Victims of Violence and Psychiatric Illness - Case Study Example

Victims of Violence and Psychiatric Illness Domestic abuse is not something unheard of by any person considering that it is common in almost all parts of the world regardless whether the country one lives in is developed or not, whether the people who are the perpetrators or the victims are educated or not, domestic abuse is always present in every society. Some, on the other hand, tend to see it to be gender based (Summers, 2002). The Surrey County Council had defined domestic abuse to be any form of violent behavior that is present in a family or a relationship and this abuse is by one family member onto another or by one partner onto the other. This abuse or violence may of any of varying nature, financial, sexual, and physical or even emotional (Surrey County Council). The definition is, however, restricted to the abuse that is ongoing between adults and not children but does make a note to point out that children may vulnerable to secondary abuse because of the violent and hostile environment that they live in. Victim Support in 1992 defined that domestic abuse was when a man abused a women which is certainly not the case now as abuse can be the other way around (Victim Support, 1992). However, victims of domestic abuse are not only those who the ones being abused. Others who live in a household or in proximity of such abusive relations can also become the targets of the abuse and are often overlooked in cases. In case of one parent abusing another, the children are also affected and the younger they are the more traumatic the effects of the violence witnessed may be. Men and women both show aggression towards one another but in most cases the consequences are direr for women (Vincent & Jouriles, 2000). In 1992 a survey showed that eleven percent of women had suffered from physical abuse at the hand of their partner (Charlot et al, 1997). There are many signs that one can observe which can lead one to assume or infer that a person is a victim of child abuse. Unexplained injuries can be a tell tale sign of abuse. Some bruises and injuries are in plain sight and when some people ask about them, the victim makes excuses to hide the true reason for them. At other times these victims have such injuries that they need medical attention and when asked questions at the hospital have no real reason for the injury but instead blame their own clumsiness and carelessness as a cause for the bruise. This can also show the extent of fear and control the abuser has festered upon the victim that they fear to tell others of the circumstances in which they live and are even fearful of leaving their abuser. Absences from work in terms of an adult victim and school when the victim is a child are also something common. Due to the abuse and violence that victims are put through they make take time to recover and in order to hide their injuries and the circumstances of the household or relationship they will miss school or be absent from work. At other times they will be late. Self esteem is another sign which is common and normal for all those who live through abuse. They are constantly told that they are of a lesser standing than the abuser who needs to feel in control and so dominates and exerts his power over others. Low self esteem may also explain why these victims are not ready to leave their abuser as they feel reliant on them and have been told that they are not capable of going out into the world on their own. Not only this but these victims tend to begin thinking that they are not good at anything whether it is the relationship or at their work or even their pass time hobbies. Helplessness is thus a branch that stems from low self esteem. The above mentioned signs and symptoms are only a few of the many that are linked to domestic abuse. It is not clear which of these will manifest in a victim and in which particular manner and at times it is not easy to determine who is being abused as these individuals try to hide the abuse. Individuals feel shame and loathing for themselves even (Shalev et al, 2000). Domestic violence is an off shoot of domestic abuse and is the second most reported crime in the United Kingdom and some experts believe that those which are reported are not even half of the crimes of domestic violence that even occur (Shalev et al, 2000). It has also been observed through study of past occurrences that about 97% of the times the abuser is a man and the victim, a woman. In such a case that a woman is the victim and there are children involved then in most circumstances the child is usually in the same room or in a room nearby where they can hear all the is happening. In certain situations they are even made to watch the abuse first hand. In such situations the child is the secondary victim and usually in such cases the emotional trauma is extreme. Studies have shown that children who are below the age of eight and exposed to such treatment, they tend to internalize the abuse. This is to say that they start to think that they are the reason for the abuse in the first place. They seem to grasp the idea that abuse is normal in a relationship and can even carry this trend forward to the relations that they later begin to establish in life. In a survey that was conducted in the 1970’s there was shown that young boys who were secondary victims or even abused themselves were more likely to show the same abusive attitude towards their own wives later on in life and in general those who were abused were more likely to abuse others later in life (Carmen et al, 1984). It was also shown that boys were to have more likelihood of developing an attitude of externalizing and so would behave in an aggressive and disruptive way