Exploration of the course of control in domestic violence against women, from its establishment of the influence to its awareness

Emeline Pasdeloup, Chamant Christelle

Keywords: domestic violence ; women

Background:

The authorities of health of several western countries recommend a systematic identification of domestic violence during general medicine consultations. However, this identification seems difficult since these women are unaware of the influence held upon them. One of the keys to improve care would be to identify the levers that would enable these women to become aware of and to recognise themselves as victims of violence.

Research questions:

Explore the course of control in domestic violence against women, from its establishment of the influence to its awareness.

Method:

We conducted a qualitative study. Individual semi-directive interviews were carried out on a purposive sample of female victims recruited from GP practices, a family planning and education centre, and a medical-judicial unit. The applied analysis was inspired by the grounded theory.

Results:

Six women aged 32 to 73 were interviewed. The installation of the influence was facilitated by the vulnerability and low self-esteem. It resulted in a climate of fear, shame, and guilt, which maintained and strengthened the abuser's influence on the victim. The intensity of the violence, the women’s desire to protect her children, and the external aid favoured the awareness of her situation and the will to act to escape the influence. When the mechanism of control and its role in domestic violence was elucidated, the women recognised themselves in the explanations given, this constituted a "mirror effect", which revealed to them their status as victims.

Conclusions:

The "mirror effect" seemed to have an influence on women's awareness of their status as victims of violence. It would be interesting to evaluate its appropriation and use by GPs as well as its effect on the identification of women who are victims of violence.

Points for discussion:

Prospects for improving the identification and support of women victims of domestic violence

Perspectives in terms of initial medical training of medical students on the identification of domestic violence

Perspectives in terms of continuing medical education of health professionals on the role of control in domestic violence