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Battered Women's Syndrome

Battered Women's Syndrome
In 1991, Governor William Weld modified parole regulations and
permitted women to seek commutation if they could present evidence
indicating they suffered from battered women's syndrome. A short while
later, the Governor, citing spousal abuse as his impetus, released
seven women convicted of killing their husbands, and the Great and
General Court of Massachusetts enacted Mass. Gen. L. ch. 233 � 23E
(1993), which permits the introduction of evidence of abuse in
criminal trials. These decisive acts brought the issue of domestic
abuse to the public's attention and left many Massachusetts residents,
lawyers and judges struggling to define battered women's syndrome. In
order to help these individuals define battered women's syndrome, the
origins and development of the three primary theories of the syndrome
and recommended treatments are outlined below.

I. The Classical Theory of Battered Women's Syndrome and its Origins

The Diagnostic and Statistical Manual of Mental Disorders
(DSM-IV), known in the mental health field as the clinician's bible,
does not recognize battered women's syndrome as a distinct mental
disorder. In fact, Dr. Lenore Walker, the architect of the classical
battered women's syndrome theory, notes the syndrome is not an
illness, but a theory that draws upon the principles of learned
helplessness to explain why some women are unable to leave their
abusers. Therefore, the classical battered women's syndrome theory is
best regarded as an offshoot of the theory of learned helplessness and
not a mental illness that afflicts abused women. The theory of learned
helplessness sought to account for the passive behavior subjects
exhibited when placed in an uncontrollable environment. In the late
60's and early 70's, Martin Seligman, a famous researcher in the field
of psychology, conducted a series of experiments in which dogs were
placed in one of two types of cages. In the former cage, henceforth
referred to as the shock cage, a bell would sound and the
experimenters would electrify the entire floor seconds later, shocking
the dog regardless of location. The latter cage, however, although
similar in every other respect to the shock cage, contained a small
area where the experimenters could administer no shock. Seligman
observed that while the dogs in the latter cage learned to run to the
nonelectrified area after a series of shocks, the dogs in the shock
cage gave up trying to escape, even when placed in the latter cage and
shown that escape was possible. Seligman theorized that the dogs'
initial experience in the uncontrollable shock cage led them to
believe that they could not control future events and was responsible
for the observed disruptions in behavior and learning. Thus, according
to the theory of learned helplessness, a subject placed in an
uncontrollable environment will become passive and accept painful
stimuli, even though escape is possible and apparent.

In the late 1970's, Dr. Walker drew upon Seligman's research
and incorporated it into her own theory, the battered women's
syndrome, in an attempt to explain why battered women remain with
their abusers. According to Dr. Walker, battered women's syndrome
contains two distinct elements: a cycle of violence and symptoms of
learned helplessness. The cycle of violence is composed of three
phases: the tension building phase, active battering phase and calm
loving respite phase. During the tension building phase, the victim is
subjected to verbal abuse and minor battering incidents, such as
slaps, pinches and psychological abuse. In this phase, the woman tries
to pacify her batterer by using techniques that have worked
previously. Typically, the woman showers her abuser with kindness or
attempts to avoid him. However, the victim's attempts to pacify her
batter are often fruitless and only work to delay the inevitable acute
battering incident.

The tension building phase ends and the active battering phase
begins when the verbal abuse and minor battering evolve into an acute
battering incident. A release of the tensions built during phase one
characterizes the active battering phase, which usually last for a
period of two to twenty-four hours. The violence during this phase is
unpredictable and inevitable, and statistics indicate that the risk of
the batterer murdering his victim is at its greatest. The batterer
places his victim in a constant state of fear, and she is unable to
control her batterer's violence by utilizing techniques that worked in
the tension building phase. The victim, realizing her lack of control,
attempts to mitigate the violence by becoming passive. After the
active battering phase comes to a close, the cycle of violence enters
the calm loving respite phase or "honeymoon phase."

