By Pamayla E. Darbyshire, APRN
Domestic Violence Awareness Month (DVAM) is observed in October, uniting supporters and survivors nationwide in their efforts to end domestic violence. It was first observed in 1981 and labeled a National Day of Unity.
DV/IPV includes all ages, genders, and ethnicities, shows no partiality, and affects everyone
from all levels of society, from the rich to the homeless (https://www.thehotline.org/ )
Now you know what the purple ribbon is and what it stands for.
Stand up! Speak out! Don't be afraid! Be brave!
Introduction
Anonymous story: I have a story to tell: how do I tell it without jeopardizing the peace and solitude I have built over the years? After decades of quiet, silent abuse in every aspect but physical, I left, disrupting the family unit. I didn't tell anyone in the immediate family why I was going, but in my mind, it was time to leave and find a safe place to heal and begin to discover who I was and would become.
Anonymous: How can I let you know you can overcome the abuse, no matter how insignificant it may seem or how visible the scars are? Later, after I had gained some stability, established my living space, and sought counseling to assist with healing, I began to wear the purple ribbon on my badge. If someone asked, I shared parts of my story, just enough to let the other person know that I was a survivor of domestic violence, the color of the DV ribbon. My scars were not visible. My abuse was non-consensual sexual assault. How is that possible in a marriage? It is. I did whatever I had to for survival. He controlled my finances and social circle, isolated me, all the things on the power wheel https://www.thehotline.org/identify-abuse/power-and-control/
Anonymous: IPV or DV is not a topic discussed in this type of relationship. In fact, it is not a relationship; it is a dictatorship. You do what the implicit covert message conveys to maintain sanity and clarity in caring for your children and yourself. By hiding the abuse, you do no harm (in your mind), but when the family unit is suddenly broken, who is harmed? Everyone but the abuser, who is oblivious of their actions.
Anonymous: why did I stay so long in a dried-up dead fairy tale? When did I decide the dream was really dead? And what do I do now? My eyes are opened, my mind is aware, through reality, the facts are now clearer, I know what I have been living in for all these years.
Coming out
Anonymous: I am in a quandary. I am the butterfly just out of the chrysalis, now on the stone, in the sun, fanning my wings to dry them for my first flight!
Compassion is the ultimate unspoken means of building the trust needed to minister to this population.
Become comfortable with silence until the survivor is comfortable opening up and speaking.
Group sessions must be a safe place for confidential disclosures.
Safe environments could be any place, either designated by professional CMs who work with the population or a place a survivor has identified as 'safe.'
A safe haven is the most critical aspect of assisting survivors on the road to recovery.
Shelters, police stations, and public facilities may expose a survivor who is trying to escape their abuser; this should be an alarm to the case manager: provide them with a safe, private place away from prying eyes.
What more can we, as case managers, do?
Case Managers collaborate with survivors to provide support, resources, and guidance in decision-making, working to ensure that safety is paramount, and believe that each survivor is the expert of their life (https://dvrcnm.org/programs/case-management/)
Case Managers connect the survivors with community agencies and resources to help them move toward independence from their abusers. It might include coordinating housing based on need and providing education on financial empowerment (learning how to save and manage money for independence). Each client has specific needs, and each community has resources to assist the case manager in locating and connecting the survivor with what is a vital immediate need (https://dvrcnm.org/)
CMs establish trust through open and honest:
1Empathetic therapeutic communication: Practice utilizing nonverbal communication and listening as a primary way to 'talk.' The role of an empathic listener is to be supportive, kind, and caring (Peplau, 1997).
- Try to see the situation from their perspective.
- Take note of their emotional state, tone of voice, and body language.
- Listen to them as they open up and relate to you about what they have finally decided to walk away from.
- It is a structured listening and questioning technique that can help you develop and strengthen interactions and improve your understanding of what someone is saying (intellectually and emotionally).
