more rapidly.
For people who suffer from depression as a result of a traumatic event, medication may help them to focus and process what has happened. It can help them sleep, increase their energy levels, and reduce feelings of hopelessness. In addition to medications, talk therapy and support groups are used to treat depression. Frequently they are used in combination.
Hostage in the Home*
Domestic Violence Seen Through Its Parallel, The Stockholm Syndrome
When most people hear the term domestic violence, they think of punches, bloody noses, black eyes, broken ribs. So people invariably react by saying, "I wouldn't take that! The very first time he hit me, I'd be out the door!" Thinking that one becomes an abuse victim at the moment of the first assault, they imagine how they would react to an assault by a stranger and blame the abuse victim for not reacting to her1 partner's assault as they think they would.
People who work with abuse victims are often frustrated and angered by decisions victims make which they consider bizarre and inexplicable. For example, abuse victims often:
Because physical abuse is concrete and is all that outsiders can see, and because people do not think that just physical assaults would make someone do the "crazy" things abuse victims do, they conclude that the victim is mentally unbalanced.
In fact, the victim's mental state is altered as a result of her relationship with the abuser. Her perceptions of herself, her abuser and life in general have been altered. Not solely due to the physical abuse she may have suffered, but due to years of psychological assaults, the unremitting use of tactics defined by Amnesty International (1973) as "psychological torture." The abuse victim's very different view of her situation is the result of a lengthy process.
1 Although it is clear that there are men abused by female and male partners, and there are women abused by female partners, because "[a]nalyses of police and court records in North America and Europe have persistently indicated that women constitute 90-95% of the victims of those assaults in the home reported to the criminal justice system," (Dobash, et al., 1992), herein the victim will be referred to as female and the perpetrator as male. The bottom line is that pain has no gender, and, as this analysis shows, human beings exposed to psychological torture will react similarly, regardless of sex. Therefore, the author asks readers to mentally translate the term "battered women" into "battered women or men."
The abuse victim being subjected to her first assault is a very different person from those who judge her. Prior to that first assault, the abuser has spent months or years using escalating tactics of mental abuse and intimidation, using "minor" physical aggression to control her before moving to actual physical assault. He undermines her psychologically before he ever lays a hand on her. By the first time the abuser strikes her, the victim is no longer like unvictimized people, and simply cannot react like them. Living in fear while undergoing constant psychological degradation each and every day changes her far beyond what outsiders can imagine.
One way to make the complex process of victimization that abusers use to gain and maintain control over victims understandable to the average person, is to look at domestic violence through its parallel: the Stockholm Syndrome.
The Stockholm or Hostage Syndrome is a "conversion" that occurs when an individual is terrorized while being held in captivity. Given certain specific circumstances, a hostage's view of his/her captor and his/her relationship to him changes 180 degrees from hatred to adulation.
The best way to illustrate this psychological turn-around is through the 1985 terrorist takeover of Flight 847 in Europe. (Walker, 1989) After capturing the plane, the terrorist released the women and children - presumably to show what good guys they were. Left on the plane were two sailors and a group of wealthy American businessmen.
The terrorists took the plane to the Beirut airport and held the men captive on the tarmac for ten days. During the ten days of captivity, the hostages had guns held to their heads and put in their mouths, and had their lives threatened. They watched their captors beat one of the sailors to death and dump his body out of the tail section of the plane. Most people remember this hijacking from that detail because the image was so vivid in the newspapers and on TV.
During their captivity, one of the hostages was forced to read a political statement to the media from the cockpit of the plane. After their rescue, the hostages were flown to the U.S. When they got off the plane, waiting reporters rushed over to interview the man who had read the statement earlier in the week. They asked him only three questions:
| "Is it good to be home?" | "Yes, it's wonderful." |
| "What was it like?" | "It was hell." |
| "What were the kidnappers like?" | "It's funny you asked that. They weren't bad people. They let me eat, they let me sleep, they gave me my life." |
Then he said something advocates and police officers have heard from hundreds of victims of abuse: "They have such potential to be good people."
