I went to an ER twice in a short span of time, during which I had three kind nurses stand with their mobile laptops and proceed to ask, “Are you safe in the place you are living?” This is the domestic violence screening question. I watched curiously as two inquired without even looking up from their screen. “We ask everyone this…” quickly followed, as if no big deal. The message was not delivered in the way those words are intended on the script. Normalizing a screening can disarm the patient and provide reassurance that the hospital staff can’t read their mind and is not singling them out as a “victim.” The question is not intended to be intrusive; nor can the provider necessarily see abuse on the patient’s body. Chronically abused people often worry that others will know their story by just being in their presence. The disclaimer is a statement that “this is important to us and we ask everyone.” It is an opportunity to provide a safe space for the patient to report if he/she is in danger.
Instead, in two of my three ER assessments, it was said in a way that made the domestic violence question that followed feel rather arbitrary. Unimportant. Routine. When the nurses did not look up from the computer when posing the questions, I knew it was impossible for them to see a flinch, a change in my face, or an alarmed look in my eyes. If I were in danger in my home, I definitely would not have felt safe telling them. It was a very awkward experience as a clinical psychologist who specializes in women’s issues and trauma. I appreciate that the screening questions are uncomfortable questions to ask, particularly when we don’t want to envision the answer, “Yes, I am in danger” as a possibility. Perhaps heightening awareness regarding the domestic violence prevalence rates and talking more openly about this very real social, medical, community, economic, human rights problem would help providers to assess for domestic violence with greater confidence and care.
Every 9 seconds in the US a woman is assaulted or beaten. Around the world, at least one in every three women has been beaten, sexually assaulted, or otherwise abused in her lifetime. While female partners sometimes abuse male partners and domestic violence can happen in heterosexual or same-sex relationships, most acts of violence are directed toward women by men. Attention to the issue has been raised for decades, but new momentum has been heightened in recent weeks surrounding NFL policies on domestic partner abuse. This is timely given October is Domestic Violence Awareness Month.
As I began to write this blog and research facts regarding domestic violence, I recognized that of all the points this topic could stem from, perhaps a vulnerable experience would be best. “What if….” I needed their help, and they didn’t even look my way? If you or someone you know is in an abusive relationship and wants help, please contact the Statewide Domestic Violence Linkline at 1-800-897-LINK, the National Domestic Violence Hotline at 1-800-799-SAFE or the National Sexual Assault Hotline at 1-800-656-HOPE.
By Dr. Ann Smith, PsyD, Core Faculty
Dr. Smith has been a Core Faculty member at MSP since the fall of 2010, following a one year appointment as Associate Faculty. She shares in the responsibility of maintaining the integrity of the academic programs of MSP and teaches several clinical and theoretical courses, including Humanistic Psychology and Psychotherapy, Identity Formation, Psychopathology, and Trauma Psychology. These courses lend themselves well to experiential teaching methods, as well as provide her with the opportunity to bring her clinical experience into the classroom.