During this phase, the batterer apologizes for his abusive
behavior and promises that it will never happen again. The behavior
exhibited by the batter in the calm loving respite phase closely
resembles the behavior he exhibited when the couple first met and fell
in love. The calm loving respite phase is the most psychologically
victimizing phase because the batterer fools the victim, who is
relieved that the abuse has ended, into believing that he has changed.
However, inevitably, the batterer begins to verbally abuse his victim
and the cycle of abuse begins anew.

According to Dr. Walker, Seligman's theory of learned
helplessness explains why women stay with their abusers and occurs in
a victim after the cycle of violence repeats numerous times. As noted
earlier, dogs who were placed in an environment where pain was
unavoidable responded by becoming passive. Dr. Walker asserts that, in
the domestic abuse ambit, sporadic brutality, perceptions of
powerlessness, lack of financial resources and the superior strength
of the batterer all combine to instill a feeling of helplessness in
the victim. In other words, batterers condition women into believing
that they are powerless to escape by subjecting them to a continuing
pattern of uncontrollable violence and abuse. Dr. Walker, in applying
the learned helplessness theory to battered women, changed society's
perception of battered women by dispelling the myth that battered
women like abuse and offering a logical and rationale explanation for
why most stay with their abuser. As the classical theory of battered
women's syndrome is based upon the psychological principles of
conditioning, experts believe that behavior modification strategies
are best suited for treating women suffering from the syndrome. A
simple, yet effective, behavioral strategy consists of two stages. In
the initial stage, the battered woman removes herself from the
uncontrollable or "shock cage" environment and isolates herself from
her abuser. Generally, professionals help the victim escape by using
assertiveness training, modeling and recommending use of the court
system. After the woman terminates the abusive relationship,
professionals give the victim relapse prevention training to ensure
that subsequent exposure to abusive behavior will not cause
maladaptive behavior. Although this strategy is effective, the model
offered by Dr. Walker suggests that battered women usually do not
actively seek out help. Therefore, concerned agencies and individuals
must be proactive and extremely sensitive to the needs and fears of
victims.

In sum, the classical battered women's syndrome is a theory
that has its origins in the research of Martin Seligman. Women in a
domestic abuse situation experience a cycle of violence with their
abuser. The cycle is composed of three phases: the tension building
phase, active battering phase and calm loving respite phase. A gradual
increase in verbal abuse marks the tension building phase. When this
abuse culminates into an acute battering episode, the relationship
enters the active battering phase. Once the acute battering phase
ends, usually within two to twenty-four hours, the parties enter the
calm loving respite phase, in which the batterer expresses remorse and
promises to change. After the cycle has played out several times, the
victim begins to manifest symptoms of learned helplessness. Behavioral
modification strategies offer an effective treatment for battered
women's syndrome. However, Dr. Walker's model indicates that battered
women may not seek the help that they need because of feelings of
helplessness.