towards not only other people but also towards objects and would be more prone to severe tantrums and tempers (Jaffe et al, 1990). First discussing a situation where the child is the primary victim of the abuse, it is pertinent to mention that this may not always come at the hand of parents. Direct abuse of children can occur even at the hands of extended family and other people in a child’s life such as teachers and baby sitters. According to Kate Hevelin there are mainly four types of abuse towards children which are identified; physical abuse, sexual abuse, emotional abuse and lastly neglect (Havelin, 2005). There are plenty of reasons abusers tend to do what they do and one main reason may be the fact they were themselves abused at one point in time. It has been argued that those parents who were abused themselves by their parents will be six times more likely to show violence or some form of abuse towards their own children. Women may show abusive tendencies towards their children because they may feel burdened by them if they have a very poor lifestyle due to early pregnancy. Early pregnancy highlights another point, poverty. Since poor parents are burdened with great and increasing stress and tension they may find that abusing their children is an outlet. Alcohol and other forms of substance abuse are also major factors of abuse. Alcoholics and drug abusers tend to isolate themselves from their family due to their habits and make people act out in a manner that is not appropriate. Abuse toward children may have several detrimental effects on the child them self. Abuse may affect the physical and psychological maturation of the child and the impact of the abuse will determine to which extent. A child may be a victim of malnutrition due to neglect on part of their caretaker and this may lead to stunted development. There may even a chance of contracting a sexually transmitted disease or become pregnant due to sexual abuse which can have severe detrimental effects on the child’s life. In the case of a pregnancy due to the abuse, the child may project their feelings of resentment and hatred towards the baby thus carrying on the cycle of abuse. Emotional abuse can cause low self esteem and may even cause other psychological issue such as anger, mood swings, and hatred and so on. Such harm is not easy to be rid of and a poll conducted by the Los Angeles Times showed that those adults who were abused in their childhood felt that the damage was done then and there was no way of escaping it (Mwiti, 1997). The effects of abuse may vary of course from situation to situation and from the frequency of the abuse to its intensity to the age of the child. Physical abuse towards children and neglect even can cause the death of a child in the extreme cases and a report by the U.S department of Health and Human Service in 2005 estimated that a total of 1460 children who were victims of physical abuse and/or neglect were killed. A majority of these children were below the age of four (Mooney et al, 2008). Abusers fail to think how their abuse may affect the life of the child once they are adults. Children may develop serious psychological problems or permanent disabilities as is the case of those children who suffered from shaken baby syndrome. There may even be disfigurement in situations and children of abuse have a higher tendency to smoke, drink and be involved in criminal behavior. It is of even greater shock when the perpetrators are the parents of the child. These children develop serious trust issues later on in life failing to communicate with their parents in the years of their need. In cases there may even be abuse from a sibling. A study showed that a sibling had at one time or another had been emotionally abused by their sibling and 88% of the females and 77% of the males confessed to have been physically abused by their sibling (Mooney et al, 2008). There are also studies that show that tensions may rise in siblings living in a domestic household (Jaffe, 2004). Preventive measures have been taken extensively to stop child abuse but there is only so far that the measures can be expected to succeed. There are three forms of preventions that are currently being used, primary prevention, secondary prevention and tertiary prevention (Mooney, 186). Primary prevention is aimed towards the general public to not indulge in activities of abuse towards children. It can be said to be an informative method of the causes and effects. Secondary prevention is aimed at those particular groups which may present higher chances of abuse and finally the tertiary preventive form is particularly for those families which have a history of abuse. Primary prevention is essential as it informs the public about abuse and also relays the idea that it’s a criminal offence and the penalty for it is severe. Parents are also taught about child abuse and the many forms that it may infest. In the United States all the states allow for a child to be spanked and hit in a manner so as to use to teach them right from wrong as long as the line between teaching and abuse is not crossed. Children who are secondary victims of abuse are susceptible to have traumatic effects die to the witnessing of rape, violence and other forms of abuse directed towards an adult figure by another. In most cases that have been observed the child is of a battered woman. Children of such women may at a later point develop post traumatic disorder (PTSD). In a study it was observed that the victim children who saw death as a result of uxoricide poisoning, nearly all of them ended up developing symptoms common to PTSD. In an environment when the mother is repeatedly abused, physically or sexually, the child may learn not to be reliant on the parents