Abusive Relationships and
People Experiencing Disability
by Lance Hegland
Occasionally, we hear public service announcements highlighting
the facts, dangers, and signs of domestic violence. But, seldom is
it a topic of daily, weekly, or even monthly discussion among family
and friends unless they or someone they know is impacted by it. Similarly,
disability is rarely approached by individuals outside of the aging
and disability community. Dialogue involving violence encountered
by individuals with disability during health care, dating, romantic,
and sexual relationships is virtually silent.
The Centers for Disease Control and Prevention define domestic violence,
also known as intimate partner violence, as physical, sexual, or
psychological harm by a current or former partner or spouse. It also
includes threats. According to the Center, approximately 8.5 million
incidents of intimate partner violence occur each year among people
18 years of age and older. Although anyone can experience abuse,
studies generally focus on women as they encounter and report abuse
more often than men. One study discovered that at least one out of
four women and one out of five men had experienced some sort of physical,
sexual, or psychological abuse during their lifetime. Common injuries
range from scratches, bruises, and welts to more serious and long-term
conditions such as central nervous system abnormalities, gastrointestinal
difficulties, heart problems, as well as post-traumatic stress disorder.
Historically, little
has been known about the unique effects of abuse on women with
physical disabilities. In recent years, work by various advocates,
health care professionals, and researchers have been uncovering
new information. Dr. Dena Hassouneh-Phillips is one such person
examining and raising awareness of this very important issue. Her
most recent paper, “I Thought I was Less Worthy:
Low Sexual and Body Esteem and Increased Vulnerability to Intimate
Partner Abuse in Women with Physical Disabilities,” was published
in the December issue of Sexuality & Disability.
Dr. Hassouneh-Phillips
shared several findings with us during a recent exchange of e-mails.
She said, “Women with physical
disabilities experience violence at similar or higher rates than
women in the general population. Women with physical disabilities
are also more likely to be abused by multiple perpetrators than non-disabled
women. Although women with physical disabilities experience the same
types of abuse that non-disabled women experience, they also suffer
from care-related and disability-related forms of abuse. Care-related
abuse and disability-related abuse are intentional harmful or potentially
harmful acts that are related in some way to disability-status. Care-related
abuse is always perpetrated by a care provider. Funded by the Paralyzed
Veterans of America, I am conducting an ongoing study with individuals
with spinal cord injury and dysfunction. Based on these findings,
women with physical disabilities who experience abuse have an increased
risk for the onset of secondary conditions such as depression and
post-traumatic stress disorder. Currently abused women are also less
likely to engage in healthy behaviors such as eating well, exercising,
and accessing preventative health care.”
Dr. Phillips also indicated
that individuals surviving previous abuse and individuals physically
relying on others for personal assistance are at greater risk for
abuse. In addition, she identified a few “warning
signs” of abusers, such as “controlling behavior, jealousy,
alcohol and drug use, and past history of violent behavior.” Regarding
identifying individuals who have experienced or are experiencing
abuse, she said some signs are “increased social isolation,
onset or increased use of alcohol or drugs, psychological distress
and depressed mood, and physical injury.”
Finally, Phillips said, “Women with physical disabilities
who use wheelchairs often have limited options for fleeing their
abusers for a number of reasons. First, many women rely on their
abusers for essential personal care. Second, many women have accessible
home environments set up to maximize their functional status. For
this reason, when a woman has to suddenly leave her home she may
also lose some or much of her functional ability. Third, some women
with physical disabilities cannot physically flee from their abusers.
Fourth, many local shelters are not physically accessible. [Some
strategies that could be employed in local communities, which would
help women with physical disabilities stay safe, are: checking the
physical accessibility of local domestic violence shelters, organizing
systems to provide emergency back-up care, and finding ways to remove
abusers from women’s homes.]”
If you or someone you know
is experiencing abuse or would like more information about abusive
relationships and potential assistance, please feel free to contact
either the National Domestic Violence Hotline or the Communication
Service for the Deaf of Minnesota. The National Domestic Violence
Hotline can be reached via telephone at 1-800-799-7233 or at www.ndvh.org.
Individuals experiencing deafness or difficulty hearing can contact
the Communication Service for the Deaf of Minnesota at 1-800-759-8331
or at www.c-s-d.org. Links to
additional sources of information can also be found on our Web site,
see organizations.
Editor's Note
We would like to thank
Dr. Dena Hassouneh-Phillips for her valuable contributions and
tremendous guidance developing this article. She has worked as
an advocate, health care provider, and researcher in the field
of intimate partner violence since 1991. Currently, Dr. Hassouneh-Phillips
is an assistant professor with the Oregon Health & Science University’s School of Nursing.
Her research primarily focuses on violence against women from often-under-served
and often-neglected populations.
