ARE ALL HITS THE SAME? A MIXED METHODS INVESTIGATION OF GENDER AND VIOLENCE IN HETEROSEXUAL RELATIONSHIPS by Alisa J. Velonis B.A., Hampshire College, 1992 M.P.H., Boston University, 2000 A thesis submitted to the Faculty of the Graduate School of the University of Colorado in partial fulfillment of the requirements for the degree of Doctor of Philosophy Health and Behavioral Sciences 2013
! ! ! ! ! 2013 Alisa Joy Velonis ALL RIGHTS RESERVED
ii This thesis for the Doctor of Philosophy degree by Alisa J. Velonis has been approved for the Health and B ehavioral Sciences Program by Jean Scandlyn Chair Richard Miech Advisor Sarah Hautzinger Jacqueline Campbell Annie Lewis O'Connor March 29, 2013
iii Velonis, Alisa J. (Ph.D ., Health and Behavioral Sciences) Are All Hits The Same? A Mixed Methods I nvestigation Of Gender And Violence In Heterosexual Relationships Thesis directed by Professor Richard A. Miech ABSTRACT Intimate Partner Violence (IPV) has increasingly become recognized as a public health concern in the United States. Recent research f inds that that roughly one in three women and one in four men in the United States have been raped, physically assaulted, or stalked by an intimate partner and the association between IPV and chronic physical and mental health conditions, acute injuries, and lost wages and productivity has been well documented. For decades, however researchers have debated the issue of "gender symmetry," or claims that women and men use violence equally in heterosexual relationships. Different research methodologies (su pported by different theoretical perspectives) have produced contradictory answers to questions of gender symmetry, spurring multiple suppositions about the very nature of IPV. This research build s on existing quantitative findings to determine if theorie s supporting gender symmetry are validated by data from qualitative, in depth interviews with a sample of individuals who report the existence of violence in a current or past heterosexual relationship. The findings suggest that the construct of control m ust be considered before drawing conclusions about IPV and gender symmetry. The form and content of this abstract are approved. I recommend its publication. Approved: Richard A. Miech
iv DEDICATION I dedicate this work to my parents, Pete and Clare Ve lonis. Without your support, encouragement, and belief in my abilities, this dissertation would never have been possible. Everyone who knows you agrees: you are the best parents in the world!
v ACKNOWLEDGMENTS This dissertation would not have been possibl e without the support, advice, and encouragement of numerous people. I am especially grateful for the faculty and staff of the HBS department, and none more so than Dr. Richard Miech. From my first days in HBS, Dr. Miech proved to be exceptional mentor, and despite having little background in the subject of IPV, jumped right into the topic, providing the guidance, challenging questions, and resources I needed to succeed. Likewise, Dr. Jean Scandlyn has been an ongoing source of both academic and moral su pport Over the years, Dr. Scandlyn has pushed me to b roaden my thinking about theory, public health, IPV, and (most recently) data. More importantly, she has become a trusted colleague and friend. I was exc eptionally lucky to have three remarkable schol ars also serve on my committee. Dr. Sarah Hautzinger's research in Brazil helped me refine my own beliefs about IPV, feminism, and power, and her suggestions of how to deepen my theory were invaluable. Dr. Jacquelyn Campbell's expertise in IPV research is unmatched, and her pointed questions, observations, and challenges (not to mention general guidance) have helped me become a better researcher and scholar. Finally, Dr. Annie Lewis O'Connor may have formally joined the committee toward the end of the pro cess, but has been a teacher, colleague, and friend for nearly 15 years; not only did she encourage me to start this journey, she cheered me on and showed me it was possible. In addition to my formal committee members, the plethora of individuals whose pr actical and emotional support saw me through this challenge is too numerous to list in entirety. Emily Chas c o read numerous chapter drafts w(h)ined with me on the back patio and became the little sister I never had Jeanette Lardinois has been a stalwa rt
vi friend this past six years and even gave the document a final (professional!) proofread for me, in addition to all the cups of coffee she drank while listening to my writing anxieties. Pam Dittman's long distance love, quirky comments and unending beli ef in me made it possible to get this far Finally, I am indebted to the directors of the Leite Head Dissertation Consultation and Retreat Center, who offered organizational guidance, survival tips, and an excellent wine selection Prior to coming to UCD I benefitted from working with a group of amazing domestic violence advocates, law enforcement officers, researchers, and public health colleagues in Tacoma, Washington. Ann Eft and the other advocates in Pierce County t aught me the most important aspec ts of IPV prevention and intervention work and left me in awe of their strength and dedication This amazing group of women (and men) encouraged me to pursue this doctorate, and I only hope I h ave done them proud Likewise, I am indebt to each of the tw enty two women here in Denver who shared with me their time and their stories. Every one of them contributed to the insights that follow, and I am eternally grateful for their trust and candidness. Finally, no words can adequately express my gratitude to my wonderful husband, Tony Donatelli, who kept me supplied with tea, cats, and chocolate, and who made sure that the last three years have been as full of laughter and joy as with research and writing.
vii TABLE OF CONTENTS CHAPTER I INTRODUCTION ................................ ................................ ................................ ............ 1 Background ................................ ................................ ................................ ................................ .. 1 Research Goals ................................ ................................ ................................ ............................ 4 Research Question 1: ................................ ................................ ................................ ............... 5 Research Question 2: ................................ ................................ ................................ ............... 5 Research Que stion 3: ................................ ................................ ................................ ............... 6 Research Question 4: ................................ ................................ ................................ ............... 7 Additional Survey Questions ................................ ................................ ................................ ... 7 But What About The Men ? ................................ ................................ ................................ ..... 7 Key Terminology ................................ ................................ ................................ ......................... 8 Intimate Partner Violence / Domestic Violence ................................ ................................ ........ 8 Coercive Control ................................ ................................ ................................ ................... 10 Situational Violence ................................ ................................ ................................ .............. 11 A Review Of The Literature ................................ ................................ ................................ ...... 11 The Debate : Sy mmetry Vs. Asymmetry ................................ ................................ ............... 13 Current Research Gaps ................................ ................................ ................................ .............. 20 II THEORIES OF IPV ................................ ................................ ................................ ...... 23 Historical Theoretical Perspectives ................................ ................................ ........................... 23 Theoretical Basis Of The F amily Conflict Paradigm And The CTS / CTS2 .............................. 24 Feminist Theories Of IPV ................................ ................................ ................................ .......... 30 Taking A Feminist Standpoint Approach ................................ ................................ .................. 37 III METHODS ................................ ................................ ................................ .................. 42
viii Phase On e : The Quantitative Survey ................................ ................................ ......................... 45 Defining And Identifying Variables ................................ ................................ ...................... 46 The Variables ................................ ................................ ................................ ......................... 47 Lifetime And Past Year Prevalence ................................ ................................ ...................... 49 Statistical An alysis ................................ ................................ ................................ ................ 50 Phase 2 Qualitative Interviews ................................ ................................ ............................... 51 Data Gathering ................................ ................................ ................................ ....................... 51 Analysis ................................ ................................ ................................ ................................ 56 Qualitative Sample Overview ................................ ................................ ................................ 57 IV FEW SIGNIFICANT DIFFEFENCES ................................ ................................ ........ 60 Physical And Psychological Experiences By CTS2 Scale ................................ ........................ 61 Lifetime ................................ ................................ ................................ ................................ 61 Past Year ................................ ................................ ................................ ................................ 63 Additional Violence And Injury Variables ................................ ................................ ............ 67 Gender And Coercion : Examining The Sample Questions On Coercive Behaviors ................. 67 Discussion Of Quantitative Findings ................................ ................................ ......................... 69 General Interpretations ................................ ................................ ................................ .......... 69 Use Of Computers ................................ ................................ ................................ ................. 74 Final Thoughts ................................ ................................ ................................ ....................... 76 V GENDER VIOLENCE AND CONTROL ................................ ................................ .. 78 Research Question 2 ................................ ................................ ................................ .................. 80 The Relat ionship Between Gender & Control ................................ ................................ ....... 84 Perpetration Of Violence In The Context Of A Partner's Coercive Control ........................ 90 Physical Aggression Outside The Context Of Control ................................ ......................... 94 A t The Intersection Of Control Gender And Violence ................................ ....................... 95
ix Research Question 3 ................................ ................................ ................................ .................. 97 Violence In The Context Of Control ................................ ................................ ..................... 99 Psychiatric Diagnoses And Treatment ................................ ................................ ................ 100 The Relationship Between Emasculation And Violence ................................ .................... 104 Discussion : It's The Same But Different ................................ ................................ ............ 105 VI SITUATIONAL OR COERCIVE ? ................................ ................................ ........... 118 Using Scale s To Ascertain Control ................................ ................................ .......................... 120 Are Highly Controlling Relationships Terroristic ?" ................................ .............................. 123 Mild Intimate Terrorism ?" ................................ ................................ ................................ ..... 126 The Right Tool For The Job ................................ ................................ ................................ .... 129 VII USING NARRATIVES TO INTERPRET NUMBERS ................................ .......... 130 Contradictions Context And Consistency ................................ ................................ .............. 131 When The Qualitative Didn't Match The Quantitative ................................ ....................... 131 Something About That Must Have Convinced Me That's All You Wanted ..." ................ 133 Including What Wasn't Counted ................................ ................................ ......................... 136 Context And Control ................................ ................................ ................................ ........... 138 Are You Sure You Have The Right Survey ?" ................................ ................................ ... 141 Considering Multiple Perspectives ................................ ................................ .......................... 143 The Place Of The CTS / CTS2 In IPV Research ................................ ................................ ....... 145 The Bottom Line : A Discussion On Qualitative Quantitative And Mixing Methods I n IPV Research ................................ ................................ ................................ ................................ ... 149 VIII CONCLUSIONS AND FINAL DISCUSSION ................................ ...................... 161 Contributions To The Field ................................ ................................ ................................ ...... 164 Assessment Instruments ................................ ................................ ................................ ........... 172 Beyond Triangulat ion : Unique Contributions From A Mixed Methods Approach ................. 174
x Engaging Men : Asymmetric Perspectives In IPV Research ................................ ................... 177 Limitations & Strengths ................................ ................................ ................................ ........... 179 Future Directions ................................ ................................ ................................ ..................... 183 REFERENCES ................................ ................................ ................................ ............... 188 APPENDIX A. Qualitative Interview Guide ................................ ................................ ....................... 200
xi LIST OF TABLES Table 3.1 Quantitative Phase Participant Demographics ................................ ............................ 48 3.2 Summary of Participant's CTS2 Results ................................ ................................ ..... 53 3.3 Qualitative Participant Demographics ................................ ................................ ........ 59 4.1 Gender as a Predictor of IPV, Lifetime ................................ ................................ ...... 62 4.2 Severity of IPV by Gender and Gender as Predictor of Severity, Lifetime ................ 64 4.3 Gender as Predictor of IPV, Past Year ................................ ................................ ........ 65 4.4 Severity of IPV by Gender and Gender as Predictor of Severity, Past Year .............. 66 4.5 Gender As A Predictor of Reporting Receipt of Coercive Behaviors, Past Year ....... 68 4.6 Gender As A Predictor of Reporting Receipt of Coercive Behaviors, Lifetime ........ 68 5.1 Participants' Experience of Physical Violence and Male Control .............................. 83 7.1 Examples of Inconsistencies Between Qualitative and Quantitative Results ........... 133
xii LIST OF FIGURES Figure 2.1 Continuum of Family Violence. ................................ ................................ ................. 24 3.1 Additional Survey Questions ................................ ................................ ...................... 47 3.2 List of Qualitative Codes ................................ ................................ ............................ 58 5.1 Public Health Model of Control ling & Non Controlling Relationships. .................. 114 7.1 Women's Perpetration of Violence ................................ ................................ ........... 152 7.2 Women's Receipt of Violence ................................ ................................ .................. 152
1 CHAPTER I INTRODUCTION His method of abu se was much more verbal and emotional, like the isolation and he would constantly critique my appearance and tell me that my makeup made me look like a whore. He loved to tell me I was a whore. And clothing didn't go or didn't look right on me, [saying th ings] like "You're going to wear that jacket? Why would you wear that? It's so boring." He was kind of into fashion. Yeah, just very critical and just slowly like broke you down over time. I'm certain that if I had stayed with him longer, it he would hav e turned much more physical than it already was. (Kellsey, early 30s) Background Intimate Partner Violence (IPV) has increasingly become recognized as a public health concern in the United States. With recent research finding that roughly one in three wo men and one in four men in the United States have been raped, physically assaulted, or stalked by an intimate partner, it is impossible to contemplate the public health arena of "injury prevention" without considering IPV ( Black et al., 2011 ) Moreover, given its association with chronic physical and mental health con ditions, acute injuries, and lost wages and productivity, it seems to be an issue we cannot afford to ignore in this era o f increasing medical costs and health care reform" ( Black, et al., 2011 ; NCIPC, 2003 ) My introduction to IPV as a public health concern began as a graduate student at Boston University, when I enrolled in the class Family Viol ence and the Practice of Public Health Later, after joining the staff of a county level public health department, I found myself serving as an informal liaison between the more scientifically oriented world of public health and community based domestic v iolence advocates, law enforcement officers, and political leaders. Dubbed the "research and data wonk" of the
2 local domestic violence commission, I often helped my advocacy colleagues sort out the confusing and seemingly contradictory conclusions that em erged from the scientific literature, particularly around gender and IPV. When talking about IPV in public, they often found themselves confronted with the inevitable accusation that men were domestic violence victims as often as women (claims generally b uttressed by "data" found on the Internet), and most would respond defensively, inferring that these studies were just examples of "bad research." Uncomfortable with this cursory response, I dug into the literature, hoping to arm the advocates with inform ation that explained why some studies found men and women to be equally violent while others did not; this would allow them to respond to these questions sounding knowledgeable and thoughtful rather than defensive or angry. The more I read, however, the m ore I began to see not only the depth of the debate over "gender symmetry" in the IPV field, but also the importance of the debate itself on public health efforts to respond to relationship violence. For several decades, researchers and program advocates in the IPV field have strongly disagreed about the gendered nature of violence within intimate heterosexual relationships. Feminist theorists traditionally argue that IPV is violence primarily directed towards women by men, that it is a function of the pa triarchal structure of society (or at least a by product of that structure), and that when women are violent, it is generally in reaction to men's violence against them ( Gilfus, Trabold, O'Brien, & Fleck Henderson, 2010 ) Justification for these claims emerges from years of formal research (as well as anecdotal conversations) with women in shelters, courthouses, and support groups. Increasingly, other researchers in the field disagree, pointing to findings that suggest women use violen ce as frequently as men in heterosexual relationships (or that
3 IPV is "gender symmetrical"). Support for this perspective comes primarily from survey data gathered within large community based samples of men and women using the Conflict Tactics Scales (CT S), the Revised Conflict Tactics Scales (CTS2) or a modified version of these instruments and leads many researchers to assert that in general, IPV results at least in part from our increasingly violent society ( Gilfus, et al., 2010 ; Straus & Gelles, 1988 ) Michael Johnson, among others, has proposed a third approach that differentiates between types of vio lence based on the dynamics within the relationship. Johnson's violence typologies include "intimate terrorism/coercive controlling violence" (an ongoing pattern of abusive and coercive behaviors) and "situational partner violence" (incidents that are sit uation specific and are not patterned behaviors). According to Johnson, while intimate terrorism/coercive controlling violence generally presents as asymmetrical (with men most often serving as primary perpetrators), situational partner violence tends to be symmetrical, with women and men reporting equal usage of violent behaviors ( Johnson, 200 6 2008 ) Moreover, he claims, the existing research that suggests that women and men are equally violent tends to be based on community samples that identify situational partner violence (and exclu de women experiencing more severe controlling violence, who would likely not respond out of fear of harm from their partners), whereas studies showing gender asymmetry use clinical populations in which intimate terrorism is more common ( Johnson, 2006 2008 ) Although a significant amount of quantitative research has been conducted in this area, the findings are not conclusive.
4 Despite Johnson's efforts to bridge the philosophical gaps between perspectives, one avenue of research that has been conspicuously neglected has been any attempt t o combine existing investigative approaches to answer questions about gender and violence. Theories of health and behavior change suggest that the multitude of factors that influence individual behaviors are complex, and yet some have attempted to underst and an issue as intricate as IPV with single pronged approaches ( Sallis & Owen, 2002 ) However, it seems impossible to draw conclusions about a multi layered phenomenon that affects thousands of people by learning about the experiences of a very limited group of women or men, even though they have first hand e xperience with the issue in question. Similarly, it seems unlikely that we can create an in depth understanding of a complex experience like violence by asking simple, closed ended questions just because they are asked of a large number of people. On its own, neither approach is sufficient. To truly begin to comprehend violence between men and women in intimate relationships, we must allow individuals with different experiences to tell their stories while simultaneously looking at the larger picture. Res earch Goals The primary goal of this research was to build on existing quantitative findings to determine if theories supporting gender symmetry are validated by data from qualitative, in depth interviews with a sample of individuals who report the existe nce of violence in a current or past heterosexual relationship. Additionally, I looked for common contextual factors (such as past experiences, feelings of fear or intimidation, or other relational dynamics) within intimate relationships that researchers should include in future studies in which the identification and understanding of IPV is paramount.
