Domestic Violence and the Impacts on your Physical and Mental Health
The health impacts of domestic violence present themselves in a range of short and long term effects that are both physical and psychological. As a result of domestic violence, you may need medical treatment for immediate care and long term care. At Harbor Community Health Centers, we provide care and support for domestic violence survivors and will do so safely, with compassion, and with confidentiality. We are partnered with local support organizations, such as Rainbow Services, that provides shelter and support to anyone impacted by domestic violence, empowering them to move beyond trauma, towards safety & stability. If you or someone you know is a victim of domestic violence, contact Rainbow Services at 310.548.5450, and receive immediate medical care at Harbor Community Health Centers.
In this article we will cover the warning signs of abuse, impacts of domestic violence on your physical and psychological health, the impacts of domestic violence on children, and how you can create a safety plan.
Disclaimer: this topic can be heavy, overwhelming, and can cause you to be triggered leading to feelings of sadness, anger, and anxiety. If at any point you feel triggered we ask that you stop and take care of your emotional well-being and engage in self-soothing activities
Approximately 1 in 3 women and 1 in 4 men have experienced some form of physical violence by an intimate partner, and 1 in 7 children will experience childhood domestic violence by a parent or guardian. On a typical day, domestic violence hotlines nationwide receive over 19,000 calls. On average, 20 people per minute are physically abused by an intimate partner in the U.S.; this amounts to more than 10 million people a year.
Domestic violence and abuse can be more than physical violence. It is a pattern of behavior that a partner uses to maintain power and control over another partner or person. This can include physical harm, intimidation, control, emotional abuse, and financial control that force a person to live in fear and behave in ways that they don’t want to. The health impacts can range in physical, psychological, short and long term and can have a significant impact on your health and well-being and for your children as well.
Warning Signs of Abuse
It is important to be able to recognize the signs of abuse when they first present themselves. At the start of any relationship, things can seem perfect and that you have an ideal partner, and it can be difficult to tell if it will later become abusive. Controlling and possessive behaviors will not be present right away but may emerge and intensify as the relationship continues to progress. And although every relationship is different, one shared sign of domestic abuse that all abusive relationships have in common is that the abusive partner establishes and gains control of the relationship and the other person through varying methods.
Common Warning Signs of Abuse:
(“Warning Signs of Abuse, What to Look Out For”. www.thehotline.org)
- Telling you that you never do anything right.
- Showing extreme jealousy of your friends or time spent away from them.
- Preventing or discouraging you from spending time with friends, family members, or peers.
- Insulting, demeaning, or shaming you, especially in front of other people.
- Preventing you from making your own decisions, including about working or attending school.
- Controlling finances in the household without discussion, including taking your money or refusing to provide money for necessary expenses.
- Pressuring you to have sex or perform sexual acts you’re not comfortable with.
- Pressuring you to use drugs or alcohol.
- Intimidating you through threatening looks or actions.
- Insulting your parenting or threatening to harm or take away your children or pets.
- Intimidating you with weapons like guns, knives, bats, or mace.
- Destroying your belongings or your home.
Physical and Psychological Effects of Violence on Victims and Children
Violence against a partner, including sexual or physical violence, is linked to short and long term health problems and effects that can be seen in a variety of ways. The immediate physical impact can range in minor to serious injuries such as cuts and bruises, broken bones, injuries to organs, internal bleeding, gastrointestinal issues, STDs, and can sometimes lead to death. The long term effects can include chronic pain, heart disease, diabetes, asthma, arthritis, heart problems, digestive problems, sexual problems, problems with the immune system, difficulty sleeping, eating disorders, migraines, and stress. Traumatic brain injury is a serious risk of physical abuse and is caused from being hit on the head or falling and injuring your head. The symptoms can take a few days to present themselves and can cause headache, confusion, dizziness, nausea and vomiting, slurred speech, memory loss, trouble concentrating, sleep loss, and loss of consciousness. A brain injury can also lead to depression and anxiety and impair your cognitive thinking and make it difficult to formulate a plan for safety. Some physical injuries can be difficult or impossible to see without scans, x-rays, or other tests done by a doctor or nurse. If you have experienced any physical injuries, seek medical assistance and treatment right away.
