The stark reality of abuse

DESPITE the fact that domestic abuse and violence against women and children are often under-reported owing to the victim’s fear, statistics of abuse experienced and reported in South Africa remain extremely high, according to occupational therapist at Akeso Clinic in Umhlanga, Courtney Greene.

Abuse defined
Defined by the World Health Organisation (WHO) as ‘a single, or repeated act, or lack of appropriate action occurring within any relationship where there is an expectation of trust, which causes harm or distress’, this broad definition of abuse includes five sub-types, namely physical abuse, sexual abuse, neglect and negligent treatment, emotional abuse and exploitation.

Causes
A number of factors may prompt someone to abuse another person, Greene points out.
‘Often abuse may stem from early learning experiences. Many abusers were abused in their lifetime and have learned to see hurtful behaviour as ‘normal’.’
The lack of social support or social resources may also lead to abuse, she adds.
Caregivers who have the support of an extended family, religious group or close friends and neighbours, are less likely to lose their self-control under stress.
‘Likewise, both substance use disorder and mental health disorders may cause a person to abuse someone as alcohol and mood-altering drugs provoke erratic and often violent behaviours.
‘These weaken or remove a person’s inhibitions against violence toward others.
‘Mental health disorders such as depression, personality disorders, dissociative disorders, adjustment disorders and anxiety disorders can all affect parents’ ability to care for their children appropriately, which unfortunately leads to child abuse and/or neglect.

Psychological impact
Distorted thought patterns, depression, post-traumatic stress disorder (PTSD), drug dependence (substance use disorder), eating disorders and anxiety disorders are some of the negative psychological effects of abuse, Greene advises.
An article published by the Livestrong Foundation mentions three signs of emotional and mental abuse that one can identify in relationships:
• Jealousy: the abuser often shows signs of extreme jealousy, demanding to know where you go, who you see and may stop you from seeing certain people and going to certain places.
• Disrespect: disrespect by mocking, criticising or humiliating the victim, often in public trying to shame and embarrass him or her.
• Control: The aggressor often uses mind games, anger, threats and insults to dominate the victim and control her actions and habits. They may tell you what to wear, who you may see, and use threats of violence or self-harm in order to attempt to control the victim.

Sombre statistics
In May, the South Africa Demographic and Health Survey, conducted by Stats SA in partnership with the South African Medical Research Council, released the following sombre statistics of women abuse and sexual violence against them:
21% of women over the age of 18 reported that they had experienced violence at the hands of a partner. That’s one in five women.
8% of these women reported that they had experienced such violence during the last 12 months of taking the survey.
The Eastern Cape has the highest rate of physical abuse with a whopping 32% women reporting physical abuse.
KwaZulu-Natal has the lowest rate of physical abuse with 14% of women reporting physical abuse).
Other provinces also showed worryingly high figures – North West (29.4%); Mpumalanga (26.4%); Free State (21.4%); Western Cape (21.2%) and the Northern Cape (18.7%).
The survey also showed that it is particularly women living in the lowest wealth quintile that experiences the most physical violence; similarly, women with no education.

Child abuse 
The repercussions of child abuse and the impact of abuse on their journey to adulthood is also severe, Greene stresses.
Research evidence shows that such abuse has long-lasting psycho-social consequences that impact the social development of children differently.
Where girls are victimised, for instance, the consequence of abuse can lead to depression, anxiety disorders, substance use disorder, eating disorders, suicidal tendencies and unwanted pregnancy.
‘Boys, in turn, are prone to manifesting behaviour such as truanting, gang involvement, and crime.
‘In addition, children who are abused are often in physical and emotional pain at school; they cannot concentrate on schoolwork and consequently fall behind in their grades.
‘They often find it hard to make or keep friends, and may be victimised by bullies or become bullies themselves.
‘Sadly, in adult life, abuse survivors are at risk of repeating childhood patterns through forming relationships with abusive spouses, employers, or professionals,’ Greene explains.

Treatment
Alas, the journey to recovery is long.
‘Abused adults and children often require long-term psychological treatment including trauma counselling and psychotherapy in order to treat specific mental health disorders and to learn new ways of dealing with distorted thoughts or feelings (new coping skills).’
She adds that it is difficult to pinpoint whether abuse against women or against children is most rife. ‘Partly this is due to the lack of reporting any form of abuse, and the classification of such abuse when reported. Domestic violence is often captured as assault, and therefore statistics will be incorrect.
‘Victims are often less likely to report cases of mental/ emotional and financial abuse as these are often viewed in a less serious light, as it often leaves no physical evidence.’
If you suspect that a person or loved one is suffering from some or other form of abuse, approach them in a safe place, using a non-judgemental manner.
Encourage them to reach out to organisations that can help, Greene concludes.

Tell-tale signs of abuse
People who are being abused may:
Seem afraid or anxious to please their partner;
Talk about their partner’s temper, jealousy, or possessiveness;
Have frequent injuries, with the excuse of ‘accidents’;
Frequently miss work, school, or social occasions, without explanation;
Dress in clothing designed to hide bruises or scars (e.g. wearing long sleeves in summer or sunglasses indoors);
Show major personality changes (e.g. an outgoing person becomes withdrawn, or is depressed, anxious, or suicidal);
Have limited access to money, credit cards, or the car.

Helpful organisations
Akeso (24-hour helpline): 0861 4357 87
Family And Marriage Society of South Africa (FAMSA) gives counselling to the abused and their families. Tel: 011 975 7101/ www.famsa.org.za.
Lifeline provides 24-hour counselling services. Call the SA National Counselling Line on 0861 322 322.
People Opposing Women Abuse (POWA) provides telephonic, counselling and legal support to women experiencing abuse. Tel: 083 765 1235/ www.powa.co.za
Rape Crisis offers free confidential counselling to people who have been raped or sexually assaulted. Call 011 642 4345.
SAPS: 10111
SADAG Mental Health line: 011 234 4837

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