5 Research Question 1: When administered in a non clinical sample of men and women, does the CTS2 find quantitative evidence of gender symmetry in IPV with in intimate heterosexual relationships? Hypothesis 1 : I anticipated the number of violent incidents perpetrated by men would not be significantly different from the number of violent incidents perpetrated by women Research Question 2: When female IPV r ecipients and/or perpetrators (as identified by the CTS2) are asked in depth questions about the power dynamics and patterns of coercive and controlling behaviors within those relationships, how do their descriptions of men's violence and women's violence differ vis a vis these patterns, and how do these descriptions relate to current family conflict and feminist theories? Hypothesis 2 : When examining the sample as a whole, I anticipated that the qualitative data would illustrate differences in the context ual nature of men and women's violence. Specifically, I expect that although the CTS2 quantitative results will ostensibly support "gender symmetry" in IPV, a close examination of the context and meaning of the responses will actually su pport "gender asym metry" in IPV by showing: a. That men's violence against women would be more likely to be accompanied by other controlling or coercive behaviors, including the use of fear, threats, and intimidation than women's violence against men;
6 b. That women's violence ag ainst men would be more likely to be reactive of experiences with coercive and controlling behaviors used against them than men's violence against women; c. That when both partners have used violence in the relationship, men's violence would be more likely to be accompanied by behaviors aimed at controlling or coercing their partners and women's violence would be more likely to be reactive to those behaviors. Research Question 3: Do specific contextual factors associated with men's use of violence or with wo men's use of violence emerge from a series of qualitative interviews with female victims and/or perpetrators of heterosexual IPV identified in a non clinical sample? Hypothesis 3 : I anticipated identifying several specific contextual factors that are pote ntially associated with men's use of violence and with women's use of violence: a. Factors associated with men's use of violence would include the previous use of physical/sexual violence, aggression, isolation, or other controlling behaviors directed towards their female partner. b. Factors associated with men's use of violence would include male perceptions of humiliation or a threatened loss of power directed at them by their female partner. c. Factors associated with women's use of violence would include having experienced prior acts of physical/sexual violence, aggression, isolation, or controlling behaviors directed at them by current or previous male partner.
7 Research Question 4: In addition to these primary research questions, I decided to conduct an addit ional analysis of these data to weigh the evidence supporting or countering Johnson's theories of violence typologies Thus, RQ4 asked Can violence in heterosexual intimate relationships as identified using the Revised Conflicts Tactics Scale (CTS2) be c learly distinguished as "situational" or "coercive/controlling" when examined using qualitative in depth interviews with participants? Hypothesis 4 : I anticipated finding a continuum of violent dynamics, with behaviors resembling intimate terrorism/coerc ive controlling violence marking one end and behaviors resembling situational partner violence marking the other. Additional Survey Questions Finally, as one step in considering how researchers might measure relationship dynamics empirically, I included a small set of questions intended to identify key contextual factors (e.g. I have felt afraid of my partner; I have not seen friends or family because my partner would make it a hassle) at the end of the CTS questions. Although preliminary, examining the co rrelations between gender and experiences may inform future research questions and methods But What About the Men? Generally speaking, any effort to investigate gender and IPV requires that both men and women be included in the data, and in my initial re search proposal, I intended to interview equal numbers of women and men However, despite multiple approachs to recruitment, I was unable to find a sufficient number of men willing to discuss these issues, even with a male interviewer. This issue is disc ussed further in Chapter 8.
8 Key Terminolog y Intimate Partner Violence/Domestic Violence One of the challenges inherent in studying violence within familial or relational systems is the lack of consistency in terminology and definitions. Even if the dis cussion is limited to violence between adults who are or have been involved in some form of intimate or sexual relationship, terms such as "domestic violence," "spousal abuse," "partner violence," or "dating violence" are used interchangeably to describe t he same or similar types of behaviors. Moreover, different social and academic disciplines use identical terminology, but attach different definitional parameters to them. For example, legal definitions of "domestic violence" outline specific criminal ac ts (and the relationships between the parties involved) that are considered unlawful, where as advocates for battered women use the same phrase to refer to a broad set of actions that may not be illegal but contribute to a pattern of controlling behaviors. 1 Within the academic and scientific research communities, similar definitional inconsistencies exist, with some researchers focusing solely on physical violence and others including sexual violence and/or psychologically coercive behaviors. Additionally how these behaviors are conceptualized and measured varies, making comparisons across surveillance systems or between individual studies difficult. For 1 For example, the Colorado Revised Statute 18 6 800 defines domestic violence as: "an act or threatened act of violence upon a person with whom the actor is or has been involved in an intimate relationship." "Domestic violence" also includes "any other crime against a person or against property or any municipal ordinance violation against a person or against property, when used as a met hod of coercion, control, punishment, intimidation, or revenge directed against a person with whom the actor is or has been involved in an intimate relationship." However, The Advocacy Center of Ithaca, NY defines domestic violence as "when one person in a relationship uses abuse to get power and control over their partner. It can include emotional, sexual and economic abuse, threats and intimidation, and isolation from friends and family."
9 example, when asking about experiences with sexual violence, the 2004 National Crime Victimization Su rvey (NCVS) ask respondents if they "have been forced or coerced to engag e in unwanted sexual activity" ( Bureau of Justic e Statistics, 2004 ) This is quite different from 1995 National Violence Against Women Survey (NVAWS) or the more recent National Intimate Partner and Sexual Violence Survey (NIPSVS), which ask a series of very specific questions about different acts th at comprise sexual violence, including unsuccessful attempts at force ( Black, et al., 2011 ; Tjaden & Thoennes, 2000b ) Although both measure "sexual v iolence," a respondent who successfully fended off an attack may respond "no" on the NCVS, but "yes" to the question on the NVAWS or NIPSVS. For the purposes of this dissertation, I will generally follow the guidelines set forth by the Centers for Disease Control and Prevention, which proposes using the term "intimate partner violence" (IPV) (which I will use interchangeably with "domestic violence") to refer to behaviors that include physical violence, sexual violence, threats of physical or sexual violenc e, and emotional abuse that occur between current or former spouses or dating partners. That said, because Phase One of this project rested heavily on the use of the CTS2 to measure the amount and type of violence, the quantitative phase of this research conceptualizes "violence" using the behaviors and outcomes identified by this survey. In the qualitative phase, the construct becomes more broadly defined in accordance with the parameters set forth by the CDC. In all cases, the term "intimate partner" i s inclusive of current or former spouses, dating relationships, or sexual partners
10 Coercive Control While some researchers have identified specific tactics as controlling (e.g.; economic abuse, use of children, threats and intimidation, male privilege, monitoring, and blaming) or suggest that a relationship is coercive or controlling based on the quantity of tactics employed ( Johnson, 2008 ) others look more broadly at the intention and impact of actions. Evan Stark, one of the seminal researchers in the IPV field, describes "co ercion" and "control" as forces that work together to limit the agency of victims. "Coercion," he states, "entails the use of force of threats to compel or dispel a particular response" ( p. 228 ) and control: is comprised of structural forms of deprivation, exploitation, and command that compel obedience indirectl y by monopolizing vital resources, dictating preferred choices, microregulating a partner's behavior, limiting her options, and depriving her of supports needed to exercise independent judgment. Control makes up in scope what it lacks in immediacy and is rarely confined to a specific time or space. Control may be implemented through specific acts of prohibition or coercion, as when a victim is kept home from work, denied access to a car or phone, or forced to turn over her paycheck. But its link to depen dence and/or obedience is usually more distal than coercion and so harder to detect, making assigning responsibility a matter of working back from its effects through a complex chain of prior events (p. 229). When those prior events include actual or thre atened violence (against the individual partner herself or against her children, family, friends, pets, etc.), the effectiveness of those controlling and coercive behaviors can multiply as the recipient realizes that resistance is likely to have physical c onsequences. Ultimately, it is extremely difficult to systematically categorize individual behaviors or experiences as "coercive/controlling" or "inappropriate/hurtful, but not controlling" using a set of criteria that all researchers would agree upon. E ven if such a definition could be crafted, its use would remain subject to interpretation, dependent on
11 how the subject views her experiences, how she relays those experiences to the researcher, and how the researcher, with her own interpretive lens, hears that story Situational Violence In several of his publications, Johnson uses the term "situational couple violence" to refer to a specific type of violence between couples which is "not part of a pattern of control, but rather occurs when couple conflic ts become arguments that turn to aggression that becomes violent" (2011). Throughout this dissertation, I often refer to violence as "situational" in nature or "situation specific," and although my use of the term "situational" is similar in meaning to hi s (violence that occurs as a result of a specific situation rather than as part of a larger pattern of control), it does not always refer exclusively to Johnson's typological category. In earlier works, he has referred to the same dynamic as "common coupl e violence," so to avoid confusion, I will use this term when referring Johnson's specific classification. A Review Of The Literature Despite numerous examples of disparities in victimization by gender ( Black, et al., 2011 ; Romans, Forte, Cohen, DuMont, & Hyman, 2007 ; Thompson et al., 2006 ; Tjaden & Thoennes, 2000a ) a debate has raged since the mid 1990s over the nature of violence between men and women in intimate relationships. Specifically, a significant body of quantitative research points to violen ce perpetration as "gender symmetrical," with women reportedly perpetrating at least half of all violent incidents ( Cho, 2012 ; D. G. Dutton & Nicholls, 2005 ) However, other research suggests women are the primary victims of violence in relationships, even when they themselves engage in violent acts ( Dobash & Dobash, 2004 ; Hamberger & Guse, 2002 ; Loseke & Kurz, 2005 )
12 From a policy and intervention development stan dpoint, this debate is not merely semantic; allocating resources effectively and designing appropriate criminal justice and treatment responses is dependent on understanding the nature of violence between intimate partners, as intervention measures that ma y be efficacious for one typology may be inappropriate for the other. Currently, a substantial proportion of domestic violence services are based in feminist theory, which asserts that power imbalances between men and women in society influence intimate r elationships and lead to men's violence against women ( C. C. Collins & Dressler, 2008 ; Jones, 1994 ; Loseke & Kurz, 2005 ) Although rates of IPV have generally decreased in the past several decades, recent statistics indicate that IPV remains a significant problem ( Black, et al., 2011 ; Catalano, 2007 ; Rennison & Welchans, 2000 ) Moreover, a review of the ba tterer treatment literature suggests that the success of perpetrator treatment programs is mixed, at best, leading some to question the efficacy of perceiving all violence as patriarchal ( Babcock, Green, & Robie, 2004 ; D. G. Dutton & Corvo, 2006 ; Langhinrichsen Rohling, 2010 ; Ross & Babcock, 2010 ) If neither men nor women who use violence perceive an imbalance within their relationship, we are doing a disservice in labeling women as victims and men as villains. Furthermore, to be effective prevention and intervention programs must reflect the reality of those experiencing violence; efforts thus far to categorize IPV as solely about male oppression (or solely about inappropriate conflict resolution skills) have yet to result in programs tha t demonstrate clear success. A more accurate specification of the dynamics at play is needed to create effective and comprehensive intervention and primary prevention programs ( Langhinrichsen Rohling, 2010 )
13 The Debate: Symmetry vs. Asymmetry In the 2.5 years since I completed the prospectus for this research, the li terature on gender and intimate partner violence has at least doubled. Although a substantial portion of this new research supports the notion that IPV may be, as Cho (2012) describes, quantitatively symmetrical but qualitatively different, the debate bet ween feminist and family violence researchers has not subsided; indeed, if an exchange published in the journal Aggression and Violent Behavior in 2011 2012 is any indication, the animosity has only increased ( D. G. Dutton, 2012 ; Johnson, 2011 ; Straus, 2011 ; Winstok, 2011 ) The Family Violence Perspective and the CTS/CTS2 Data that support gender symmetry often come from large, population based research studies that rely on quantitative scales, most commonly the Conflict Tactics Scale (CTS), the re vised Conflict Tactics Scale (CTS2) ( Straus, Hamby, Boney McCoy, & Sugarman, 1996 ) or a modified version thereof. Consisting of five scales (each with subscales) measuring items such as negotiation, psychological aggression, physical assaul t, sexual coercion, and injury the CTS2 measures the number and severity of violent exchanges between intimate partners. This 78 question survey asks respondents how many times, if ever, they or their partner perpetrated or received specific acts of violence. In addition to calculating the number of discrete incidents, the data can also be dichotomously classified by level of severity per incident (e.g. minor vs. severe). Studies using these scales often find that women report engaging in at least as many violent acts against men as men perpetrate against them ( D. G. Dut ton & Nicholls, 2005 ; Hines & Saudino, 2003 ; Straus, 2008 ) In 2002, Archer published a meta analysis of research based on the CTS/CTS2 that sugge sts that although men's violence against
14 women is a serious problem, women are more likely than men to commit certain forms of violence, including throwing something at a partner, slapping, kicking, biting, punching, or hitting their partner with an object ( Archer, 2002 ) More recently, Dixon and Graham Kevan authored a review of "methodologically sound" 2 research, finding no evidence for claims that women's violence against men occurs in s elf defense and ultimately concluding that a "gender inclusive approach" (i.e., one based on gender symmetry) should be used to guide future IPV research and practice. ( Dixon & Graham Kevan, 2011 ) The Feminists: Context, Motivation, and Outcomes Feminists and victim advocates question the validity of this interpretation. They argue the CTS (and its revised and modified versions) measur es concrete acts and events without considering the causes or consequences of those actions. Although the scales may provide an accurate assessment of the number of violent events that occur in a relationship, they cannot place the violent acts within the context of the relationship ( Loseke & Kurz, 2005 ) For example, partner A may act aggressively towards partner B, who responds by using violence in self defense. In this case, the number of violent acts and the directionality of the violence may appear even, but the effects are very different. In this example, partner A uses violence as an assertion of power over partner B, whereas partner B uses violence to defend him/herself from the aggressor, partner A. Moreover, although the CTS2 includes a psychological aggression scale, many of the questions inquire about behaviors that occur so frequently that, in one study over 80% of all respondents reported engaging in at least one of those tactics ( Hines & Saudino, 2003 ) 2 At no point do the authors define their construct of "methodologi cally sound."