He went on to talk about how the terrorists had to do what they did to get publicity for their cause and how America mistreats third world countries. Within minutes, a government spokesperson appeared on camera to say that the kidnappers were not really "good people" - that the man who had been interviewed was a victim of the Stockholm Syndrome. (Walker, 1989)
The Stockholm Syndrome was named for the terrorist take-over of a bank in Stockholm, Sweden, in August 1973 when three women and one man were held hostage for six days by two men. (Cooper, 1978) During that incident, when the police stormed the bank to rescue the hostages, the captives fought police at the side of the captors. Afterwards they blamed the police for endangering them, and one of the freed hostages became engaged to a jailed terrorist. This last occurrence led to the investigation and definition of the Stockholm Syndrome.
Since then, following numerous hostage-takings, the world has seen former hostages:
minimize their injuries
refuse to participate in prosecuting terrorists
visit their captors in jail
recommend and pay for defense counsel
... ALL THE SAME THINGS BATTERED WOMEN DO.
While hostages sometimes refuse to prosecute terrorists, hostages receive compassion and understanding. But all too often, when a battered woman is afraid to prosecute her batterer -- who, unlike terrorists, is out on the street knowing where the victim and her loved ones live -- her "refusal" to prosecute is used as an excuse by some members of the criminal justice system to refuse to protect her and prosecute him.
The bond of interdependence between captive and captor called the Stockholm Syndrome develops "when someone threatens your life, deliberates, and doesn't kill you." (Symonds, 1980) The relief arising from the removal of the threat of death generates intense feelings of gratitude as well as fear, which combine to make captives reluctant to display negative feelings toward the terrorist. This is pathological transference, a kind of "conversion." Recognition that the terrorist/abuser has the power of life and death over them, combined with gratitude that he has let them live, causes a unique change in perspective -- the hostage/abuse victim and children come to see the captor/abuser as a "good guy," even a savior. "The victim's need to survive is stronger than his impulse to hate the person who has created his dilemma." (Strentz, 1980)
Overwhelmingly grateful to terrorists for giving them life, hostages focus on their perceptions of their captors' kindness, not their brutality. Similarly, battered women convince themselves that the abuser is a good man whose violence stems from problems they can help him solve.
Stockholm Syndrome develops when an individual is subjected to four conditions (Graham, et al., 1988)
| Condition One |
A person is held captive and cannot escape, so her or his life depends on the captor.
The reality of captivity is easy to understand in the context of hostages or prisoners because the walls which confine them are made of brick or stone or wood. However, the walls which confine the abuse victim are built from societal attitudes and practical barriers, as well as the psychological pressures she is subjected to every day by her abuser.
A now-familiar example of isolation while living in the public eye is Nicole Brown Simpson. That the beautiful, wealthy wife of a famous public figure could actually be a victim of domestic violence -- the cliché being a low-income, downtrodden hag -- electrified America and blasted open the stereotypical image of battered women. Because her image and circumstances are now firmly engraved in the public consciousness, it is easier to evoke thoughts of captivity in the midst of everyday "freedom."
Societal Barriers - Many victims ask family, friends, police and/or the courts for protection or help to escape, only to be refused and find that nothing stopped the abuser from punishing them for the attempt. Often it is not only the abuser, but his family and friends, who threaten, harass, intimidate and harm the victim seeking help. Victims all too frequently learn that no one will treat their situation seriously, and they feel as though they have run into a brick wall when they hear:
"What did you do to deserve it?"
"Give him another chance. Stand by your man."
"It's only a family argument -- I'm not going to arrest him."
"We're releasing him on his own recognizance."
"We don't prosecute first-time batterers -- we send them to diversion."
These responses to her appeals for help, repeated over and over, teach the victim that she cannot escape. Her situation is very similar to that of a dog being trained to stay within a certain area through the use of a shock collar. Every time the dog reaches the edge of the designated area, the collar shocks it. Eventually, after enough shocks, in the animal's mind there is an invisible wall around the property. After that training, when the electricity is turned off, the dog will still not go beyond the border. Invisible to the outside observer, the wall of pain and fear is very real to the animal.
