Violence against women Mental health consequences and Rehabilitation strategies

Violence against women Mental health consequences and Rehabilitation strategies


Violence against women is highly prevalent, yet we all try to steer clear from the discourse about the same. Most of us also perceive it to be a personal issue and remain ignorant about the global nature of this social evil. As per the World Health Organization (WHO), “Violence is the intentional use of physical force or power against oneself, or another person, or against a group or community that either results in or has a high likelihood of resulting in injury, death, or psychological harm.”

While all of us can agree about violence being one of the significant issues faced by humanity, violence against women is a much worse problem. The then secretary-general of the United Nations (UN), Ban Ki-Moon stated on the occasion of International Women’s Day March 8th, 2007, that
“Violence against women and girls continues unabated in every continent, country, and culture. It takes a devastating toll on women’s lives, their families, and society as a whole.”

Related: Women’s Day: Unrealistic Beauty Standards and Mental Health

Although most societies morally, constitutionally and legally prohibit such violence, the reality is that often, it is covered up or tacitly condoned.
Whenever there is an incident of violence against women in society, particularly domestic violence, we label it as a personal problem and undermine the importance of finding effective community solutions for it.

Violence against women could be in the form of physical, sexual, and emotional violence that most of the time committed by known persons like the women’s spouse/partner, boyfriend, family members or sometimes by people who are unrelated to the women. Women may even be subjected to secondary violence that can be performed through pornography or objectification of women in media and through social interactions.

Related: The Impact of Domestic Violence on Women’s Mental Health

In several studies worldwide, it is found that at least one in every three women has been a victim of violence during her lifetime, 35% of women have experienced intimate partner or non-partner sexual violence, and that 39% of murders of women have been committed by intimate partners or ex-partners. One cannot deny that the picture of women’s conditions emerging from these numbers is quite frightening.

Women are vulnerable to violence throughout their life cycle from infancy to old age. During the infancy stage, the female babies are more vulnerable and are more likely to be neglected and receive less health care and nutrition than male children of the same age. During childhood, many young girls are subjected to sexual abuse, malnutrition and even female genital mutation. At the adolescent stage, girls may even be forced into prostitution, transactional sex, early marriage and rape.

During the reproductive phase, women may become victims of violence perpetrated by partners and violence in the form of sexual harassment, sex trafficking and dowry. Older women might also become victims of widow abuse, loss of land, or rape. Other forms of violence against women include violence during pregnancy, dowry murders and acid attacks. Our society has been patriarchal, resulting in a superior social and economic status for men than women. This in addition to alcoholism and substance abuse plays a triggering role in violence against women.

Related: How Dowry Abuse Becomes a Concern for Women’s Mental Health

The self-silencing tendency of women to adhere to the socially prescribed definition of a ‘good woman’ leads to gross underreporting of the issue of violence against women.

There are consequences to everything, and the result of domestic violence is battered women syndrome, which Lenore Walker first coined. It is a set of distinct psychological symptoms that result from prolonged exposure to situations of intimate partner violence. According to walker’s cycle of violence, spousal abuse generally occurs in cycles. The first stage in this cycle is the ‘tension building stage’ when the victim is exposed to verbal and/or emotional abuse and minor physical abuse.

The victim attempts to pacify the abuser utilizing techniques that have been effective in the past. In the second stage of ‘acute battering incidents’, physical violence increases and the victim’s sense of fear and perception of danger is at the most heightened state, as the risk of death or injury. This is followed by the loving contrition stage, in which the offender attempts to convince the victim that the violence won’t be meted out again.

However, this again gradually leads to the tension building stage resulting in a cycle of this experience. The consequence of extreme sexual violence against women, such as rape, can cause the symptoms of rape trauma syndrome to occur. This phenomenon occurs in two phases, first is the acute phase, which starts at the time of incidence and may continue for the next 2-3 weeks. Victims in this phase undergo acute somatic manifestations such as physical trauma, including general sores, bruising in the throat, neck, breast, thighs, legs and arms. Skeletal muscle tensions such as headaches, fatigue, sleep pattern disturbances, edginess, and jumpiness over minor incidents. Gastrointestinal irritability such as stomach pains, loss of appetite, nausea and genitourinary disturbance like vaginal discharge, itching, burning sensation on urination are common during this phase.