15 Feminist scholars often point to data that suggest men and women report incidents of violence differently. Whereas women are more likely to over report their use of violence while under reporting experiences of victimization, men tend to do the reverse ( H. Melton & Belknap, 2003 ; H. C. Melton & Sillito, 2011 ) ; even Hamby one of the authors of the revised version of the CTS, admitted that evidence shows men underreport IPV perpetration, concluding that "male and female reports should not be used for gender comparisons" ( Hamby, 2009, p. 29 ) Moreover, when women do use violence, some research suggests it is more likely to be defensive or reactive in nature and the specific violent actions are ofte n different ( Allen, Swan, & Raghavan, 2009 ; H. Melton & Belknap, 2003 ; H. C. Melton & Sillito, 2011 ) Using six questions from the CTS2's "minor physical violence" scale, Allen and colleagues conducted a path analysis to test the relationship between perpetrating and receiving violence by gender. Whereas "wom en's victimization from male partners was a strong predictor of women's perpetration women's perpetration was not shown to predict women's victimization by male partners," suggesting that women's violence was "primarily a reaction to male violence against them" ( Allen, et al., 2009 ) Additionally, numerous studies conclude that when compared to male victims of female violence, women are more likely to experience sexual victimization, chronic patterns of violence, and high level of fear ( Ansara & Hindin, 2010 ; Black, et al ., 2011 ; Cercone, Beach, & Arias, 2005 ; Kar & O'Leary, 2010 ) For example, a lthough the recent NIPSVS found high levels of non sexual IPV reported by both men and women using CTS style questions, the percentage of women who reported any form of sexual violence or coercion was at least double that
16 of men, and women more much more likely to re port a plethora of negative outcomes ( Black, et al., 2011 ) In an apparent attempt to acknowledge some of the feminist cri tiques of the CTS/CTS2 while justifying its continued validity, Hamby suggests that we consider IPV and women's use of violence as "moderately asymmetrical." Reviewing data from several criminal justice sources, she points to evidence that women perpetrate between 20% 30% of most other forms of physical violence; thus, it would stand to reason that women commit around the same proportion of IPV. While this may appear to contradict the arguments in favor of true gender symmetry, she nonetheless dismisses s everal of the critiques of the survey, including arguments that self defense, power, control, dominance, and fear should be considered in any measurement of relationship violence ( Hamby, 2009 ) Research relying on smaller samples of both victims and perpetrators identified primarily from clinical settings, such as law enforcement, shelter, and perpetrator treatment programs suggest that even when both parties admit to using violent behaviors, violence directed towards women tends to be more severe, more frequent, more physically and psychologically damaging, and intended to assert power when compared to women's violence against male partners ( Anderson & Umberson, 2004 ; Cascardi & Vivian, 1995 ; Dobash & D obash, 2004 ; Hamberger & Guse, 2002 ; Loseke & Kurz, 2005 ; Malloy, McCloskey, Grigsby, & Gardner, 2003 ) This has led some researchers whose quantitative findings suggest symmetry to actively caution against drawing firm conclusions, given the inability to analyze the context of the violence
17 participants reported ( Cho, 2012 ) In a 2003 review of the literature surrounding the gender symmetry debate, Mallory and colleagues concluded that: Simple counts from most, but not all, studies of IPV suggest gender symmetry. Yet this "snapshot" approach does not accura tely portray the entire picture. Women are not violent "like men" nor are men violent "like women" within intimate relationships. The negative outcomes of IPV overwhelmingly affect women, whether this concerns rates of injury or homicide, sexual assault, s talking, levels of fear, or other emotional sequel. In addition, striking differences are found between women and men concerning the motivation for using IPV, with women often using IPV in self defense and most men using IPV to control their intimate partn ers. The differences between women and men for both outcome and motivation suggest not only gender asymmetry, but also the need to design future studies to capture a "video" representation of domestic violence disputes, rather than the more common snapshot approach that serves to de contextualize IPV ( Malloy, et al., 2003 ) A more recent editorial in the journal Violence Against Women reached a similar conclusion: Including mutu al aggression and female perpetration under the umbrella of IPV as a public health issue implies that (a) this is a nongendered phenomenon that affects the health and well being of men/boys and women/girls similarly and at the population level, and (b) the etiology and nature of the behavior are similar regardless of perpetrator gender. Neither research nor practical external evidence supports such assumptions. ( Reed, Raj, Miller, & Silverman, 2010 ) In a brief prepared for the VAWnet (a project of the National Resource Center on Domestic Violence), DeKes eredy and Schwartz summarized many of the criticisms launched against the CTS and the CTS2. Without dismissing the usefulness of these existing scales, they concluded by highlighting the critical need for researchers to use multiple methods when examining IPV if we are to truly understand its multidimensional characteristics comprehensively ( DeKeseredy & Schwartz, 1998 )
18 Violence Typologies Although pitted against one another in the literature and professional debates, these approaches rely on different methods and sampling practices and, therefore, measure different phenomena. One cap tures the number of violent events (without context) in a general sample; the other examines experiences of extreme violence in clinical samples. In an attempt to explain these divergent findings, Johnson asserts that IPV should not be thought of as a "un itary phenomenon," but rather an umbrella under which several different types of violence between partners can be categorized ( Johnson, 1995 2007 ) After completing a secondary analysis of two data sets (including the National Violence Against Women Survey, which used a modified, partial version of the CTS2), Johnson and Kelly distinguish four major types of IPV: "coercive controlling violence" (r eferred to in past publications as "intimate terrorism"), "situational couple violence" (previously called "common couple violence"), "violent resistance," and "separation instigated violence" ( Johnson, 2007 2008 ; Kelly & Johnson, 2008 ) Of these four typologies, the first two have drawn the most significan t attention in the literature surrounding theories about IPV gender symmetry. Coercive controlling violence or intimate terrorism is the dynamic most frequently associated with terms like "domestic violence" or "wife battering." It reflects "a pattern of emotionally abusive intimidation, coercion, and control coupled with physical violence against partners" ( Kelly & Johnson, 2008 ) ; coercive methods can include controlling finances and resources, threats, inti midation, isolation, and degradation ( Johnson, 2006 ; Stark, 2007 ) Johnson emphasizes that although women can be the principle perpetrator of coercive
19 controlling violence, research clearly illustrates that men comprise the vast majority of intimate terrorists ( Johnson, 1999 2006 ) Johnson defines situational couple violence as the "intermittent response to the occasional conflicts of everyday life, motivated by a need to control in the specific situation" ( Johnson, 1995 ) Unlike coercive cont rolling violence, situational violence, "does not involve an attempt on the part of one partner to gain general control over the other," and he describes this as, "the most common form of physical aggression in the general population of married spouses and cohabitating partners" ( Johnson, 2001 2006 2007 ; Kelly & Johnson, 2008 ) Although his theory is compelling, more in depth research is required before concluding that the majority of violence in heterosexual relationships is "situational" and without any gendered patterns of coercion. After examining data on 331 abused women in 11 cities, Frye and colleagues question Johnson's methodology when defining a relationship as "coercive controlling" verses "situational" since they found more of a continuum o f controlling behavior than two distinct types ( Frye, Manganello, Campbell, Walton Moss, & Wilt, 2006 ) Still others criticize his typologies as focusing on "attempted contro l" rather than on the actual power held by individuals in relationships ( Emery, 2011 ) Moreover, very few researchers have engaged qualitative methods to explore the nature of relations hip violence in non clinical populations. Nazroo conducted in depth interviews with 96 cohabitating couples and illustrated how gender differences in the severity, intensity, and intent of violence become obvious once contextualized, despite substantially more women using violence in their relationship than men (55% compared to 38%), ( Nazroo, 1995 ) These findings lead to further questions about how
20 men and women perceive violence within their relationships, and whether dichotomous labels such as "victim" and "perpetrator" are truly accurate. Women who use violence in response to their partner's behavior may not view themselves as victims, although their partner has intimidated them for years. Current Research Gaps Although each standpoint on gender and IPV offers useful theoretical perspectives, empirical research will enable us to generate a better specification of violence between men and women in intimate rela tionships. Researchers advocating gender symmetry provide strong evidence about the frequent use of certain behaviors by both sexes, but ignore the importance of contextual elements that underlie those behaviors (or measure them in ways that are incapable of identifying power differentials). Even Johnson, who acknowledges the likely existence of gender asymmetry in coercive controlling heterosexual relationships, substantiates his assertions by counting the numbers of controlling behaviors women experience in relationships; although this method goes farther in exploring the context of relationships, it remains limited by relying on researcher defined categories of "controlling behaviors." Feminists focus extensively on contextual power and control, yet much of this work lacks generalizability due to the frequent use of clinical samples. Moreover, feminist theory often perceives women entirely as "victims" and overlooks ways in which women may perceive their own use of violent behaviors as reclaiming a sense of personal power in the face of gender oppression. Much of the previous research in this field lacks detailed consideration of the specific experiences of violence among individuals not actually seeking assistance or
21 treatment for domestic violence. When a general sample of women and men admit to using and/or receiving violence in an intimate heterosexual relationship, how do they perceive relational power dynamics? Is our interpretation of the CTS "score" accurately reflected in these contextual descrip tions? Is male violence likely to emerge from a real or threatened loss of power or patriarchal attitudes (as feminist theory suggests)? Can we clearly distinguish "coercive controlling violence" and "situational partner violence"? Very few studies attem pt to address these questions surrounding gender symmetry by using qualitative methods to assess the balance of power, threats, and/or coercion. Even when qualitative data is gathered, it is frequently transformed into quantitative categories (e.g., Johns on's use of Frieze's data) ( Johnson, 2008 ) Qualitative research has the ability to contextualize the research findings, to tell the story behind the numbers or dichotomous answers of "yes/no." Moreover, combining qualitative and quantitative methods while preserving the unique strengths that each bring can provide particularly rich information. To my knowledge, few if any investigators have followed the administration of the CTS with qualitative interviews designed to better understand the meanings and experiences behind the violent acts identified. Put simply, we are missing the voices of the individuals telling the stories that underlie their "score" on a quantitative scale. This dissertation will help to bridge the current gaps in the literature by using a mixture of qua ntitative and qualitative methods to better understand individuals' experiences of violence as both aggressors and victims. Furthermore, by comparing quantitative indicators (CTS scores) with qualitative findings, this project can begin to broaden our und erstanding about how measurements such as CTS scores should be interpreted in the literature. Beyond making theoretical contributions, however, the
22 ultimate goal behind this research is to expand our insight into the nature of heterosexual IPV and provide guidance for the development of efficacious and appropriate prevention and intervention approaches.
23 CHAPTER II THEORIES OF IPV Although much has been written about the theoretical basis for partner violence ( Gelles, 1980 1997 ) the question here is not why violence occurs in intimate heterosexual partnerships, but rather who tends to be the primary perpetrator and wh ere the balance of power within the relationship lies. The viewpoint that women and men are equally violent, what I will call the Family Conflict Paradigm, suggests that violence is primarily (although some would argue not entirely) an un gendered phenome non, and that when women use violence against male partners they are asserting the same manner of power as men who use violence against women. Feminist theorists, on the other hand, argue that the prevalence of sexism and gender oppression throughout soci ety makes it more likely that even when women use violence against male partners, they are doing so from a disadvantaged situation and rarely have a similar amount of power in the relationship as their male partners. At face value, both perspectives are l imited in their abilities to explain the gendered nature of heterosexual intimate violence, and, I would argue, a more expansive form of feminist theory is necessary to adequately address the dynamics of heterosexual intimate partner violence (IPV). Histor ical Theoretical Perspectives One of the apparent differences between the family conflict paradigm and the feminist perspective is the unit of analysis used to describe the subject of inquiry. As the name suggests, family conflict theorists focus on viole nce within families of which heterosexual partner violence is one component (see figure 1). Although there are different levels of power within family units, age serves as the main source of
24 discrepancy, with children and elderly being considered more v ulnerable than other adults. Feminist theorists, on the other hand, view the couple as the primary unit of analysis, and gender becomes the operative power differential in heterosexual relationships. Figure 2 1 Continuum o f Family Violence Theoretical Basis Of The Family Conflict Paradigm And The CTS / CTS2 As documented by Gelles and others, violence within family systems was a neglected topic of research prior to the 1970s, and even in the decade that followed, the bulk of scientific inquiry focused on child abuse and neglect and not on partner violence ( Gelles, 1980 ) Early work primarily entailed creating reliable research tools and measuring the extent of violence present within predominantly U.S. and Western European families. Initial efforts centered on events that occurred in families where Family Violence Child Abuse Dating Violence Adult Partner Violence Elder Abuse Neglect Physical Sexual Physical Sexual Emotional Coercion Physical Sexual Emotional Coercion Financial Physical Emotional Coercion Financial Intimate Partner Violence
25 violence was already known, such as women residing in battered women's shelters or those who had obtained restraining order s against their husbands. According to Gelles, the development of the Conflict Tactic Scale (CTS) in the 1970s (originally titled "Conflict Resolution Techniques") "showed that research could be conducted using non clinical, non officially reported cases" of spousal abuse ( Gelles, 1980 ) Although theoretical models surrounding family violence were developed and debated, the emphasis fell on describing why violence occurred within families rather than on understanding the dynamics within violent relationships ( Gelles, 1980 ; Straus, 1979 ) As a methodological tool, one of the strengths of the CTS lay in its ability to operationalize definitions of "violence" and obtain reliable data based on self re port ( Gelles, 1980 ; Straus, 1979 ) Arising from a desire to quantify violence within "typical" families (and define exactly what actions are considered violent), the CTS counts the number of times specific actions have taken place between family me mbers or intimate partners. As Campbell noted in her 2000 review of IPV surveillance methods, the CTS engages normative and non judgmental language that may set the respondent at ease and result in greater levels of disclosure, critical when examining a ph enomenon with a relatively low base rate ( J. C. Campbell, 2000 ) The questions focus on the specific events themselves, not on the consequences of the events, and although it does allow researchers to classify violent actions as "more severe" or "less severe," outcomes such as injury or emotional distress are not measured by the main scales, nor are contextual factors surrounding the events. 3 3 Some research using the CTS has also measured rates of injury, but this is not part of the initial CTS.
26 As noted earlier, when the CTS is used to identify and quantify IPV in large, community based samples, the findings often suggest that men and women engage in similar levels of violence, thus supporting the family conflict paradigm. However, when describing these findings, very few researchers acknowledge any theoretical basis for their research m odels or hypotheses. Rather, there appears to be an underlying assumption that "good" research is empirical and not theory driven; it represents an unbiased and objective search for "the truth." Both Straus and Dutton, strong proponents of the family con flict paradigm, have criticized feminist approaches as being political in nature and designed to support a feminist activist agenda ( D. G. Dutton, 1994 2012 ; D. G. Dutton & Corvo, 2006 ; D. G. Dutton & Nicholls, 2005 ) However, it seems doubtful that any research process is truly theory neutral; Straus himself acknowledges his commitment to ending all forms of violence, and his belief that all partner violence is equal in its moral reprehensibility, regardless of the gender of the participants ( Straus, 2005 ) Investigators choose methods, write questions, and analyze data using theoretical lenses, whether they identify these lenses or not. For example, when considering the impact of gender on heterosexual intimate partner violence, one of the key differences between feminist theory and the family conflict paradigm lay in the interpretation of power and personal agency within heterosexual relationships. Whereas feminist theory suggests that male gender is a source of power within heterosexual relationships, the family conflict paradigm considers all instances of similar ly severe violent acts as being equal regardless of the gender of the perpetrator, implying that both partners have equal
27 levels of personal agency. Although this theoretical perspective is generally left unstated, the assumption clearly drives the approa ch to data analysis, if not data collection. Another indication that the family conflict paradigm is not atheoretical has to do with its dependence on the CTS, which its creators acknowledge is based on conflict theory ( Straus, 1979 ; Straus, et al., 1996 ) Although broader definitions of conflict theory focus on power and conflict at a structural and societal level (see, for example, the writings of Marx and Weber), theorists such as Coser and Dahrendorf applied these idea s to dynamics that exist between individuals and groups of individuals. Daherndorf described conflict as a natural result of differences in power and the tension between those seeking control and those supporting the status quo ( Dahrendorf, 1958 ) Coser identified two forms of conflict: conflic t within groups, and conflict between groups. Conflict is not necessarily negative, Coser argued; often, it leads to stronger bonds within groups, serves as a means of releasing pent up hostilities, and leads to the development of clear lines of authority and jurisdiction ( Allan, 2007 ) Building on these models of conflict, Gelles and Straus observe, "conflict in social relations whether in the family, in the streets, or between nations is an inevitable and necessary part of social relationship, but physical violence is not," concluding: ...if the structure of the society or family does not provide nonviolent means for individuals and groups to redress grievances and to engage in efforts to further their interests vis Âˆ vis other individuals or groups, physical violence may be the only way to correct injustices, to bring about neede d social change, and to maintain the viability of the social unit ( Gelles & Straus, 1979 ) As the primary authors of the CTS, Straus and Gelles appear to view physical violence as resulting from the build up of ordinary, every day conflict for which the actors i dentify
28 no non violent outlets. Both partners are perceived as having an inherently equal position, at least prior to the use of physical violence. Based on this conceptualization of violence, it is not surprising that the CTS is limited in its ability to focus on the gender and power dynamics within individual relationships. Using conflict theory in this way provides one explanation of why violence occurs in relationships, but it does little to explain any dynamics that underlie the conflict. This interpr etation of conflict theory seems particularly narrow; although Coser and Dahrendorf both discuss the influence of power differences between parties, the CTS allows no exploration of this dynamic when assessing violent conflict between partners. Additional ly, by measuring levels of violence in this quantitative and positivistic manner (in which violence is an act that either occurred or did not), the methodology is based on an assumption that both parties within the relationship have an equal ability to eng age in these behaviors, and that the results of these behaviors are the same; there is no attempt to explore other conclusions. It should be noted that the full version of the CTS /CTS2 includes a scale intended to measure psychological aggression, which i ncludes a few questions about some specific controlling behaviors. However, the authors themselves seem to acknowledge that although these responses are useful when using the instrument in clinical settings, the prevalence of those behaviors will likely be close to 100% when used to measure conflict in research samples ( Straus, et al., 2003 ) possibly explaining why few scholars examine these responses when using the CTS/CTS2 to measure IPV. Thus, a lthough the CTS provides valuable information about the existence of violence i n relationships, it seems questionable that it serves as the best tool for understanding the intersection of gender, power, and violence.
29 In addition to shaping data collection and research methodologies, theoretical perspectives also drive data analysis. Family conflict researchers tend to draw conclusions about violence in relationships based on a count of violent incidents and use pre determined definitions of severity. For example, if an open handed slap and a shove are both determined to be "moderate ly severe," when one person slaps another and the second person shoves the first, both individuals are thought to have used equal violence against the other (regardless of consequences). Moreover, the conviction that measuring violent incidents at specifi c points in time serves as an acceptable framework through which to analyze long term relationships suggests a belief that the violent acts themselves are important, not whether a pattern of abusive behaviors has occurred throughout the span of the relatio nship. Even when attempts have been made to determine which party instigated the violence, the focus remains on a particular incident in time, rather than exploring past acts ( Straus, 2005 ) A primary weakness inherent in the family conflict paradigm is its inability to recognize that personal relationships are compl icated and that behaviors between partners happen within a historical context that is not easily quantifiable. By assuming that all acts of violence are equally destructive (morally, if not physically), and by basing conclusions strictly on the number of violent incidents, there is a tendency to overlook long term patterns of abusive behaviors and coercive techniques that are difficult if not impossible to count. Moreover, cultural variables (including ethnicity, class, family structure, experiences, etc.) likely result in different behaviors holding different meanings for different couples. For example, within some families, shouting or yelling is construed as threatening or hurtful, particularly if the content is cruel or is often followed by
30 additi onal abusive behavior or threats. However, other families may be loud and aggressive as a general rule, and although a couple may yell or shout at each other, the action is not interpreted as threatening and there is no perception of the possibility of ha rm. Feminist Theories Of IPV Although there is no single "feminist" perspective, by most accounts feminist theory is focused on "explaining the origins of women's oppression and the means by which it has been sustained over time" ( Nicholson, 1997 ) Different feminist branches struggle to account for this oppression using different lenses: liberal feminists tend to view inequality as an issue of political rights and responsibilities; radical feminists see the problem as one of cul tural beliefs which position women as "less than" men; Marxist / socialist feminists explain gender discrepancies as related to women's material position within capitalist societies; and other perspectives generate additional explanations. However, regardle ss of the specific political or cultural standpoint used, most feminist theorists agree that because of the historically patriarchal structure of Western society generally and the family specifically, violence within heterosexual relationships must be cons idered within the context of gender and power, which leads to defining the problem as one of violence against women ( Loseke & Kurz, 2005 ) Whereas the theoretical underpinning of the family conflict paradigm suggests that on a normative level, men and women hold equally powerful positions within heterosexual relationships, research emerging from a feminist framework argues that because of the social, political, and economic differences between men and women, violence by men must be considered inher ently different from violence by women.