Financial Barriers - Another brick in the wall preventing victims from escape is lack of access to money. Abusers control the family finances to more effectively control victims because their financial dependence gives him power. If the victim has a job, the abuser's harassment may cause her to lose it. "Battering, not pregnancy, is the main reason women leave the workforce altogether." (Jones, 1991) Lack of access to money makes it extremely difficult, if not impossible, for even a middle-class woman to be able to afford to take care of herself and the children if she leaves.
Even in the 1990's, a woman faces major barriers when seeking a way to support herself and her children if she leaves her abuser:
According to the U.S. Bureau of Labor Statistics, women still earn only 66¢ for every dollar in annual salary an American man earns - even female college graduates. (Faludi, 1991)
More than 80% of full-time working women earn less than $20,000 a year -- nearly double the male rate. (Newton, 1989)
One of the prevalent myths about divorce is that women receive generous alimony and child support from former husbands. While this may be true for some, it is far from true for the majority:
In the first year after a divorce, the women and children suffer a 33% drop in their standard of living, while the man enjoys a 10% to 15% rise in his. (Duncan & Hoffman, 1988)
One year after going to court and being awarded support, 88% of women with full restraining orders and 81% of those without had not received any money to support themselves, and 64% of those with orders and 49% of those without full orders had never received any child support from the abuser. (National Center on Women and Family Law, 1993)
"Divorced men are now more likely to meet their car payments than their child support obligations -- even though, as one study in the early '80s [sic] found, for 2/3 of them, the amount owed their children is less than their monthly auto loan bill." (Hewlett, 1986)
Children - When the couple has children, the situation becomes extraordinarily complicated. The children, who dare not confront their father, often blame their mother for not pleasing him and avoiding the violence that terrifies them: "Why did you do that, Mom? You knew it would make him mad." Having no safe release for their fear, they may take the side of the parent they perceive to be the stronger, wanting to be on his side to escape his violence themselves.
The mother worries that their lower standard of living after separation or divorce will result in increased danger to her children from a new environment: exposure to drugs, gangs, etc.
Most horrifying of all to the victim is the abuser's most common and most dreadful threat: he will win custody of the children, or simply snatch them.
Chesler (1991) found that:
14% of the paternal kidnappers had been involved in primary child care. None had been prevented by the mothers from seeing their children.
None of these fathers was economically, legally or custodially punished.
Of the smaller number of maternal kidnappers, 80% were both found and punished.
The abuser's threat to gain custody through the legal process can be seen as easily plausible. Since he has spent years denying his violence to his partner, the children, and their families, he is well practiced at denying his abuse. So he behaves precisely in accordance with the criteria judges use in assessing a witness' veracity. He makes good eye contact with the judge, speaks calmly and tells a coherent story. In contrast, the victim, often unrepresented, has also spent years denying the violence. Her testimony may be the very first time she has spoken in public about the degrading abuse to which she has been subjected. So she doesn't make a very good witness. She may avoid eye contact, break down on the witness stand, and omit details.
More than 40 children are abducted by a parent each hour in this country. Most of these abductions are perpetrated by fathers or people acting on their behalf, including step-mothers and relatives. Fifty-four percent of these abductions are short-term manipulations around custody orders, but 46% involve concealing the whereabouts of the child or taking the child out of state. Fully 82% occur between the couple's separation and two years after the parents have separated or divorced. (Finkelhor, et al., 1990)
In 1988, an estimated 163,200 children abducted by parents or family members were taken across state lines, concealed from or prevented from having contact with the custodial parent, or taken with the intention of being kept indefinitely or changing their custody. (Finkelhor, et al., 1990)
More than 54% of abductions occur in the context of domestic violence. (Greif & Hegar, 1992)
"Each publicized custody battle terrorizes married, divorced, and unwed mothers in non-measurable and unknown ways." (Chesler, 1991)
Scarcity of Available Services - Services for abuse victims are poorly funded by state and federal governments, and thus are not available everywhere, and are generally offered by networks of volunteers.
Between 1983 and 1987, one-third of the 1 million battered women in the U.S. who sought shelter were turned away due to lack of space. (Women and Housing Task Force, 1988)
In 1991 there were 3,200 animal shelters in the U.S., but only 1,200 shelters for abuse victims. (Washington Post, 1991)
"There are no governmental protective services for battered women. Furthermore, over one half of all counties in the U.S. have no battered women's programs." (Jackson, 1990)
If his victim does succeed in escaping, the abuser often resorts to even more serious violence because he has lost the very people his abuse is aimed at keeping and controlling -- his partner and children.
