House Call: Is someone close to you experiencing domestic violence? Here’s how to help

Spokane, we need to talk more about domestic violence and abuse. Violence and abuse between intimate partners is widespread in our country and, it’s difficult to admit, especially in Spokane. About 1 in 4 women and nearly 1 in 10 men have experienced sexual violence, physical violence and/or stalking by an intimate partner during their lifetime.

It affects people of every age, gender, education level, financial bracket, race and ethnicity. Abusive interactions can happen between partners or former partners, family members or roommates. Spokane County has one of the highest rates of domestic violence in the state, almost double that of the state average. That’s a statistic the whole community should want to get lower.

Isolation and feeling alone make it even more difficult for a survivor to leave an abusive situation or relationship. Our shift to working at home and more remote lifestyles, combined with increased stress and financial instability from the pandemic, have significantly contributed to increased domestic abuse. Calls to Spokane’s YWCA’s Helpline increased more than a 40% in 2020.

We see it in the news in Spokane and nationally. It’s important that we also talk about abuse among ourselves and in our communities because communication can make a huge difference. Abuse can be difficult to recognize (especially when you’re in it), and leaving can be a difficult and complicated decision. But you can start communicating with and supporting someone affected by intimate partner violence by asking, “How can I help?”

If you are a victim of domestic violence, take your safety into account first. Safely reach out for help if you can by calling the National Domestic Violence Hotline or finding a local resource at End the Violence Spokane (but please be aware that your calls, text, web history and other communications could be monitored by your partner).

If you think or know someone in your life is dealing with abuse or violence, here’s some guidance.

Do I know someone in an abusive relationship?

Abuse can take many forms: mental and emotional manipulation, financial control, isolation and physical violence can all be described as intimate partner violence or abuse. Abuse also impacts children, seniors and those in assisted living and in foster homes.

An abuser creates and leverages power, and this may happen over time. It may start as isolated instances and increase slowly or escalate rapidly, often with a pattern of cycles of reconciliation, calm and then repeating the abuse. The nature of the pattern means victims may protect or placate their abusers, take the blame and sometimes appear held together in person or online. But it’s never their fault – no one deserves abuse or violence.

The reality of abuse is often complex, and it isn’t always obvious that it’s happening. Health care providers watch for centrally located bruises on the body, injuries that seem out of proportion to a reported story or implausible stories that don’t match the degree of trauma.

As family physicians, we need to be especially vigilant about identifying victims of abuse because they often don’t show clear signs. They might show signs of being depressed or anxious, maybe be pregnant (often a high-risk group) or simply withdrawn. A simple inquiry like “Do you feel safe at home?” can often draw out important clues or outright affirmation of victimization.

As a family member, neighbor, friend or colleague, some of the signs that this person is in abusive situation include:

• Missing an unusual amount of work or appointments

• Isolating themselves from activities, friends and family

• Expressing that their partner is controlling or jealous

• Relating that their partner is putting them down or making them feel irrational

How can I help?

First, if you are currently experiencing violence or are in imminent danger, or if you are a witness to intimate partner violence, take your own safety into account as well as the survivor’s. Consider contacting law enforcement or emergency services or leaving the location of abuse in order to ensure safety.

Start by communicating with the person. If you know someone who might be experiencing intimate partner violence or abuse, one of the best things you can do is ask: “Are you OK? How can I help?”

Let them know you are there to support them and there are resources to help them find opportunities to safely navigate a way out.

• Ask: Do you feel safe at home? Do you ever feel threatened?

• Listen and believe what they tell you. Assure them it is not their fault.

• Let them know you care about them, they are not alone, and there is help.

• Connect them with resources, and support yourself with resources, too.

• Keep communication lines open, both before and after the person may leave the situation.

You can also encourage them to talk to their health provider if that’s a more comfortable option. Most providers have telehealth and phone appointments and will schedule them at a time when that person feels safe and free to talk.

Speaking out about abuse and leaving isn’t always an option for the people experiencing it. They may be unsafe, fear retaliation or fear being judged or not believed. Financial and housing worries are barriers. Sometimes, victims label the relationship as a mix of good times and bad times or the behavior as just a really bad fight and aren’t ready to make an exit plan.

No matter what they have asked you to do, talk to them about making a safety plan. A safety plan allows survivors to plan out situations that might arise and how to respond. The most dangerous time for a victim of partner violence is when leaving an abusive relationship.

Suggest they talk with an advocate at a free, confidential hotline to create a safety plan. They don’t need to be in a crisis to call or to even feel sure they are a victim of domestic violence. You can find a list of local and national hotlines and resources at End the Violence Spokane.

A safety plan might include what to do during an argument, safety for children, security at work and a plan for securing or escaping the home in a crisis. It can help the survivor plan finances, housing and resources for leaving and safety supports like identifying a neighbor who will call the police if they hear a disturbance or a code word to use with family and friends.

Exiting a domestic abuse situation can take time. Remember that intimate partner violence goes in cycles. Things might seem better for a while but usually cycle back into the abuse pattern, and it often progresses. This is about control, and victims deserve to be safe, so reach out if you can to help break that cycle of violence.

Talking about abuse is difficult, and watching someone you know experience it is challenging. If you are in an abusive relationship, or you think you know someone who might be in danger, there is support in Spokane. There is hope, and there is a way out.

Dr. Jeff Markin is a family medicine physician practicing at Kaiser Permanente’s Veradale Medical Center.