31 Within Western society, gender has been one of the central organizing factors, with men occupying the dominant role in the larger society and women existing (ideally) within the realm of the home. 4 Although we have seen tremendous changes in women's levels of social and economic power, this historical inequality remains evident and has significant impacts on dynamics within intimate relationships and families. As Loseke and Kurz note, To summarize, what happens in side homes, and the meaning of what happens inside homes, is different from women and for men. The gendered nature of coupling leads to the typical situation in which the woman has less income than her partner, he is bigger than she is, and she is more in volved, in time as well in psychological commitment, with her children and household than he is. These gendered characteristics of family life influence how women and men think about violence, how they can think about the possibilities of eliminating the violence or of "leaving home." We see the world through the lens of gender, and this is the context for violence ( Loseke & Kurz, 2005 ) Although we are increasingly seeing situations where women earn more income or have equal or even higher leve ls of public prestige than their male partners, international research suggests that in some places, this can actually increase women's vulnerability to violence, as established gender roles become threatened ( J. C. Campbell, 1999 ; Hautzinger, 2007 ; Koenig, Ahmed, Hossain, & Mozumder, 2003 ; Okenwa, Lawoko, & Jasson, 2009 ) Combined with traditional notions of masculinity (that exude the importance of being tough and aggressive) and femininity (that emphasize gentleness and passivity), feminist the orists argue these characteristics make it virtually impossible not to view heterosexual partner violence within a gendered context. Even when women 4 Obviously, this is a dramatic oversimplification; poor women and women of color have always worked outside of their own homes, illustr ating the ways in which other oppressive forces shape experiences of gender and power
32 initiate or engage in violence, they do so from a disadvantaged location ( Kimmel, 2002 ; Loseke & Kurz, 2005 ) One underlying premise of many feminist theoretical frameworks is the belief that women and men demonstrate different ways of "knowing" the world around them. Whether this is due to biologica l differences in the ways men and women inherently think or because of the very strong scripts that both genders are forced to accept from an early age, a number of feminist theorists argue that women relate to others and perceive information differently f rom men ( Chodorow, 1997 ; C. Gilligan, 1982 ; Tong, 2 009 ) However, because men have traditionally retained the seats of power within society, masculine approaches to science and research have been established as normative. Many feminist researchers argue that traditional, so called objective "scientific" methodologies do not serve the interests of women well. Women's issues have generally been left out of the research arena, and even when present, the approaches taken to understand them are often rooted in masculine biases and ways of understanding ( Hesse Biber, Leavy, & Yaiser, 2004 ; Sprague & Kobrynowicz, 2004 ) Opponents of traditional empirical sociological methodologies argue that this approach to science is rooted in a positivist framework that objectively seeks to find the one "truth." For many feminists, this perspective is inadequate; not only do they find true "objectivity" questionable, they also criticize the researcher 's power to define "knowledge" and the engagement in a rational emotional dualism in which feminine tendencies to focus on emotion and care become impediments to the research process ( Hesse Biber, et al ., 2004 ; Sprague & Kobrynowicz, 2004 ) Although Chafez, a self proclaimed "unrepentant" feminist positivist, dismisses many of the claims against positivism, she acknowledges that the
33 ways in which positivistic research has been conducted in the past has helped uphold a patriarchal gender system ( Chafetz, 2004 ) Feminist oriented IPV researchers frequently take issue with empirical, positivistic approaches to examining gender and violence. In particular, they criticize family conflict paradigm research for its nearly singular use of "act based" definitions of violence as characterized by the CTS, which fails to consider more subjective constructs such as situational or historical context, motivations and intentions, and the severity of outcomes ( Dobash & Dobash, 2004 ; Dobash, Dobash, Cavanagh, & Lewis, 1998 ; Kimmel, 2002 ; Loseke & Kurz, 2005 ) Framing the argument another way, family conflict research rarely takes the "standpoint" of any of the key players into account. Standpoint theory (discussed in greater depth below) allows the inve stigator to reduce the power differential between herself and her subjects by valuing the experiences of the subject as primary knowledge. This methodology suggests that phenomena related to human behavior cannot be accurately understood without consideri ng the ecological factors that impact the individuals involved, including the researcher herself ( Hesse Biber, et al., 2004 ; Naples, 2003 ) Alt hough we can document an incident in which one partner hit another, standpoint theory suggests that in order to truly understand the event we must explore the context of the relationship, the experiences, beliefs, and attitudes of the individual partners, and the biases brought by the investigator. For example, if a woman has been raped in her past, she may perceive certain behaviors by her male partner as threatening and act preemptively. Moreover, if the investigator herself experienced rape, she views the relationship she is learning about through the lens of a survivor. Although few researchers in this field self identify as standpoint theorists, the
34 qualitative and descriptive approaches they take when allowing women (and men) to tell their own storie s are reflective of standpoint practices; rather than counting violent acts, they attempt to contextualize them through narrative ( Bacchus, Mezey, & Bewley, 2006 ; Landenburger, 1989 ; Nazroo, 1995 ) In addition to adopting methodologies designed to understand the experiences of victims and perpetrators, f eminist research focuses on the consequences of partner violence. By incorporating findings that suggest women experience significantly higher rates of injury, hospitalizations, and homicide compared to men, a feminist perspective uses these discrepancies in outcomes to illustrate the power disparity between men and women ( Kimmel, 2002 ; Loseke & Kurz, 2005 ) For example, through a series of in depth interviews with men participating in a batterer tr eatment program, Anderson and Umberson found that men themselves reported perceiving women's violence against them as ineffective and hysterical, while they viewed their own behaviors as dangerous ( Anderson & Umberson, 2004 ) In a recent literature review, Caldwell and colleagues describe similar findings, conc luding that, while they do not subscribe to the belief that women are inherently predisposed to poor outcomes in response to IPV, "gender matters because it is so highly correlated with power" ( Caldwell, Swan, & Woodbrown, 2012 ) From an activist perspective, these approaches to exploring gender and IPV are critical to efforts to maintain services for battered women; Loseke and Kur z observe how research that shows gender symmetry in incidents of violence (but does not examine the gendered nature of the consequences nor other elements of the dynamic) has been used to support efforts to dismantle shelter and advocacy programs in sever al states ( Loseke & Kurz, 2005 ) Although criticized for engaging in politically driven investigation, most
35 feminist researchers are keenly aware of the political nature of their work; just as family conflict adherents choose questions and methods best suited to their beliefs and hypotheses, feminist research is generally grounded in the assumption that violence against women is prominent, that it has severe consequences for women and larger society, and that research must focus on how to prevent i t ( DeKeseredy & Dragiewicz, 2007 ) Although feminist research overcomes several of the flaws of the family conflict paradigm (including the de gendering of power in relationships and the refusal to consider complexities within the relati onship), it presents limitations, as well. Although most of its proponents identify with feminist theory and acknowledge the desire to end violence against women (and many of them engage non positivistic research approaches), few are openly descriptive ab out the ways their own experiences shape their designs and analyses. While this fault exists within most disciplines, by strongly emphasizing the importance of the dynamics in the relationships of their subjects, the ignorance of their own power and abili ty to influence research outcomes appears particularly shortsighted. More unique to the practices of feminist research on gender and violence, however, is its tendency to reinforce traditional notions of female victimization, despite most feminist intenti ons to promote female empowerment. By placing responsibility for men's violence against women almost exclusively on patriarchal notions of power and control, and by describing women's use of violence against men as purely reactionary and defensive, tradit ional feminist theory overlooks some of the social and historical shifts within society that could provide alternate explanations. Through the past three to four decades, communities across the globe have seen dramatic changes in the overall
36 status of wom en. As women have achieved greater power within the public sphere (through educational, professional, political, economic, and legal means), male oriented patterns of behavior and power have been disrupted. Not only might these changes in gender and powe r dynamics have resulted in greater levels of equality within many heterosexual relationships, but they also illustrate losses of traditional male power (and masculinity), which could also have an impact on violence. 5 By examining social dynamics in this way, it may be possible to view men's use of violence as a learned reaction to the experience of perceived emasculation or other losses in power, rather than as an attempt to gain complete power and control over a female partner. Likewise, rather than def ining women's violence against men as purely defensive, women may see themselves as claiming or re claiming power that should be theirs within their relationships. In her ethnography Violence in the City of Women anthropologist Sarah Hautzinger illustrate s ways in which relationship violence experienced by some women in rural Brazil resembles a pattern of "contestation" more than one of "domination." Based on her observations and conversations with both women and men, as gender roles change in the communit y and each partner struggles for power within the relationship, men resort to violence because it is the accepted thing to do, and women meet them with equal resistance. Rather than allowing themselves to feel powerless in the face of abusive male behavio rs, women assert their own power, both through physical tactics as well as threats to report their husbands to the female police authorities ( Hautzinger, 2007 ) Although it is difficult to make comparisons across 5 In more recent writings, some feminist based family violence researchers have started acknowledging these shifts towards egalitarianism in Western societies and incorp orating this into their theories. For example, see Stark 2010, pg 202
37 cultures, the narrow focus of most forms of western feminist theory rarely allow us to see wo men involved in violent relationships as strong and powerful until they leave the relationship and transition to "survivor." However, it seems that an equally strong feminist argument can be made in favor of viewing this dynamic as one of structure and ag ency: women are demonstrating their ability to claim their own agency in the face of oppressive structures of gender and power. Taking A Feminist Standpoint Approach In defining my personal theoretical perspective, I must acknowledge up front that my own f eminist leanings strongly influence my understanding of violence and gender in heterosexual relationships. However, I think that we must go beyond where traditional feminist theory has led us; to adapt language from sociologist and ethnographer Nancy Napl es, I propose examining these issues using a social ecological feminist standpoint lens. For me, engaging a feminist perspective on gender and intimate partner violence primarily means paying careful attention to the dynamics of power within heterosexual relationships. In public health, we teach that behaviors must be considered within the socio cultural framework of the individual or community. Numerous factors personal, interpersonal, structural, and social affect behavior. The influence of gende r on power at the individual, interpersonal, and social level has tremendous impact on behaviors between intimate partners. Gender is often related to income, perceived social role, physical strength, and other markers of power within intimate relationshi ps. As mentioned earlier, although we've seen a lessening in the overall power inequity between women and men within our society, disparities continue to exist. If a woman earns less
38 money than her husband, her economic dependence on him may be greater; if she is also a mother, her childrearing responsibilities may increase that sense of dependence; if she left school before completing her degree because she became pregnant or to support his work or education, her lack of education limits her employment p ossibilities, allowing her husband even greater power; if traditional social gender roles are influential in her family or community, her agency may be even further restricted. Each of these factors shapes the dynamics within a relationship. Although rare ly brought into the discussions on gender and violence, multicultural and postcolonial branches of feminist theory involve discussions about the overlapping forms of oppression many women face daily ( P. H. Collins, 1997 ; Hesse Biber & Yaiser, 2004 ; Reay, 2004 ) Paying attention to these intersections between gender, race, class, and culture is critical to any analysis of violence in general and intimate partner violence in particular. Perceptions of gender and gender roles differ across race, class, and culture, as does the meaning of "violent" behavi ors. Moreover, as theories of structural violence suggest, the elements of multiple oppressions overlie and reinforce one another, forming what might be thought of as a "matrix" of oppression and domination that exists at both the individual and structura l levels ( Farmer, Connors, & Simmons, 1996 ; J. Gilligan, 1992 ; James et al., 2003 ) For example, because of sexist and racist practices in society, women of color are more likely to live in poverty than white men (or women). Because higher rates of drug use and violence exist in impoverished communities, wom en of color are more likely to be exposed to addictive substances, violence, and life threatening diseases such as HIV/AIDS. When exposed to these elements, they are also less likely to be able to be able to seek help because they lack
39 access to resources such as health insurance, medical care, and adequate financial support. When we do not analyze violence in heterosexual intimate partnerships through the lens of multiple forms of oppression, we avoid seeing the actual reality faced by the individuals w ithin that relationship. We overlook the ways in which race, class, and gender intersect, and how those interactions affect the power dynamics between men and women. Is a woman who throws something heavy at her partner after enduring years of psychologi cally abusive behavior (but who has refused to leave him because they have children and there are very few black men not in prison or unemployed) perpetrating the same behavior as the white man who throws something equally heavy at his partner after she ch allenged him in front of her parents? Feminist theory suggests that these different levels and forms of power must be considered if we are going to understand the role of gender in violent heterosexual relationships. To fully comprehend dynamics of gender and power, standpoint theory suggests that "there are some perspectives on society from which, however well intentioned one may be, the real relations of humans with each other and with the natural world are not visible" ( Hartsock, 1997 ) As researchers, we must allow those whose experiences we seek to understand the ability to serve as an expert. Because of the structural differences in the lives o f women and men, Hartsock argues, adopting a feminist standpoint may be necessary to understand completely the realities of women's lives ( Hartsock, 1 997 ) Naples notes that standpoint epistemologies are "powerful tools for the exploration of the micro dynamics of the operation of power" ( Naples, 2003 ) Referencing Hartsock, she writes "Women's different understanding of power provides suggestive evidence that
40 women's experience of power relations, and thus their understandi ng, may be importantly and structurally different from the lives and therefore the theories of men" ( Naples, 2003 ) In her work, Naples has defined three main elements of standpoint theory: the recognition of how the individual, embodied elements of a woman (experiences, class, race, religion, etc) shape her life and the lenses thro ugh which she sees the world; the recognition that individual understanding is constructed by the communities in which women reside; and the identification of standpoint as a place to begin research by privileging the subject as the "knower" rather than th e researcher ( Naples, 2003 ) From this perspective, to truly begin to uncover and understand the nature of power and violence within heterosexual relationships (particularly from the point of view of women), we must allow women to tell their own stories about their lives, about violence, and about its meaning to them in the context of their worlds. We must employ methods that enable us to see our subjects as complete people, and to attempt to view the phenomenon we are investigating through their eyes. Additionally, we must identify and come to terms with our own standpoint as re searchers. As a white, middle class, female public health professional who has worked with and been trained by feminist domestic violence advocates and who has never personally experienced intimate partner violence, my view of the world is situated within a particular framework. This framework shapes my research questions, methods, and analysis, and is something that I should be conscious about and acknowledge throughout the research, analysis, and reporting processes. By engaging in reflective practices, a researcher attempts to lessen the natural power differential between herself and her
41 subjects by taking conscious measures to situate the position of "expert" in the realm of the subject and not in herself. By incorporating a feminist standpoint epistem ology, I hope to expand on traditional feminist research by focusing on the meanings of both the experiences of violence and the uses of violence within relationships. How do women and men themselves define violent behavior? Do women view themselves prim arily as victims, or do they see their use of reciprocal violence as a way of claiming (or re claiming) their own power, thus equalizing the relationship? Do men consciously or unconsciously perceive experiences of losses of power or influence as relating to violence against women? Are there ways in which the shifts in power and gender within the larger community have influenced the use of violence within individual relationships?
42 CHAPTER III METHODS T h roughout the previous chapter, I outlined the theoretical perspectives that have shaped discussion on gender and violence within heterosexual relationships, concluding with a description of my own personal paradigm. Like all research, the methodological framework I adopted is reflective of this theor etical perspective. As I described above, one of the distinctions that separate the two prominent theoretical positions on gender and violence in heterosexual relationships is epistemological; each "side" prioritizes different types of knowledge as valuabl e. Those who support the family conflict paradigm value knowledge that is quantifiable and based on empirical observation and measurement; those who adopt a feminist paradigm value knowledge that is more constructivist, that involves understanding the his torical and emotional context of the variable being examined. My intention behind this research has been to develop a broader understanding of the types and meanings of violence as identified by the CTS, and to bring individual voices and stories about ex periences of violence to the forefront. Because the focus of my questions is rooted in two different philosophical worldviews, my approach to answering them required the use of a combination of these methodological paradigms. To my knowledge, this is on e of the few studies in this field to engage what has become known as a "mixed methods" approach; the vast majority of research relies on quantitative or qualitative design and analysis alone ( C. C. Collins & Dressler, 2008 ) However, because the nature of gender, human behaviors, and relationships are each in and of themselves "messy," no single approach to examining the relationship between
43 gender and violence in relationship is likely to adequately address the questions set forth in this study. As Quinlan and Quinlan note, "social research almost inevitably requires a number of different perspectives to be brought to bear if it is to provide useful answers to important social questions" ( Quinlan & Quinlan, 2010 ) In 2008, Collins and Dressler exemplified this need to blend paradigms when seekin g to understand how different types of service providers conceptualize domestic violence. Using a multi phased approach, they engaged both qualitative techniques (such as free listing, pile sorting, and open ended interviews) as well as quantitative metho ds, using qualitative findings to create a survey testing qualitative assumptions. Although their specific research structure is different from mine, it n ever the less demonstrates the richness of data and complexity of questions that can be addressed thr ough a combination of research approaches ( C. C. Collins & Dressler, 2008 ) One of the central aims of this research was to evaluate the ability of a quantitative survey like the CTS2 to accurately assess perpetration and vict imization through a comparison of participants' answers on this survey to their own verbal descriptions of those situations. This is a situation in which "the combination of qualitative and quantitative data provides a more complete picture by noting tren ds and generalizations as well as in depth knowledge of participants perspectives" ( Creswell & Plano Clark, 2007 ) A second aim of this research has been to improve our understanding of the gender dynamics involved in heterosexual IPV, enabling us to refine our current (and I believe inadequate) th eories. Although the methodology generally employed to address this type of research question tends to be qualitative, the ability to test our existing beliefs about relationship dynamics is equally important; thus, I used
44 qualitative approaches to identi fy new themes and tested a few existing themes using experimental quantitative questions. Most commonly, mixed methods have been used to triangulate findings, to "directly compare and contrast quantitative statistical results with qualitative findings or to validate or expand quantitative results with qualitative data" ( Creswell & Plano Clark, 2007 ) This research, on the other hand, employed what Creswell and Plano Clark refer to as an "explanatory design" using a "participant selection model" ( Creswell & Plano Clark, 2007 ; G elo, Braakmann, & Benetka, 2008 ) Rather than gathering qualitative and quantitative data simultaneously, I engaged in successive phases using the same participant base to explain (rather than compare or expand on) the quantitative findings by asking me mbers of the quantitative sample to further describe the incidents being identified in the survey. According to Creswell and Plano Clark, explanatory designs are most useful for research questions that are best answered by using qualitative data to expan d on or explain quantitative findings ( Creswel l & Plano Clark, 2007 ) Given that one of the goals of this research is to explore the accuracy of a quantitative scale by improving our understanding of participants' answers, I administered the quantitative scale most frequently used (the CTS2) among p rofessionals in a medical research community. From there, I identified individuals who reported any experience with heterosexual IPV (Phase 1). I then conducted qualitative in depth interviews with 22 women in order to better understand the context and d ynamics in which the violence they reported was situated (Phase 2).