Some men would rather kill "their" women and/or themselves than see women make a new life. We, and victims, see these stories in the press and on television regularly. Victims know full well that their escape may end in their death. Statistics verify that battered women's lives do indeed depend on their batterers.
Approximately 70% of murdered women are killed by a husband, lover or estranged same. Approximately 2/3 of those murdered by intimate partners or ex-partners have been physically abused before they were killed." (Campbell, et al., 1992)
The most common type of homicide-suicide episodes, representing fully 50% to 75% of all murder-suicides in the U.S., typically involved a male between the ages of 18 and 60 years who physically abused his girlfriend or wife, feared her infidelity or estrangement, murdered her, and committed suicide, usually by firearm. (Marzuk, et al., 1992)
| Condition Two |
The captive is isolated from outsiders so that the only other perspective available to her or him is that of the captor.
Hostage-takers routinely keep information about the outside world's response to their kidnapping from captives to keep them totally dependent.
Like terrorists, abusers isolate their victims. Isolation is the back-drop against which the entire drama is played because in isolation, all the victim hears is the negative messages of the abuser. Abuse victims are isolated in many ways:
Geographical Isolation - In rural areas, she may be isolated because she lives at the end of a road or in the back woods. There are few things more terrifying than living with someone violent, knowing that no matter how loudly you scream, no one will hear you. No one will come. No one will call 911 when the batterer rips out your phone.
Social Isolation takes many forms:
Family/Friends/Work - Many batterers control who the victim's friends are and who she spends time with, determining who the couple will socialize with, or whether they will socialize at all. If he is angry, threatening, violent, or is even merely argumentative in front of others, they avoid associating with the couple. Thus the woman is left even more alone so the abuser's demeaning messages become her reality because they are all she hears. Kept totally under his thumb, she cannot bond with anyone else.
Many abusers are obsessively jealous and possessive. They conduct surveillance on their partners, "following [them] around, interrogating the children, eavesdropping on telephone conversations, and making frequent telephone calls to monitor [their] activities... Closely related to this is extreme possessiveness which is often manifested by the abuser's unwillingness to accept the end of the relationship." (Adams, 1990)
"Women ... are subjected to ongoing harassment and pressure tactics including multiple phone calls, homicide or suicide threats, uninvited visits at home or work, and manipulation of children.... Some abusers use their children as emissaries who are responsible for spying on mom's activities or for convincing mom to 'let Daddy come home'." (Adams, 1990)
Often when a victim has separated from her abuser, his harassment in the workplace leads to her losing her job.
Abusive husbands and lovers harass 74% of employed battered women at work, either in person or over the telephone, causing 56% to be late for work at least five times a month; 28% to leave early at least five days a month; 54% to miss at least three full days of work a month; and 20% to lose their jobs. (New York Victim Service Agency, 1987; Schechter & Gray, 1988)
Religion - Most organized religions are based on the premise that suffering on earth is the prerequisite for eternal life in Heaven. Christians are taught, "God never gives you a burden greater than you can bear." They are told to carry the cross of their pain and suffering just as Christ did, that suffering on earth is the price you pay to earn eternal life in Heaven.
Romantic Relationships - The batterer repeatedly tells his victim, "If you leave me, no one will want you." Over time, she comes to believe that and, when considering whether to leave, she has to confront the very real possibility that she will never have another relationship -- and accept that perhaps she will never have sex again. Never again will a man touch her with love and caring.
The Isolation of Stereotypes - Society's stereotypes reinforced by the abuser's psychological brainwashing form a powerfully effective section in the wall of isolation. In an effort to evade a realization of their personal vulnerability to being victimized, the public accepts victim-blaming stereotypes about crime victims in general (Bard & Sangrey, 1986), and abuse victims in particular. One of the most widespread stereotypes about battered women is: Women are masochists -- they ask for it -- they stay because they like being beaten. This myth is repeated as truth by people who know little or nothing about the reality of violent relationships.
