CONTENTS

About This Course

Table of Contents

1. Introduction to the Issues
2. Understanding Alcohol Abuse
3. Understanding Violence Against Women
4. Alcohol and Domestic Violence
5. Alcohol, Sexual Assault, and Rape
6. Prevention and Early Intervention
7. Screening and Assessment
8. Diagnosis and Treatment
9. Legal and Ethical Issues

Supplements
Fact Sheets
Videos
Resources

Silence Hurts:
Alcohol Abuse and Violence Against Women

The Link Between Alcohol and Violence

In the past, society often excused men for committing violent acts against women when they were drunk. Today, however, people no longer accept such behavior as normal. Alcohol and domestic violence have some things in common:¹

• Both can be passed down from generation to generation.
• Both involve denying and minimizing the problem.
• Both may cause the abuser and the victim to feel isolated.
• Both stem from a need for power and control.

How Violence Begins

Destructive drinking and violence in the home can exist prior to marriage. Bad habits can begin in the teen dating years, sometimes after watching parents exhibit the same behaviors.

Whenever destructive drinking and violence occur, one partner will be exerting power and control over the other.²

A woman who becomes a victim of abuse is at risk of abusing alcohol and other drugs to escape the pain and shame of abuse. Some abusive partners force the woman to drink or do drugs under the threat of further violence. Most women do not realize that drinking alcohol (in any quantity) puts them at risk for violence. Alcohol can be connected to domestic violence, although one does not cause the other. Not every man who abuses alcohol becomes violent. Some men are violent whether they drink or not.

In cases where alcohol and violence are both present, the family violence may worsen when a man ceases to drink. In response, some women may try to encourage a man to begin drinking again so they can better predict the pattern of abuse.³

Cycle of Violence

Domestic violence often runs in cycles. If nothing is done to stop it, violence can repeat itself generation after generation. Violence also occurs cyclically in the stages of a relationship between two people. The stages include:⁴

• The Honeymoon Phase: The partners are both on their best behavior; and they share a sense of excitement and newness. Gifts are exchanged. Alcohol may be present only in social or romantic settings. There is no real increase in drinking.
• The Tension Building Phase: Over a period of months or a year, a woman feels tension building and notices signs of temper or criticism from her partner. She may try to minimize problems and tends to feel like she is "walking on eggshells." In some, but not all abusive relationships, the man may begin to drink more heavily. As the tension builds, alcohol abuse may become a problem, playing a larger role in verbal attacks and minor violence. Some women may drink to decrease the tension.
• The Serious Battering Phase: In this stage, the violence that results may be severe, requiring medical attention for fractures, breaks, and burns. A man who abuses both alcohol and his partner may begin to depend on alcohol to ease his feelings of powerlessness, guilt, and stress. Women also may use alcohol to escape the physical and emotional pain. Following a violent incident, the man's behavior may change dramatically. He becomes charming, which leads to the next phase.
• The Honeymoon Phase: The man feels guilty about the violence and asks for forgiveness. He behaves in ways similar to the early relationship. He tells the woman how much he loves her and how much he needs her. If he has been abusing alcohol, he may stop drinking. Whether or not alcohol is involved, in any abusive relationship, the honeymoon phase eventually leads to the next cycle of violence.

The Importance of Recognizing the Problem

Families experiencing both alcohol and physical abuse have a strong need to deny the problem.⁵ People who don't experience the problems directly also need to recognize the problem in their communities. An estimated 3 million children between the ages of 3 and 17 years are at risk of exposure to parental violence each year.⁶

Many people are unaware of the impact that alcohol and domestic abuse have on children. Children may lack hope and feel helpless. They live with fear and shame. Infants can "fail to thrive" or fail to become attached to caregivers. Children may register their trauma in physical ways. They may complain of stomachaches, headaches, and sleep problems. Children may also suffer neglect because their physical and emotional needs are not met.⁷ Older children may become aggressive, depressed,^8,9 or perform poorly in school.¹⁰ In addition, children may become addicted to alcohol or drugs to escape their home life.

Teen Dating Violence

Alcohol plays a large role in abusive relationships among teenagers.¹¹ More than 60 percent of sexual assaults involve alcohol. In fact, one in four teenagers will experience sexual or nonsexual abuse by the time they finish college or turn 21.¹² Abusive teen relationships follow some of the same patterns as those of older couples. However, the effects of violence on teenage women may include:¹³

• Eating disorders
• Use of drugs and alcohol
• Trouble sleeping; stress-related physical illnesses
• Depression; suicidal tendencies; increased isolation from friends
• Lack of concentration and lower grades in school

For more information for consumers, go to www.samhsa.gov/preventionpathways and click on "courses" to find the online course, "It Won't Happen to Me: Substance Abuse and Violence Against Women."

References

1. Fazzone, PA; Holton, JK, and Reed, BG. (1997). Substance abuse treatment and domestic violence. Treatment improvement protocol series 25. (DHHS Publication No. SMA 97-3163). Rockville, MD: Center for Substance Abuse Treatment.
2. National Institutes on Alcohol Abuse and Alcoholism. (1997, October). Alcohol, violence, and aggression (Alcohol Alert No. 38). Rockville, MD: Author, National Institutes of Health, Department of Health and Human Services. Available at www.niaaa.nih.gov/publications/aa38.htm
3. Bennett, L. (1997). Substance abuse and woman abuse by male partners. Chicago, IL: Jane Addams College of Social Work, University of Illinois. Available at http://www.vaw.umn.edu/documents/vawnet/substanc/substanc.html
4. Walker, L. (1984). The battered woman syndrome. New York: Springer, 1984.
5. National Association for Children of Alcoholics. (2002). Children of addicted parents: Important facts. Rockville, MD: Author. Available at www.nacoa.net/pdfs/addicted.pdf
6. Straus, M.A., and Gelles, R.J. (1995) Physical violence in American families: Risk factors and adaptations to violence in 8,145 families. New Brunswick, NJ: Transaction Publishers.
7. Osofsky, J. (Winter 1999) The Future of Children. Domestic Violence and Children, 9(3):33-49.
8. Edleson, JL. (1999). Children's witnessing of adult domestic violence. Journal of Interpersonal Violence, 14 (8):839-871.
9. Kairys, SW, Johnson, CF, and the Committee on Child Abuse and Neglect. (2002). The psychological maltreatment of children-technical report. Pediatrics,109(4). Available at www.pediatrics.org/cgi/content/full/109/4/e68.
10. Kernic MA, Holt VL, Wolf ME, McKnight B, Huebner CE, Rivara FP. (2002). Academic and school health issues among children exposed to maternal intimate partner abuse. Arch Pediatr Adolesc Med, 156(6):549-555.
11. The Centers for Disease Control and Prevention. (2001). Dating violence [Fact Sheet]. Atlanta, GA: Centers for Disease Control and Prevention, 2001.
12. Ibid.
13. Silverman JG, Raj A, Mucci LA, et.al. (2001, August 1). Dating violence against adolescent girls and associated substance use, unhealthy weight control, sexual risk behavior, pregnancy, and suicidality. Journal of the American Medical Association,286(5):572-9.