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fact that those studied are at different stages in their own histories as batterers. The diversity of perpetrators is limited only by the diversity represented in a community. Sometimes a health care provider or community agency will deal with one group more than another (e.g., a particular socioeconomic class, ethnic group, or age group). This may lead to some inaccurate generalizations about perpetrators (or victims) as providers start to think of abusers solely in terms of the cases they see. In order not to make errors in identification of domestic violence, the health care provider should remain open to the possibility of domestic violence being an issue for diverse individuals. Clinical experience is a reminder that perpetrators come in many forms and ultimately can only be identified by knowing how they relate to their intimate partners. UNDERSTANDING DOMESTIC VIOLENCE 35 2. DOMESTIC VIOLENCE PERPETRATORS AVOID TAKING RESPONSIBILITY FOR THEIR CONDUCT BY MINIMIZING, DENYING, LYING ABOUT OR JUSTIFYING THEIR ABUSIVE TACTICS Perpetrators minimize their abusive conduct and its impact on the victim and others by making the abuse appear less frequent and less severe than it really is (e.g., “I only hit once,” “I just pushed her to the floor,” “The children never saw the abuse,” “She bruises easily,” “I’m not one of those wife-beaters. I have never punched her”). In talking with others about the problem, perpetrators will sometimes use euphemisms for their violence, such as “We’re not getting along so well” or “We had a little fight last night,” when referring to incidents in which the victim required major medical attention for serious injuries. Sometimes perpetrators acknowledge what they do, but justify it by externalizing responsibility for their behavior to others or to factors supposedly outside their control. The health care provider will hear many different ways abusers justify or blame others for their abusiveness. Perpetrators primarily blame the victims for the violence: “She wouldn’t listen to me,” “She’s an alcoholic,” “She’s crazy,” “I can’t handle her,” “My lover is the abuser,” “This pregnancy has made her wild,” “She’s suffering from post-partum depression,” “She’s clumsy,” or “She’s running around on me.” They also blame other factors: “I have PTSD (post-traumatic stress disorder)/hypoglycemia/ attention-deficit disorder/mood swings,” “I was drinking,” “The kids are just too much,” or “The EMT got his facts wrong. I didn’t do nothing that you wouldn’t do.” Sometimes they do not lie about their behavior because they believe they have the right to do what they do. When blaming, perpetrators fail to mention their violent behaviors and avoid taking responsibility for them. Sometimes perpetrators lie about their abuse to avoid the external consequences of their behavior and to maintain control over their partner. They will lie to the victim, family, friends, police, judges, health care providers, and anyone else who has contact with them. They lie because they do not want to deal with possible consequences (e.g., arrests, prosecution, jail, loss of visitation, etc.). Sometimes perpetrators use denial and minimization not only to avoid the external consequences but also to protect themselves from the personal discomfort of recognizing that they are abusing someone they love. This denial is a means of deceiving themselves. Just as there are alcoholics who are in denial about their drinking, there are perpetrators in denial about their battering. There are some perpetrators who are conflicted about what they are doing and they distort it through minimization, denial, or rationalization to make it more acceptable to themselves. Regardless of why a perpetrator is distorting the truth, this distortion can be misleading to both victims and to health care providers and can present barriers to identifying domestic violence. Health care providers should be aware of perpetrators’ tendency to lie, deny, or minimize the violence and avoid colluding with abusers. 3. DOMESTIC VIOLENCE PERPETRATORS CONTROL THE VICTIM THROUGH THE HEALTH CARE SYSTEM Perpetrators use multiple tactics of control against the victim. Sometimes they enlist others in