In terms of the psychological effects of being in domestic violence relationship, those who are victimized feel shame and embarrassment, helplessness and confusion, lowered self-esteem. These can lead to more severe symptoms like anxiety, depressive disorders, even suicidal ideation or attempts, PTSD, and ultimately higher risk for alcohol or substance use, and body dysmorphia resulting in unhealthy eating patterns or disorders. Other effects can be seen such as shutting people out, not being able to trust others, and not wanting to do things that you once enjoyed. Domestic violence can also affect the lives of victims in other ways, such as impairing your ability to work, homelessness, inability to continue your education, and fear of losing custody or contact with your children. If you are feeling any of these symptoms, you can get help from a mental health professional. At Harbor Community Health Centers, we have trained mental health professionals and therapists that can help you with your emotional concerns and help you develop healthy and effective coping skills.
Childhood domestic violence is when a person grows up living in a home with violence between their parents or violence towards a parent. This can include hearing a violent event such as arguing, yelling, throwing objects, witnessing the violence, experiencing the aftermath of a violent event, being used as a spy or a pawn between parents, forced to watch or participate in the abuse, intentional abuse to children, accidental harm during violent attacks on a victim, or coerced to remain silent about the abuse. Children who grow up with domestic violence are 6 times more likely to commit suicide and 50% more likely to abuse drugs and alcohol, 74% more likely to commit a violent crime, 3 times more likely to repeat the cycle in adulthood as either the person being victimized or becoming the perpetrator, and developing PTSD. Exposure to traumatic or stressful experiences/environments can influence how genes are expressed as well. Long exposure to domestic violence can alter a child’s DNA, aging them prematurely 7 – 10 years. As a result of witnessing domestic violence, children can have health and behavioral issues such as headaches, stomach aches, bed wetting, trouble at school, difficulties learning, anxiety, depression, low self-esteem, high levels of aggression and anger, deficiencies in visual-motor skills, and problems with attention and memory. Domestic violence can also leave children feeling powerless, fearful, insecure, feelings of worthlessness, guilt, separation anxiety, and abandonment.
The stress of domestic violence can also have permanent effects on the child’s brain development and how it adapts to cope with dangerous and unsafe environments. As children age, different regions of the brain go through rapid changes of development. Exposure to domestic violence during these sensitive periods can create long term effects to the brain. The first sensitive period of development happens during early childhood when they are going through a period of active overproduction of synaptic connections. The next sensitive period happens during puberty when the brain systematically cuts back synaptic connections that the brain deems unimportant. The two main changes to the brain are to the amygdala and the hippocampus. The amygdala is responsible for detecting fear and preparing the body for fight, flight, freeze or appease. Constant stress causes the amygdala to grow. The hippocampus is responsible for memory and regulating emotions. On-going trauma causes the hippocampus to shrink. The adult brain is developed and wired by the experiences in childhood and when those experiences include trauma or neglect, the brain adapts to survive the adversity. For more early childhood resources on domestic violence, please go to http://www.ncdsv.org/images/EarlyChildDev.DVResources3.pdf.
Creating a Safety Plan
For domestic violence survivors/victims, ensuring their immediate and continuous safety is a top concern. Due to the unequal power dynamic within domestic violence relationships, there is little a survivor can do to stop the violence within their relationship, but they can take steps to protect themselves and their children from harm. It is important to have a plan to increase safety as violence within harmful relationships can escalate.
A safety plan is an outline that includes ways to remain safe while in a domestic violence relationship, planning to leave, or after you leave an abusive relationship. Creating a personalized safety plan encompasses how to cope with emotions, telling friends and family about the abuse, legal remedies, and important documents to gather. . An effective safety plan will have specific details tailored to meet your unique situation as you are the best judge of your own safety.
