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abusive control (Pence & Paymar, 1993). H. Domestic Violence Is Not Caused by the Victim’s Behavior or by the Relationship People can be in conflicted relationships and experience negative feelings about the behavior of their partner without choosing to respond with violence. Focusing on the relationship or the victim’s behavior as an explanation for domestic violence removes the perpetrator’s responsibility for the violence and coercion and supports the perpetrators’ minimization, denial, blaming, and rationalization for the violent behavior. Blaming the victim for making the perpetrator angry, or blaming the violence on problems in the relationship (e.g., poor communication) provides the perpetrator with excuses and justifications for the conduct. This reinforces the perpetrator’s use of abuse to control family members and thus contributes to the escalation of the pattern of domestic violence. Many batterers bring this pattern of control into their adult relationships and repeat it in all their adult intimate relationships, regardless of significant differences in the personalities or conduct of their intimate partners or in the characteristics of those particular relationships. These variables in partners and relationships supports the position that while domestic violence takes place within a relationship, it is not caused by the relationship. Research indicates that there are no personality profiles for battered women (Hotaling & Sugarman, 1986). Battered women are no different from non-battered women in terms of psychological characteristics. Once again, this challenges the myth that there is something about the woman that causes the perpetrator’s violence. Furthermore, a study by Jacobson et al. (1994) indicates that no victim behavior could alter the perpetrator’s behavior. This also suggests that the victim’s behavior is not the determining factor in whether or not the perpetrator is abusive. Domestic violence in adolescent relationships further challenges the notion that the abuse is the result of the victim’s behavior. Often times the adolescent abuser only superficially knows his victim, having dated her only a few days or weeks before beginning the abuse. Such an abuser is often acting out an image of how to conduct an intimate relationship based on the recommendations of his peers, music videos, models set by family members, etc. The adolescent’s abusive conduct is influenced more by that image or script than by the victim’s behavior. Both adult and adolescent batterers bring into their intimate relationships certain expectations of who is to be in charge and what mechanisms are acceptable for enforcing that dominance. Those attitudes and beliefs, rather than the victim’s behavior, determine whether or not they are violent. CHAPTER 1 30 III. DOMESTIC VIOLENCE: THE VICTIM, THE PERPETRATOR, THE CHILDREN AND THE COMMUNITY A. The Victim Victims of domestic violence have multiple health problems as a result of the abusiveness of their partners. They seek medical care for injuries resulting from the perpetrators’ acts (e.g., burns, broken bones, internal injuries, vaginal injuries, miscarriages, head injuries, damage to eyes or ears, dental injuries, knife or gunshot wounds, cuts, back injuries) and with illnesses aggravated by the stress of living with their partner’s abusiveness (e.g., asthma, lupus, MS, depression, anxiety, insomnia, eating disorders). Victims may also be patients in the health care system for issues seemingly unrelated to their victimization, and their treatment for their medical conditions may be compromised by the continuing abuse (e.g., an insulin-dependent patient whose perpetrator controls her by withholding her medications or by refusing to allow her to keep her medical appointments). This victimization by intimate partners puts patients at future risk for medical and psychological sequelae to abuse. If the domestic violence is not identified and addressed, there are both long and short-term consequences for the victims. Unidentified victims may receive inappropriate treatments for their presenting injury or illness (e.g., over-medications, treatment protocols they are unable to carry out due to the control of the abusers) and/or they may be denied the opportunity to get the information and support they need to protect themselves from