II. An Alternate Battered Women's Syndrome Theory: Battered Women as
Survivors.

Over the years, empirical data has emerged that casts doubt on
Dr. Walker's explanation of why women stay with their batterers or, in
extreme cases, why they kill their abusers. Two researchers, Edward W.
Gondolf and Ellen R. Fisher, make reference to voluminous statistics
that refute the classical battered women's syndrome theory, and
suggest Dr. Walker erroneously attributes a victim's refusal to leave
her batterer to learned helplessness. For instance, the two, in
discounting Dr. Walker's theory, cite a study conducted by Lee H.
Bowker that indicates victims of abuse often contact other family
members for help as the violence escalates over time. The two also
note that Bowker observed a steady increase in formal help-seeking
behavior as the violence increased. In addition to citing empirical
data, Gondolf and Fisher point out that using Dr. Walker's theory to
explain the battered woman's actions in extreme cases creates the
ultimate oxymoron: a woman so helpless she kills her batterer. In an
effort to account for the shortcomings of the classical battered
women's theory, Gondolf and Fisher offered the markedly different
survivor theory of battered women's syndrome, which consists of four
important elements. The first element of the survivor theory surmises
that a pattern of abuse prompts battered women to employ innovative
coping strategies and to seek help, such as flattering the batterer
and turning to their families for assistance. When these sources of
help prove ineffective, the battered woman seeks out other sources and
employs different strategies to lessen the abuse. For example, the
battered women may avoid her abuser all together and seek help from
the court system. Thus, according to the survivor theory, battered
women actively seek help and employ coping skills throughout the
abusive relationship. In contrast, the classical theory of battered
women's syndrome views women as becoming passive and helpless in the
face of repeated abuse. The second element of Gondolf and Fisher's
theory posits that a lack of options, know-how and finances, not
learned helplessness, instills a feeling of anxiety in the victim that
prevents her from escaping the abuser. When a battered woman seeks
outside help, she is typically confronted with an ineffective
bureaucracy, insufficient help sources and societal indifference. This
lack of practical options, combined with the victim's lack of
financial resources, make it likely that a battered women will stay
and try to change her batterer, rather than leave and face the
unknown. The classical battered women's syndrome theory differs in
that it focuses on the victim's perception that escape is impossible,
not on the obstacles the victim must overcome to escape. The third
element expands on the first and describes how the victim actively
seeks help from a variety of formal and informal help sources.

For instance, an example of an informal help source would be a
close friend and a formal help source would be a shelter. Gondolf and
Fisher maintain that the help obtained from these sources is
inadequate and piecemeal in nature. Given these inadequacies, the
researchers conclude that the leaving a batterer is a difficult path
for a victim to embark upon. The fourth element of the survivor theory
hypothesizes that the failure of the aforementioned help sources to
intervene in a comprehensive and decisive manner permits the cycle of
abuse to continue unchecked.

Interestingly, Gondolf and Fisher blame the lack of effective
help on a variation of the learned helplessness theory, explaining
help organizations are too overwhelmed and limited in their resources
to be effective and therefore do not try as hard as they should to
help victims. Whatever the case may be, the researchers argue that we
can better understand the plight of the battered woman by asking did
she seek help and what happened when she did, rather than why didn't
she leave.

Because the survivor theory of learned helplessness attributes
the battered woman's plight to ineffective help sources and societal
indifference, a logical solution would entail increased funding for
programs in place and educating the public about the symptoms and
consequences of domestic violence. There are battered women's advocacy
programs in place in courts located throughout the country. However,
inadequate funding limits their effectiveness. By increasing funding,
citizens can assure that all battered women will receive the
assistance that will permit them to escape their batterer.
Additionally, if we educate citizens about the harmful effects of
domestic abuse, the public will no longer treat victims with
indifference.

To recap, Edward W. Gondolf and Ellen R. Fisher developed the
survivor theory of battered women's syndrome to explain why statistics
indicate that battered women increase their help seeking behavior as
the violence escalates. The theory is composed of four important
elements. The first recognizes that battered women actively seek help
throughout their relationship with the abuser. The second element
posits that a lack of options, know-how and finances creates anxiety
in the victim over leaving her batterer. The third element describes
the inadequate and piecemeal help the victim receives. Finally, the
fourth element concludes that the failure of help sources, not learned
helplessness, accounts for why many battered women remain with their
abusers. Under the survivor theory, the best method for helping
battered women is to increase funding for battered women's assistance
programs and agencies and educate the public about the harmful effects
of domestic abuse.

III. Battered Women's Syndrome Equals Post Traumatic Stress Disorder

Although the DSM-IV does not recognize battered women's
syndrome as a distinct mental illness or disorder, some experts
maintain that battered women's syndrome is just another name for post
traumatic stress disorder, which the DSM-IV recognizes. The post
traumatic stress disorder theory is also applied to individuals who
were never exposed to domestic abuse, and, in the domestic abuse
ambit, does not exclusively focus on the battered woman's perception
of helplessness or ineffective help sources to explain why she stayed
with her batterer. Instead, the theory focuses on the psychological
disturbance an individual suffers after exposure to a traumatic event.

