Women at Risk: Domestic Violence and Women's Health

289 Pages·1996·13.025 MB·English

by  Evan D. Stark, Anne Flitcraft

WOMEN
* AT
RISK

WOMEN

* AT
RISK
Domestic Violence and
Women's Health
Evan Stark, Ph.D., M.S.W.
Anne Flitcraft, M.D.
®
SAGE Publications
International Educational and Professional Publisher
Thousand Oaks London New Delhi
Copyright © 1996 by Sage Publications, Inc.
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Printed in the United States of America
Library of Congress Cataloging-in-Publication Data
Stark, Evan.
Women at risk: Domestic violence and women's health / authors,
Evan Stark, Anne Flitcraft.
p. cm.
Includes bibliographical references and index.
ISBN 0-8039-7040-4 (acid-free paper). — ISBN 0-8039-7041-2
(pbk.: acid-free paper).
1. Wife abuse—United States. 2. Family violence—United States.
3. Abused wives—Medical care—United States. 4. Abused women—
Medical care—United States. 5. Patriarchy—United States.
I. Flitcraft, Anne, 1948- . II. Title.
HV6626.2.T72 1996
362.82'92'0973—dc20 95-50153
This book is printed on acid-free paper.
97 98 99 10 9 8 7 6 5 4 3 2
Sage Production Editor: Tricia K. Bennett
Contents

Acknowledgments ix
Introduction xiii
Part I Theoretical Perspectives
1. Medicine and Patriarchal Violence 3
The Study: Abuse in a Medical Setting 7
Medicine Constructs the Battering Syndrome 14
Toward a Theory of Social Causation 25
Conclusion 38
2. Imagining Woman Battering: Social Knowledge,

Social Therapy, and Patriarchal Benevolence 43
Frances Cobbe's Dilemma—Circa 1870 43
The Evolution of Benevolence: 1870-1970 46
England: Mugging, Battering, and the Cycle

of Deprivation 51
America: The Social Construction of

the Violent Family 55
Conclusion: Cobbe's Dilemma Reconsidered 65
Postmortem: Social Therapy 67
Part II Health Consequences
3. Women and Children at Risk: A Feminist

Perspective on Child Abuse 73
Child Abuse and Woman Battering:

Gender Politics or Female Pathology? 74
Battering and Child Abuse: A Study 82
A Feminist Approach to Battering and Child Abuse 88
Conclusions 95
4. Killing the Beast Within: Woman Battering

and Female Suicidality 99
Background 99
The Research Study 105
Discussion and Conclusions 111
Implications for Intervention 116
5. Preventing Gendered Homicide 121
Primary Homicide: Empirical Dimensions 125
Models of Violence, Theories of Homicide 134
Gendered Homicide 143
Conclusion 150
Part III Clinical Interventions
6. Personal Power and Institutional Victimization:

Treating the Dual Trauma of Woman Battering 157
Defining Terms: Domestic Violence, Abuse,

and Woman Battering 160
The Battering Syndrome: From Injury

to Coercive Control 161
Reconsidering Traumatization Theory 168
Treating the Dual Trauma of Wife Battering 174
7. Clinical Violence Intervention: Lessons From

Battered Women 192
Clinical Violence Intervention 197
8. Discharge Planning With Battered Women 201
The Background of Medical Concern 201
The Challenge to Discharge Planning 202
The Patient-Centered Interview 206
Assessment 206
Safety Planning 208
9. Physicians and Domestic Violence: Challenges

for Prevention 211
Definition and Classification 214
Clinical Violence Intervention 216
The Message to Physicians 219
References 221
Name Index 238
Subject Index 246
About the Authors 263

Acknowledgments

The articles and chapters adapted for this book reflect the support of
two decades of coworkers and friends.
The idea of analyzing the medical dimensions of woman battering was
conceived while we were participants in two lively group efforts, the
East Coast Health Discussion Group (ECHDG), a radical collaboration
to revise theories of health and medical care, and the New Haven Project
for Battered Women (NHPBW), one of the early shelters for battered
women in the United States. ECHDG participants Sally Guttmacher and
her husband, the late Eric Holtzman, Joann Lakumnick, Meredith
Turshen, Alonzo Plough Jr., and Janette Valentine became our intellec­
tual mentors as well as lifelong friends. Vicente Navarro added a key
element to friendship and intellectual guidance by opening the pages of
the International Journal of Health Services to our work at a time when
feminist, radical, and more conventional academic publications showed
little interest in the problem. From the original NHPBW the friendships
of Sophie Turner, Patricia Dillon, and Patricia Weel have been particu­
larly important.
The research reported in Chapter 1 was supervised by Dr. William
Frazier, then a young specialist in plastic surgery and director of the
ix