Psychological consequences of battering. Implications for women's health and medical practice

Battering means more than just physical assault. It means pain and injury from physical assault plus continuous psychological degradation, sustained fear, diminished power and control, and loss of identity and self-esteem. Women often feel trapped in violent relationships because of their partners' threats to kill them if they leave, and because police, medical, and social services systems often inadequately protect and help them. Battering is best understood as a continuous traumatic experience and, like many other forms of trauma, it takes a considerable psychological toll on its victims. Battered women are at risk for chronic physical and psychological health problems including PTSD, depression, chronic pain, and substance abuse. The high prevalence of battering, and its psychological and physical consequences, means that battered women present with a multitude of acute and chronic symptoms and are not easily identified. The most practical and effective way to identify battering is to routinely ask all women patients about it. Identification gives physicians a way to understand complex and confusing symptoms and an opportunity to help battered women undertake the difficult and dangerous process of leaving abusive partners. In addition, doctors, in collaboration with battered women patients and other professionals, can help develop comprehensive plans to reduce this complex public health problem.