Disclaimer: Safety planning is unique to each survivor and this process should take into consideration the individual circumstances and needs of each survivor. There is no blanket, one-size-fits all approach to safety planning and domestic violence response.
When You Are Ready to Create a Safety Plan:
Creating a safety plan is an accessible way to manage risk factors, identify security resources, and collaborate with a domestic violence advocate, such as Rainbow Services’ Support Services Advocates, to increase your safety and overall well-being.
Below are scenarios for your consideration when creating your personalized plan with a Domestic Violence advocate:
☐ Safety When Preparing to Leave: Utilize the personalized safety plan for detailed plan. (Contact Rainbow for guidance)
☐ Safety During Violent Incident:
- Room safety: Avoid rooms like bathroom, kitchen, or rooms with possible weapons
- Have a packed bag ready- for self and children
- Discuss bag contents: documents, clothing, money, pictures, etc.
- Identify a safe person or place to go to
- Code word for friends or children
☐ Safety at Home:
- Practice (with children) how to get out of home, if needed.
- Inform housemates, property owners, neighbors of abuse
- Avoid rooms like bathroom or kitchen during violent incidents
- Change keys, locks
- Practice safe word and calling 911 with children
☐ Safety with Restraining Order:
- Carry a copy with you
- Provide copy to schools, employer, childcare, service providers
- Inform family, friends, neighbors
- Call police to enforce Restraining Order
☐ Safety at Work:
- Copy of restraining order
- Inform building security
- Provide picture, car information
- Change your work route
- Switch your lunch places
☐ Safety at School:
- Copy of restraining order
- Inform building security
- Change your school route
- Inform school administration, professors/teachers, classmates
☐ Emotional Safety:
- Remind myself: this is not my fault
- Practice “I can…” statements
- Talk with friends, family, counselor
- Limit direct communication with partner/ex-partner
- Attend support groups
- Practice self-care and coping strategies
- Create emotional safety plan for before and after interactions with partner/ex-partner
☐ Financial Safety:
- Gather family documents with identifying information: IDs, birth certificates, social security cards
- Save any amount in hiding place or open separate account
- Avoid opening a joint bank account
- Change account direct deposits, passwords, and PINS (personal identification numbers)
- Check credit history with free reports
- Setup alerts on credit cards and other financial accounts
☐ Technology and Social Media Safety:
- Change passwords
- Clear computer search history
- Change agency names on phone
- Remove locations from posts, turn off GPS or location settings on apps
- Limit online information sharing, filter friends, block partners/mutual friends
☐ Safety with Children:
- How to stay safe at home during violent incident: safe word, calling police, staying in room
- Practice safety plan with children
- Confirm pick-up authorization from school, childcare, after school program, and/or camps
☐ Visitation Safety:
- Talk with children about safety in other homes during visits/overnights
- Practice how to call 911
- Create an exit plan if child needs to leave the home
☐ Custody Exchange Safety:
- Avoid exchanging custody at your home or other parent’s home
- Meet in public place: restaurant, bank, store, police station
- Bring someone with you
- Use school times for exchanges to avoid direct interaction
☐ Safety while houseless, sleeping in car or on streets:
- Have a code word with friends staying near you
- Keep a charged cell phone on you if possible
- Try to not keep a weapon with you
- Inform case manager, advocate, counselor of current location
It is important to remember that in moments of panic, your brain may not remember even the simplest of details due to the large amount of adrenaline pumping through your veins — so creating a safety plan will give you protection during these stressful moments.
Whether you decide to stay or to end the relationship, Rainbow Services can help you create a safety plan. The changes may be big, such as going to a confidential shelter or changing schools, or smaller, such as changing your e-mail passwords or the route you take to work. Safety plans look different for each survivor/victim and their family. Proactive planning on how to safely leave, protect your children, and get assistance and support can enhance your safety if a violent incident occurs.
