Victims of Domestic Trauma & Substance Abuse
Survivors of domestic trauma sometimes cope with their experiences by turning to substance abuse. Understanding the psychology of violence and victimization is key to treating both the trauma and the addiction.
What Is Domestic Violence?
Domestic violence is also known as intimate partner violence (IPV). It also goes by the terms domestic abuse and relationship abuse. It refers to a specific pattern of behaviors used by one partner in a relationship to exercise and maintain control over the other partner in the relationship. The behaviors can be physical, emotional, sexual, financial, or digital in nature.
An “intimate relationship” refers to people who are married, cohabiting, or simply dating. Domestic violence occurs in relationships of all sexual orientations and gender identities, race and ethnic backgrounds, ages, socioeconomic demographics, and education levels.
The definition of domestic violence covers any behavior that not only causes physical harm to a person, but also creates fear, prevents the person from doing what they want to do, or forces them to behave in undesirable ways. Domestic violence can include physical and sexual violence, intimidation, threats, insults, and financial control and deprivation. Many of these behaviors can occur at different times within the same relationship.
Physical, Emotional & Sexual Abuse
Examples of physical abuse include:
- Hair pulling, punching, slapping, kicking, and choking.
- Forbidding the person to eat or sleep.
- Preventing the person from calling the police or seeking help.
- Forcing the person to use drugs or alcohol.
- Threatening to use weapons on the person.
An emotionally abusive relationship still falls into the “domestic violence” category. It can include:
- Insults, name-calling, or constant belittlement.
- Acting unreasonably jealous or possessive.
- Isolating the person from their family or friends.
- Tracking where the person goes, monitoring whom they interact with, and demanding to know where they are at all times.
- Preventing the person from leaving the house.
- Threatening to hurt the person’s children, pets, or other family members.
- Damaging property, such as punching walls or throwing objects.
- Gaslighting (manipulating the survivor into believing that either no abuse happened, or they caused the abuse).
The use, promise, or deprivation of sex can be weaponized as a form of sexual abuse in domestic violence. The abuser may:
- Force their partner to dress in a sexually provocative or demeaning way.
- Force or manipulate their partner into having sex or engaging in sexual behavior.
- Be non-consensually controlling during sex.
- Insist that sex is “owed.”
- Ignore their partner’s sexual boundaries and preferences.
Sexual coercion is another element of sexual abuse within the context of domestic violence. Coercion can include the perpetrator verbally or physically persuading the other partner to engage in unwanted sexual activity, usually by using force or a power dynamic within the relationship. Victims are usually meant to feel guilty or shamed into consenting to sex.
The process of making the victim feel obligated to have sex, or consent to sexual activity, is a form of coercion and sexual abuse. The idea of “owing” a partner sex is not a healthy expression of sexuality within a relationship. If it is weaponized, it could be a form of domestic abuse.
Statistics of Domestic Violence
Figures compiled by the National Coalition Against Domestic Violence show that as many as 20 people experience physical abuse at the hands of an intimate partner every minute. Over the course of a year, this can mean more than 10 million women and men are victimized.
Twenty-five percent of women experience severe violence carried out by their intimate partner, either physically, sexually, or emotionally. As many as 25 percent of men have also experienced some degree of physical abuse by their respective partners.
In addition, 1 in 7 women have been injured by a domestic partner (1 in 25 men), and 1 in 10 women have been raped by their partners (no figures currently exist for men).
Every day, domestic violence hotlines across the United States receive more than 20,000 phone calls.
More Domestic Trauma Statistics
Per the American Journal of Public Health, if there is a gun in a house where domestic violence takes place, the risk of homicide increases by 500 percent. Out of all reported violent crime in the country, domestic violence accounts for 15 percent.
Survivors of domestic abuse have been found to have higher rates of depression and suicidal behavior. Only 34 percent of people who are hurt by their relationship partners receive medical care.
Per the Centers for Disease Control and Prevention, almost half of the female rape victims in America are raped by an intimate partner. As many as 19.3 million women have been stalked, and 60.8 percent of them were stalked by a current or past intimate partner.
Another study of homicides found that 72 percent of all murder-suicides take place within an intimate partner relationships, and 94 percent of the victims in these crimes are female.
If there are children in the relationship, they are at extreme risk for lasting and lifelong trauma. As many as 1 in 15 children experience intimate partner violence every year, and upward of 90 percent of these children see violence from one partner to another.
