Causes of PTSD: Domestic Abuse
Post Traumatic Stress Disorder (PTSD) is condition that some people develop after experiencing or witnessing a traumatic event, and experiencing domestic abuse is one such trauma that can cause PTSD. Unfortunately, domestic abuse is a far more common occurrence than most people would like to think: according to the Office for National Statistics, in the UK some 1.2 million women and 700,000 men experience domestic abuse each year, however, these figures relate only for official reports, with the real figure likely to be much higher.
Domestic Abuse is defined as ‘an incident or pattern of incidents of controlling, coercive, threatening, degrading and violent behaviour, including sexual violence, in the majority of cases by a partner or ex-partner, but also by a family member or carer’.
Domestic abuse can include, but is not limited to, the following:
- Coercive control (a pattern of intimidation, degradation, isolation and control with the use or threat of physical or sexual violence)
- Psychological and/or emotional abuse
- Physical or sexual abuse
- Financial or economic abuse
- Harassment and stalking
- Online or digital abuse
To be clear, in our definitions, Domestic Abuse is abuse that takes place within a household and can be between any two people within that household. Domestic Abuse can occur between a parent and child, siblings, or even roommates. Intimate Partner Violence (IPV) can only occur between romantic partners who may or may not be living together in the same household and includes physical, sexual, and psychological maltreatment.
In this article, when talking about Domestic Abuse, this also covers IPV within the term (unless noted) but we cover childhood abuse in a separate article here.
How can domestic abuse cause PTSD?
Traumatic events like being a victim of domestic abuse can often lead to shame and confusion, particularly surrounding the way someone responds to it. They may wonder why they didn’t fight back or try to escape, and the reality is that we have little control over the defence mechanisms of our brains – the ‘fight/flight/freeze/flop/fawn’ trauma response allows little room for ‘logic’ or reasoning in the moment.
Even if the victim escapes their abusive partner, it can take time to adjust to a safe environment. This is particularly true if the perpetrator was very controlling and/or violent over a long period of time. When trauma is not processed properly, it can linger in the subconscious and cause severe psychological problems that inhibit a person’s day-to-day life, such as PTSD or C-PTSD.
It is still a common misconception that PTSD is a condition that only affects veterans who have experienced the horrors of military combat. While it is very common amongst this group of people, it can actually develop in anyone after experiencing or witnessing a major life-threatening event. This can include domestic abuse as it exposes the victim to extremes of fear, helplessness and vulnerability.
The fear can become overwhelming during and after an experience of abuse. In instances of domestic abuse, this can be exacerbated by the fact that the perpetrator remains close by, often for long periods of time.
Not every person who experiences trauma will go on to experience symptoms of PTSD, however domestic abuse stats show the high result of PTSD in domestic abuse survivors.
- Almost two thirds of domestic abuse survivors experience PTSD
- PTSD is experienced by 51% to 75% of women who are victims of IPV (compared to an average of 10.4% of women in the general population).
- In one study, 20% of men who reported sustaining physical IPV had moderate-to-severe PTSD symptoms
Sophia’s story shows just how PTSD can affect someone who has been a victim of domestic abuse. “Right after she escaped her abuser, Sophia was “petrified” to be alone. A friend stayed with her in her apartment, and Sophia literally followed her from room to room. “I wasn’t able to take care of myself.” She would have to remind me to eat and help me go grocery shopping. The best way to describe it is that I was a zombie.” Scared that her abuser would find her, Sophia was often too afraid to leave the house. If she heard even the slightest noise, her heart rate would skyrocket, a stress rash would creep across her cheeks, neck, and chest, and she would start to shake. “I was a wreck,” she says.
Almost three years later, Sophia has made incredible strides in her healing process. But like many survivors, she says she has sometimes struggled with everyday things that remind her of what she went through.”
Domestic abuse ‘witnesses’
Much of the information and statistics on Domestic abuse and PTSD occurrence focuses on partner-to-partner abuse – but what happens when someone, particularly children, witness this abuse between their parents or carers? ‘Exposure to violence in the home occurs at high rates and often is noted as one of the most common and severe adverse events during childhood. Recent data from a nationally representative sample in the US show that, each year, domestic violence occurs in the homes of approximately 30% of youth living with two parents.’
As with all traumatic events, only a portion of the children who experience violence exposure in their homes will develop PTSD. Reports show that 13–50% of youth exposed to inter-parental violence qualify for diagnosis of PTSD. In a sample of community children exposed to partner aggression, 13% of the children met diagnostic criteria for PTSD.’
What can help after experiencing domestic abuse?
The very first thing that can help in the aftermath of domestic abuse is to seek emotional support. This should come from a trusted person like a friend or family member. It’s important to escape the situation if possible, as the longer you are exposed to that fear and danger, the more likely it is that symptoms of PTSD will occur.
Unfortunately, the victim does not always have full control over their options. In some cases, the abuser may even seek the emotional support of the victim after a traumatic event, which inhibits the victim’s ability to care for themselves.