Battered women who are still hiding the violence of their home lives hear this "common wisdom" from friends, family, co-workers and the public so often that many become convinced of its truth, and believe that people will look down on them and be unwilling to help them. Taught first by batterers and then by the stereotype that the violence is their fault, shame and fear keep victims silent. So they stay in the relationship, afraid to turn to anyone for help for fear of being rejected and despised.
"The propensity to fault the character of the victim can be seen even in the case of politically organized mass murder. The aftermath of the Holocaust witnessed a protracted debate regarding the 'passivity' of the Jews and their 'complicity' in their fate. But the historian Lucy Dawidowicz points out that 'complicity' and 'cooperation' are terms that apply to situations of free choice. They do not have the same meaning in situations of captivity." (Herman, 1992)
Another common stereotype about battered women is the "Bad Faith" Stereotype. This stereotype is described by members of the justice system as the woman who uses and abuses the abuse prevention process to manipulate and punish her male partner.
The danger of this stereotype is illustrated by the Thurman vs. Torrington case. Because the Torrington Police Department saw Tracey Thurman as a stereotype rather than an individual, they were blinded to her real danger -- which led to her being disfigured and partially paralyzed for life -- and to their having to pay her $1.9 million in damages.
While some women, abused and not abused, certainly do "abuse" the system, and while one finds evil among some members of any group, the generally held stereotypes about battered women are not true of the vast majority of victims.
Isolation strengthens and enforces abusers' use of the following tactics to demoralize and brainwash their victims because the victim has no one to turn to for a "reality check." The tactics used by abusers have been defined by Amnesty International (1973) as psychological torture. Yet while world opinion can be mobilized and concrete sanctions imposed against countries which treat prisoners and dissidents in this way, even though they use these same tactics against women, abusers are rarely prosecuted or receive meaningful sentences. These tactics are the cornerstone of the brainwashing and manipulation used on P.O.W.'s, political dissidents and hostages as well as battered women:
Verbal Humiliation and Degradation - This is not simply the use of foul language. It is unrelenting criticism and constant attacks on the victim's worth as a human being. Who she is and what she does are never good enough. It is not only the viciousness of these attacks that makes this tactic so effective -- it is the constant repetition of the batterer's denigrating messages. Repeated humiliation is the abuser's strongest weapon. The messages that she is utterly worthless, and the cause of his anger and violence become part of the victim's self-image due to constant repetition of the same theme -- which he delivers verbally and reinforces with his fists.
Self-blame is a common reaction to being victimized. (Bard & Sangrey, 1986) But in addition to natural feelings of self-blame (it is easier to deal with guilt than the fear of reccurrence [Miller & Porter, 1983]), the abuse victim's self-blame is actively stimulated by her abuser, and her suffering minimized:
"'If we had a problem, it's because I loved her so much... Like all long-term relationships, we had a few downs and ups.... All this press talk about a rocky relationship was no more than what every long-term relationship experiences... At times I have felt like a battered husband or boyfriend but I loved her.'" (Simpson, 1994)
Each of us forms our self-image from how others respond to us. The more important a person is to us, the more we value and rely upon their opinion of us. Women in our society are taught to believe that a partner's love is supposed to be the most important thing in their lives. Success, financial gain, status and prestige are supposed to be secondary to finding a partner and keeping his love. So, when the abuser rejects her, the victim has to admit to herself that she has failed in making what society has taught her was the single most important choice in her life, that of a husband or lover. Thus, she has to overcome the socialization of a lifetime as well as her love for her partner, to reject his importance in her life, in order to discount his opinion of her.
Threats of Harm - The abuser threatens to harm the victim, the children, her family, pets, treasured personal belongings; he threatens to abandon her and the children, to further isolate them, to snatch the children or to kill her, the children or himself. These threats often include detailed descriptions of how he will harm or torture her loved ones. In the beginning, the abuser's threats are usually ominously vague, and he may not carry them out.