45 Phase One: The Quantitative Survey As the initial phase of this research, I administered an on line version of the CTS2 to a sample of women and men affiliated with the University of Co lorado's Anschutz Medical Center. While restricting my study population to individuals associated with a university system was not ideal, limited resources prohibi ted using preferable community based surveying techniques. The Anschutz Medical Campus dire ctly employs over 8,000 people, 6 and is listed as one of the largest employers in the greater Denver area enabling me to recruit from a somewhat representative cross section of the Denver metropolitan area population. Additionally, by not limiting my sam ple to just faculty or students my sampling frame encompassed both professional and non professional level individuals. This is a unique approach as the majority of research conducted in university settings focus on academic populations (students and/or faculty) rather than on the system as a whole. Participants were primarily recruited using an email list serve for individuals in the Anschutz community ( regardless of job type or education level) who have expressed an interest in assisting with resear ch 7 8 The initial recruitment invitation (sent via email) included an electronic link to the project's Survey Gizmo site, where an informed consent page explained the project in greater detail. Before proceeding, potential participants were asked to ackn owledge that they had read the information, consented to participate, 6 http://www.ucdenver.edu/about/denver/Pages/AnschutzMedicalCampus.aspx 7 In 2013 there were approximately 7,000 subscribers to the list serve; the administrator estimates this number remains constant over time. This likely includes faculty, staff and students who are not included in official University reports, but who none the less are professionally affiliated with AMC. 8 Recruitment advertisements were also included in several o ther electronic newsletters, but very few individuals responded using these methods.
46 were over 18, and had been in at least one heterosexual relationship. All respondents were eligible to receive a $5 gift card to Starbucks. The nature of the email distribution process (in which people delete messages without reading or forward them on to others) makes calculating an overall refusal rate extremely difficult. Within the span of approximately three weeks, 398 eligible individuals completed the informed consent page. Of these, 48 were classified as "withdrawals" after failing to complete more than 10 survey questions. Eight additional respondents were later disqualified when contact information indicated they did not live in Colorado (nor were they part of the UC communi ty), leaving a final Phase One sample size of 342. Defining And Identifying Variables The CTS2 is divided into five scales measuring negotiation psychological aggression physical assault sexual coercion and injury and can measure these events based on the number of times the action took place in the past year, or whether it happened before but not in the past year ( Straus, et al., 1996 ) Actual scores based on the report ed frequency of events can only be calculated for past year events, but "prevalence" or whether an event ever happened can be calculated for both past y ear and lifetime. Additionally, all of the scales except the negotiation scale can be divided into "s ev ere" acts and "minor" acts Finally, the additional questions about coercive behaviors were modeled after those from the CTS2 (see Figure 3.1)
47 Figure 3.1 Additional Survey Questions The Variables Table 3.1 shows the basic demographic characteristic s of the sample. Because of the very skewed distribution, several categories were collapsed for analytical purposes. Ethnicity was examined in terms of "white" and "non white" and education was categorized as "less than college degree," "college degree," and "more than college degree." Age, which had been measured by asking participants where their age fell in 10 year age categories (e.g., 25 or under, 26 35, etc.), was transformed into quartiles based on the distribution: category 1 = 25 and under, cate gory 2 = 26 31, category 3 = 32 39, category 4 = 40 and over. Individuals who responded positively to any of the perpetration questions on the physical assault scale were counted as perpetrators of physical assault. Likewise, participants who responded positively to any of the recipient focused questions on the 79. I felt afraid because of something my partner said or did 80. My partner felt afraid because of something I said or did. 81. I have not spent time with other friends or family because my partner would be upset. 82. My partner has not spent time with friends or family because I would be upset. 83. I have told my partner that I would hurt myself if s/he ever left me 84. My partner has told me that s/he would hurt himself/herself if I left. 85. My partner calls or texts me several time a day to check on me. 86. I call or text my partner several times a day to check on him/her.
48 Table 3. 1 Quantitative Phase Participant Demographics (N= 342) N Gender Men 53 Women 282 Gender Missing 7 Race/Ethnicity Asian 20 African American 12 Latino/a 25 White 275 Other 5 Race/ethnicity Missing 5 Education Some high school 1 High school grad 4 Some college 41 College grad 148 Advanced school/degree 144 Education Missing 4 Age Age <= 25 79 Age 26 35 151 Age 36 45 52 Age 46 55 34 Age 56+ 17 Age Missing 9 Age Category Age Category 1 79 Age Category 2 101 Age Category 3 76 Age Category 4 77 Age Missing 9
49 physical assault scale were counted as recipients of physical assault. It should be noted that these are not mutually exclusive categories; many participants are counted in both groups. 9 This same system was used to identify perpetrators and recipients of sexual coercion, psychological agg ression, and injury. In addition to the variables defined by the scales of the CTS2, I created two variable s for Total Violence which is not part of the traditional scoring rubric. I selected five questions on the sexual coercion scale that could clearl y be considered "violent" in nature, 10 and combined them with all of the questions on the physical violence scale to generate an estimate of total experience with intimate partner violence. The second variable included the questions about severe injury. Al l quantitative analysis was done using STATA 11.1 for Mac. Lifetime And Past Year Prevalence The lifetime prevalence of physical violence perpetration was calculated by adding the number of participants who responded positively to ever using physical viol ence as identified by the physical assault scale, regardless of the number of incidents s/he reported or whether it happened in the past year or previous, and dividing by the number 9 Given the structure of CTS2, we cannot know if participants would be referencing "mutual" violence in a single relationship with a single partner, or if they were the re cipients of violence from one partner and the perpetrator of it in another or some combination thereof. Because this research is concerned with the influence of gender on the dynamics between heterosexual partners, the lack of specificity about what this category referred to made it less than useful. 10 The sexual coercion questions included in the total violence variable included all of the questions considered "severe" as well as a question about being made to have sex without a condom. I initially inclu ded that question because of the potential morbidity and mortality associated with unprotected sex as well as the literature surrounding reproductive control. ( Moore, Frohwirth, & Miller, 2010 ) However, when I asked women about this response, none of them described feeling forced or strongly coerced into unprotected sex.
50 of participants; likewise, the prevalence of physical violence receipt was calculated by adding the number of participants who reported ever receiving physical violence and dividing by the number of participants. I further stratified the data by severity (as defined through the CTS2) and by gender To calculate the past year p revalence of any of the variables related to perpetration or receipt, I used the above process, but limited the analysis to answers referring to past year experiences only. Thus, if an individual indicated any past year experience with an item on any of t he scales, s/he was considered a perpetrator or recipien t of that category of behaviors regardless of frequency. These were further stratified by gender and severity. In addition to past year prevalence, I also calculated the actual past year "score" for participants which accounts for the frequency of violence in the past year, not merely the prevalence. However, when I conducted statistical analyses looking at scores rather than prevalence, I found virtually no meaningful differences between men and wom en that did not surface initially. Thus, I dropped this as a variable of consideration. Statistical Analysis Because the purpose of this phase is to examine the association between gender and experiences with violence and/or abusive conflict behaviors (a s perpetrator or as recipient), two statistical approaches were used: chi square tests were implemented to determine if general associations between gender and behaviors/outcomes could be identified, and logistic regression was used to see if those associa tions held once other key demographic variables were controlled.
51 Phase 2 Qualitative I nterviews To better understand the experiences and context of physical and/or sexual violence reported on the CTS2, women who reported at least one experience with ph ysical or sexual violence were asked to participate in additional in depth interviews. Unlike quantitative surveys, open ended interviews allow the respondent to provide details about her/his relationships, the types of violence used and received, and th e meanings and experiences that underlie those episodes, often leading to the development of new domains or theories ( Schensul, Schensul, & LeCompte, 1999 ) For the purposes of this research, I was especially interested in pinpointing patterns of coercive or controlling behaviors and examining how these overlap with violence, identifying new categories or typologies of violent and controlling behaviors, and comparing participants' narrative experiences with their CTS responses. Data Gathering Participants were selected f rom the female participants who completed the CTS2, indicated any lifetime experience with physical or sexual IPV, and previously agreed to be contacted for follow up. Using the lifetime total violence variable (described above), I identified potential pa rticipants using a stratified sampling frame designed to identify both typical and case critical examples. Typical case sampling means identifying those participants whose experiences resemble the "typical" experience of the larger sample population; criti cal case sampling involves selecting participants on their ability to shed new light on experiences with violence ( Patton, 2002 ) Eligible respondents were initially stratified based on perpetration/recipient status: women who reported perpetrating (but not receiving) at least one violent act, women who reported receiving (but not
52 perpetrating) at least one viol ent act, and women who reported experiences with both perpetration and receipt. I further stratified based on the severity of the violence, and finally considered the specific types of incidents (e.g., shoving, grabbing, slapping, etc.), the amount and fr equency of incidents, and demographic characteristic in an attempt to create as diverse a sample as possible. 11 Participant identification occurred in two rounds. In September 2011, I selected an initial group of 21 women, and between September and Nove mber, I sent approximately half of this group emails requesting their assistance and conducted seven interviews. Over the winter holidays, I conducted a preliminary analysis of the data, identifying key themes and making slight revisions to the interview process. After the first of the year I resumed the interviews, and by April, after talking with six more women, it was clear that I had exhausted the initial sample. Although I was starting to hear similar themes from many of the women, I had spoken with only two whose CTS2 results indicated that they had been both perpetrators and recipients of IPV. Using a similar sampling process (with a particular focus on perpetrator/recipients), I selected an additional 12 women to contact, resulting in nine additi onal interviews (See Table 3.2 for a summary ) 12 On average, the interviews lasted one hour, and most were conducted in a conference room at the medical library on the Anschutz campus or in the participant's 11 Because only 5 women in my sa mple reported experiencing any severe injury, this was not included as a necessary category for exploration; rather, I looked for women who reported severe violence. 12 In addition to physical and sexual violence, it is worth noting that 100% of participant s reported both perpetrating and receiving any type of psychological aggression, and 9 of the 22 (41%) acknowledged perpetrating a form of severe psychological aggression and a full 50% acknowledged receiving the same.
53 Table 3.2 Summary of Participant's CTS2 Resul ts CTS2 Classification Name Minor physical Severe physical Minor sexual Severe sexual Recipient Only Brenda Connie Ellen Jenny Lauren Mary Raelynne Rochelle Wendy Perpetrator Only Becky Katrina Lorraine Marisol Megan Sandra Both Jackie Joannie Juanita Karen Kellsey Maya Regan = recipient = perpetrate
54 office. 13 In addition to the convenience for the participants, meeting on the same campus where they were employed (often during or just before or after normal business hours) reduced the likelihood that partners would learn of the interview or try to accompany the participant. All interviews were conducted in a private room, yet were located in a public building during regular operating hours. To my knowledge, no participant was accompanied by her partner or other family members (except one participant who brought her 6 week old infant after her childcare provider cancelled). At the end of each interview, participants were provided with a $25 gift certificate to Target as expression of my gratitude. Prior to the first interview, I created a detailed interview gui de outlining each area of investigation, potential questions, and follow up probes. The guide was designed to uncover key elements of relationship dynamics, based in part on coercive and controlling behaviors identified in the literature and through inter views with advocates from the domestic violence field ( Dobash, et al., 1998 ; Hamberger & Guse, 2002 ; Hoffman, 2008 ; Kelly & Johnson, 2008 ; Winskill, 2008 ) However, in order to take full advantage of the iterative process of these interviews, the guide primarily served as a broad roadmap from which the interviews digressed. Because one of the primary goals of conducting in depth interviews was to give participants the opportunity to tell their storie s in their own words, I also wanted to allow as much flexibility as necessary so that the women could drive the conversation as much as possible, and to allow themes or st ories that I did not anticipate emerge. 13 One participant met me in the confe rence room in my department on the UCD Auroria campus, and another participant requested to meet in the conference room of a public library close to her home.
55 This said, most of the interviews follow ed the basic outline sketched in the interview guide, (Appendix A ) although each was tailored based on the participant's CTS2 responses. Before each meeting, I carefully reviewed the participant's survey, noting each incident of physical violence, sexual coercion, or psychological aggression (such as yelling, swearing, or name calling). At the beginning of each interview, I inquired about the participant's reason for joining the study, and then asked each of them to start by describing their current or mo st recent relationship, or the relationship they were in when they completed the survey. Over the course of the interview, I prompted them to talk about the specific incidents they recounted on the CTS2, starting with minor events such as yelling or swear ing and progressing to more serious and sensitive incidents, such as sexual coercion and physical assaults. If they indicated they had been in more than one significant relationship, I asked them to describe each of them, particularly if their answers on the CTS2 referenced different partners. I also inquired about other controlling behaviors, such being forced or coaxed into doing things they didn't want to do (including sexual acts) or not being able to see friends or family (at all or without significa nt conflict). Finally, as the conversation drew to a close, I tried to elicit information about the power dynamic within the relationship(s), questioning them about how important decisions got made (such as major household purchases or where to go for vac ation) or how they dealt with finances and parenting. With the permission of the participant, all interviews were digitally recorded and sent to a professional transcriptionist to be typed. Although I took minimal notes during the interviews, as soon as possible after the participant left, I recorded extensive field notes in a hand written journal. Later, while typing up the field notes, I listened to the
56 recording of each interview, and added additional comments or observations. All notes, transcripts and any additional communication 14 with participants were then entered into Atlas ti and assigned a series of organizational codes (participant number, age, type of document, etc.). Analysis Prior to coding the first document for content, a list of a prio ri codes was developed based on the CTS2 scales (physical violence, sexual coercion, etc.), themes present in the literature on IPV and controlling behaviors (isolation, fear, jealousy, etc.), and directionality (participant perpetrate, participant recipie nt). Documents were coded over the course of the qualitative phase of analysis, and as the interviews and preliminary analysis continued, additional themes were identified and new in vivo codes were included in the codebook (and new questions were asked d uring the remaining interviews). When appropriate, documents that had been previously reviewed were reexamined and coded bas ed on newly i dentified themes (see Figure 3. 2 for the complete list of qualitative codes). Using my research questions as guides, I created several "partially ordered matrices," which Miles and Huberman recommend as a starting point for exploring, describing, and ultimately explaining a large quantity of qualitative data ( Miles & Huberman, 1994 ) Using the Atlas ti query function, I explored and recorded the details o f physical and sexual violence perpetration and receipt within each participant's narrative, ultimately expanding this to differentiate between multiple partners when appropriate and adding notes about other controlling behaviors or observations. As 14 One participant sent a n email after the interview to express additional thoughts about violence and control in relationships.
57 vario us patterns emerged, I continued to use the query function to explore specific themes or codes, such as "leaving the room" or "mental health." I differentiated between women who described only perpetrating violence, only receiving violence, or doing both, and explored specific themes within these categories, looking for patterns or a lack of patterns that related to the research questions. As I dug deeper into the data, I realized that several participants described stories that were illustrative of many of the key themes. Stepping back from the larger thematic analysis, I reviewed the notes and transcripts from these participants carefully and created two page "case studies" detailing both the events and the participant's reactions to and f eelings about the events. Qualitative Sample Overview The 22 women I interviewed comprised a relatively diverse group, considering the homogeneity of my overall sample (see Table 3.2). Among them, we discussed a total of 30 different relationships. Sixteen par ticipants (73%) described times when they engaged in physically violent or threatening behaviors against male partners, and 15 (68%) described times when they had been recipients of violence from male partners. According to their stories, 6 women (27%) ha d never been physically assaulted, grabbed, or threatened by a male partner, and 5 women (23%) said they had been the recipients of physical violence, but never used it themselves. Nine women (41%) perpetrated violence against and received violence from th e same partner; three women reported perpetrating and receiving violence, but not with the same man. One woman reported neither perpetrating nor receiving any violent behaviors or threats in any relationships.
58 Figure 3. 2 List of Qualitative Codes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
59 Table 3.3 Qualitative Participant Demographics (N=22) N Age 20 29 8 30 39 6 40 49 6 50 59 2 Race/Ethnicity White 16 African American 1 Latina 3 Asian 2 Education Some college 5 College degree 10 Graduate school/degree 7
60 CHAPTER IV FEW SIGNIFICANT DIFFEFENCES Exploring the Quantitative Results and Addressing Research Question 1 More than 1 in 3 women (35.6%) and more than 1 in 4 men (28.5%) in the United States have experienced rape, phy sical violence, and/or stalking by an intimate partner in their lifetime. ( National Intimate Partner and Sexual Violence Survey, 2010 ) Even as they debate the meaning behind the numbers, few researchers argue that when the CTS or CTS2 (and their many mod ified versions) is administered on a large scale in non clinical populations (for example, among college students or as part of national survey), there appear to be few differences between men's responses and women's responses. Although I cannot claim that my sample is generalizable to the larger U.S. population, neither is it clinical, limited to previously identified battered women or incarcerated men. Thus, it was not surprising to find that the answer to my first research question, when administered in a non clinical sample of men and women, does the CTS2 find quantitative evidence of gender symmetry in IPV within heterosexual relationships, was a resounding "yes." In an effort to provide data that can be compared to other studies using the CTS2, the following categories and subcategories reflect the scale definitions set f orth by the authors of the CTS2 ( Straus, et al., 2003 ) The data below are organized by general category ("sexual coercion") as well as by severity (e.g.: "minor" and "severe ). In an effort to address concerns about whether an action is truly violent and the distinction between violent sexual coercion and physical violence I also explored the data using the
61 previously described variables representing physical and sexual IPV as well as physical/sexual I PV and injury Physical And Psycholo gical Experiences By CTS2 Scale Lifetime To determine whether gender impacted the respondents' experiences over the course of their lifetime, I conducted both bivariate (chi 2) and multivariate (logistic regression) a nalyses looking at all reported experiences. Using the standard p robability criteria of p < 0.05 as the significance cut off, when all experiences were included, gender was no longer predictive of perpetrating psychologically aggressive behaviors, but was predictive of perpetrating any sexually coercive behavior. The initial bivariate model showed that 37.5% of men reported engaging in sexual coercion, compared with 21.7% of women ( 2 (324, 1) = 5.56, p < 0.05). When age, education, and ethnicity were controlled, gender was still predictive of sexual coercion perpetration ( 2 (316,4) = 16.46, p < 0.005), with women half as likely to report the use of these behaviors compa red to men (Table 4.1 ). To confirm that additional factors such as age, race/ethnicity, or level of education were not interacting with gender, I ran a logistic regression stratified by gender (analysis not shown). No consistent differences across coeffic ients were apparent. Among men, more education predicted lower levels of sexual coercion and psychologically aggressive behaviors. Among women, identifying as non white increased the likelihood of being a victim of sexual coercion and physical violence, as well as being a perpetrator of sexual coercion and physical violence. Additionally, as seen with past year violence, higher levels of education protected against perpetrating physical violence.