Getting help as soon as possible can also help you in not trying to find alternative ways to cope with your symptoms. Abuse victims suffering from PTSD and depressive symptoms often turn to self-medicating tactics in order to cope with the negative cognitive, behavioural, and affective features of these disorders – 13.5% of victims were alcohol dependent in comparison with 1.4% in non-victims. Similarly, 22.8% of victims used illicit drugs within the past 12 months in comparison to 2.8% in non-victims.
If you have experienced domestic abuse, it’s worthwhile knowing what symptoms to look out for in the case of PTSD. PTSD symptoms include flashbacks, emotional distress, physical reactions to upsetting memories, forgetting key parts of the traumatic event, emotional numbness, trouble focusing, and physical distress like sweating, trembling or nausea. In most cases, PTSD is very treatable, so it’s important to seek help if you are experiencing symptoms.
What treatments are there for PTSD after domestic abuse?
NICE guidance updated in 2018 recommends the use of trauma focused psychological treatments for Post Traumatic Stress Disorder in adults, specifically the use of Eye Movement Desensitisation Reprocessing (EMDR) and trauma focused cognitive behavioural therapy (CBT).
For some Domestic Violence survivors, ‘therapy works especially well in conjunction with meditation. Melanie took up the practice after her counsellor mentioned how beneficial it can be. “I’ve found meditation to be extremely effective in quieting the noise and guilt and echoes and remnants of doubt this type of experience can put you through,” she says.
Whether they seek therapy or not, some survivors have to do the heavy emotional lifting on their own. One essential part is learning how to deal with the flood of emotions triggers can release.
Dr. Carole Warshaw, M.D., director of the National Centre on Domestic Violence, Trauma, and Mental Health says happiness after domestic abuse isn’t out of reach by any means, but getting there is a different process for everyone. “It takes time and patience—it’s not linear,” she explains. “But there’s no reason people can’t expect to heal.”
What should I do if I think I may be suffering from PTSD?
Taking the first step to help yourself is often the hardest thing to do. Understand that it may take time for treatment to help, but you can get better. The first thing to do is to make an appointment with your GP and speak about your concerns. Your GP will be able to perform basic screening and either make a referral to a mental health service or give you the details to self-refer.
For more support and information on Domestic Abuse, the following organisations are available:
- National domestic abuse helpline 24-hour helpline: 0808 2000 247
- Welsh Women’s Aid Live Fear Free 24-hour helpline: 0808 80 10 800
- Scotland National Domestic Abuse and Forced Marriages 24-hour helpline: 0800 027 1234
- Northern Ireland Domestic Abuse 24-hour helpline: 0808 802 1414
- Men’s Advice Line 0808 801 0327
- Police: 999 (press 55 when prompted if you can’t speak – please note: pressing 55 only works on mobiles and does not allow police to track your location.)
Online webchats and text services are also available.
If you are worried that someone you know is a victim of domestic abuse, you can call Refuge’s National Domestic Abuse Helpline for free, confidential support, 24 hours a day on 0808 2000 247. Visit the helpline website to access information on how to support a friend.
If you believe there is an immediate risk of harm to someone, or it is an emergency, always call 999.
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Ferrari, G., Feder, G., Agnew-Davies, R., Bailey, J. E., Hollinghurst, S., Howard, L., Howarth, E., Sardinha, L., Sharp, D., & Peters, T. J. (2018). Psychological advocacy towards healing (PATH): A randomized controlled trial of a psychological intervention in a domestic violence service setting. PloS one, 13(11), e0205485. https://doi.org/10.1371/journal.pone.0205485
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Nathanson, A. M., Shorey, R. C., Tirone, V., & Rhatigan, D. L. (2012). The Prevalence of Mental Health Disorders in a Community Sample of Female Victims of Intimate Partner Violence. Partner abuse, 3(1), 59–75. https://doi.org/10.1891/1946-6560.3.1.59
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Margolin, G., & Vickerman, K. A. (2007). Post-traumatic Stress in Children and Adolescents Exposed to Family Violence: I. Overview and Issues. Professional psychology, research and practice, 38(6), 613–619. https://doi.org/10.1037/0735-7028.38.6.613
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Hines, D. A., & Douglas, E. M. (2011). Symptoms of Posttraumatic Stress Disorder in Men Who Sustain Intimate Partner Violence: A Study of Helpseeking and Community Samples. Psychology of men & masculinity, 12(2), 112–127. https://doi.org/10.1037/a0022983
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What It's Like to Live With PTSD After Escaping Domestic Violence
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Why mental health support for survivors of domestic abuse is so vital
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Treatments for PTSD
It is possible for PTSD to be successfully treated many years after the traumatic event occurred, which means it is never too late to seek help. For some, the first step may be watchful waiting, then exploring therapeutic options such as individual or group therapy – but the main treatment options in the UK are psychological treatments such as Eye Movement Desensitisation Reprogramming (EMDR) and Cognitive Behavioural Therapy (CBT).
Traumatic events can be very difficult to come to terms with, but confronting and understanding your feelings and seeking professional help is often the only way of effectively treating PTSD. You can find out more in the links below, or here.