Today’s topic is that of domestic abuse and intimate partner violence (IPV). I am limiting this to abuse that occurs between those in an intimate/romantic/sexual relationship, as the topic of family violence and childhood abuse is beyond the scope of this article.
There are of course parallels between the IPV and child abuse literature and both are focussed on the results of the abuse as the defining feature rather than a focus primarily on abusive acts. However the key difference is that while adult abuse is directed towards a presumably psychologically developed individual, child abuse is directed at a developing individual. Thus the range of behaviours considered abusive is overlapping but not completely comparable- examples include neglectful behaviour in child abuse.
First things first
Abusive relationships can involve emotional/psychological abuse, physical abuse and sexual abuse. Often these things can co-exist in fact:
Emotional and psychological abuse can be difficult to detect to the outsider- resulting in low detection rates and low rates of complaints. Psychological abuse is better recognised in the child-abuse literature than in the IP literature. This can involve very varied tactics such as:
- Threats to physical health: physical threats, damage to property
- Control of physical freedoms: isolation and restriction of partner access to others, preventing partner from physically leaving, not letting partner sleep or fulfil basic human needs
- General destabilisation of partner identity/perception of reality: convincing partner that they are responsible for and deserve abuse, threats of suicide, threats of abandonment, humiliation and ridicule, verbal abuse and criticism, forcing partner to beg for things, making partner believe they are crazy
- Controlling behaviour: morbid jealousy and suspiciousness, threats of abandonment, emotional and sexual withholding and blackmail, excessive checking up on partner, following, stalking
- Ineptitude: failure to live up to expected roles, clingy and needy behaviours, rigid gender role ideas
(Follingstad, DeHart 2000 – in order of decreasing severity of abuse)
Additionally certain other more innocuous behaviours have been identified as being correllated with psychological and physical abuse- such as excessively physical behaviour in public, suicide threats and other behaviours.
While psychological abuse may be perceived as less harmful, in actual fact it has been shown to have a similar or in some cases higher negative psychological impact on the victim of the abuse- perhaps due to the brainwashing, controlling, psychological and less easy to identify nature of psychological abuse. (Follingstad & DeHart 2000 “Defining Psychological Abuse of Husbands towards Wives” (Journal of Interpersonal Violence), Marshall L.L. “Physical and Psychological Abuse” (The Dark Side of Interpersonal Communication eds Cupach & Spitzberg) 1994, Engels & Moisan “The Psychological Maltreatment Inventory” (Psychological Reports) 1994)
In addition, psychological abuse is also a predictor of long-term physical abuse.
Physical abuse includes battering, slapping, punching, biting and otherwise physically assaulting a partner. Sexual abuse runs the gamut from coercive sexual assault to severe repetitive rape.
Let me trot out the old line: Domestic abuse is common. In particular, Intimate Partner Violence (sexual and physical abuse) has a lifetime prevalence of victimisation in Australia of 16-20% among females and 4-9% among males. (Roberts et al (1996), Robbe et al (1996), Krahe, Bieneck, Moller (2005) “Understanding gender and intimate partner violence from an international perspective” (Sex roles: A Journal of Research))
Once again as in other behaviour such as stalking, abuse has been reported to be perpetrated with comparable frequency by females as males. The range of behaviour and the physical threat is different, however- females are more likely use psychological forms of abuse and are less likely to inflict grievous bodily harm when physically abusing (perhaps reflected in the lower rate of male physical victimisation). There is, as ever, significant overlap.
As in the previous articles, we will discuss various psychiatric syndromes and motivations behind the abuse.
In the IPV literature, there is a common trend for between 2-4 typologies of abusers to be identified. Generally speaking, there is a clear distinction made between the occasionally violent, mostly normal personality offender and the far more violent, personality disordered abuser.
Attachment styles as pictured above are a way of conceptualising relationships. Those who have good self-esteem and see others as good are likely to form positive, secure relationships. Those who have poor self-esteem but see others as good are likely to be anxious and preoccupied about their worthiness in the relationship and thus preoccupied with thoughts and fears of abandonment- much like those with Borderline Personality Disorder. Those however with good self-esteem but who view others with suspiciousness or look down on others tend to have a “dismissing” attachment style- they look down upon their partners and tend to be colder and less responsive towards their emotional needs, thus making them comparable to those with Paranoid and Psychopathic/Narcissistic traits. Finally we have the “fearful” attachment style- that of those with poor self-esteem and who view others with suspiciousness or fear. This style is characterised by avoidance of intimacy due to fear of rejection.
Thus one would expect that the “secure” and “fearful” attachers would be least likely to be abusive- they would either be content with no reason to abuse or too scared to enter a relationship in the first place. The “pre-occupied”/borderline attachers may lash out due to their insecurities and fear of rejection while the “dismissing”/antisocial/paranoid attachers may lash out due to seeing their partner as inferior or bad.
Ehrensaft et al. (2006) find in their large longitudinal study that all personality disorder clusters are positively correlated with abusiveness. All clusters were moderately associated with each other- it was more likely for someone to exhibit other personality disorder traits if they had a personality disorder already. Cluster A and B were the most correlated with abusiveness. In particular, a combination of jealous, suspicious, paranoid (cluster A) and emotionally volatile, impulsive, unpredictable (cluster B) behaviour was found to be strongly correlated with abuse. After accounting for cluster A and B traits, however, the remaining compltely independent cluster C traits were actually found to be protective against abusiveness- perhaps because those who are fearful of others are also less likely to be aggressive towards them.