Gradually, "mere" threats alone become insufficient to maintain control over partner and children, so he begins carrying some of them out. When he does act on his threats of physical violence, studies show that his victim's likelihood of injury is great:
"Women suffering violent victimizations were almost twice as likely to be injured if the offender was an intimate (59%) compared to offenders who were strangers (27%). Women were also [almost twice] more likely to receive injuries requiring medical care if the attacker was an intimate (27%) compared to a stranger (14%)." (Bachman, 1994)
"Domestic violence is the largest single cause of injury among women seen at hospital emergency rooms, more common than auto accidents, muggings, and rapes combined." (Stark & Flitcraft, 1985)
"[A]s many as half of the domestic 'simple assaults' actually involved bodily injury as serious as or more serious than 90% of all rapes, robberies, and aggravated assaults." (Langan & Innes, 1986)
Eventually the victim is constantly off balance -- a key factor in brainwashing -- because she never knows whether or when he will act on his threats.
Enforcement of Trivial Demands - This tactic forces the victim to develop the habit of complying with whatever demands the abuser chooses to make. Her life is governed by long lists of demands and rules: how clean the house must be, how the children are to be disciplined or dressed or fed, having to account for how she spends her time, where she goes, whom she sees, etc. Whatever an individual abuser's demands, when they are not met, he demonstrates his power with a variety of physical and psychological punishments. The victim lives in a continual atmosphere of impending doom.
Monopolizing Perceptions - The abuser creates an atmosphere so dangerous that the victim becomes totally focused on remaining safe here and now. Monopolization of perception is the psychological state which results from living in an atmosphere of fear and impending punishment created through the use of the psychological manipulative tactics discussed above by themselves or in combination with physical assaults.
Because the outpouring of the abuser's rage is so unpredictable, the victim protects herself and the children by maintaining the family and the home in accordance with his ever-changing demands. Her time and energy are focused on the abuser and his impending rage over anything that may turn out to be "wrong." She becomes exhausted by her constant efforts to totally control the home environment to pacify him: controlling the children, pets and visitors; attempting to anticipate his whims and assuage his frustrations; and suppressing her fear, sorrow and rage, which, if revealed, will lead to punishment.
Taught that they can be punished for virtually anything they say or do, the victim and children become afraid to make choices, to do anything on their own. For abuse victims and their children, as well as POW's and hostages, all aspects of life relate only to how the batterer/captor will react. They "walk on eggshells," constantly trying to read the captor's mind to anticipate his wishes and thus deflect his anger. Abuse victims become totally absorbed in arranging every aspect of their lives to keep him calm.
Since abusers use precisely the same techniques as terrorists, it is completely logical that battered women suffer the same psychological effects as hostages. Subjected to these tactics on a daily basis, victims also isolate themselves out of shame, believing that they have failed their partners and thus are failing at what society has taught them throughout their lives are the most important roles a woman can assume -- wife, mother and homemaker. Trying to do better, but never succeeding in ending the beatings, they become depressed, apathetic and despairing. Abusers constantly tell them the abuse is their fault, and they hear from their families as well as his, "You've made your bed, now lie in it." Even the children, who dare not confront the abuser, release their tension and fear by blaming their mother for not pleasing him and avoiding the violence that terrifies them.
The tremendous isolation in which the victim lives causes her to derive too much of her identity and self-esteem from the batterer, so when he rejects her with verbal degradation and beatings, the entire foundation of her self-esteem is demolished. Her learned belief in her personal unworthiness and her blame for the violence makes her isolate herself from family and friends who may also blame her for not keeping the violence in check.
Walled in by outsiders' attitudes, victims come to believe there is nowhere they can turn for support, much less assistance. The victim is forced to take on the abuser's perspective of her because she has found that when she reaches out for a different viewpoint, she is too often rebuffed.
Eventually, the mental cage the abuser has erected around the victim becomes as strong as the walls which confine and isolate the hostage.
| Condition Three |
The captor threatens to kill the victim and is perceived as having the capability to do so.