62 Table 4.1 Gender as a Predictor of IPV, Lifetime Total Ye s % (n) Men % (n) Women % (n) OR SE p Respondent is Perpetrator Psyc. Aggression 91.3 (304) 88.5 (46) 91.8 (258) 1.44 0.71 0.463 Physical Violence 30.3 (100) 26.9 (14) 30.9 (86) 1.23 0.42 0.546 Sexual Coercion 24.1 (78) 37.5 (18) 21.7 (60) 0.51 0.18 0 .050 Caused Injury 6.3 (21) 7.8 (4) 6.1 (17) 0.73 0.43 0.594 Respondent is Recipient Psyc. Aggression 90.6 (299) 88.2 (45) 91.0 (254) 1.36 0.66 0.532 Physical Violence 30.6 (101) 33.3 (17) 30.1 (84) 0.87 0.29 0.679 Sexual Coercion 33.4 (109) 28.0 (1 4) 34.4 (95) 1.58 0.57 0.205 Experienced Injury 10.0 (33) 13.5 (7) 9.3 (26) 0.65 0.30 0.346 Finally, I examined the impact of gender on the level of severity of lifetime violent or coercive behaviors and injury. To address the question of whether gend er is, on its own, predictive of either experiencing or perpetrating minor or severe violence, Chi2 analyses were conducted; the only item in which gender was found to be significant was the perpetration of minor sexual coercion, in which men were more lik ely to report havi ng ever perpetuated minor sexual coercion compared to women ( 2 (329, 1) = 6.66, p = 0.01). When logistic regression was conducted and age, ethnicity, and education level were controlled for, gender still remained significant, with women almost half as li kely to perpetrate minor sexually coercive behaviors compared to men ( 2 (321, 4) = 15.48, p <
63 0.005) (Table 4 .2 ). It is worth noting that too few individuals indicated positive experiences with several of the "severe" behavior to allow enough power to sh ow any differences; in fact, no men reported any severe sexual coercion victimization or severe injury perpetration or victimization (see discussion below) Past Year To determine whether gender impacted respondents' reported experiences with psychologica l aggression, physical violence, sexual coercion, or injury during the past year, I conducted both bivariate (chi 2) and multivariate (logistic regression) analyses on respondents' past year only answers. In the bivarite model, the only category in which gender was found to be a significant factor at the p < 0.05 level was in terms of perpetrating psychological aggression ( 2 (333,1) = 7. 8157, p = 0.005). This difference held true in the multivariate model, and when age, level of education, and ethnicity were considered, women continued to perpetrate psychologically aggressive behaviors at a higher rate than men ( 2 (324, 4) = 10.59, p <0.05) (Table 4.3 ). T o confirm that other demographic factors (race/ethnicity, age, and education level) were not interact ing with gender, I ran a logistic regression stratified by gender (analysis not shown). No consistent differences across coefficients were apparent across sex. However, it is interesting to note that higher levels of education predicted lower levels of s exual victimization for both genders; this is in keeping the findings of other research using similar methods, and is particularly noteworthy given the already high prevalence of physical and sexual IPV identified in this highly educated sample. Among me n, identifying as non white also decreased the likelihood of reporting the use of psychologically aggressive behaviors. Among women, higher levels of education
64 Table 4.2 Severity of IPV by Gender and Gender as Predictor of Severity, Lifetime Total Yes % (n) Men % (n) Women % (n) OR SE p Respondent Perpetrate Minor Physical 30.1 (100) 26.9 (14) 30.7 (86) 1.21 0.42 0.579 Severe Physical 6.6 (22) 1.9 (1) 7.5 (21) 4.44 4.63 0.152 Minor Sexual Coercion 23.7 (78) 38.0 (19) 21.2 (59) 0.48 0.16 0.030 Sever e Sexual Coercion 1.8 (6) 4.0 (2) 1.4 (4) 0.24 0.23 0.129 Minor Injury 6.3 (21) 7.7 (4) 6.1 (21) 0.75 0.44 0.623 Severe Injury 0.3 (1) 0 (0) 0.4 (1) n/a n/a n/a Respondent Recipient Minor Physical 29.5 (98) 33.3 (17) 28.8 (81) 0.82 0.27 0.538 Severe Physical 10.2 (34) 5.8 (3) 11.0 (31) 1.83 1.15 0.342 Minor Sexual Coercion 33.3 (109) 28.0 (14) 34.3 (95) 1.57 0.56 0.212 Severe Sexual Coercion 3.3 (11) 0 (0) 3.9 (11) n/a n/a n/a Minor Injury 9.9 (33) 13.5 (7) 9.2 (26) 0.64 0.30 0.335 Severe Inj ury 1.5 (5) 0 (0) 1.8 (5) n/a n/a n/a
65 Table 4.3 Gender as Predictor of IPV Past Year Total Yes % (n) Men % (n) Women % (n) OR SE p Respondent is Perpetrator Psyc. Aggression 85.6 (285) 73.1 (38) 87.9 (247) 2.79 1.03 .005 Physical Violence 15.8 (52 ) 7.7 (4) 17.3 (48) 2.86 1.60 .060 Sexual Coercion 18.2 (59) 25.0 (12) 17.0 (47) 0.71 0.28 0.377 Caused Injury 3.0 (10) 2.0 (1) 3.2 (9) 1.88 2.02 0.557 Respondent is Recipient Psyc. Aggression 82.4 (272) 76.5 (39) 83.5 (233) 1.61 0.60 0.202 Physical Violence 18.8 (62) 19.6 (10) 18.6 (52) 1.01 0.40 0.987 Sexual Coercion 27.0 (88) 26.0 (13) 27.2 (75) 1.23 0.46 0.579 Experienced Injury 4.5 (15) 3.6 (2) 4.7 (13) 1.36 1.07 0.692 decreased the likelihood of reporting either the perpetration or victim ization of physical violence or sexual coercion. Women's age was also a protective factor against the victimization and perpetration of physical violence, and identifying as nonwhite increased the likelihood of reporting physical violence perpetration and sexual coercion victimization. In addition to considering general types of experiences, I looked to see if there were any differences in severity of past year experiences by gender. Both bivariate and multivariate analyses revealed none (Table 4 .4 ). Finally, in addition to determining lifetime prevalence and past year incidence of physical violence, sexual coercion,
66 Table 4. 4 Severity of IPV by Gender and Gender as Predictor of Severity, Past Year Total Yes % (n) Men % (n) Women % (n) OR SE p Parti cipant Perpetrate Minor Physical 16.0 (53) 7.7 (4) 17.5 (49) 2.90 1.61 0.056 Severe Physical 3.6 (12) 0 (0) 4.3 (12) n/a n/a n/a Minor Sexual Coercion 17.9 (59) 26.0 (13) 16.5 (46) 0.64 0.24 0.240 Severe Sexual Coercion 1.8 (6) 4.0 (2) 1.4 (4) 1.9 0. 77 0.139 Minor Injury 3.0 (10) 1.9 (1) 3.2 (9) 1.88 2.02 0.556 Severe Injury 0 (0) 0 (0) 0 (0) n/a n/a n/a Participant Recipient Minor Physical 18.7 (62) 19.6 (10) 18.5 (52) 0.99 0.39 0.984 Severe Physical 3.3 (11) 3.9 (2) 3.2 (9) 0.80 0.65 0.779 Minor Sexual Coercion 26.9 (88) 26.0 (13) 27.1 (75) 1.22 0.45 0.588 Severe Sexual Coercion 1.5 (5) 0 (0) 1.8 (5) n/a n/a n/a Minor Injury 4.5 (15) 3.9 (2) 4.6 (13) 1.35 1.06 0.700 Severe Injury 0.6 (2) 0 (0) 0.7 (2) n/a n/a n/a
67 psychological aggre ssion, and injury, the CTS2 can be used to calculate individual "scores" for each scale based on the reported frequency of events that happened in the past year. 15 I found no significant differences by gender after conducting both parametric and nonparamet ric analyses. Additional Violence and Injury Variables Because several of the questions from the CTS2 sexual coercion scale reflect actions that are physically violent in nature, I created a variable representing "any violence" which included all questions asking about actual physical or sexual violence. After conducting both bivariate and multivariate analyses using both past year and lifetime timeframes, I found no significant differences in perpetration or receipt by gender (analysis not shown). Finall y, in case participants recalled injuries related to a fight with an intimate partner but did not report the incident itself, I included the questions related to severe injury to the "any violence" category, creating a second alternate variable representin g "any violence or severe injury. Once again, no significant differences were found (analysis not reported). Gender And Coercion: Examining The Sample Questions On Coercive Behaviors In order to examine the relationship between gender and certain coerciv e behaviors separately from that of previous experiences of violence, a three model approach was taken (Tables 4 .5 & 4.6 ). Model 1 is a bivariate analysis (chi 2) examining the association between coercive behaviors and gender alone. Model 2 is a multiva riate 15 Because the CTS2 only asks about the number of times events happened over the past year, lifetime frequency scores cannot be calculated.
68 Table 4.5 Gender As A Predictor of Reporting Receipt of Coercive Behaviors Past Year Model 1 Model 2 Model 3 Past Year Receipt of Violence Lifetime Receipt of Violence Past Year Perp of Violence Lifetime Perp of Violence !"#$ % & % '( % )* % & % '( % )* % & % '( % )* % & % '( % )*% % & % '( % )* % & % !"# $ !"#$ % $"$& % '"(# % )"*( % $"$+ % %&"' $ (&)* $ +&+% $ %&%" $ (&(, $ +&+) $ !"&' % '"*' % $"$+ % !"() % '"(& % $"$* % !*+ $ $"), % $"*) % )"'* % $"(! % $"*' % )"+! % )",+ % $"!+ % )"+' % )",# % $",$ % )"#' % )"'$ % $"#+ % )"&! % )"'* % $"#! % !*' $ )"!$ % $"'# % $"&+ % $"'# % $"!$ % $"** % $"!$ % $"#) % $"** % $"!$ % $"#$ % $"*$ % $"'* % $"!# % $"*! % $"'* % $",$ % !*$ )"*+ % $")( % $"&) % $"'& % $"'! % $"&+ % $"!' % $",! % $"*$ % $"!' % $",, % $"*& % $"!* % $"#* % $"** % $"!* % $"#( % !*( $ $"+# % $"!! % % % % % % % % % % % % % % % % !*% $ $"!, % $"#& % $"&( % $",& % $"#* % '!, % '"#! % $",! % '"!$ % '",* % $",, % )"&) % )"*& % $"&& % )"*+ % ) "+' % $"#+ % !*) $ $"$$ % $"++ % )"$) % $"!) % $"+( % )")& % $"!+ % $" % )"), % $"!( % $"&( % )"$# % $"!# % $"(* % )"$+ % $"!& % $"*( % !*, $ $"$! % $"(* % )"$* % $"!! % $"(' % )"'! % $",) % $"#! % )"') % $",$ % $"#& % )"$!%%% % "$!) % $"($ % )")# % $"!( % $"&* % Â¤ Gender (male) predicted failure perfectly; insufficient varia tion in data T able 4.6 Gender As A Predictor of Reporting Receipt of Coercive Behaviors Lifetime Model 1 Model 2 Model 3 Past Year Receipt of Violence Lifetime Receipt of Violence Past Year Perp of Violence Lifetime Perp of Violence Chi2 p OR SE p OR SE p OR SE p OR SE p OR SE p Q79 2.92 0.09 1.90 0.83 0.14 2.35 1.13 0.08 2.47 1.21 0.07 1.87 0.88 0.18 1.93 0.91 0.17 Q80 0.03 0.87 0.87 0.39 0.76 1.20 0.62 0.73 1.24 0.66 0.68 1.11 0.58 0.84 1.10 0.58 0.85 Q81 6.08 0.01 0.46 0.14 0.01 0.51 0.17 0 .04 0.49 0.17 0.04 0.45 0.15 0.02 0.46 0.15 0.02 Q82 4.32 0.04 0.49 0.17 0.04 0.55 0.20 0.11 0.55 0.20 0.10 0.55 0.21 0.12 0.56 0.21 0.13 Q83 2.14 0.14 Â¤ Â¤ Â¤ Â¤ Â¤ Â¤ Â¤ Â¤ Â¤ Â¤ Â¤ Â¤ Â¤ Â¤ Â¤ Q84 0.05 0.83 0.86 0.45 0.77 1.49 0.99 0.55 1.50 1.01 0.55 1.12 0.78 0. 78 1.15 0.76 0.83 Q85 0.00 0.98 0.95 0.30 0.88 1.06 0.34 0.85 1.06 0.34 0.86 0.96 0.31 0.91 0.99 0.32 0.98 Q86 0.00 0.97 1.01 0.31 0.99 1.24 0.41 0.51 1.23 0.40 0.52 1.01 0.36 0.78 1.15 0.37 0.67 Â¤ Gender (male) predicted failure perfectly; insufficient variation in data
69 analysis (logistic regression) examining the predictive value of gender on reported coercive behaviors after controlling for age, race/ethnicity, and level of education. Model 3 is the same analysis as Model 2, this time controlling f or violence perpetration or receipt. When examining the relationship between gender and the use of potentially coercive behaviors over the past year, once experiences of violence are included in the model, the only time that gender becomes a significant predictor is when participants are asked if they have felt afraid of a partner; when receipt of violence is controlled for, women are 4.5 (past year) 4.7 (lifetime) times more likely to report feeling afraid of a partner compared to men. When considerin g the receipt of coercive behaviors over a lifetime, in addition to feeling afraid (see above), the only experience that stands out as significant was isolation ( measured as the respondent not seeing family or friends because of a partner or as having a pa rtner who didn't see family or friends because of the respondent); in this case, women were less likely to report both preventing and being prevented from seeing others. However, once experiences of violence (perpetration and receipt over the past year an d lifetime) were added to the model, only being prevented from seeing other remained significant. Discussion Of Quantitative Findings General Interpretations Broadly speaking, the findings reported in this section are similar to those in other large stud ies of IPV using the CTS or CTS2; if anything, they show higher levels of violence than found in other research including investigations using general populations
70 and samples of university students ( Nabors & Jasinski, 2009 ; Straus, 2008 ; Straus & Ramirez, 2007 ) The participants in this sample are overwh elmingly female, white, and highly educated, factors that make these results both unique and limiting at the same time. The fact that participants were predominantly white with at least a college education is hardly surprising, given the larger sampling f rame of employees on an academic medical campus. 16 The non random nature of this sample is also important to consider: not only were these individuals who chose to complete the survey even after learning about the nature of the questions, but almost all of them had previously self selected to be notified of opportunities to participate as subjects in research studies. How this impacts the overall prevalence of violence is unclear, but it remains a caveat that must be acknowledged. One of the more interes ting aspects of these findings is this high prevalence was reported in a population that is so highly educated, a variable often used as a proxy for income A common perception is that IPV is found more prominently in lower income communities, and several large scale investigations have identified this as a pattern ( Carlson, Harris, & Holden, 1999 ; Jewkes, 200 2 ; Kessler, Molnar, Feurer, & Appelbaum, 2001 ) My findings suggest that physically and sexually aggressive behaviors may be more common among well educated and higher income individuals than often t hought, or that some aspect of the research design led to higher levels of reported violence. Moreover, the similarity between my results and those reported in other studies suggest 16 Approximately 20% of study participants were individuals of color, which roughly e quivalent to the 17% reported by the University of Colorado Office of Institutional Research and Effectiveness for faculty and staff on the AMC campus Although the educational level of employees is not available, the nature of the venue lends itself to a n unusually high percentage of college educated individuals.
71 that these findings are not anomalous, providing a strong framework for P hase Two, which examines the meaning behind the responses. One of the strongest limitations of these data is the huge imbalance between female and male respondents. While it not uncommon for surveys related to health, IPV or other personal characteristics to attract more female participants than male (see Chapter 8 for a more detailed discussion of this), the very small number of male responses com pared to female is concerning and likely compromised my ability to show gender distinctions that may actually exist particularly in behaviors that are rarely reported in nonclinical samples 17 One approach to addressing this lack of power is to relax the generally accepted significance criteria of p < 0.05 and consider gender differences that emerge at the p < 0. 10 level as (at the very least) indicative of significance. Adopting this strategy, several other potential differences emerge, including the finding that women, not men, actually report perpetrating higher levels of physically violent behavior in the pas t year (particularly minor forms of physical violence) ( 2 (323, 4) = 23.26, p = 0.056) This is not an anomalous finding ; many researchers have shown that when using the CTS2 or modified versions thereof, women often report engaging in higher levels of p hysical violence (especially minor acts, such as throwing something or slapping) compared to men ( Allen, et al., 2009 ; Archer, 2002 ; Straus, 2008 ) 18 Pushing the criteria just a bit further, we also see (not surprisingly) that 17 Although women outnumber men as employees on the AMC campus (62% vs. 38%) this does not account for the extremely skewed gender demographics of my sample. 18 Numerous theories have been postulat ed to explain this finding, from arguments suggesting that women are more likely to over report their use of violence whereas men under report it to those that conclude that women really DO use violence at higher rates than men, in part because it is not s een as unacceptable.