Everyone deserves respect, love & safety.
Where to Seek Treatment
At Harbor Community Health Centers, we are here to treat you with compassion, take care of your physical and psychological needs, and connect you with community agencies and county services that can help you. Our staff, doctors, dental providers, and behavioral therapists are trained to recognize the signs of abuse and know how to help, all while being confidential.
We have three locations to help you with any of your needs. At our 6th St Clinic (located at 593 W 6th St. San Pedro, CA) we can take care of your general and primary care, diabetes treatment, asthma treatment, and behavioral health. At our Pacific Ave Clinic (located at 425 S. Pacific Ave. San Pedro, CA) we can take care of your family planning, OBGYN, pediatrics, dental, psychotherapy, and behavioral health. If you are suffering from homelessness, we can see you at our Beacon St Clinic for all services (located at 731 S. Beacon St. San Pedro, CA). To reach us by phone please call 310.547.0202.
We will start by creating a safe place to talk about what is going on. We approach this in a very compassionate and trauma-informed way because we know that it is a difficult conversation to start and that it takes so much bravery and courage to be able to have that conversation with someone else. We delicately point out the safety risks and assess what level of change you are ready for, see if you recognize that you are in a dangerous situation, and help you to create a safety plan or readiness to taking active steps to ending the relationship. For your physical needs, we will assess and treat all of your physical injuries that are both immediate and long-term. With your permission, we will ask how the injury occurred and ask to record it, and we will also photograph injuries and have them signed and dated, as this may be needed as evidence in court. If you are pregnant or think that you might be, you will also be examined by one of our OBGYN doctors to ensure that the health of the baby has not been affected by the violence.
Our medical staff and behavioral health providers are always focused on the safety of our patients and anyone who is close to them. We are not required by law to make a police report if there are no children involved and you are an adult and do not wish to do so. But if you are ready or would like to make a police report about the abuse, we are here to help every step of the way. When children are in the household it becomes a risk to their emotional and possibly physical well-being. Necessary steps will be taken to protect the children. We are required by law to report the abuse to the Department of Children and Family Services.
The next step will be to help connect you with community resources. We will sit with you and call the service organizations with you to make sure that you have been linked. Our main community partner and support organization that we will connect you with is Rainbow Services. Additionally, our patient care coordinators can help with supplemental linkage to other resources such as community agencies, county services, transportation assistance, etc. We try to make sure that we continue to provide a team approach to your care with these external resources and will continue to provide long-term medical treatment as well as behavioral health services if you wish to continue doing so.
Rainbow Services is a domestic violence agency serving the diverse needs of survivors and their children. Rainbow Services’ work extends far beyond the immediate needs of those experiencing intimate partner violence. Rainbow seeks to establish long-term, sustainable funding and policies that will make a positive impact on the lives of survivors. During the month of October, Rainbow celebrates the many accomplishments and victories made on behalf of survivor rights and recommits itself to the important advocacy work that lies ahead. In addition to its survivor programs, Rainbow Services provides prevention education presentations to the community and this includes healthcare providers, educators, students, and many others. For more information, visit www.RainbowServicesDV.org.
October is National Domestic Violence Awareness Month and is a way to unite advocates, survivors, and communities and raise awareness in an effort to end the cycle of violence. Together, we have the power to end domestic violence. Commit yourself to one awareness promoting activity this October, such as taking a photo of yourself wearing purple and using #ISTANDWITHSURVIVORS, #RAINBOWDVAM2021, and #HCHCDVAM2021 in your social media.
If you or someone you know is a victim of domestic violence please use the following resources:
Harbor Community Health Centers | 310.547.0202
Rainbow Services | 310.548.5450
National Domestic Violence Hotline | 1.800.799.SAFE (7233) | Text “START” to 88788
National Sexual Assault Hotline | 1.800.565.HOPE (4673)