for his safety or nurture. Attachment may also not be easy to develop as the mother may be in hospitals repeatedly and at times may even leave the household only to return. This returning may be due to the child as mothers usually leave a household to protect their child from abuse. Women who have left their abusive partner or husband do so because they fear for the child’s safety or perhaps the abuse was starting to trickle to the child. A child can also easily be one step away from being the victim. It can’t be said what the frame of mind the abuser supports at a particular instance and it is only a matter of time that the child will be hit or pushed during a period of anger. In some scenarios the child may not know it but may also cause more abusive behavior. Due to the lack of sleep that a child gets and the sleeping habits that result from abuse which includes screaming at night can cause anger in the abuser which he may take out on his wife for her inability to quite the child. It is easier for a child to feel sympathy towards their mother in his early years but as time passes the sympathy can change to a feeling of resentment for a failure to protect the child. In some cases it has been observed that the child will manifest the feelings of the father and may even learn to manipulate his or her mother into staying in the family and continue the abuse. Many critics state that therapy is no help in trying to root out the effect of child abuse whether as a result of being abused directly of witnessing an adult figure being abused. Some have demanded that there be counseling offered as schools to resolve the issues that a child might face and help them improve their household environment (House of Commons, 2008). Such techniques do not tend to work at times as children, as the mothers do at times, will hide the abuse that they are subjected to. If a child is expressive about the abuse and the parents are called in to resolve the tension, there may be consequences later on which can heighten the abuse and the frequency even. There are now interview techniques that are being introduced. These techniques are introduced to those who may have contact with those who are involved with abuse victims in any way. Police are also being trained to interview children in a house in a case where a call has been made of abuse (Marans & Cohen, 1993). Children do not disclose the violence in a house and so it is important to get information from then but due to abuse they have grown to be reserved and have learned that any attempt to gain outside help may have an adverse effect and so try not to step on the toes of the abuser. It thus becomes imperative that time be spent with such children to have them open up to the interviewer and gain their trust and that the child learn that they will not be sent back to the abusive environment they grew up in. In the United States there exist certain clinics that are designed to specifically deal with children who come from abusive homes. They may not be able to help the child to completely shed all that they have gathered from their past but at times the child learns to accept that the abuse was not of their doing and nothing they could have done would have helped to prevent it. This in itself is a big step to take and can offer some closure. There has been some criticism toward s emergency departments of hospitals who treat women who have been abused for their failure of recognizing and even failing to ask for the cause of the injuries that they want treated (Smith, 1992). One research found that only 1 of every 25 women who were subjected to abuse was recognized to be abused while in an emergency room (Stark et al, 1979). Many criticize that the event of abuse that take place after the visit could easily be prevented if hospital officials take care to ask women of the causes of the bruises. Hospitals on the other hand argue that their emergency rooms are at times flooded with cases and it is not too easy to spend too much time on one patient at the expense of others and so it is easy to miss at times even obvious signs of abuse. However, there have been recommendations that physicians take steps on their own to prevent abuse by recording it with evidence and even do routine screenings on their own (Reyes et al, 2002). Social services and other departments of the respective governments also need to step forward to prevent violence. They have access to information of households and can also raise awareness of problems through the various channels that they have. The U.S congress has also mentioned the need for protection of abused children in many of their hearings (Congressional Record, 2010). At times social services fail to notice any abuse as well. Teaching neighbors to be more attentive towards the attitude and behavior of children living in houses around them is another method of prevention which can be done easily and will work better on the ground as no state officials will need to be spared for such purposes. Child abuse and the effects that it may have are varying and can be long lasting. It needs to identify at an early stage and prevented so as to reduce the repetition that may result out of it. Though there are many instances where nations have done quite a lot to reduce the rate of abuse there are many others such as India where child abuse is rampant. In such countries it is difficult to try and curb abuse towards children where it is found to be perfectly fine due to the custom. However, awareness needs to be created and steps need to be taken as child abuse is also a cause of death. As mentioned there are many methods of prevention but some need to be revised and other need to be promoted. 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