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Unlike victims of stranger violence, victims of domestic violence face social barriers to a separation from their perpetrators as well as barriers to other strategies for self protection (Hart, 1993). Domestic violence as defined here does not include other types of intimate or family violence: child abuse/neglect, childto-parent violence, sibling violence, and the abuse of the elderly (unless the abuse is being perpetrated by the elder’s intimate partner). While other types of family violence may result in the same kinds of physical injuries and psychological damage found in domestic violence cases, the dynamics are different, require different interventions, and are beyond the scope of this manual. B. Domestic Violence: A Pattern of Behaviors Domestic violence is not an isolated, individual event, but rather a pattern of perpetrator behaviors used against a victim. The pattern consists of a variety of abusive acts, occurring in multiple episodes over the course of the relationship. Some episodes consist of a sustained attack with one tactic repeated many times (e.g., punching), combined with a variety of other tactics (such as name calling, threats, or attacks against property). Other episodes consist of a single act (e.g., a slap, a “certain look”). One tactic (e.g., physical assault) may be used infrequently, while other types of abuse (such as name calling or intimidating gestures) may be used daily. Battering episodes last a few minutes to several hours or days. While some perpetrators repeat a particular set of abusive acts, other perpetrators use a wide variety of tactics with no particular routine. Each episode of domestic violence is connected to the others. One battering episode builds on past episodes and sets the stage for future episodes. Perpetrators refer to past episodes (e.g., “Remember the last time?”) and make threats about future abuse as a way to maintain control. Batterers use a wide range of coercive behaviors that result in a wide range of consequences, some physically injurious and some not, but all psychologically damaging. Some parts of the pattern are crimes in most states (e.g., physical assault, sexual assault, menacing, arson, kidnapping, harassment) while other battering acts are not illegal (e.g., name calling, interrogating children, denying the victim access to the family automobile). All parts of the pattern interact with each other and can have profound physical and emotional effects on victims. Victims respond to the entire pattern of perpetrators’ abuse rather than simply to one episode or one tactic. While a health care provider may be attempting to make sense of one incident that resulted in an injury, the victim is dealing with that single episode in the context of all the other obvious and subtle episodes of abuse. The abusive and coercive behaviors take different forms: physical, sexual, psychological, and economic.
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