In 1980, the American Psychiatric Association added the post
traumatic stress disorder classification to the Diagnostic and
Statistical Manual of Mental Disorders III, a manual used by mental
health professionals to diagnose mental illness. Although the
diagnosis was controversial at the time, post traumatic stress
disorder has gained wide acceptance in the mental health community and
revolutionized the way professionals regard human reactions to trauma.
Prior to the disorder's inception, experts attributed the cause of
emotional trauma to individual weakness. However, with the advent of
the theory of post traumatic stress disorder, experts now attribute
the etiology of emotional trauma to an external stressor, not a
weakness in the psyche of the individual.

Since 1980, the American Psychiatric Association has revised
the criteria for diagnosing post traumatic stress disorder several
times. Currently, the diagnostic criteria for post traumatic stress
disorder include a history of exposure to a traumatic event and
symptoms from each of three symptom clusters: intrusive recollections,
avoidant/numbing symptoms and hyper arousal symptoms. Recent data
indicate that many individuals qualify for a post traumatic stress
disorder under the current diagnostic criteria, with prevalence rates
running between 5 to 10% in our society. As noted earlier, in order
for a diagnosis of post traumatic stress disorder to apply, the
individual must have been exposed to a traumatic event involving
actual or threatened death or injury, or a threat to the physical
integrity of the person or others. The authors of the early theory of
post traumatic stress disorder considered a traumatic event to
be outside the range of human experience, such events included rape,
torture, war, the Holocaust, the atomic bombings of Hiroshima and
Nagasaki, earthquakes, hurricanes, volcanos, airplane crashes and
automobile accidents, and did not contemplate applying the diagnosis
to battered women. The American Psychiatric Association loosened the
traumatic event criteria in the DSM-IV, which replaced the DSM-III and
DSM-IIIR. Presently, the traumatic event need only be markedly
distressing to almost anyone. Therefore, battered women have little
trouble meeting the DSM-IV traumatic event diagnostic requirement
because most people would find the abuse battered women are subjected
to markedly distressing.

In addition to meeting the traumatic event diagnostic
criteria, an individual must have symptoms from the intrusive
recollection, avoidant/numbing and hyper arousal categories for a post
traumatic stress disorder diagnosis to apply. The intrusive
recollection category consists of symptoms that are distinct and
easily identifiable. In individuals suffering from post traumatic
stress disorder, the traumatic event is a dominant psychological
experience that evokes panic, terror, dread, grief or despair. Often,
these feelings are manifested in daytime fantasies, traumatic
nightmares and flashbacks. Additionally, stimuli that the individual
associates with the traumatic event can evoke mental images, emotional
responses and psychological reactions associated with the trauma.
Examples of intrusive recollection symptoms a battered woman may
suffer are fantasies of killing her batterer and flashbacks of
battering incidents.

The avoidant/numbing cluster consists of the emotional
strategies individuals with post traumatic stress disorder use to
reduce the likelihood that they will either expose themselves to
traumatic stimuli, or if exposed, will minimize their psychological
response. The DSM-IV divides the strategies into three categories:
behavioral, cognitive and emotional. Behavioral strategies include
avoiding situations where the stimuli are likely to be encountered.
Dissociation and psychogenic amnesia are cognitive strategies by which
individuals with post traumatic stress disorder cut off the conscious
experience of trauma-based memories and feelings. Lastly, the
individual may separate the cognitive aspects from the emotional
aspects of psychological experience and perceive only the former. This
type of psychic numbing serves as an emotional anesthesia that makes
it extremely difficult for people with post traumatic stress disorder
to participate in meaningful interpersonal relationships. Thus, a
battered woman suffering from post traumatic stress disorder may avoid
her batterer and repress trauma-based feelings and emotions.

