He Who Knows Domestic Abuse Knows Human Folly

He Who Knows Domestic Abuse Knows Human Folly
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The recent incident in which the NFL star Ray Rice punched his then fiancé, Janay Palmer, in the face in an elevator has forced the American public to again face the ugly reality of domestic abuse. However, the puzzling fact that the woman Rice knocked unconscious stayed with him and married him only leads us to wonder, "What is wrong with people?" and "Why do we do such irrational, self-destructive things?"

Domestic abuse is common. In the U.S. government's 2010 National Intimate Partner and Sexual Violence Survey, it was found that roughly 30 percent of American women had been slapped, pushed or shoved by an intimate partner at some point in her lifetime. In the same study, nearly 26 percent of men reported themselves to have been victims of the same level of violence.

In a similar study titled, "Physical and Emotional Partner Abuse Reported by Men and Women in a Rural Community" it was reported that even in bucolic, rural mid-America, roughly 3 percent of women and 5 percent of men reported an incident of severe physical violence directed against them by their spouse in the 12 months prior to the study. Nearly 47 percent of women and 30 percent of men reported having suffered severe emotional abuse perpetrated by their partner in that period of time.

Why do we humans, both men and women, so regularly inflict abuse upon our partners? Indeed, the numbers suggest that the behavior is statistically normal. The wry response might be, "Why abuse a perfect stranger?" Indeed, it is those closest to us that rouse in us the strongest emotions. Moreover, as the ones being around us the most often, they are the ones most likely to be around us when we erupt in anger and aggression. However, I believe the obvious answer is that we physically and emotionally injure in the attempt to control and keep the person that we need more than we love.

The more curious question is, "why do we put up with the abuse of partners who are supposed to love us?" The analogous answer must be, "We stay and tolerate abuse because we need the abuser more than we love ourselves." Certainly, in some cases there are deep, dark psychological processes at work. In Sylvia Plath's poem, Daddy, she famously wrote, "Every woman adores a Fascist, The boot in the face." In the context of her describing a cold, cruel, domineering father, this line suggests that without a kind and loving father, some women prefer abuse to nothingness. Much to the relief of thoughtful readers, the poem ends, "Daddy, you bastard, I'm through." The fact that Plath later committed suicide does not diminish the triumph of that declaration.

Of course, in many cases women, especially women with young children, simply have nowhere to go and no way to get there. They have no choice but to stay. I have also seen men in this position. For this reason, our communities must invest in Battered Person Shelters that can offer refuge and resources for people needing to extricate themselves from abusive relationships. However, in my experience as a psychiatrist working with people in painful marriages and relationships, I sadly conclude that not everyone will take advantage of this service even when it is available. The inner conflicts they experience in believing they love their abuser are too paralyzing in nature.

William Osler, often referred to as the Father of Modern Medicine, once said, "He who knows syphilis knows medicine." What he meant by that peculiar statement was that the complexity of syphilis was so profound, its presentations so varied, and the likelihood of mistaking it for something else so great, that the ability to correctly recognize and deal with the illness entailed knowing all of the complexities and subtleties of human pathology. We can make a similar grand statement about the tragedy of domestic abuse. The dispensing and accepting of abuse is often written off as "love." "I hit her because I love her so much." "I stayed with him because I love him so much." While each explanation may have a kernel of truth, both fall far short of satisfying any intelligent person puzzled by this behavior. But, perhaps there is no good explanation, just as there is no good explanation for why humans are so eager to march off to war; why we so often kill in the name of God; why we smoke when we know it is bad for us; why so many of us live lives of "quiet desperation; and why we hold to superstitions in the face of scientific facts. As with Osler and syphilis, if we could understand the complexities of domestic abuse, how and why men hurt women and women hurt men, and why we hurt the ones we love and love the ones that hurt us, perhaps we would understand the entirety of the human condition and our follies.

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