72 men were more likely to report perpetrating severely sexually coercive behaviors ove r the course of a lifetime ( 2 (321, 4) = 7.28, p = 0.13 ). Another area in which gender emerges as a possible predictor when we relax this criteria is with their experiences with certain coercive behaviors. Not only are women more likely to report having felt afraid of a partner in the past year (as reported earlier) but also over the course of a lifetime (after controlling for experiences as a recipient of violence). Furthermore, when looking at past year experiences with fear gender remains a predicto r even once the previous use of violent behaviors has been taken into account. The relationship between fear and gender is hardly surprising and is supported by other study findings ( Black, et al., 2011 ; Sillito, 2012 ) Conversely, not only do the data suggest that women are less likely than men to report not spending time with friends or family because of a partner's behaviors, but they are also less likely to believe that they have prevented a partner from seeing others. In addition to relaxing the significance critical value, there were several categories for which I was unable to calculate any meaningful multivariate statistics because no men responded positively; rather than assuming that no differences exist at all, by looking at the data themselves, we can gain some idea of the differences that may emerge if our power increased. For example, e ven when previous studies find support for gender symmetry overall, evidence suggests that sexual coercion in general and severe sexual coercion in particular are actions that are predominantly used against women by men. In this sample, no men reported severe sex ual victimization yet 11 women out of 280 (4%) reporting the same. Were this trend to hold true in a sample with sufficient power, not only would the finding likely be statistically significant but also clinically significant.
73 Although the primary fo cus of this dissertation is on gender and IPV, many of the regression models suggest that other demographic factors are likely stronger predictors of violence at least in this sample of university employees Because my sample was so heavily skewed by eth nicity and education, I conducted a second analysis with those factors excluded but in no case was the significance related to gender altered. Finally, because being a non white woman was associated with both IPV perpetration and victimization in virtual ly all categories, I explored the impact of specific ethnic group identification among women in the two groups with the largest sample: Asian women and Latinas (each of which comprised approximately 34% 36% of the non white participants respectively). Wh en I removed Latinas from the sample, the association between being non white and a recipient of any type of physical violence was lost, but this was most likely due to the reduction in sample size, as the change in the magnitude of effect was minimal (OR for all women = 1.7; OR without Latinas = 2.0). Likewise, wh en Asian women were removed from the sample, the associat ion between being non white and perpetrating any sexually coercive behavior became non significant, which was also likely related to the r eduction in sample size ( OR for all women = 2.5, OR without Asian women = 2.2 ). However, while t he association between sexual coercion receipt and gender also lost significance, t he difference in magnitude suggests that t his change could be related specif ically to the removal of Asian women (OR for all women = 2.6; OR without Asian women = 1.7). T he direction of the change suggests that the high levels of sexually coercive victimization (specifically minor coercive behaviors) reported by Asian women in pa rticular drove the overall finding of significance In general, the literature describing Asian American and Asian immigrant
74 women's experiences with sexual violence are mixed; while larger general studies tend to report lower levels of reported IPV and se xual violence among Asian American women compared to white women ( Black, et al., 2011 ; Crisanti, Frueh, Gund aya, Salvail, & Triffleman, 2011 ) smaller studies focused on specific ethnic groups or recent immigrants find high levels of IPV victimization ( Raj & Silverman, 2003 ) Without any information about the background or immigration status of my sample, it is difficult to make accurate comparisons (although it is unlikely that my sample reflects the experiences of most recent working class immigra nts); what was apparent was that while Asian women were likely to experience non violent sexual coercion or pressure, they were not likely to report more severe forms of sexual violence Use of Computers Over the past decade or two, the use of computers fo r survey administration has grown, as has the debate over the validity and reliability of computer and web based surveys. The psychometric properties of the CTS2 have been well documented elsewhere, and the instrument has been found to be consistently rel iable and valid ( Straus, et al., 2003 ) Although the use of computers in general and the Internet in particular are novel approaches to CTS2 administration, it should be noted that the questions were presented in the exact order as they appear on the offici al paper version pur chased from Western Psychological Services and respondents had the ability to skip questions, return to questions, or edit their responses, just as they would on the traditionally used pencil and paper copy. The only substantial difference is that each pa ir of questions was displayed on a separate "page" of the survey rather than presented in one long list; if anything, this should decrease the likelihood that respondents confused
75 one question for another. Although four additional pairs of questions about coercive behaviors were added to the survey, they were included at the very end and should not have biased the survey questions at all. On the whole, the research seeking to identify measurement differences between computer based and pen and paper based s urveys have found mixed results. Looking specifically at the impact of computers on socially desirable response bias, Booth Kewley and colleagues noted that the "most striking trend in the research literature, especially in recent years, is the large numb er of studies that found essentially no difference in socially desirable responding due to administration mode" (emphasis in the original) ( Booth Kewley, Larson, & Miyoshi, 2007, p. 465 ) Their own study of undergraduate reporting of risky behaviors revealed no differences between computer based and pencil and paper based survey administrat ion on the intentional misrepresentation of personal behaviors, but did find that respondents who completed the computer based version scored higher on the scale used to measure non deliberate self enhancing responses; moreover, those who completed the sur vey on the computer reported higher levels of alcohol consumption and riskier sexual behaviors when compared to those who took the pencil and paper version. One argument used to explain these (and similar results) is the hypothesis that for many users, co mputers feel more "anonymous" than written forms of communication, making it more likely that participants will respond honestly about sensitive behaviors and experiences ( Booth Kewley, et al., 2007 ) This could also explain the higher than expected levels of violence found in my study population.
76 Final Thoughts The ultimate question, however, is not whether incidents of violenc e are higher or lower in my sample than in similar research, or even if administering the survey via computer makes a difference in the amount of violence reported. Given the focus of this research, the question of utmost importance is W hat do these find ings actually mean?" One conclusion that could be drawn is that the men and women who work on the Anschutz Medical Campus are a violent and controlling group, at least in their personal relationships. While this may sound like a flippant and superficial interpretation of these data, if they are taken at face value with no further exploration, this is essentially what we are left with. In the chapters that follow, I will show that there is, most likely, more to this story. Obviously, it is impossible t o contact all 342 respondents and ask detailed questions about their responses, but if my interviews with twenty two women are any indication, it seems clear that drawing conclusions about violence based solely on these responses is, at best, premature, an d should be done with caution. Among my qualitative participants, I met women who had been in extremely violent relationships that were not included in their CTS2 responses, women who had both used and received violence that was unreported, and women who reported using or receiving violence that they later said never happened. I heard about incidents involving cell phones, coffee makers, and even frozen chickens being thrown, yet I also heard about times when the object that was hurled was a pillow or a p ile of clothes. I talked with women whose only violent behaviors were shoving a partner who had grabbed them, and others whose attacks were so severe that they left marks and scars. What may be more important to this discussion,
77 however, is that I learne d about women whose lives were circumscribed by a partner's attempt to usurp their independence; sometimes this involved the use of violence, and sometimes not. Several of the control tactics women discussed were not part of the CTS2 or any of the other q uantitative scales I have seen, but were extremely personalized or cultural actions that may not have had the same impact on all women. On the whole, although the prevalence of violent behaviors was higher than I expected in a non random, well educated, f emale, and white sample, I am not surprised that women appear to use violence in equal proportion to men Furthermore, while the small number of men in this sample is a significant limitation, I do not believe that it negates this primary conclusion. How ever, as the following chapters will illustrate, without exploring the historical and contextual basis surrounding this violence (i.e., without considering positions of power within the dyad), we cannot responsibly draw conclusions about the nature of the violence in these relationships, much less presume that men's and women's violence is always the same.
78 CHAPTER V GENDER, VIOLENCE, AND CONTROL Add ressing Research Questions 2 and 3 Kellsey met Kurt when she was 23. Three years older than she was K urt was initially "very romantic and wooing," and after dating for almost a year, they moved in together; that was when the relationship began its downhill slide "We started fighting a lot," she recalled. "W e had fought a little bit before then, but not like that. And it'd be like door slamming fights and, you know I'm leaving' type of fights. As time went on, Kurt grew more controlling. [He] never did anything that you typically think of as abuse," she remarked. "For example," I would be reading Twilight or Harry Potter a book I was really into, and he would take it and hide it so that I couldn't read it and it was like a way of controlling me. And he wouldn't tell me where it was and we'd get in a fight about that because I would be like, "Stop it, I just want to read my book." And he'd be like "Ha, ha, ha, ha, you can't." And it was like a funny joke, but it wasn't funny, and it would go on to the point where I was angry, like, "Show me where my book is, that's not cool." It would just sort of escalate and until finally he'd take the book out, throw it, and be like, "Whatever. There's your book. Fine. Go read it if you want to. I just wanted to spend some time with you" or something like that. Slowly, her universe became more isolated "[He] didn't like me have any sort of connection with the outside world, tried to disconnect me from family and friends." After becoming engaged, they fought over who would be invited to the wedding: Kellsey wanted to include her close family at the ver y least, but Kurt demanded the ceremony be completely private, with no guests except the officient. After extensive arguments over this and other issues, Kellsey said she usually gave in, feeling she had no voice. Although Kurt never hit Kellsey or t hrew objects at her, he frequently told her that she looked or acted like a whore and played on he r vulnerabilities in numerous ways.
79 Once, he tossed her dog outside by the scruff of its neck after it had an accident in the house. She recalled some of th e worst incidents being times when he would physically dominate her, but not actually harm her: And there were a couple of times where, like one time he held me down, like he would like to tickle me, but to the point where it was uncomfortable. Like I did not like it and I'd be like, "Okay, stop, stop, stop." and it would escalate [He] liked to hold me down I have this thing where when I was a kid, my friend and I used to play this game where she would like kind of hold this blanket on you and see how long you could stay under the blanket or something. And I've kind of been traumatized since that and so I told him that I don't like to be held down or under a blanket too much and he would take advantage of that. He'd be like, "Ha, ha, ha. Isn't this s o funny? I can make you freak out." She learned quickly that the best way to get him to stop was to cry, prompting him to give her a disgusted look and tell her she was "weak. Occasionally Kellsey would respond with force of her own. She said that wh en they argued, one of them would often t ry to leave the house and the other would grab his/her arm or block them from going ; she said they "traded off" on who did the l eaving and who did the grabbing Kellsey recalled one time when Kurt shoved her agains t a wall and blocked her way out of a room. "I did feel threatened. He was yelling, calling me name s and blocking the door." She asked him to move, he refused, and she pushed him. "And it was definitely a light push, it wasn't like push you down the s tairs to really hurt you. It was just like I just need you to move right now. You're in my way and you won't let me out.'" Kellsey eventually left Kurt, but only after several years of enduring his physically and emotionally controlling behaviors. In many respects, Kellsey's story illustrates many of the nuances that make defining IPV so difficult. Aside from grabbing her when she wanted to leave the room and shoving her one time (and she readily admits
80 to pushing and grabbing him, as well) he was n ot physically abusive in ways that are commonly recognized as "violent." He never brutalized her, never punched her or left bruises or did any of the things that television and movies portray as "domestic violence." In fact, looking at her CTS2 responses she appears to have been at least as violent as Kurt. However, the details Kellsey shared during our conversation reveal a different picture: she was a young woman in a relationship with a man who used her vulnerabilities to manipulate and control her. Exploring this disconnect between a relationship's outward appearance (seen in terms of violent incidents) and its underlying dynamic forms the core of this dissertation. Using women's own stories and words, this chapter will highlight some of the nuance s related to power and control that have often been missed or overlooked in previous IPV research by investigators on both sides of the debate, but which are critical to acknowledge when considering new approaches to intervention and prevention. Research Question 2 R.Q.2: When female IPV recipients and/or perpetrators (as identified by the CTS2) are asked in depth questions about the power dynamics and patterns of coercive and controlling behaviors within those relationships, how do their descriptions of men's violence and women's violence differ vis a vis these patterns, and how do these descriptions relate to current family conflict and feminist theories? In the first chapter, I described the general lack of consensus surrounding the meaning of the term s "coercion" and "control." Using Stark's definition as a guide ( 2007, p. 229 ) I considered a relationship to have a coercive or controlling dynamic if the participant described one partner consistently using tactics that intimidate and/or dictate the current or future actions of the other partner in ways that limited their personal
81 freedoms. For example, if one partner thinks the other is dressed too provocatively and asks them to change on one or two occasions but places no other unreasonable demands or limits on that partner's behaviors, I do not consi der the overall dynamic to be coercive or controlling. However, if a partner frequently demands that the other dress in a certain way, becomes upset or jealous if that partner socializes with anyone without them, and accuses that partner of not respecting their feelings, I consider the dynamic controlling -particularly if the result is that the second partner dresses in ways they dislike and rarely sees friends or family alone. This example is more clear cut than many of the stories the women in my samp le told, but it provides an illustration of how the same action may be part of a pattern of controlling behaviors in one case, but is clearly limited and situational in another. Even using this general definition as a guide, there were times when making t he determination about the existence of a pattern of controlling behaviors was difficult. Juanita's relationship was particularly complex. She described the earlier years of her marriage as a period of turmoil: when her husband got angry, he would occasi onally punch a hole in a wall or door, scaring Juanita enough that she left the house with her daughter. She said they usually fought over sex or money, both of which he felt she had too much control over, especially after he was laid off. For her part, Juanita did control the finances, setting and enforcing spending limits. She threatened to have his ATM card blocked after he took a female friend to lunch, and she was livid when she learned he had not applied for a job. In many respects, both Juanita a nd her husband appeared to be struggling for control, but it is not clear that either of them engaged in a pattern of behaviors designed to control the other (aside from limiting the unilateral spending of
82 household resources). Ultimately, I decided to be conservative and not to categorize either of them as coercive or controlling, reserving that category for relationships where the pattern is clearer and the impact on the recipient is more apparent. For a visual depiction of the participants and their use and receipt of violence, see Table 5.1. One of my hypotheses was that I would find that the violence directed towards women by male partners was more likely to be accompanied by a pattern of other controlling behaviors, compared to the violence women dire cted towards men; this was clearly supported by the interview data. Out of the eighteen relationships (occurring among sixteen different participants) in which women reported being the recipient of male violence, ten showed clear evidence of additional ma le instigated controlling behaviors. This compares with only two women (out of the 16 who acknowledged using violence against a male partner) who described their own patterns of behavior as clearly controlling. 19 Looking at the findings from this perspect ive, these data strongly suggest that when women are interviewed about their perceptions of relationship dynamics, they are more likely to describe being recipients of violence that is part of a larger pattern of controlling behaviors than they are to perp etrate violence that is part of a similar larger pattern. My second hypothesis, that women were more likely to use violence against coercive and controlling partners than they were when these behaviors were not present, was not supported. In exactly hal f of the relationships where women hit, grabbed, shoved, or otherwise attacked a partner, that partner demonstrated no signs of a patterned 19 Admittedly, these findings are drawn using women's reports only. However, when I reviewed the relationships in which women were violent toward a non controlling male partner, only one additional wom a n used language or examples that suggested she might be more controlling than she described herself.
83 Table 5.1 Participants' Experience of Physical Violence and Male Control attempt to dominate the participant. Mo reover, in most of those cases, the participant indicated that their partner had never used physical violence against them. These findings suggest that although women may have very different reasons for engaging in Physical Violence: Female Yes No Physical Violence: Male Physical Violence: Male Yes No Yes No Coercive Controlling Male Yes Rochelle Raelynne (1) Â Brenda Regan (2) Maya Kellsey (2) Megan Becky (1) Marisol (1) Co nnie Sandra (1) No Mary Juanita Karen Â¤ Sandra (2) Katrina Jackie Marisol (2) Lorraine (2) Joanie Kellsey (1) Raelynne Ellen (2) Regan (1) ** Jenny Wendy Becky (2) Lorraine (1) Lauren Ellen (1) Note: the numbers followi ng the names signify different relationships that participants described. ######################################## ############### # In her first relationship, Raelynne's physical violence was limited to "charging" but not hitting her boyfriend and later spitting on him. Because spitting is legally considered assault or battery in several states, I will categorize her as using violence, although this may stretch the definition. Â B oth Raelynne and Marisol described individual violent incidents, but little about the overall dynamic. Based on the severity of violence and the number of times it was used, I am categorizing them as male controlled. Mary's only use of violence was hitt ing her husband in the arm as part of a joke; his only use of violence was (from her perspective) unintentional. Â¤ Both Karen and Marisol (in her second relationship) demonstrated coercive and controlling patterns of behavior against their respective partn ers. Both also reported experiencing physical and sexual abuse as children. ** Regan's first boyfriend did not appear to be coercive or controlling until it became apparent she would be moving; I am not considering him coercive or controlling based on the lack of evidence of an ongoing pattern of behaviors. # # # #
84 v iolent behaviors than do men, they are not always a reaction to men's attempts to exert power, control or violence over them. 20 The Relationship Between Gender & Control One of Stark's ( 2007 ) primary arguments is that when we look at "coercive control" rather than just violence, we see a much stronger relationship between gender and victimization and the stories of the women in my sample support this. Out of twenty two women, eleven 21 described partners who engaged in an identifiable pattern of controlling, and/or coercive actions, with some experiences appearing more oppressive than others. Although the dynamics within each relationship were different, each of these participants recounted examples of recurring behaviors that had the effect of limiting their personal agency in some way. 22 Three women had severely violent past relationships. Becky described her first hus band degrading her, raping her, and doing "anything to keep me from having self confidence," including throwing her down the stairs when she confronted him coming home late and drunk. Raelynne also recalled being thrown down the stairs when she was 4 mont hs pregnant, after she tried to evict her then boyfriend from her apartment after learning he had been cheating on her. Both Becky and Raelynne spoke of their ex 20 In no way am I claiming that women are the "primary aggressors" in relationships where their male partner has never used violence. In some situations, women did appear to be the perpet rators of a pattern of controlling behaviors against male partners; in other situations, the violence seemed to be situation based or a one time aggressive outburst. 21 Rayelynne, Brenda, Rochelle, Regan, Kellsey, Maya, Megan, Marisol, Becky, Connie, Sand ra. 22 Types of behaviors include multiple instances of preventing a partner from seeing friends/family or harassing them when they do, insisting on accompanying a partner to medical or other appointments, making derogatory comments aimed at increasing em otional dependence, demanding a partner do things against their will and forcing them or wearing them down until they do, controlling a partner using finances, demanding money for personal expenses, etc.