The hyper arousal category symptoms closely resemble those
seen in panic and generalized anxiety disorders. Although symptoms
such as insomnia and irritability are generic anxiety symptoms, hyper
vigilance and startle are unique to post traumatic stress disorder.
The hyper vigilance symptom may become so intense in individuals
suffering from post traumatic stress disorder that it appears as if
they are paranoid. A careful reading of post traumatic stress disorder
symptoms and diagnostic criteria indicates that Dr. Walker's classical
theory of battered women's syndrome is contained within. For instance,
both theories require that the victim be exposed to a traumatic event.
In Dr. Walker's theory, she describes the traumatic event as a cycle
of violence. The post traumatic stress disorder theory, on the other
hand, only requires that the event be markedly distressing to almost
everyone. Thus, the cycle of violence described by Dr. Walker is
considered a traumatic stressor for the purposes of diagnosing post
traumatic stress disorder. Additionally, like the classical theory of
battered women's syndrome, the theory of post traumatic stress
disorder recognizes that an individual may become helpless after
exposure to a traumatic event. Although the post traumatic stress
disorder theory seems to incorporate Dr. Walker's theory, it is more
inclusive in that it recognizes that different individuals may have
different reactions to traumatic events and does not rely heavily on
the theory of learned helplessness to explain why battered women stay
with their abusers. There are several methods a professional can
utilize to treat individuals suffering from post traumatic stress
disorder. The most successful treatments are those that they
administer immediately after the traumatic event. Experts commonly
call this type of treatment critical incident stress debriefing.
Although this type of treatment is effective in halting the
development of post traumatic stress disorder, the cyclical nature and
gradual escalation of violence in domestic abuse situations make
critical incident stress debriefing an unlikely therapy for battered
women.

The second type of treatment is administered after post
traumatic stress disorder has developed and is less effective than
critical incident stress debriefing. This type of treatment may
consist of psychodynamic psychotherapy, behavioral therapy,
pharmacotherapy and group therapy. The most effective
post-manifestation treatment for battered women is group therapy. In a
group therapy session, battered women can discuss traumatic memories,
post traumatic stress disorder symptoms and functional deficits with
others who have had similar experiences. By discussing their
experiences and symptoms, the women form a common bond and release
repressed memories, feelings and emotions.

To summarize, many experts regard battered women's syndrome as
a subcategory of post traumatic stress disorder. The diagnostic
criteria for post traumatic stress disorder include a history of
exposure to a traumatic event and symptoms from each of three symptom
clusters: intrusive recollections, avoidant/numbing symptoms and hyper
arousal symptoms. After exposure to a traumatic event, defined by the
DSM-IV as one that is markedly distressing to almost everyone, an
individual suffering from post traumatic stress disorder may suffer
intrusive recollections, which consist of daytime fantasies, traumatic
nightmares and flashbacks. The individual may also try to avoid
stimuli that remind him/her of the traumatic event and/or develop
symptoms associated with generic anxiety disorders. Critical incident
stress debriefing, psychodynamic psychotherapy, behavioral therapy,
pharmacotherapy and group therapy are all recognized as effective
treatments for post traumatic stress disorder.

IV. Conclusion

Although there are many different theories of battered women's
syndrome, most are all variations or hybrids of the three main
theories outlined above. A sound understanding of Dr. Walker's
classical battered women's syndrome theory, Gondolf and Fisher's
survivor theory of battered women's syndrome and the post traumatic
stress disorder theory, will permit the reader to identify the origins
and essential elements of these various hybrids and provide them with
a better understanding of the plight of the battered woman. Given the
prevalence of domestic abuse in our society, it is important to
realize that the battered woman does not like abuse or is responsible
for her victimization. The three theories discussed above all offer
rationale explanations for why a battered women often stays with her
abuser and explore the psychological harm caused by abuse while
discounting the popular perception that battered women must enjoy the
abuse.