Threats of death are a nearly invariable feature of life with an abuser. And the almost universal threat of batterers who kill their victims is the chilling: "If I can't have you, no one will." Because we see this threat so often repeated in media reports about those murders, victims are well aware of the danger represented by such threats -- and abusers recognize the power they can gain by making the same threat. These threats become real when looking at the statistics:
From 1976 to 1987, of all deaths resulting from one partner killing another (married, common-law, ex-married, dating), 61% of victims were women killed by male partners, and 6% of male victims were killed by female partners. (Browne & Williams, in press, 1992; Bureau of Justice Statistics, 1989)
100% of Vermont's female homicide victims in 1993 are believed by law enforcement authorities to have died at the hands of an intimate partner or family member. (Martinez, 1994)
So the victim decides it is safer to stay and endure an occasional beating than to leave and be murdered -- an entirely reasonable choice. The victim's focus narrows to her and her children's short-term safety rather than long-term security through escape. But at this point, the victim is no longer her husband's or lover's partner -- she is his prisoner.
| Condition Four |
The threatening person is perceived as showing some degree of kindness to the victim being threatened.
Kindness is the cornerstone of the Stockholm Syndrome. Stockholm Syndrome will not develop unless the captor exhibits some kindness towards the victim. If the captor/batterer is purely evil, the victim responds with hatred. But if the captor/batterer shows some kindness, in the midst of terror the victim submerges the hatred s/he feels in response to the terror, and concentrates on his/her captor's good side in order to protect him/herself.
In many abusive relationships, the abuser is contrite and apologetic after an abusive incident. This is called the Honeymoon Stage of the Cycle of Violence. (Walker, 1979) Following a period during which the tension between the couple builds to a violent explosion, the abuser, filled with remorse, promises with genuine sincerity of his repentance. Wanting to believe him, and convinced by his sincerity, the victim convinces herself that it was not really that bad, and that he can change. So the abuser convinces the victim and everyone else (including himself) that he can and will stop being violent. He excuses his violence by blaming stress or alcohol or drugs. At the same time he is making excuses to deny full responsibility, he also offers justification to deny wrong-doing -- primarily blaming the victim for provoking him: "If you were a better wife, I wouldn't lose my temper."
Often the psychological confusion and shock of the traumatic incident cause both victim and perpetrator to minimize, deny or suppress the details of the violence. The couple rebounds in warmth and intimacy. It is at this time that the victim is most thoroughly victimized psychologically because his manipulation of her emotions leaves her feeling responsible both for him and for her own victimization.
It must be remembered that, like most relationships, when it began, the relationship was probably satisfying. Since no one is 100% bad, or 100% good, even despite the battering, there are aspects of the relationship which remain rewarding, and with many batterers who never go beyond the stage of moderate assaults, the beating may be infrequent.
The bonding between captive and captor called the Stockholm Syndrome "is no longer considered unusual by professionals who negotiate with hostage-takers. In fact, they encourage its development, for it improves the chances of the hostages surviving, despite the fact that it means the officials can no longer count on the cooperation of the hostages in working for their own release or in later prosecuting the hostage-takers." (Graham & Rawlings, 1991)
As shown above, all four of the conditions which cause Stockholm Syndrome in the hostage are recreated by abusers within abusive relationships. Although the Stockholm Syndrome is caused in both hostages and battered women by virtually identical treatment, the way these two groups are treated by the outside world is very different (Graham, et al., 1988):
Public authorities sympathize with hostages, seeing them as having little control over their situation, and media coverage generates public sympathy. In contrast, abuse victims are blamed for their situation: "She deserved it." "Why doesn't she just leave?" "She stays because she likes it."
Authorities are likely to negotiate for the release of hostages. Hostages are generally released from captivity or rescued by the State. Battered women, however, must find a way to leave their captivity more or less on their own, and rarely are abusers imprisoned -- unlike kidnappers and hostage-takers.
Negotiations for the release of hostages are not dependent on their proving that they are targets of physical violence nor that they did not desire or provoke it. But unless a battered woman can prove she was subject to life-threatening violence, the legal and criminal justice systems are often unwilling to intervene.
Governments attempt to capture and punish hostage-takers while abusers are rarely punished, even for decades of abuse, unless the woman or children are killed.
During the ordeal of Flight 847, businessmen changed in a mere ten days. However, research shows that a terrorist captor can achieve the "conversion" effect of the Stockholm Syndrome with a stranger in less than 4 days using the psychological torture tactics mentioned earlier. In contrast, a batterer has months or years - sometimes decades -- to use precisely the same tactics to terrorize a victim made much more vulnerable because she loves him.
As one victim put it, "It's hard to find an enemy who has outposts in your head."
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