Abuse, Neglect and Family Violence
Abuse & Violence in the Family
(Dr. Samson Omotosho, PhD, APRN/PMHN)
Introduction: Abuse and violence in the family refer to physically and emotionally harmful behaviors that occur between family and household members. It includes child abuse, child neglect, intimate partners abuse and violence, marital rape, and elder abuse. It could be a learned behavior that can be unlearned through therapy. Perpetrators try to isolate the family to keep it secret and avoid sanctions. They usually have some power and control over the other members of the family. They may rationalize the violence with their drug use. The use of cocaine, PCP, amphetamine etc may increase violent behavior.
Forms of Abuse: Physical abuse includes hitting, punching, shoving, stabbing, shooting, kicking, and withholding medication, wheelchair, food, and fluids. Sexual abuse includes coercion, marital rape, and withholding sex. Psychological abuse includes threat, harassment, and blackmail. Emotional abuse includes name-calling, insults, and ridicule. Economic abuse includes total control over finance, running up bills, forbidding school or work.
Myths and Reality About Violence: Family violence occurs at all levels of society. Separation or divorce may not end violence. Abuser does not need to be provoked. Some survivors wrongly tend to blame self. Treat the violence but also the alcohol, drug, stress, and mental health problems if any. Violence occurs between gays and lesbians too. Abused women are discouraged from disclosure by threats, fear, denial and disbelief expressed by ?confidants?.
Models of Intervention: The Paternalistic model assumes that the clinician has more knowledge than the patient; that the survivor is responsible for ending the violence; that the clinician should give advice and sympathy; and see the patient as a victim. Whereas, the Empowerment model, which is better, assumes that the clinician should mutually share knowledge with the patient, plan strategies with the patient, respect patient?s competence, experience and strengths, and see the patient as survivor.
Response of Survivors to Violence: Physical signs include injuries at multiple sites in various stages of healing (head, neck, face, throat, sexual organs), headache, insomnia, and stress. Behavioral sign is that the individual does not leave the abuser or leaves and returns before making a final break. Psychological signs include delayed reaction, depression, lowered self esteem, attributions e.g. self-blame, impaired school or work performance and conduct, poor concentration and poor problem solving.
Why Individual Does Not Leave the Abuser? Abused individuals do not leave the abuser for any of many reasons, which include fear of being stalked and killed (which is a realistic fear), strong emotional attachment to the abuser, determination to end the abuse, sanctions present in the couple?s culture, fear of stigma, lack of resources to live away from the abuser, and consideration of what will happen to her children if she leaves. She may leave and return, thinking, ?Maybe he will change?.
Child Abuse & Neglect: In every state, child abuse and neglect are must be reported. Types of abuse include child sexual abuse, child physical abuse, child emotional abuse, and child neglect. Child that witnesses family violence may also suffer abuse.
Child Sexual Abuse: This is the involvement of children in sexual activities that they do not fully comprehend and to which they do not or cannot freely give consent. This violates child?s trust in the adult that is supposed to protect him/her. Threat to the child, pet, and others keeps the child quiet. It results in confusion, shame, and helplessness. Its effect may last a lifetime and affect mental health. It may be guarded as a family secret.
