KOCHI: A well-educated and employed woman in her thirties was brought to hospital with injuries. The doctor was unconvinced by the explanation of a fall in the toilet, as reported by her husband. Multiple injuries did not match this story.
When questioned in private, the woman broke into tears and revealed that her husband had brutally assaulted her. She pleaded that the matter be not recorded or reported to the police. Emotionally shattered, she was in desperate need of help.
Theirs was a marriage following a three-year love affair. He had been possessive and controlling even then, refusing to tolerate her phone being engaged when he called. He would make her swear it wasn’t another male friend on the line and insisted she wear what he deemed decent.
Frequent verbal abuse, along with pushing or hitting, marked their relationship. During their courtship, she had tried to end the relationship several times, but he would become desperate, threatening to die by suicide. Believing he would change after marriage, she had persisted, only to find that the abuse continued.
This incident came to mind following recent reports of spousal violence in Kozhikode. The social evil, sadly, continues despite media attention and legal interventions.
Understanding the problem
Intimate partner violence (IPV) encompasses any form of violence within a relationship with a thread of intimacy. It includes partners who are married, unmarried, or in live-in relationships, as well as premarital affairs.
Domestic violence, on the other hand, refers to violence within the family by any of its members, while IPV is limited to acts of aggression between intimate partners.
IPV can occur in heterosexual and same-sex relationships and can be bidirectional, with a partner reacting violently in self-defence. In patriarchal societies, male-to-female aggression is more prevalent. Social pressures often force victims to stay in abusive marriages, even when their lives are at risk.
Forms of IPV:
Physical, sexual, emotional, or psychological abuse
Financial abuse
Controlling behaviour
Intimate partner cyber abuse: online behaviours threatening, harassing, or harming a partner
Worrying stats
The National Family Health Survey (NFHS-5) conducted between 2019 and 2021 revealed:
31.4% of women aged 18-49 faced domestic abuse at least once.
In Kerala, 10% of women reported physical or sexual abuse, lower than the national average, possibly due to better education and employment among women.
57% of victims did not report or seek help.
These figures are an index to intimate partner violence within families. This, however, does not reflect the status in pre-marital affairs.
Mental health implications
The victims may develop depression, anxiety, suicidal thoughts and post-traumatic stress disorder. The threat to physical health and life is another issue.
It is to be noted that the victim may also have a personality disorder that predisposes them to be bonded in a traumatic relationship.
The mental health issues usually seen in the abusive partner are severe personality disorders. Persons with traits of antisocial behaviour, narcissism, dependency, or possessiveness may indulge in partner violence. Alcohol/substance use disorder is, of course, a risk factor.
The relationship itself may be pathological. Social attitudes rooted in patriarchal concepts that ‘sanction’ men to be dominant and violent towards women are crucial in the genesis of male-to-female IPV.
Steps to fight this evil
No one should suffer in silence. Rail against it. Proactive steps are needed to address IPV:
Recognise early signs: The first instance of violence is a red flag. Address it immediately.
Identify triggers and factors: Assess personality traits, mental health issues, and societal constructs contributing to the violence. Make mutual efforts for correction.
Seek safety: If violence persists, move to a safe space away from the abuser. Stress the need for an aggression-free relationship. Beware of false apologies intended to manipulate reunions.
Handle coercion: During separation, abusers may use threats to force a reunion. Stay calm and seek police or legal help.
Seek professional support: Professional intervention can be crucial for victims and abusers alike.
Exit abusive relationships: If attempts for change fail, be gritty enough to leave the relationship.
Mind space
Fortnightly column on mental health
The writer is a senior consultant psychiatrist at Medical Trust Hospital, Kochi