Domestic Violence; can we be more effective in ending this?

cursenurse · Aug 7, 2005

my main concern about domestic violence is trying to get to the root of why the women (and in some cases men) put up with it time and again. i feel that it is probably d/t poor self esteem. i think that most, if not all d.v. begins with emotional abuse. i think that the abuser wears down the abused person's self esteem and self worth to the point that they feel they are unlovable or that they somehow deserve the abuse. i would like to somehow work with the abused person to help with their self esteem and sense of self worth, so that they don't continue to be abused. i am more concerned with getting to the underlying reasons why the abused person stays, than to try to change the abuser.

i work in er, and i try to see if the abused person wants help, to me it's almost like dealing with a person addicted to drugs/etoh, they have to want help, and be willing to do whatever it takes to get out. i have given the phone number for Haven, which is a shelter for abused persons in MI.

SmilingBluEyes · Aug 8, 2005

I agree with Cursenurse. The victim needs to be in a position/want to get help in order for US to be more effective. All our screening tools and reporting systems are just not enough w/o their cooperation.

momking · Aug 8, 2005

Thank you for your responses so far. I appreciate your perspectives, & frustrations.

I agree, abuse can parallell addictive behavior, & more often than not, in my experience, also comes with addictions as a problem when presenting in the ER or other place of contact which is relatively brief & can be accessed easily without more comprehensive or primary relationship developed with the clinicians.

I think this is why people go to the ER with such histories. "Just the quick fix, please, no long term therapies or internal cleansing, soul-searching...it may be too painful, & I may lose my legitimate need for the strong meds I can get..." is the rationale I have heard before repeatedly in one form or another.

What I am frustrated with in this picture, is the lack of forsight in our own healing arts to see these trends coming together. We, as professionals are often so overworked ourselves that we are too tired to "connect the dots", to take in the his & herstories, while looking at the community within which these stories are emerging, & seeing the contributing factors to this dysfunctional form of care.

Let me be more specific.

My own background spans over 27 years as an RN, graduating from a school with a BA in nursing. I started out with a baccalaureate, from a school for women. It was in the seventies.

We were very proud of the education we had received, & had good courses in epidemiology, & tracking the source of dis-eases. We were trained in a major city, with many very good clinical experiences in this urban setting along with some in more suburban community hospital settings.

We graduate when the book "Our Bodies, Ourselves" was just published, the birth of feminism applied to womens' worklives was emerging.

We were fresh with inspiration from the laws passed in that era to prevent child abuse, elder abuse etc. which had been a struggle to emerge.

Yet, it took nearly twenty years or more to actually uncover & bring to accountability pedophile priests iin our same community. Who used the cloth of the calling to hide the activities that warped many peers for their whole productive adult lives! I say peers because these stories broke two decades later about people I am sure I had seen or rubbed elbows with along the way on the same city streets. Stories which were unraveling & emerging during the now adults's midlife years.

I have been a big advocate of independent nursing practice since graduation, often combining a "regular job" with an institution with a private practice in prepared chilbirth, home care, & or counseling.

Why is this? Because with the way we finance health care, the instituitons are where we find benefits to cover our own health care needs, along with colleagues to interact with. In private practice, we have the freedom to grow in the areas we are drawn to, with a more entrepreneurail spirit. Private practice breaks down stereotypes as well. Both areas of practice however, are rich with experiences with patients who give us the opportunity to observe directly these trends, & to compare & contrast them with research being published in the field.

I say this because in my own experiences I saw that many adult children began, in the pedi clinics I worked in as an example, both East & West coast, to have break through memories of childhood abuse. My own observations in urgent but not emergent settings was, as a child of an adult survivor of abuse had regular health issues bring them to the clinic, oddly usually on the weekends, the parent would catch me as I was going out the door to reveal often very florid recall of episodes in their own lives that were coming up; in dreams, in sudden recall with a new encounter with their child over a similar issue, & it made me think of Maslow's heirarchy of need.

Further research in trauma & recovery writing showed me this is common. Perhaps our psyche has its own self-defense mechanisms which allow us to survive into a functioning adulthood, fulfilling the biological imperative to procreate; we do, have children, & THEN, once a new nest is formed for new offspring, the old traumatic issues resurface when the organism, the parent, can more fully be equippedto handle it.

