Chapter 14: Family Abuse, Violence, & Other Health Issues

1. Summary:

            Chapter 14 covers the various problems that many U.S. families encounter today; like domestic violence, child maltreatment, sibling and elder abuse, as well as health issues that often lead to a crisis situation. It begins by discussing intimate partner violence (IPV), which occurs between two people in close relationship and states that more abuse comes from a family member than by strangers and may result in death. There are 3 types of behaviors that IPV consists of: 1) physical abuse which occurs when a person hurts or tries to hurt a partner using physical force; 2) sexual abuse which occurs when a person forces a partner to engage in nonconsensual sexual behavior; and 3) emotional abuse which occurs when a person abuses a partner or his/her loved one by threatening to harm them or their possessions or by attempting to destroy a partner’s sense of self-worth. Both male and female abusers tend to be young, poor, unemployed, cohabiting or separated.  They also often abuse alcohol or drugs, and may have seen a parent use violence to resolve conflict. While men are more likely to commit familycide which is the killing of one’s spouse, ex-spouse, children, or other relatives; women have the highest victimization rates across all racial and ethnic groups and are more likely to experience serious emotional and physical injuries than men, possibly resulting in suicidal attempts. Many women refrain from reporting such violence out of shame, fear of revenge, or the belief that no one can help. Men often engage in emotional or physical abuse when they feel as if they need to gain power over their partner because they adhere to the traditional gender role views in which men are the breadwinners and women are homemakers. IPV isn’t limited to just the poor as abuse is also present in high socioeconomic families. While marital homicides have decreased in recent years, marital rape where one partner forces the other to have unwanted sexual intercourse is the most widespread form of sexual abuse in the U.S. This type of abuse is often underreported because of the difficulty many face trying to prove the act actually took place. Many women develop battered-woman syndrome which a psychological condition characterized by women feeling powerless and unable of leaving their partners after years of abuse.  This condition has been used successfully as a defense for women who have killed their husbands after being abused. The cycle theory of battering incidents holds that a tension-building phase leads to an acute battering incident, followed by a period of calm until the cycle starts again; this theory considers a Dr. Jekyll and Mr. Hyde personality where Mr. Hyde is seen in phase 2 with abusive behavior, but becomes Dr. Jekyll in phase 3 as he persuades his partner that he is really going to change; but unfortunately the cycle starts all over again when the calm behavior fades and the abuse starts up again. While some women have the ability to leave abusive relationships, some women remain in them for several reasons such as negative self-concept and low self esteem, belief that the abuser will change, economic hardship and homelessness, need for child support, shame or guilt, blaming themselves, fear, or the fact that the home becomes a prison that they can’t escape. As much emphasis is on women being the primary victims and men being the perpetrators, men are also victims but fail to report the abuse because they may be embarrassed or for other reasons. There are 2 types of IPV identified in this chapter: 1) intimate terrorism where the primary perpetrator is the male who uses various methods of control which keep escalating in an attempt to dominate his partner and 2) situational couple violence in which both partners are perpetrators.

            The next section examines child maltreatment, which unhealthy behaviors that either results in a child being seriously harmed or placed at serious risk; 4 categories of child maltreatment are discussed: 1) physical abuse which causes bodily injury to a child, 2) sexual abuse which involves engaging a child in inappropriate sexual activity, 3) neglect when a caregiver fails to provide a child with life’s basic necessities, and 4) emotional abuse which may include rejecting, terrorizing, isolating, or exploiting and corrupting the child. Although child abuse rates have decreased, many children still experience abuse and neglect every day. Parents, relatives, or parents’ intimate partners are commonly the people who abuse children. Incest is often very difficult to prove, but occurs more often than people imagine and is normally committed by men for emotional satisfaction; in addition, children may feel frightened or responsible for the abuse, leading them to opt to not tell anyone about it. Various reasons are presented as to why adults abuse children such as substance abuse, stress, poverty, partner abuse, divorce, or a combination of factors. The lives of children who are abused are negatively impacted, tormented with physical, social, emotional, and mental problems/disorders.

            Sibling violence is also very common, but often goes unnoticed or is regarded as normal interaction/behavior between siblings. But, in reality, physical, emotional, and sexual abuse among siblings can leave lasting emotional scars and may result in many problems later in life (such as substance abuse or participation in criminal/violent acts). Sometimes violence between siblings might get so severe it results in the murder of a brother or sister, which is often triggered by an argument or disagreement between siblings. Moreover, like child abuse, children tend to keep the sexual abuse a secret from their parents because they either fear retaliation or they think no one will believe them.

            Next, the chapter explores elder abuse, which is often committed by baby boomers now in their late 40s to early 60s know as the  sandwich generation who have the added responsibility of caring for both their own children and their aging parents. Elder abuse involves physical abuse; deprivation of basic necessities; isolation from friends and family; as well as not administering needed medications. The victims of elder abuse tend to be white women; because women are now living longer than men, rates of abuse may be higher for them than men. Furthermore, family members, especially adult children or the victim’s spouse, are often the abusers of these elderly people. There are various motives for family members mistreating the elderly, which include risk factors such as shared living arrangements, social isolation, alcohol abuse, impairment of the caregiver or the care recipient, dependency of the older person on caregiver, medical costs & financial stress, or personality characteristics of older people.

