Domestic violence toward women: Recognize the patterns and seek help
Domestic abuse can happen to anyone, regardless of age, economic status, race and educational background. Find out how to recognize an abusive relationship and what resources are available to help.
He says he‘s sorry and that it won‘t happen again. But you fear it will. Angry outbursts, hurtful words, sometimes a slap or a punch. You may start to doubt your own judgment, or wonder whether you‘re going crazy. Maybe you think you‘ve imagined the whole thing.

But you haven‘t. Domestic violence can and does happen to people of all ages, races, and socioeconomic and educational backgrounds. Domestic violence happens to men and to same-sex partners, but most often domestic violence involves men abusing their female partners. In fact, the Department of Health and Human Services estimates that as many as 4 million women suffer abuse from their husbands, ex-husbands, boyfriends or intimate partners in the United States each year.

Domestic violence — also called domestic abuse, intimate partner violence or battering — occurs between people in intimate relationships. It takes many forms, including coercion, threats, intimidation, isolation, and emotional, sexual and physical abuse.

Without help, abuse will continue and could worsen. Many resources are available to help you understand your options and to support you. No one deserves to be abused.

An abusive relationship: It‘s about power and control
Though there are no typical victims of domestic violence, abusive relationships do share similar characteristics. In all cases, the abuser aims to exert power and control over his partner.

"A lot of people think domestic violence is about anger, and it really isn‘t," says Diana Patterson, a licensed social worker and violence prevention coordinator at Mayo Clinic, Rochester, Minn. "Batterers do tend to take their anger out on their intimate partner. But it‘s not really about anger. It‘s about trying to instill fear and wanting to have power and control in the relationship."

But anger is just one way that an abuser tries to gain authority. The batterer may also turn to physical violence — kicking, punching, grabbing, slapping or strangulation, for example. The abuser may also use sexual violence — forcing you to have sexual intercourse or to engage in other sexual activities against your will.

In an abusive relationship, the abuser may use varying tactics to gain power and control, including:

Children as pawns. Accuses you of bad parenting, threatens to take the children away, uses the children to relay messages, or threatens to report you to children‘s protective services.
Coercion and threats. Threatens to hurt other family members, pets, children or self.
Denial and blame. Denies that the abuse occurs and shifts responsibility for the abusive behavior onto you. This may leave you confused and unsure of yourself or make you feel like you‘re going crazy.
Economic abuse. Controls finances, refuses to share money, makes you account for money spent and doesn‘t want you to work outside the home. The abuser may also try to sabotage your work performance by forcing you to miss work or by calling you frequently at work.
Emotional abuse. Uses put-downs, insults, criticism or name-calling to make you feel bad about yourself.
Intimidation. Uses certain looks, actions or gestures to instill fear. The abuser may break things, destroy property, abuse pets or display weapons.
Isolation. Limits your contact with family and friends, requires you to get permission to leave the house, doesn‘t allow you to work or attend school, and controls your activities and social events. The abuser may ask where you‘ve been, track your time and whereabouts, or check the odometer on your car.
Power. Makes all major decisions, defines the roles in your relationship, is in charge of the home and social life, and treats you like a servant or possession.
Recognizing abuse: Know the signs
It may not be easy to identify abuse. An abusive relationship can start subtly. The abuser may criticize your appearance or may be unreasonably jealous. Gradually, the abuse becomes more frequent, severe and potentially life-threatening.

"It‘s important to know that these relationships don‘t happen overnight," says Patterson. "It‘s a gradual process — a slow disintegration of a person‘s sense of self."

However, many characteristics signify an abusive relationship. For example, you may be abused if you:

Have ever been hit, kicked, shoved or threatened with violence
Feel that you have no choice about how you spend your time, where you go or what you wear
Have been accused by your partner of things you‘ve never done
Must ask your partner for permission to make everyday decisions
Feel bad about yourself because your partner calls you names, insults you or puts you down
Limit time with your family and friends because of your partner‘s demands
Submit to sexual intercourse or engage in sexual acts against your will
Accept your partner‘s decisions because you‘re afraid of ensuing anger
Are accused of being unfaithful
Change your behavior in an effort to not anger your partner
Pregnancy is a particularly perilous time for an abused woman. Not only is your health at risk, but also the health of your unborn child. Abuse can begin or may increase during pregnancy.

Breaking the cycle: Difficult, but doable with help
Domestic violence is part of a continuing cycle that‘s difficult to break. If you‘re in an abusive situation, you may recognize this pattern:

Your abuser strikes using words or actions.
Your abuser may beg for forgiveness, offer gifts or promise to change.
Your abuser becomes tense, angry or depressed.
Your abuser promises to stop but repeats the abusive behavior.
Typically each time the abuse occurs, it worsens, and the cycle shortens. Breaking this pattern of violence alone and without help is difficult.

"When you live in an environment of chaos, stress and fear, you start doubting yourself and your ability to take care of yourself," says Patterson. "It can really unravel your sense of reality and self-esteem."

So it‘s important to recognize that you may not be in a position to resolve the situation on your own. You may need outside help, and that‘s OK. Without help, the abuse will likely continue. Leaving the abusive relationship may be the only way to break the cycle.

Getting ready to leave: Use a safety plan
Leaving an abuser can be dangerous. You‘re the only person who knows the safest time to leave. Make sure you prepare a safety plan so that you can act quickly when the time is right. Consider taking these precautions:

Arrange a safety signal with a neighbor as an alert to call the police if necessary.
Prepare an emergency bag that includes items you‘ll need when you leave, such as extra clothes, important papers, money, extra keys and prescription medications.
Know exactly where you‘ll go and how you‘ll get there, even if you have to leave in the middle of the night.
Call a local women‘s shelter or the National Domestic Violence Hotline at (800) 799-7233 to find out about legal options and resources available to you, before you need them.
If you have school-age children, notify the school authorities about custody arrangements, warn them about possible threats and advise the school on what information to keep confidential.
As part of a safety plan, avoid making long-distance phone calls from home because the abuser could trace the calls to find out where you‘re going. And the abuser may be able to intercept your cell phone conversations using a scanner. Switch to a corded phone if you‘re relaying sensitive information.

Also, be aware that the abuser may be able to monitor your Internet activities and access your e-mail account. Change your passwords, get a new e-mail account or access a computer at a friend‘s house or a local library.

Where to find help: Options abound
In an emergency situation, call 911 or your local law enforcement agency. If you aren‘t in immediate danger, consider contacting one of the following resources:

National Domestic Violence Hotline: (800) 799-SAFE or (800) 799-7233. Provides crisis intervention and referrals to in-state or out-of-state resources, such as women‘s shelters or crisis centers.
Your doctor or hospital emergency room. Treats any injuries and refers you to safe housing and other local resources.
Local women‘s shelter or crisis center. Typically provides 24-hour, emergency shelter for you and your children, advice on legal matters, advocacy and support services, and evaluation and monitoring of abusers. Some shelters have staff members who speak multiple languages.
Counseling or mental health center. Most communities have agencies that provide individual counseling and support groups to women in abusive relationships. Be wary of anyone who advises couples or marriage counseling. This isn‘t appropriate for abusive relationships.
Local court. Your district court can help you obtain a court order, which legally mandates the abuser stay away from you or face arrest. These are typically called orders for protection or restraining orders. Advocates are available in many communities to help you complete the paperwork and guide you through the court process.
"There are many resources available to help you if you are being abused." says Patterson. "You can have and you deserve a peaceful life."

http://www.mayoclinic.com/health/domestic-violence/WO00044