Yet, because of the abuses surfacing, because of the trauma experienced, we outreach to authority figures with medicine; in our culture that is often the ER staff. A comforting man or woman in white with medicine & directions to take care.

Perhaps ER staff are more approachable than the scary notion of a psych professional who can & has in past times, stigmatized & added to abuse rather than alleviating it. By locking up & hiding the traumatized person, relabeling them in pejorative ways as far as society goes, then confining them to the margins of that society again through institutions, or half-way places.

When what someone suffering from abuse really wants is the pain to end. And it does temporarily when a new drug or set of them works for a time.

But usually the drugs serve only as "magic feathers". Temporary relief, without rooting out the deep source of the trauma & pain to begin with, at its source. So another vicious cycle begins. The drinking, drugging, I'm-a -psycho-anyway syndrome. The-woe-is-me, pity syndrome which gets "secondary gain". If I can not function in this society as a full productive member, I can function with a haze as some sort of psycho with problems on a fixed income with a set of paid friends who keep my chemicals in some sort of balance.

What if we took several steps BACK to look a this bigger picture?

What if we decided, as they have in Sweden as an example, as a whole society to place more attention & enrgy on PREVENTION rather than "cure"?

What would our "big picture" look like then?

Are you willing to envision a different bigger picture with me?

In Sweden there are not the extremes of rich & poor we have in this country. Most people work. Much more of their taxes go to a far more socialist government, one which VALUES FAMILY LIFE, as this society sees that the support of the family at its start is the nexus, or building block of a stable community. Every child a WANTED child.

So this country invests TIME into the young family. The society allows for BOTH the new mom & dad to stay home for a year, doing the MOST IMPORTANT work, young parenting together.

This is where the activism comes in. We are the health professionals who see time after tragic time what the EFFECTS are of a society which values only mass production & profits over relationships & stable domestic situations regardless of our our very diverse families are constellated. Stability in the HOME would be a shift in consciousness, rather than the home being the stopping point between trips through the MacDonald's pick-up with cell phone in hand driving the kid or elder to the next appointment.

The HOME is the place of refuge, not a place of imprisonment. A place where the first dawnings of learning occur with smiles, coos & hugs, not a desolate place with scattered empty beer cans & prescription bottles. Which is the wasteland of many a home these days I am sad to report BECAUSE the doctors are prescribing controlled substances & psych drugs in bath tub quantities these days, then retreating to their own insular mansions & country clubs, far removed from the urban black markets they themselves have created by not "connecting the dots", & seeing the "bigger picture".

My proposal is this; let us go back to basics as we see our world change before us. Let us remember how Nature designed the continuation of human life on the planet.

First one, then two, then love made three. A family born of two loving adults. The FIRST community. The first movement of stability from two, to highly unstable three. And on we go. Perhaps to four.

One small group, living next to another small group. We have community.

Each of us has been trained to see this. Then overworked to forget this.

We are not simply drug pushers, or pill purveyors. There is a MASS intelligence embodied in our noble profession of nursing. So many sets of eyes, ears, hands & hearts.

If we collectively said to our government "we stand for nurturing", we would reduce the number of pills being sold & pushed. We would look to South Africa & other "third workld" nations to see how the most neglected, abused oppressed & impoversished of nations has risen, in large part due to the diligence of NURSES, to birth an integrated society post-apartheid. The nurses there reshaped & revisioned their system of caring. They began to oragnize their clinics around GARDENS. A community health center is a place where FOOD is the first medicine, good food, food grown right on site at the clinic. Organic food. Along with a center for educational outreach, materials & resources to maintain a family in a community.

For my own small contirbution I have shifted toward this model. I have been active in helping midwife a Community Garden in a section 8 housing project, with some really wonderful results already, & this is the first year. Informal talking in the gardens, on benches close to the earth, the source of all of our nutrients. Planting & growing vegetables & food helps us realign oursleves with the actual seasons of our lives, & observing the simple needs of plants in a living lab which a garden is, teaches us to realign ourselves with the simple Maslow's heirarchy of need we often lose touch with when wizzing through ATMS, scanners for security, & moving in & out of modern buildings. Growing gardens together in a small community is prevention . We see each other more often, a natural neighborhood watch develops, not out of fear but in faith & hope & love of neighbor.

Anyone else? Thoughts? Feedback?

Love & blessings to you all, momking