Women who are abused by their intimate partners have higher risks of contracting sexually transmitted diseases, as a result of forced sexual intercourse or chronic exposure to stress. Research has suggested that there is a significant connection between domestic trauma and depression and suicidal behavior.
Effects of Domestic Violence
Additionally, a number of negative physical, mental, sexual, and reproductive health effects have been connected with intimate partner violence:
- Unintended pregnancy
- Adolescent pregnancy
- Nutritional deficiency
- Gastrointestinal problems
- Neurological disorders
- Chronic pain
- Noncommunicable diseases
- Post-traumatic stress disorder
Survivors of domestic violence also have a higher risk for developing substance abuse problems.
Effects on Children
In 2019, Psychology Today wrote that in homes where intimate partner violence occurs, the chances of co-occurring child abuse taking place are as high as 45 to 60 percent, which is 15 times higher than average. Even only witnessing domestic trauma, without experiencing violence themselves (which happens in as many as 80 percent of cases of domestic assault) takes a horrendous toll on children.
Children who see, experience, or are otherwise exposed to domestic trauma can develop a lifelong fear of abandonment, which might lead to borderline personality disorder; unresolved feelings of guilt, sadness, or shame; inability to express empathy; pathological lying; and other forms of emotional imbalances. Many children who grow up with domestic abuse may struggle with feeling that their emotional needs are unmet, even if they were not the intended victims of the abuse.
Children, writes Psychology Today, are not simply bystanders or witnesses to domestic trauma. In moments of stress, emotions and memories are powerfully imprinted onto a child’s brain. These imprints can deeply affect the feelings, beliefs, and choices the child will make in their adult life.
Parents in a relationship where intimate partner violence takes place — whether aggressor or survivor — risk having a poor emotional connection with their children. They may not be able to sufficiently provide protection for their children.
Compared to other children, kids who have experienced some form of domestic trauma experience greater levels of:
- Cognitive issues.
- Learning difficulties.
- Aggressive and anti-social behaviors, which might persist into adulthood. Boys tend to become offenders (although many are compelled to enter relationships where they are victimized), and girls are more likely to become victims themselves.
Additionally, many children who have been exposed to domestic trauma are more likely than other children to have higher rates of bullying, assault, animal cruelty, property destruction, and substance abuse.
What Might Lead a Trauma Victim to Turn to Drugs or Alcohol?
The American Society of Addiction Medicine writes that in as many as 60 percent of all cases of intimate partner violence, substance abuse was also found. Much evidence suggests that drugs or alcohol has a “facilitative role” to play, by either encouraging violence or sexual situations, or exacerbating violence.
Furthermore, spousal abuse has been found to be a predictor of whether a substance addiction will develop in a relationship. Women who have been abused by their partners often report that they were coerced or outright forced into using drugs or alcohol by their partners. Studies have compared women who have not experienced intimate partner violence with those who do and found that high-risk drug and alcohol use is more prevalent in the latter group.
One such study was covered by the American Journal of Public Health, where researchers found that on days of heavy drug and/or alcohol consumption, physical violence was 11 times more likely to take place in an intimate partner relationship.
Drugs & Domestic Abuse
More than 20 percent of male perpetrators of intimate partner violence said they used alcohol or illegal drugs before their most recent and severe acts of violence. That figure is backed up by many survivors of domestic trauma, who have told police and first responders that their offending partner had been using drugs and/or alcohol before violence broke out.
Much research has further uncovered that high-risk alcohol consumption is strongly connected with carrying out violence against a partner, although there remains debate as to what degree heavy drinking causes men (who may be inclined toward aggressive behavior) to actually become violent.
The connection between intimate partner violence and substance abuse has been frequently noted among patients who check in to psychiatric and substance abuse treatment centers.
Why Do Some Victims Not Seek Help?
With how dangerous intimate partner violence is and how bleak the outcomes are, the question is often raised as to why some victims don’t seek help. The truth, as USA Today puts it, is stark: Many women are simply afraid to call the police.
Many survivors of domestic trauma fear that they will not be believed if they go to the authorities, that their partner will not be given a sufficient punishment, or that their partner will abuse them even more for trying to get help. Police are also at risk when they respond to a call, and some officers have been killed in the line of duty when they have tried to intervene.
In 2015, a survey by the National Domestic Violence Hotline showed that 25 percent of women who had called 911 to report sexual assault or domestic violence would not call the hotline again.
Additionally, survivors of intimate partner violence have other reasons for not seeking help, such as:
- Fear of getting arrested if they have a history of sex work or substance abuse.
- Fear of losing custody of their children.