Dutton (2007) in his book “The Abusive Personality” on the other hand notes 3 main typologies.
There is the impulsive, brooding, cyclically loving, clingy, needy and abusive violent, angry, jealous type- most likely to score very highly on measures of borderline personality traits. Described as “Jekyll & Hyde”, a person who seems like a perfect partner, then starts brooding and getting more and more volatile until he/she finally lashes out violently. This is followed by gifts and other behaviour to make up for the bad behaviour.
There is the coldly calculating extremely violent (antisocial/psychopathic) type who controls, is constantly angry, batters severely and often uses instruments such as weapons, chairs, frying pans, what comes to hand to inflict severe violence.
Finally there are those who are passive, avoidant and often quite dependent- those who, due to their overcontrolled nature bottle up all of their negative emotions and anger until they finally explode in a bout of rare rage, sometimes with lethal consequences.
There are some parallels between this model, attachment theory and Ehrensaft’s model.
Dutton also speaks of 2 types of co-existing traits- combined violent and borderline traits and combined passive and borderline traits. These combinations tend to be associated with greater violence and adverse outcomes.
Holtzworth-Munroe et al have the most complex model following a 3 year longitudinal study of 102 couples recruited from the community who had had an incident of IPV.
By far the largest category of couples (55%) scored close to normal on personality testing, with very low scores on measures of both psychopathy and borderline traits. These they denoted FO or “Family Only” Batterers. They had some passive personality traits (but not enough to qualify for a diagnosis of personality disorder). They were the least likely to have suffered physical or sexual abuse as a child and least likely to suffer from substance abuse disorders. They were the most loving, securely attached and remorseful and had the most liberal political and gender ideas. They also committed the lowest level of violence and only reported occasional violence vs family with no violence outside the family. They also had the most stable relationships. They could be considered to be securely attached.
Next there was a category known as BD or “Borderline/Dysphoric”. These had high scores on the Borderline Personality Organisation Questionnaire and reported low mood, self-esteem and the lowest relationship satisfaction of all groups. They were also the most jealous of all three groups, being morbidly jealous as a group. They tended to visualise their partner as part of their self-identity rather than another individual. Additionally they saw themselves at times as a “knight in shining armour” or “rescuer” of their spouse. They were needy and clingy and desired their partner to be dependent on them. Their relationships had intermediate stability. They could be considered to have preoccupied attachment.
The most aggressive and violent category was the GVA, “Generally Violent Abuser” category. These abusers scored very highly on the Hare Psychopathy Self-Report Questionnaire measure of psychopathy. They were very likely to commit many acts of violence outside the family setting, have friends/peers with misogynistic/violent/criminal attitudes and to have significant alcohol and substance abuse problems. They were also the group who had experienced the highest rate of and most severe child abuse. They were emotionally void, felt the least love and tended to see their partner as an object rather than fellow human. They also tended to blame their victims, have the most conservative gender roles. They had the most unstable relationships with by far the majority experiencing repeated separations and many having had their partner file for divorce after 3 years.
Lastly there was the LLA “Low Level Aggression” category. They were like a much less severe form of the GVA category. They had moderate scores on psychopathy and were intermediate on all measures between the GVA and FO categories.
Interestingly although there were psychologiical differences found between the BD, GVA and LLA categories, these differences were not found to be statistically significant. The authors posited that this may mean that these categories have a great deal of overlap and may in fact be subtypes of the same psychological phenomenon, the cluster B/paranoid violent type. Also there were no significant differences between FO abusers and the general population- a finding which warrants further investigation as to how they differ from non-abusers.
All groups in the Holtzworth-Munroe study showed a reduction in violence as reported by both the abuser and victim over time- a finding which flew in the face of conventional wisdom. It is unknown at this stage whether this finding will be replicated and whether there was self-selection bias evident. This does however correlate with the finding that personality disorder scores in individuals and incidence in the community decrease slowly with age after a peak in the early 20s, reflecting greater maturity and moderation of undesirable traits with time.
All studies found a strong correlation between child abuse (including physical punishment, neglect, more severe physical abuse, sexual abuse) and future IPV. This alone should be argument enough to oppose the use of physical force against children and to oppose sexual abuse of minors.
There is also a dichotomy found in all studies between normal/passive occasional abusers and the cluster B (+/- A) impulsive/jealous/borderline/antisocial routinely violent abusers- often with a jealous subtype identified.
The major weakness in these typologies is the lack of an explanatory model for the personality changes and future abuse as well as perhaps being simplistic in their formulations. On a population level this all makes sense- how about on an individual basis? It is also noted that co-abuse is common. How does this factor into models of abuse?
There is a multifactorial Bayes network that has been produced to show risk factors to predict sexual offending. A similar sort of network may be what is needed in this area.
I offer the following two theoretical flowcharts in lieu:
As you see, there is one pathway for those with normal personality but low assertiveness and high partner dissonance. The other pathway depicts the evolution of the borderline and the psychopathic abuser via triggers and innate ideas about self and others.
Further research must of course be done!
Additionally, once again I must emphasise that these typologies and mechanisms suggest intervention strategies depending on underlying psychological pathology. The “normal” offender may benefit from assertiveness training and relationship counselling and other forms of psychotherapy. The “borderline” offender needs more intense psychotherapy and therapy directed towards the style of problem-solving and attachment style. The “psychopathic” offender of course requires better problem solving strategies as well as behavioural controls and a large degree of monitoring in the community.