2Professional competency: how much do you, as the CM, know about the power wheel, cycle of abuse, types of abuse?
Types of DV/IPV
Cycle of Abuse
3Practice style: adapt to the client across the table or in the shelters. These folks have survived decades of some form of control and abuse, and they have survived to be in your office today.
4Emotional equity involves creating a sense of safety, trust, belonging, and empowerment. Provide a safe, private space when interviewing and assessing the amount of abuse, the survivor’s willingness to open and share, remembering to maintain their dignity and autonomy (Felitti et al., 1998; Sharma & Gupta, 2023).
CMs meet the client where they are emotionally. Practice therapeutic listening as a communication technique (listening with empathy and understanding) (Felitti et al., 1998; Sharma & Gupta, 2023).
- Be aware of YOUR nonverbal body positions. Your client is attuned to reading silent forms of communication. This is how they have survived for so long: reading the room and all the people, taking stock of the actions and conversations.
- Practical, empathetic communication is 60 to 80% silent (nonverbal, body language) and 20 to 30% verbal (hearing what the other is saying).
- Be mindful of what is not said. What the speaker holds back is often as important as what they are saying.
- Nonverbal signs, such as keeping their head down, shifting away from you, or covering their mouth, could signal that they're holding something back or that they feel uncomfortable.
Conclusion
If you know of an individual who may be in this type of milieu, is willing to open up with someone to discuss a way out, and you happen to be that 'someone,' pause, be transparent, accept the survivor and recognize the emotional energy it took for them to acknowledge what they are now willing to leave for their mental health.
Be that someone. Be that robust and knowledgeable someone. Be, just be, for them, their family (usually children). Realize that DV/IPV and SA (sexual assault) are not just an October event, they happen all too often in all walks of life. I challenge you to be available and willing to provide the resources necessary for a survivor like Anonymous. Know what your community has available for immediate rescue and safety. Know the national DV hotline listed in the resources.
Resources
National Domestic Violence Hotline: 1-800-799-7233. Survivors have access to this number 24/7/365. https://www.thehotline.org/
DV Shelters: Most states have DV/IPV services and protection. A Google search will identify and direct individuals or professionals in the right direction. There are shelters for men, women and children, for women, and some will accept pets.
Definitions
Survival sex implies that women (or men) are engaging in sexual exchanges to meet a survival need, that can include housing or shelter, food, tobacco, protection, alcohol and/or substances https://www.changing-lives.org.uk/insights/what-is-survival-sex
Intimate partner violence is an intimate relationship involves a current or previous partner, spouse, live-in companion, or dating partner, whether or not they live in the same household. It can be physical, sexual, economic, social or psychological harm, including physical aggression, sexual coercion, psychological abuse and controlling behaviors. IPV against males is significantly underreported (Breiding et al., 2018; Takov et al., 2023; WHO, 2024).
No one can overstate the difference that case managers make in the lives of their clients and their families every single day. National Case Management Week is the time to celebrate the unparalleled dedication, expertise, and compassion of case managers. Join us for a month of free education, CEs, networking, recognition, prizes and more: https://cmsa.org/about/national-cm-week/
Bio: Dr. Darbyshire has over 40 years’ experience in nursing and has had extensive experience in Med/Surg, Critical Care, the Operating Room, and has precepted in all areas. She is a fellow with the Center for Educational and Instructional Technology Research (CEITR) (UoPx). She is a Case Management Society of America (CSMA) member and has a pivotal role in the Diversity, Equity, Inclusion, and Belonging (DEIB) core committee, tasked with developing the DEIB committee's mission, vision, and official statement for the society. Dr. Darbyshire's commitment to the academic community is evident in her role as a mentor for College of Doctoral Studies students (UoPx). Her research focus is case management and chronic diseases, and she has presented at virtual conferences with an international audience.
References
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What is Survival Sex? | Changing Lives.
https://www.changing-lives.org.uk/insights/what-is-survival-sex