- Fear of losing their house or their job.
- Fear of deportation if they are an undocumented immigrant.
The Los Angeles Police Department explains more reasons why some survivors might decide not to inform the authorities. They may fear losing support from their family or friends if the news gets out that they were in an abusive relationship. Others may be worried that court proceedings could be prohibitively expensive, and they do not have the options or resources to start a new life.
In some cases, survivors are lonely, or they may have been manipulated into feeling guilty or ashamed for getting their partner in trouble or for “failing” the relationship, even if their partner was truly abusive. In extreme cases, some survivors develop a Stockholm syndrome kind of dependence on their abuser, becoming emotionally dependent on them, even as the abuser exacts physical, emotional, or sexual abuse.
How to Safely Intervene to Get a Loved One Help
If you know of someone in an abusive relationship, there are certain steps you can take to determine what’s going on. Let them know that you believe them and want to help them. Reaching out to a survivor can make a life-changing difference, but it has to be done carefully. Intervening too soon or too suddenly could put them or you at risk from their partner.
In order to properly reach out to a survivor of domestic trauma, it is best to do so during a period of calm. You also need to have a lot of time on your hands when you reach out. The survivor might want to talk for hours about their experience, and you cannot cut the conversation short.
For natural reasons, many survivors of intimate partner violence will not want to start the conversation. You can bring it up by expressing that you’re worried about the survivor, and you’re concerned for their safety. It is vital that you clarify that you will be discreet about whatever they tell you. Do not force the survivor to tell you what’s going on because that might drive them further away. Let them know you care, and that you will always listen to them and believe them. When they are comfortable, they will take you into their confidence.
It is also important to be nonjudgmental about whatever the survivor tells you. Don’t offer advice or solutions at this point. The temptation might be to go to the police, but acting hastily can put the survivor in even more danger. Simply listen, give them the opportunity to tell their story, and understand where they’re coming from. You might be the first person to actually listen to the survivor’s story, and that is a significant responsibility.
Because many survivors fear that they will not be believed if they tell their story, you have to make it clear to the survivor that you will believe them. From their perspective, having someone who knows the truth about their abuse can be what helps them break the cycle.
Validating their feelings and experiences will help the survivor know that they are not at fault for being abused, but you also have to make clear that they are in an unhealthy, dangerous situation, and you are concerned for their safety. Do not attempt to convince them to call the police. They have to make that decision for themselves, and the extent of your responsibility is to support them in that decision.
How Trauma & Addiction Are Best Treated
Trauma and addiction are most effectively treated with an approach known as trauma–informed care. This is a system that looks to understand how the brain processes trauma, and then uses that understanding to address the symptoms of trauma, especially as they pertain to substance abuse. Trauma-informed care does not look to treat the trauma experience; instead, it aims to help survivors control the effects of their symptoms, such as substance abuse, and reduce the likelihood of re-traumatization as they work through the recovery process.
Trauma-informed care helps survivors in three main ways:
- It helps them understand the mechanisms of their substance abuse, drawing a direct connection between their addiction and their trauma.
- It reduces the risk that working through recovery will re-traumatize them.
- It identifies and offers support systems that understand the psychology of trauma.
Trauma-Informed Care & Substance Abuse
What does this look like? Harvard Health Blog explains that it means communicating compassion, understanding, and patience, especially in cases of sexual abuse. Survivors are allowed to empower themselves during treatment, which is a critical part of rebuilding their self-esteem following experiences of abuse.
In cases of addiction, trauma-informed care acknowledges that survivors have understandable reasons for using drugs or alcohol to cope with the trauma, while not denying that such methods are unhealthy, and they have to be gradually reduced.
Without trauma-informed care, doctors and other health care providers will unlikely be able to help survivors.
Psychology Today suggests the use of trauma-informed care should go beyond medical professionals, writing that law enforcement officers and first responders should also receive such training. People who are first on the scene of a situation of intimate partner violence need to deliver holistic patient care, which means being sensitive to the survivor’s current health and their behaviors, whatever they may be.
Sometimes these behaviors might seem mismatched, like a survivor lashing out at police or trying to protect their abuser. First responders have to be aware that there is a range of unexpected behaviors that survivors of domestic trauma can display. When responding to an abuse call, police have to believe that the survivor has been abused, even if the survivor does not behave in a way that would suggest they were a victim of intimate partner violence.
Ultimately, trauma-informed care is about empathy and tolerance, from the first moment of contact with a survivor, through every step of the process to recover from domestic trauma and substance abuse.