Why you may want to know this
While the statistics on domestic violence vary widely, we know at the very least that it is a large and underreported worldwide problem. It doesn't respect class, income, religion, or any other number of demographic factors; it cuts across all of them and is represented in every population group. While women are most often the victims of male abusers, it is also true that there are female abusers as well as male victims. The gay and lesbian community is also not immune from the problem, so probably one of the most important things we can do is not to bring assumptions into the therapeutic encounter that create the impression that we cannot be confided in if our client needs to reach out for help.
Depending on the licensing jurisdiction (state, province, other region) you live in, as an MT, you may or may not be considered a healthcare provider, and you may or may not be a mandated reporter, which means you have to report cases of abuse, or your suspicions that abuse may be taking place. Patient confidentiality and privacy is always important, and even required, but there are times when for the safety of yourself or another, patient confidentiality may have to be broken in order to fulfill the mandated reporter requirement. I really can't give you a one-size-fits-all answer here, except to say that you should be aware of the laws that apply to you, and what your responsibilities for protecting your clients under those laws are.
Not everyone encounters domestic violence, but many of us will have a client, a friend, or a relative who faces it. Some of us may experience it ourselves. We may never need this information, but if we ever do need it, it is better to have it in advance, rather than try in the middle of an emergency to find it from scratch.
In general, massage schools don't prepare us for what to do if, in the clinic, a client tells us they are being abused, or if we suspect that a client is being abused.
This general information from GroupHealth (such as definitions, the description of the battering cycle, the effects on children, and making a safety plan) is relevant for anyone, while the specific information (such as telephone numbers) is relevant for people, primarily GroupHealth Cooperative members, in the Seattle area.
What you may want to do with this information:
- Find out what your legal responsibilities are where you live and where you have your license. Specifically, find out whether you are considered a healthcare provider, and whether you are considered a mandated reporter. If so, for what populations are you a mandated reporter? Everyone, children, elderly clients?
- Take the following information provided, and replace the phone numbers and websites with information that is relevant and helpful where you live--local resources, for example.
- Visualize scenarios with clients where you may need to provide information about where to turn for help, as rehearsal in case this situation ever occurs in real life. You may wish to adapt this information for a brochure that you keep in your office, and can give to clients who need it. You can find brochures online, or you can adapt the following information.
- Be clear on our limits and scope of practice--we are not psychotherapists, and we do not counsel. But we can have general educational material, such as is contained in this brochure, available for distribution, and we can refer out when we are confronted with a situation that is outside our scope of practice. And counseling domestic violence victims is definitely outside our scope of practice.
- Reach out for help, preferably before you need it--cultivating a network of therapists and counselors to whom you can refer clients, if you ever need to, is always a useful step. And you may find you want to check in with a counselor or mentor as well, if a particularly harrowing story from a client has a strong bad effect on you (secondary trauma) as well.
- Be prepared. If someone else in your life, other than a client, ever confides in you that they are in a domestic violence situation, you can be a supportive friend to them as well, and urge them to get professional help. And if you ever find yourself in a domestic violence situation, please don't hesitate to reach out. There are caring people out there who want to help. No one ever deserves to be abused. You deserve to be safe.
All of this information is copyright 2009 GroupHealth Cooperative. I thank them for distributing it, and I appreciate their willingness to assemble and provide the information.
When I picked up the flyer at their medical center, I inquired about disseminating the information, and was told that they care more about getting the information out to people who need it than strictly about the copyright, so it would be ok to reproduce it here.
I have, however, enclosed it in block quotation to make it clear that I am not representing them as my words, but simply quoting the information they provide. GroupHealth gets the full credit for authoring this information.
Domestic violence
- The battering cycle
- How children are affected by domestic violence
- Develop a safety plan
© 2009 GroupHealth
What is domestic violence?
Domestic violence is violence or the threat of violence in an intimate relationship. This is often referred to as intimate partner violence or IPV An intimate relationship includes couples who are married, living together, or dating.
Domestic violence is sometimes called "battering" or "wife beating": it's always abusive. An abuser is a person who uses or threatens the use of violence to control another person. A victim is a person to whom a violent act is directed.
Many abusers grew up seeing violence as the way to express anger or as the method used to get control. Because of this, violence is what he or she uses as an adult to express anger or gain control.
Domestic violence is never okay--no one ever deserves to be abused. It is never the fault of the victim.
Who is abused?
Domestic violence happens to people from all different kinds of backgrounds. It happens to people of all ages, races, cultures, sexual orientations, religions, economic levels, and educational levels. Both men and women can be victims of domestic violence.
What is abuse?
Abuse falls into three categories: psychological, physical, and sexual. An abuser may use any or all types to try to control the victim.
