A submissives journey
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Intimate
Partner Violence: The Silent Epidemic
Open
any newspaper and you'll find at least one story related to
domestic violence, but a growing body of evidence suggests that
these stories do not adequately reflect the high prevalence of
domestic
brutalities. Violent relationships are a tangled web, often
spanning many years, and as such it is thought that many women
are suffering in silence because they choose not to report
intimate partner violence (IPV). Frequently, when health
professionals suspect that a patient is the victim of IPV, they
feel uncomfortable making inquiries, because there is little
that they can do if a violent relationship is uncovered. This in
turn leads to a situation where intervention strategies go
untested, leaving few options available to remove women from
abusive environments. With only a fraction of cases reported and
only weak, unproven intervention strategies at hand, there is a
perception that IPV is a low-frequency problem, and continues to
remain in the shadows. While the situation looks hopeless,
in-depth studies have made some headway, and new initiatives are
being considered. Until now, it has been the woman who has been
burdened with the responsibility of taking the first step toward
breaking the cycle of IPV, but perhaps it's now time for health
professionals to start asking the right questions.
According to the American Journal of Preventative Medicine, 44 percent of women aged 18-64 (from a sample of more than 3,000) said that they had experienced IPV during their lifetime, with 15 percent currently experiencing IPV. It also seems that IPV is not subject to the socio-economic status of the women involved; running counter to the common misconception that IPV is a problem that affects mostly young, single women from low-income backgrounds. "The findings are important in helping to establish that prevalence is very high in educated, employed U.S. women with healthcare coverage, which indicates that IPV is a problem for the entire population, not just certain subgroups," says IPV researcher Robert S. Thompson. This candid view of a secret and violent existence has shown researchers that current methods are doing next to nothing to help women, and that a new and more practical approach is needed quickly.
Studies into IPV paint a bleak picture of endemic partner abuse, showing an underbelly of society that elicits unwarranted shame and self-loathing from the victim. The stigma and shame associated with IPV are the main reasons why so many cases of IPV remain unreported. Along with the physical and sexual types of IPV, psychological abuse not only prevents women from speaking out, but has also been associated with social isolation, and is no less of an issue than physical abuses. Thompson's study showed that there is often an overlap between the types of IPV experienced by women, but showed that over 35 percent of women experiencing IPV had been subject to psychological abuse. This kind of abuse includes controlling behavior and/or threats and anger from partners; and again there is some overlap with unwanted sexual contact and "forced sex".
These individuals not only suffer the immediate and socially debilitating effects of psychological abuse, but are also more likely to develop depression and other illnesses than women who have not experienced IPV. "The findings on non-physical abuse help to fill in this picture. The linkages of non-physical IPV to health status, and health outcomes are beginning to emerge, as... women experiencing [only] psychological abuse reported a wide range of physical symptoms and diagnoses similar in magnitude to those for people positive for physical abuse only. Thus, it appears that the impacts of non-physical abuse are measurable and significant," said Thompson and his colleagues.
Armed with this bevy of disturbing statistics, researchers have thrown the gauntlet at the feet of public health authorities; challenging them to implement measures to prevent IPV. The first question that needs to be answered, according to Ann L. Coker, PhD, is why public health communities are not universally screening women (and men) for IPV victimization. The main response is that there is insufficient evidence to support routine universal screening. Writing in the American Journal of Preventative Medicine Coker says that: "the evidence to support the effectiveness of screening women for IPV in the primary care setting is lacking, of poor quality, or the balance of the benefits and harms cannot be determined." Coker adds that there needs to be a thorough examination of screening procedures to see if it is more or less beneficial to the safety and well-being of IPV victims. Unfortunately, this requires federal funding, which has to date only been forthcoming as a trickle – perhaps confirming the perception that IPV is a low-frequency problem.
Coker says that while clinicians may currently query patients with visible signs of IPV victimization - such as depression, anxiety and injury - these cases represent IPV in-process, or after the fact. Coker believes that there needs to be a more holistic approach that involves primary and secondary prevention that will allow clinicians to identify women in danger of IPV, and offer them access to information on legal, social, and other community-based services. "The patient has the choice to act on the information provided when she feels safe and ready to access services. It is the responsibility of the healthcare provider to identify the health threat and to provide information on safety and the range of community resources to empower women to make the best decisions for them," says Coker.
Even with resources available, there is still the chance that women will stay with their partners, often reflecting many years of physical or psychological abuse, and the fear and dependency that it has engendered. Coker says that this is often the most disheartening and frustrating time for clinicians, and suggests that more patience is required to allow the woman to choose the safest time to make her move. "It is well documented that the most dangerous time for a battered woman is when she tries to leave," warns Coker.
Coker believes that the primary preventative measure is the changing of attitudes to IPV. If there is a perception that the screening process and support systems for IPV victims works; then more women will likely open up about their own IPV victimization to clinicians. Universal screening should become a social norm, says Coker, as "Asking about IPV is a powerful statement to the victim. Asking removes the veil of secrecy and supports disclosure. Asking changes the social norms surrounding the secrecy of IPV for victims. Asking also changes the social norms in healthcare settings. Asking will eventually change our community's social norms, which allow IPV to continue."
There's no doubt that talking openly with others will be a traumatic and even dangerous period for women suffering IPV, but the sheer magnitude of the problem necessitates such disclosures. An initiative for health professionals to broach the subject of IPV with those women they consider most in danger is an important first step, as this candid approach should normalize the idea of women talking freely about their experiences with IPV.
Ultimately, however, action can only be taken when women do speak out, and in the coming years we will see whether increased opportunity to speak about IPV will override the fear of partner retribution. Governments must also come to understand that IPV is an insidious and widespread blight throughout all sections of the community, and must therefore invest in screening and preventative programs accordingly. The clearest and most important message that women who feel they are suffering IPV can take away from these studies is that they are not alone, and that there is no shame in disclosing the crimes inflicted upon them. Nobody should ever have to bear that heavy load.
BDSM activities, when done in accordance with the principles of Safe, Sane and Consensual (SSC) and/or Risk Aware Consensual Kink (RACK) are not abuse. But remember, it's a fine line and can easily be crossed. Don't always assume that just because someone is involved in a BDSM, Master/slave or Dominant/submissives relationship that the opportunity for abuse isn't present. Open communication between all members of the relationship is essential for a safe, non-abusive relationship.
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