Emotional symptoms such as feelings of fear, humiliation and embarrassment, anger and self-blame are also present during this phase. In the acute phase, the victim may display one of the two types of emotional expression. Some people may display an ‘expressed emotional style’ where they openly express their fear, anger, anxiety through crying, sobbing, smiling, restlessness and tenseness. Other victims may display a “controlled emotional style’ in which they hide or mask their feelings and isolate themselves.

Read More: Trauma: Types, Symptoms and Treatment

After the first phase, comes the second phase of the rape trauma syndrome which is also known as the long-term reorganization process. It starts after the acute phase and lasts for about six months to a year or even longer. In this phase, the victim begins to reorganize her lifestyle and the symptoms during this phase include increased motor activity such as changing residence, going on trips, changing telephone numbers etc. Victims also turn to friends and family members for support during this phase.

The victims also experience nightmares, which can be classified into two types. One of them is that the victim wishes to act in a criminal situation but ends up waking up before that could happen. In the other nightmare type, the victim relives the traumatic experience but manages to fight off her attacker. Some trauma-induced phobic reactions are also common during this phase. These phobic reactions include fear of indoors, fear of outdoors, fear of being alone, fear of crowds, fear of people behind them etc.

Related: Understanding Psychology Behind Fear and Phobias

Reactions to the incidents of rape may occur in two variations. The first variation is the silent reaction in which the experience of current rape may trigger the memories and reactions related to the prior rape about which the woman might not have told anyone. The second variation involves a compounded reaction wherein women with previously existing psychiatric, social and behavioural problems experience additional and increased psychiatric issues as a result of the current victimization experience.

Depression is one of the major mental health consequences of violence. Gender-based violence is found to be a significant contributor to depression among women and the connection can be observed across cultures. A meta-analytic study conducted by Golding in 1999, observed that 46.7% of battered women experience depression. Studies have also observed that 73.3% of domestic violence victims have experienced acute feelings of shame, guilt and alienation.

Post-traumatic Stress Disorder (PTSD) is another mental health consequence that occurs in battered women. In an Indian sample, Chandra and colleagues observed symptoms of post-traumatic stress disorder (PTSD) among 12% of domestic violence victims. The third important consequence of violence is suicide. In a multi-country study by WHO, intimate partner violence was revealed as the highest contributor to female suicides. It has been reported that about 12% of family violence victims had suicidal thoughts, and 3.4% of them had attempted to commit suicide.

Now the key question before the psychologists, social workers and other mental health professionals is that how can we prevent instances of violence against women. Some common strategies to stop this gender-based violence are increased investment in prevention programs and policies, enhanced socializing of boys and girls since childhood and during adolescence on values of gender equality and non-violence and treating the problem of violence as a social and political issue rather than a personal problem.

Parents should be supported and motivated to gender sensitize their children, both male and female and promote equality and respect for all genders. The mass media can play a tremendous role in spreading awareness, initiating educational campaigns and model acceptable and unacceptable behaviours.

Women must also talk to family members about the benefits of maintaining a healthy relationship. They must support other women experiencing violence and be open and honest while seeking support. Men should commit to non-violence in their relationships and respect their partners in the same way they wish to be respected. The young generation should also talk to their friends about healthy relationships and must readily be available to offer support to friends experiencing violence, respect other boys and girls and treat them equally.

The youth must join or create youth groups to discuss gender issues that are vital for the society. As community members, it is the responsibility of each one of us to speak out whenever we witness violent incidents and encourage others to share family responsibilities. The rehabilitation of the victimized women is also a significant issue.

We need to adopt a multi-dimensional and holistic approach for the physio-psycho-social rehabilitation of women experiencing gender-based violence.

Legal and non-legal services for such women in the form of support from the judicial system, society, family, community and the healthcare system are crucial in our fight against violence against women.

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