Psychological Abuse
Psychological abuse may include name-calling or teasing, controlling the victim's activities and relationships (hobbies, friends, etc.), controlling the victim's appearance (clothing, hair style, etc.), not allowing different opinions, threatening harm or violence, or threatening suicide if the victim doesn't cooperate with demands.
Physical Abuse
Physical abuse can include punching, pushing, biting, slapping, pulling hair, kicking, pinning down, or choking.
Sexual Abuse
Sexual abuse can include any unwanted touching or fondling, physically attacking breasts or genitals, any unwanted sexual contact, including oral, anal, or vaginal intercourse, or the use of force during sex.
Why don't victims leave?
Many victims feel they have no control over the violence because it happens no matter what they do. Victims may be isolated from others, often because of the abuser. If they do have contact with people, they often don't talk about the violence due to feelings of shame and fear.
A victim may feel he or she is the only one being abused and no one else would understand. Or, the victim may believe all relationships are violent and so the abuse is normal and acceptable.
A victim may stay with the abuser for many reasons:
Fear
- Lack of physical protection.
- Fear of retaliation against victim or family.
- Fear of losing custody of children.
- Losing financial support.
- Fear of losing one's job.
- Having nowhere to live.
- Being alone.
Social and cultural reasons
- Family tells victim to stay.
- Family sees it as a private issue.
- Abuse may be viewed as acceptable in some cultures.
- Family tells victim to make the best of it.
- Others won't believe the abuse happens.
- Religious beliefs (that it is wrong to break up a marriage.)
- Cultural beliefs (that it is wrong to get help.)
Beliefs of victim
- Feels helpless to change the situation.
- Believes things will get better.
- Feels deserving of the abuse.
- Feels sorry for the abuser.
What is the battering cycle?
There are usually three phases to domestic violence, called the battering cycle. The cycle continues until the abuser or victim gets out.
Phase 1
Tension builds up. There is an increase in criticism and insults.
Phase 2
Abuser explodes into violence for little or no apparent reason.
Phase 3
Abuser apologizes and says it will never happen again, or acts as if the violence never happened. The abuser is often very charming and attentive to the victim during this phase, and promises to change or attend counseling.
How are children affected by domestic violence?
Children are impacted by domestic violence, either by witnessing the abuse or by being abused themselves. Children who witness abuse may learn that violence is normal, and is an appropriate way to solve problems.
Children affected by domestic violence may show any of the following traits:
- Anxiety and fear.
- Shame.
- Depression.
- Guilt, because they feel the violence is their fault or because they can't stop it.
- Confusion about the love and anger they feel for the abuser.
- Afraid of being left by one or both parents.
Children may experience physical problems resulting from emotional stress, including:
- headaches
- bedwetting
- rashes
- hearing or speech problems
- sleeping or eating disorders
- learning problems
They may also develop behavioral problems at school or at home or act withdrawn.
Develop a safety plan
If your partner is abusive, it's important to develop a safety plan for you and your children in case the violence happens again.
Make copies of important papers including:
- social security cards
- birth certificates
- restraining orders
- bank account statements
- insurance policies
- your marriage license, if you have one
Hide them with a close friend or relative.
Hide extra clothing, money, ATM and credit cards, and an extra set of keys with a close friend or relative.
Open a checking account separate from the abuser.
Remove weapons from your home.
Set up signals with neighbors, friends, and relatives that will let them know you are in danger. A signal could be a code word to use on the phone to indicate trouble, or closing a curtain in a certain window. Ask a neighbor to call police if violence begins.
Identify a safe place to go, and practice how you will get there. Make plans to take your children with you. Prepare older children to leave and call police from a neighbor's house if you can't get away.
During an incident:
Call 911 for help.
Get out if possible. If you must leave without your children, come back with the police to get them.
If you can't leave the situation:
Avoid rooms with only one exit.
Avoid the kitchen, bathroom, bedroom, and garage.
Computer safety
If the abuser can access your computer, they can find out what Web sites you have visited, what documents you have written, even what e-mail you have sent. The safest thing to do is to use a computer at the library instead of your computer at home.
For more information
Domestic violence is a serious health concern for you and your children. Please speak with your doctor if you are affected by domestic violence.
For help, please call:
- National Domestic Violence Hotline
- (interpreter services available)
- 1-800-799-7233
- www.ndvh.org
- Group Health Behavioral Health Services
- Western Washington: 1-888-287-2680
- Eastern Washington: 1-800-851-3177
- Group Health Consulting Nurse Service. Call 24 hours a day toll-free
- 1-800-297-6877.
- Northwest Network of Bisexual, Trans, Lesbian & Gay Survivors of Abuse
- 206-568-7777
- www.nwnetwork.org
The Group Health Resource Line can provide information about community resources and support groups in your area. Call the Resource Line toll-free 1-800-992-2279 or e-mail resource.l@ghc.org.
You are not alone. No matter what your loved one has told you, abuse is not your fault. You have a right to live without being hurt.