            The last two sections on violence/abuse discuss its prevalence among same-sex couples and racial-ethnic groups as well theories that explain family abuse and violence. While the battering in same-sex couples hasn’t undergone as much research as heterosexual couples, the prevalence of abuse is about the same for both. There are 2 stressors for lesbian couples that often trigger IPV: 1) internalized homophobia or the negative feeling some may have about being lesbian or gay because of the negative feedback society often gives toward homosexuality and 2) heterosexist discrimination which is the unfair treatment received because of one’s homosexual orientation, which may result in internalized homophobia; homosexuals tend to believe they deserve the abuse and so they stay in abusive relationships. They also often refrain from reporting the violence because they believe they won’t be taken seriously and possibly end up be arrested themselves because no one will take the time to distinguish the victim from the abuser. Research shows that IPV and domestic violence abuse among racial-ethnic groups may be experienced differently because of variations in socioeconomic status, culture, national origin, external stressors, and other factors. Five viewpoints for why families are abusive are introduced in this chapter: 1) the patriarchy/male dominance theory which implies that a man’s dominant nature justifies his involvement in domestic violence); 2) social learning theory which suggests we learn by observing the (abusive) behavior of others; 3) resource theory  suggesting the stress that often stems from a decrease of resources, may induce violence; 4) exchange theory in which both abusers and victims tolerate or engage in violent behavior because they believe that the benefit outweigh the costs; and 5) ecological systems theory that holds cultural values that demean, debase, and devalue women and children promote and reinforce abusive behavior. Researchers often consider more than one of these theories to examine family abuse because of the complexity of human behavior.

            Chapter 14 ends with an analysis of other health-related problems families often face. Substance abuse is the first issue mentioned; illicit drug use has become increasingly popular among baby boomers, but has decreased among the youth; both binge and heavy drinking are problematic drinking behaviors that may result in dangerous health problems similar to those of drug abusers. Depression is often experienced by more women than men and may lead to suicide. Additionally, some families may have to cope with eating disorders that, if not taken care of, can result in death; the increase rates of obesity in Americans may be the product of binge eating; however, there are others who experience eating disorders that result in a drastic amount of weight loss rather than obesity, which includes both anorexia nervosa and bulimia; these eating disorders are caused by cultural, psychological, and biological factors. The chapter concludes by stating that families today are subject to a number of negative issues and because they may have more choice than they did in the past, these choices sometimes go unnoticed because of a number of constraints; furthermore, family troubles may decrease if people are more informed about the problems, successful prevention programs are provided, and better intervention strategies are implemented.

2. What was interesting/what did you learn:

            I thought the section on sibling abuse was very interesting. I was surprised to read that siblings are often “hidden victims” of abuse because many parents dismiss it as normal interaction among family members, and the high prevalence of siblicides, 10% of all murders in families, really shocked me. Furthermore, as I was reading the list of common forms of sibling abuse, “name calling and ridicule” instantly caught my attention. I never considered this abuse before I read this chapter; throughout my life my sisters have always called me names to try to get the best of me and some of them have actually stuck with me even after many years; when thinking back at my experiences, I now realize that this mockery /name calling, in fact, is a form of emotional abuse that is present in many sibling relationships because, like my parents often did, parents don’t exert much effort on putting an end to name calling, especially if it may seem to be all fun and games, but in reality it can actually harm a person mentally.

            I found the little exert about Connie Culp on page 388 very fascinating, yet disturbing. I hate to imagine that someone who you feel you love and trust so much that you decide to marry could someday turn on you and shoot you, leading to either your death or significant physical and emotional damage like Connie experienced when her husband shot her in the face. However, the progress she has made with her surgeries/transplants is remarkable; I found a website that describes her process/experience in more detail: http://www.post-gazette.com/pg/10298/1097845-114.stm

I was very disturbed to hear that her husband was released from jail this year; I don’t see why this man should be given another chance to live, considering all the damage Connie has to deal with for the rest of her life because of him.

3. Discussion Point:

            After reading the section on the batter-woman syndrome defense, I thought it was worthwhile discussing. There is much controversy over this defense, but in my opinion, I don’t think anyone should be dismissed from murder charges even if they feel it is the only way out of an abusive relationship. I feel that because there are so many options out there available to protect people from abusers today; if they truly wanted help they should have taken another avenue and not resorted to murder. No one should be allowed to kill anyone including those who abuse them. In addition, the characteristics of battered women’s syndrome are common among many people; a lot of people feel depressed, like they are going nowhere and have uncertainties. Doesn’t dismissing those who kill their abusers from murder based on the batter-woman syndrome defense send the message that it is acceptable to kill if you feel trapped in a situation? Do you think this defense is reasonable? Or do you think it could trigger outrageous murders and increase the homicide rate?