Among Veterans, another cause of D.V. is cited

This is an important article on a vital topic. I have worked both with Veterans, and with Domestic Violence offenders. Both populations are both challenging and rewarding to work with. I heard many stories of returning Vets struggling to reintegrate themselves into their worlds while also struggling to manage their increased inner rage and irritability--possibly brought to the surface by PTSD. In the article below (from Psych Central) new research suggests the risk of domestic violence will rise as increasing number of veterans are diagnosed with posttraumatic stress disorder (PTSD).

"The consequences (of PTSD and domestic violence) on families and children in communities across the United States are an emerging concern says Monica Matthieu, Ph.D., an expert on veteran mental health and an assistant professor of social work at Washington University in St. Louis.

'Treatments for domestic violence are very different than those for PTSD. The Department of Veterans Affairs (VA) has mental health services and treatments for PTSD, yet these services need to be combined with the specialized domestic violence intervention programs offered by community agencies for those veterans engaging in battering behavior against intimate partners and families.'

Matthieu and Peter Hovmand, Ph.D., domestic violence expert and assistant professor of social work at Washington University, are merging their research interests and are working to design community prevention strategies to address this emerging public health problem.

'The increasing prevalence of traumatic brain injury and substance use disorders along with PTSD among veterans poses some unique challenges to existing community responses to domestic violence' says Hovmand.

'Community responses to domestic violence must be adapted to respond to the increasing number of veterans with PTSD. This includes veterans with young families and older veterans with chronic mental health issues.'

Even as the demographic of the veteran population changes as World War II veterans reach their 80s and 90s and young veterans completing tours of duty in Iraq and Afghanistan, the numbers of living veterans who have served in the United States military is staggering. Current estimates indicate that there are 23,816,000 veterans.

Matthieu says there are evidence-based psychological treatment programs that can be a great resource for clinicians to learn how to identify and treat PTSD symptoms. However, identifying battering behaviors among veterans with active PTSD symptoms may be difficult and may require consultation and referral to domestic violence experts.

Research in the VA shows that male veterans with PTSD are two to three times more likely than veterans without PTSD to engage in intimate partner violence and more likely to be involved in the legal system.

'Community violence prevention agencies and services need to be included in a veteran’s treatment plan to address the battering behaviors,' says Hovmand.

.Veterans need to have multiple providers coordinating the care that is available to them, with each provider working on one treatment goal. Coordinated community response efforts such as this bring together law enforcement, the courts, social service agencies, community activists and advocates for women to address the problem of domestic violence. These efforts increase victim safety and offender accountability by encouraging interorganizational exchanges and communication'."

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counseling

Why do victims of domestic abuse stay?

I work with a domestic abuse intervention program, co-facilitating a group designed to rehabilitate the domestic abuse offenders. This post is not about that as much as it is about the age old question that is asked of any victim of domestic abuse: "why do they stay?" I read an excellent article recently that eloquently and pretty thoroughly covers this quandary.
Here is a part of the article. The link will take you to the website and the entire article.

Domestic Violence: considering leaving

by Evan

1. Ethical objections to leaving.
Some people feel that it is their duty to stay in a relationship where they suffer violence. This is easy to reject out of hand but I’m not sure we should. Most of us don’t leave a relationship as soon as it doesn’t suit us. ... I want to pay tribute to the honor and truth in this position. Suffering can be positive.

I grew up in a tradition that values martyrdom - mainstream christianity. This is quite a different evaluation of suffering to the “If I’m not enjoying it I’m out of here” school.

So I understand and honor some elements of this ethical stance. And I think it is usually best for people to leave a situation where they are suffering violence.

Firstly about martyrdom. The martyrs went to their deaths rejoicing. If you can’t do this then it seems most likely that the suffering is demonic rather than a summons from the divine. Secondly, about children. The value of suffering for our children is in the context of the growth of a healthy person and a healthy relationship. Usually staying in a situation of domestic violence perpetuates a very unhealthy relationship - this is a decisive difference.

2. Psychological difficulties with leaving.

This can be what is called ‘learned helplessness’. People who are violated often are left devoid of initiative. (The complement to this is an all-consuming and unreasoning rage, which they suppress because they feel to let it out will have devastating consequences.)

It can also be that they feel they ‘deserve’ to be treated badly. This is often the case with abused children. They feel that they are in some way to blame, or if they weren’t bad then the other person wouldn’t have done this to them.

This can be extreme and extraordinarily difficult to be with. A woman therapist I knew was working with a woman in an awfully abusive relationship - she had been hospitalized many times and still wouldn’t leave. The woman therapist said, “Look, he nearly killed you - it probably was just an accident that you weren’t killed. What could be worse about leaving?” Dealing with this kind of stuff is quite awful.

It is important to say that rage can be worked with in a way that is safe to all people and that doesn’t damage the furniture. It can take time and patience and lots of support but it can be done. It is sometimes part of self defense for women classes.

3. Nowhere to go.
Sometimes external circumstances are very difficult. In small communities - whether geographically like a town with a small population, or in other ways (eg religious or other groups) - there can be no external supports. Leaving means leaving the whole social network.

This is really a problem with the rest of us. I’ll give an example from my own tradition - mainstream christianity. The denominations could get together and announce that every congregation would now have people in it who would offer sanctuary to anyone suffering domestic violence (the names would be kept secret). There could be a phone number for people to ring so that anonymity could be guarded. They would also institute programs that worked with perpetrators. This would involve some training and other costs. My guess is that it could easily be funded in each country by the selling of a cathedral or large piece of land.

Usually perpetrators do not stop their violence until someone outside the relationship becomes involved. Usually someone with social sanction, such as the police or other officials. Perpetrators usually don’t change until they ‘have to’ - having to because otherwise they’ll lose the relationship or end up in gaol. This is unfortunate but it is true in most areas: we usually feel stressed and over-burdened and don’t want the hassle of changing. It is just as true in the situation of domestic violence. If you are in a violent relationship or know of one, it is well worth considering getting officialdom involved.

Finally, it is important to say that domestic violence can and does end. There are relationships where the perpetrators have changed: their violence has stopped never to return. In my experience this has always been after the person suffering the violence has left. I have personally known relationships where this has happened.

I’ve written this with much nervousness. Writing about this in cold type means it can feel cold and like the suffering is being trivialized. I hope this doesn’t read this way. I decided to take the risk because it is a topic that needs dealing with.

mental health

counseling