“Home sweet home!” That’s what it means to the majority of people in the world, but for some, it can be a nightmare.
For those who experience domestic violence in their lives, home can be a living hell. This monster, domestic violence, manifests itself in the worst form of human behavior known to mankind. It results in all kinds of abuse and exploitation of the family by the aggressor. The most visible of it is physical violence targeting women, children and, in certain cases, men, too. It does not discriminate between class, ethnicity, religion and other divisions. It even goes across national and international boundaries. In brief, it is a universal phenomenon.
Why have societies not been able to effectively control it yet? To tackle this phenomenon, we as a global community have to start developing a clear understanding and address the root causes of it. In this article I will try to explain a major part of the problem and suggest some solutions.
When we think about domestic violence, the first thing that comes to mind is images of battered women around the globe. Since man is considered the head of the household in most societies, he is responsible for the welfare of the family and is expected to provide for them. In turn, more authority is also bestowed upon him. This authority allows man in most instances to be the aggressor, and because of his role as a provider, he is often able to get away with it more easily.
Communities are often implicit in it by default. Abuse by men is more physically and verbally violent and it affects women, children and anyone in their path. The family lives under a constant threat and is terrorized by the aggressor. No one seems to do anything right at any time. This traumatic environment destroys families and takes away peace. Since this abuse results in a severe form of physical abuse of women and children, the authorities tend to get involved and it comes to our attention more.
Other forms of abuse, including severe verbal and sexual abuse, are tolerated by victims silently, and often go undetected. Contrary to popular belief, in a small percentage of cases, women, adolescents and young adults can also be aggressors and can take the entire family hostage. Abuse by women tends to be more verbal and, that, too, could be as devastating to the family as physical abuse. Children in the family suffer the most from abuse. In some instances they develop severe psychological trauma and can have lifelong scars from it. Victims of the abuse, apart from enduring physical trauma, can also develop depression, anxiety disorders and post-traumatic stress disorder (PTSD). Let us analyze some of the causes of the problem.
Major causes of abuse are psychiatric illnesses, and alcohol and drug abuse. The most common psychiatric disorder that causes anger and aggression in people is bipolar disorder. This disorder is prevalent in 1-5 percent of the general population, according to various statistics. People who have this disorder can be very irritable and get angry easily. Their mood is very volatile and changes frequently. They go through periods of high and low moods. They can be very driven and pursue their goals very aggressively. Their interests can change frequently. They can be very impulsive and do things without thinking about the consequences. When they get angry, their anger can escalate very rapidly.
Mania is a phase of the disorder in which their mood is very high or irritable and they become extremely talkative, sleep less, have lot of energy and start doing too many things at the same time, things they cannot keep up with. In this phase they can be very aggressive and hostile. They become irrational and can become extremely suspicious. They become very loud and forceful and can be extremely violent. This phase can last five to seven days or longer. When they are in a depressed phase they can be suicidal and can harm themselves.
Other psychiatric disorders that can cause aggression include, among others, intermittent explosive disorder, psychotic disorders, antisocial personality disorder and others.
Social and environmental factors
Alcohol abuse is a very significant player in causing domestic violence. Alcohol acts as a disinhibitant of our mind. It takes away the normal inhibitory influence we have on our actions and leads to irrational and impulsive behavior. When people get angry under the influence, they lose control very easily and can severely hurt people around them. Illicit and prescription drug abuse can also lead to violence. There could be other causes of domestic violence, too, but I am restricting my discussion to these, which I think are very significant and are easily treatable.
Domestic violence directly affects the family but indirectly affects the entire society. That demands the use of all the community’s resources. The immediate need is to separate the victims from the aggressor. The aggressor should be appropriately charged and punished. If any underlying conditions are suspected, they should be evaluated and treated, including court-mandated treatment, if needed.
The victims should be provided with a safe environment, and appropriate counseling and therapy made available to them. Education about the problem is essential. The whole situation should be evaluated thoroughly by professionals and the rehabilitation of the family begun. These processes involve resources from all levels. I am going to briefly discuss the steps which should be in place at various levels to address the problem of domestic violence.
At the governmental level, proper penal codes and appropriate punishments need to be set for perpetrators. Provisions should be made for possible mental health and substance abuse evaluations and referrals for their treatment. Inpatient facilities should be set up to stabilize acutely ill subjects. Legal procedures must be established for the involuntary commitment of individuals who refuse treatment and are a danger to themselves or others. Alcohol and substance abuse treatment centers should be set up to address these problems.
For the victim’s benefit, adult and child protective services are to be provided and appropriate laws put in place for those services to function properly. Victims should be placed in a safe environment. Therapy and counseling services must be made available to avert the long-term consequences of abuse. Outpatient centers should be established for group therapy. Adequate funds should be allocated for these services. Education about domestic violence and mental illness should be promoted at various levels in the education system.
Media and community roles
The media have a very important role to play in this regard. Responsible media that can facilitate the education of the population about domestic violence are essential. Mental health issues are considered taboo to talk about. Media outreach can be used effectively to educate the population and dispel myths about psychiatric illnesses so people can break the barriers and seek treatment in the early stages of the problem.
Community organizations can also play a key role in this matter. Women’s organizations do a wonderful job in identifying the problem. They are very proactive and do a good job. They should be strengthened with funds, and resources should be provided to them. Mosques, churches and other religious and civil society organizations should also be more proactive in identifying the problem early on. These organizations are involved very actively in societal affairs and can help families in the early stages of the problem.
Extended families and friends also have an important role to play to help their loved ones not go through catastrophic results if they get help in the early stages of the problem. Individuals should be empowered to get the help they need. The use of emergency telephone hotlines should be encouraged.
Even though this article covers a lot of ground, it only touches very briefly on the various aspects of the problem. Regarding psychiatric disorders, only bipolar disorder is discussed in some detail. This article should be used only as a stimulus to start the serious work on this matter. Readers should do more research on this issue and enlighten themselves. Extensive literature and innumerable books are available on various aspects of domestic violence.
A happy and stable family makes a strong and confident nation. Every effort should be made to strengthen the family since this the building block of a successful nation.
Mohammed Ayoub is a psychiatrist specializing in child, adolescent and adult psychiatry and resides in Houston, Texas.
*Published in TODAY'S ZAMAN on Mar. 28