85 partners with a great deal of bravado, insinuating that they had not been fearful of their pa rtners but were enraged by their behaviors; Raelynne even commented that she instigated several of the situations that led to the violence, including the time that a spitting match ended with an ambulance trip to the emergency room. Although none of the t hree women spoke about these relationships in enough detail to identify other specific controlling tactics, in all three cases, they described multiple incidents of violence that were triggered when the participant challenged or refused their partners ; for example, Marisol's ex boyfriend attempted to strangle her when she declined to give him money to pay his rent. Although Becky was the only one of these three women to talk up front about experiencing psychological abuse and sexual violence in addition to physical attacks, I have classified all three of these relationships as "controlling" because they illustrate the most extreme forms of controlling behaviors: repetitive, severe, life threatening situations that, based on the participants' recounting of t he incidents, appear to be at least partially triggered by a perceived threat to the male partner's power. Few researchers, regardless of their theoretical perspective, would dispute these as examples of "battered women" based on the severity of the physi cal violence and its primarily uni directional nature (aside from Raelynne's spitting response). 23 Many of the women in my sample described relationships that resemble Stark's definition, but with partners whose physical aggression if any was relative ly minor in nature. These women recalled being unable to spend time with other friends without 23 In his review of quantitative data gathered from c linical populations, Johnson posits that some of the most severe violence he identified was not controlling, but was "situational" or "common couple violence" (see below for a greater discussion). Unfortunately, I was unable to gather enough information f rom Raelynne or Marisol to make a clear distinction, but the fact that the violent acts were repetitive and life threatening led me to consider them to be part of a larger pattern.
86 receiving constant telephone calls or text messages, being harassed at work (or having their colleagues harassed), and being called weak stupid slutty or fat often until they started to believe it. They lied about medical appointments, past relationships, or social events to avoid a conflict, and they stopped doing activities they enjoyed because their partner made it difficult. They were told that the probl ems in the relationship were their fault, that they didn't care enough, and that they didn't know what "love" really was. One of the most explicit examples of this came from Regan, a young woman in her thirties who recalled how her ex boyfriend had been ex tremely jealous of the men she worked with. As an EMT, she worked long hours in a male dominated environment, and after persuading her to move to a small town far from her friends and family and live with him in his RV, he pressured her to quit her job, e ffectively cutting her off from all ties with the outside world and creating an economic dependence on him. He deleted the names and numbers of anyone he didn't know from her cell phone, and accused her of being "slutty" and "worthless," insinuating that she was lucky that he continued to love her despite those qualities. After a while, she started to believe him, and, in hindsight, was shocked by the level of control he exerted. Kellsey described a similar pattern of behaviors used by her ex fiancÂŽ when he used her childhood fear of being smothered to dominate her and then expressed his disgust at how "weak" she was. Like Regan, Kellsey looks back on the relationship with amazement; a therapist by training, she understands that while she might have reco gnized the signs of control in someone else's relationship, she did not do so in her own. Several women were accused of not loving their partner enough or knowing what "being in a relationship" meant when they protested attempts to have their lives
87 microm anaged. When Brenda resisted her boyfriend's insistence on taking her to every doctor or dentist appointment, or became irritated because she was hassled anytime she wanted to spend time without him, he would tell her that she was the unreasonable one and didn't know what a loving relationship looked like. Kellsey experienced a similar dynamic when her ex fiancÂŽ hid her books and accused her of neglecting him when she demanded their return Numerous participants described their partner becoming upset if they went out for drinks after work with colleagues or friends, asserting that anyone going to a bar must be there to pick up a date, and if the participant cared about his feelings, she wouldn't put herself in that position. Among the women who described being involved with controlling male partners (or who described using control themselves), a continuum of violence severity and controlling behaviors emerged from the data. On a few occasions, male partners used physical aggression and/or threats in conj unction with controlling behaviors, such as forcefully grabbing a woman when she tried to leave the room punching holes in the door she was hiding behind or twisting her arm to force her to give up the remote control. 24 Rochelle described the time her hus band slapped the newspaper she was holding in front of her with such anger that she was sure he was trying to hit her and felt extremely threatened. Other participants recalled few, if any, physical threats. Megan, a young woman in her twenties, admitted that she was the only one to react physically, pushing her ex boyfriend into the wall after he made disparaging remarks about both her and her mother. When she described the long term dynamic of the relationship, however, 24 I included one of Juanita's experiences in this description because these events occurred during a phase in which the dynamic of fear and control was more one sided than in later stages of the marriage.
88 she revealed that he had usurped control over most of their mutual decisions, frequently put down her intelligence, appearance, and family, and covertly coerced her into limiting her contact with other people. Although Megan appeared to be the physical aggressor of the two, she clearly fe lt more powerless than powerful. When the women in my sample described their own behaviors towards their partners, on the other hand, only a few had engaged in similarly patterned controlling or coercive behaviors. Karen and Marisol both used extr emely high levels of physical violence and controlling behaviors against their current partners. Marisol described numerous times when she pushed, shoved, threw things at, and hit her now husband, frequently when she was afraid he would leave her or when she didn't get the response she thought she wanted. At one point, she described how her husband would try to leave the room whenever they fought, which made her even more upset. She would grab his shirt and try to prevent him from leaving the room in an attempt to deescalate an argument: (M): Yea, and that was a, that was a little pattern there for a while. Cause it was like, he just wanted to separate himself from the situation. And if he threatened to leave the room, it would escalate even more. S o he was like, "Oh shit, what do I do?" You know, "I don't want to be part of this, but then if I leave, it gets even worse." (AV) Okay. (M) Because all of a sudden, if he, if he threatened to leave the room, which again for me was a threat. For him it wa s just "I need to separate myself from this. We need to deescalate this." But all of a sudden this abandonment thing would kick in for me, and it was like, "No. No, you're not leaving." (Marisol, 34) Karen described similar patterns of behavior. When sh e felt insecure or slighted, she would react to her husband in physically and psychologically aggressive ways. She recalled times when she needed his help with something but he wasn't around, or when he was late and she became jealous: "I would just start yelling and, like, getting in his
89 face. Very aggressively, like you would think a man would do to a woman. You know, pointing my finger at him and then I might just shove him like that." Reflecting on the relationship as a whole, she believes she actua lly frightened him at times, and she admitted that her violence has been severe enough to leave bruises and fingernail marks. Although other participants described using behaviors that could be seen as "controlling," it was difficult to ascertain if they truly fit into a structured pattern of "deprivation, exploitation, or command that compel obedience," based on their versions of events ( Stark, 2007, p. 229 ) For example, Becky made numerous patronizing remarks about her current husband and smugly pointed to herself when I asked who holds mo re of the power in the relationship, but she also said they make most large decisions together and that neither spends more than a set amount of money without consulting the other. Her husband suffers from a bipolar condition, and while Becky clearly lose s patience with his mood swings, she relayed nothing that suggested she demanded his obedience or dependence. Likewise, several participants described behaviors on the part of partners that were hurtful or that could be construed as manipulative or contr olling, but that only happened once or twice and had no long term impact on their actions or options. For example, Wendy described her (then) long distance boyfriend expressing his displeasure at what she was wearing to a dance once, but she ignored him a nd nothing ever came of the situation; later, after he returned to Denver, he tried to convince her to not move away by claiming she didn't care about him, but she moved anyway, and when they broke up later, he left her alone.
90 Perpetration Of Violence I n The Context Of A Partner's Coercive Control Of the eleven participants who described controlling male partners, all but one said that partner engaged in some level of physical violence against them (seven stated that they had used violence against that partner). Just as the level of control these men exerted varied, so did the severity of the physical violence: on one end of the spectrum, Regan described her ex boyfriend throwing her clothing at her and grabbing her during a fight; at the other end, Mar isol's ex boyfriend wrapped his hands around her throat, and Raelynne's ex boyfriend pushed her down a flight of stairs while she was pregnant. Although several of the most severely violent incidents occurred with men who appeared to be on the highly cont rolling end of the spectrum (e.g., Becky's first husband, Raelynne's ex boyfriend), the severity of violence did not always correspond to the level of control the partner described. Both Regan and Maya described partners who were very controlling, yet the physical violence those men used was relatively minor; they used other tactics to get what they wanted from the women. Likewise, Regan's first boyfriend was primarily non controlling until she decided to end the relationship; at that point, he began call ing and harassing her, and once locked himself in her apartment alone with a loaded weapon and demanded that she come home or he would hurt her cat; had she actually been home when he came to her apartment, the potential for severe violence was huge. 25 Although approximately half of the men who used violent tactics against women did so within the context of other controlling behaviors, it is important to note that the remaining half did not engage in a discernible pattern of other controlling or coerciv e 25 This is commonly referred to as "separation induced violence" ( Johnson, 2008 ) and in this case, I did not classify this as a "controlling" relationsh ip in the long run.
91 actions; for the most part, those men used less severe forms of violence compared to the controlling men. Both Ellen and Wendy described being grabbed by ex boyfriends, but neither indicated they were shoved into anything or even remotely hurt. The mos t obvious exception to this is Karen, whose relationship is extremely different from the others involving male violence: her husband has hit her and put his hands on her throat at least once, but only after she physically attacked him (she implied that fro m her perspective, his behaviors were at least partly self defensive). In the remaining non controlling relationships that included male violence, the acts have generally been minor to moderate in nature. While not true of all participants who engaged in physical aggression, seven out of the thirteen women who reported using violence did so against moderately or highly coercive and/or controlling partners. 26 Although many of these examples occurred in the context of an argument, most would not be considere d "self defense" (commonly considered as violence used to protect one's self when feeling directly threatened). Yet, when the partner involved had a history of using a pattern of control tactics against the participant, the overall dynamic must be conside red when trying to understand women's behaviors. An excellent example of this is Rochelle. She has been married to her husband for 11 years, and throughout their relationship, he has engaged in extremely aggressive and manipulative physical, emotional, a nd sexual behaviors. In one of the worst incidents, he swung his hand at her face after she refused to do some gardening he wanted finished; although he only succeeded in slapping the newspaper she was holding, 26 Kellsey was violent against two separate partners, one was controlling and the other was not
92 she believes he would have hit her if she ha d not ducked. She was so convinced that he might hurt her that she ran from the room, locking two doors behind her and grabbing the telephone in case she needed to call 911. Although the relationship improved after he began taking antidepressants, the ag gression resumed when he stopped. One morning, they argued over whether Rochelle could use a certain thermos for their daughter's lunch. He took the thermos and started emptying the contents, and Rochelle tried to seize the thermos to stop him. While th ey were yelling, tussling and grabbing for the container, she hooked her foot around a kitchen chair and pushed it into his leg. This represented the only time that either of them successfully hit or kicked the other, and from a strictly behavioral standp oint, she could be seen as the primary perpetrator of violence in the relationship. However, when that act is considered within the context of the larger dynamic of coercion and control, it could easily be interpreted as reactive as much as assertive. M aya's story is similar. Growing up in India, both Maya and her husband have a strong respect for cultural notions of marriage and family. Over the course of their relationship, Maya's husband has engaged in controlling behaviors that Maya considers "trad itional" for Indian men, such as expecting all family members to abide by his decisions and demanding absolute obedience from his children. When I asked about her use of physical aggression, she told me she slapped him after he committed an infraction so egregious that both sets of extended family became involved in the resolution (she would not elaborate on the details of this infraction). Based on the tone of her voice, it was clear that she felt justified in her reaction. Although this violent inciden t may appear
93 uni directional in nature, it nonetheless seems important to consider it in the context of what she described as an extremely controlling and dominant husband. Brenda, Kellsey, and Regan all described engaging in violent behaviors when their c ontrolling partner tried to prevent them from leaving a room during an argument. 27 Brenda spoke of how her boyfriend sometimes grabbed her when she tried to walk away, and one time, he grasped her arm hard enough to leave bruise s More than once, she respo nded by pushing or hitting him so that she could get by: (AV) You said that he had grabbed you a couple of times in the last year. Do you remember the specifics? (B) No, just not listening or walking away or feeling like we had said all we could say and n othing we said was going to change it anymore and I didn't want to talk anymore. I wanted to walk away. I wanted to go outside and go for a walk. I wanted to walk the dog to get away and he wasn't having that, and he grabbed me to the point one time whe re he left bruises. I'm like, "Why are you doing this?" this escalates, and then one time I hit back. Kellsey remembered a similar incident. She said that, at the time, she didn't sense that her ex fiancÂŽ was going to hurt her, but he was yelling, calli ng her names, and blocking the door. "I just felt like, Let me out. I need out of here and you're blocking my way. Move!'" When he didn't let her pass, she shoved him. "It wasn't like push you down the stairs to really hurt you.' It was just like I need you to move right now. You're in my way and you won't let me out." In many respects, Kellsey's story illustrates the importance of placing both men's and women's behaviors into the larger context of power. She recalled instances where both she a nd her ex fiancÂŽ grabbed or shoved one another to prevent the other from 27 Juanita also described punching her husband when he blocked her from leaving the room during an argument, and Sandra admitted that she has shoved her husband away in similar circumstances.
94 leaving the room, and from the standpoint of counting the incidences of violence (as the CTS2 does), Kellsey could be categorized as the more physically aggressive of the two. Howeve r, when listening to her larger story, the controlling nature of her ex fiancÂŽ becomes apparent. While she may not present as the traditional "battered woman," his pattern of holding her down, tickling her against her will, rolling her in blankets until s he cried, belittling her, and isolating her suggests that her aggression was not perpetrated in the context of a "fight" between equals. Physical Aggression Outside The Context Of Control It is equally important to observe how participants described other relationships when violence and aggression occurred outside of a context that appears coercive or controlling. Approximately ten women acknowledged acting physically aggressive towards non controlling male partners, 28 and of those, only Marisol and Karen exhibited their own clear pattern of controlling behaviors. In several cases, the violence used by the participant was limited to a one time event. For example, when Jackie and her husband were packing the kitchen in preparation for a move, she found him reading the newspapers he was supposed to be using to wrap dishes. After asking him several times to stop reading and start packing, she threw a kitchen spoon (or similar utensil) across the room at him to get him to "wake up and stop reading the newspap er." In some situations, women described their violent outbursts as "losing it" because they were angry or upset. Katrina remembers a time when she was feeling under a tremendous amount of pressure from school and work; one evening, her husband made a loud noise that irritated her, and she lashed out and hit him (he responded by calmly 28 Karen, Marisol, Jackie, Sandra, Lorraine, Joanie, Katrina, Mary, Kellsey
95 telling her to "never do that again"). She was visibly embarrassed by the incident, and emphasized that she never did anything like that again. Unlike Katrina, Lorraine felt justified in her outburst: when she discovered her husband had been viewing pornography that she found extremely degrading, she was livid. When she first confronted him, he responded with shame and assured her it would not happen again. When it did she saw red and shoved him into a wall: "I got really angry outwardly that time. And I did. I shoved him. Cause I was so mad that he would do that." Several participants recounted being recipients of physical aggression that appeared obvious ly non controlling in nature (e. g. Mary, Ellen, Wendy). Many of them experienced single events that reflect Johnson's definition of "situational partner violence" perfectly: conflicts that become arguments that turn into aggression that becomes violent ( Johnson, 2011, p. 290 ) Jenny recounted the time she learned her partner was involved with someone else. She confronted him about it, and eventually they ended up arguing in a tiny bedroom. She wanted to leave the room, but he blocked her, grabbing her and (possibly unintentionally) shoving her into the wall. Eventually, the situation was resolved, and she said that nothing has ha ppened like that again. Wendy told of a similar experience when her ex boyfriend grabbed her as she was turning to walk away during an argument. At the Intersection of Control, Gender, and Violence RQ 2 asks how women's descriptions of their own viole nce differ from their descriptions of men's violence when we consider other coercive and controlling behaviors. Obviously, the stories that comprise this analysis only reflect one side of each relationship, and all are told from a woman's perspective; it i s possible that the women
96 are downplaying their own controlling tactics. However, given that approximately two thirds of women described times when they had behaved in physically aggressive ways, these women were not shy in acknowledging their own use of violence, including in situations that could not be considered defensive in nature (when they had not been threatened with physical violence or were frightened). Roughly the same number said they had been recipients of male violence, and most had experienc ed both. From a family conflict perspective, this could be seen as clear evidence of gender symmetry: even when examining data limited strictly to the reports of women, women appeared to use physically violent behaviors when they were not threatened as of ten (or more often) than they described being the recipient of men's violence. Several examples even appear to illustrate Straus' argument that women's use of violence against men results in greater violence against them (e.g., when Raelynne spit at her b oyfriend, he retaliated by beating her up) ( Straus, 2005 ) How ever, if we look at these incidents as they relate to patterns of other coercive or controlling behaviors, we see a more complex story: over half of the women who reportedly perpetrated violence did so within the context of a relationship with a controllin g partner; although this may not "justify" their behaviors or alter the ramifications, it suggests that there may be different meanings and motivations for those actions as they relate to gender and power. Additionally, women were much more likely to desc ribe being the recipients of controlling patterns in general than to recount engaging in those patterns, and whereas just over a quarter of participants recalled times when a non controlling male partner was violent, exactly half had experienced physical
97 a ggression in combination with other controlling tactics. 29 Overall, this suggests that, for many women, there is an overlap between violence and other forms of control that would not be apparent without an examination of power in relationships. Research Question 3 R.Q. 3: Do specific contextual factors associated with men's use of violence or with women's use of violence emerge from a series of qualitative interviews with female victims and/or perpetrators of heterosexual IPV identified in a non clinical sample? Across the IPV literature, there is little agreement on the factors that are or are not associated with domestic violence perpetration or victimization; any researcher, if he or she looks hard enough, can find a study, meta analysis, or literat ure review that documents a relationship between almost any demographic characteristic and partner violence. Income, race, ethnicity, family history, health status, religious background, gender attitudes, substance use, social networks, and more have, in various ways, been associated with or been not associated with IPV. In many respects, the sample of women I interviewed is very homogeneous (predominantly white, well educated, and employed on a medical campus), and while I attempted to select a diver se sample, most of these women appear to have more traits in common than not. However, the experiences they talked about are all remarkably different. While some women recounted one off incidents that happened when they or their partner had been under tr emendous stress or drinking, others described relationships where violence and/or patterns of controlling behavior had been common. 29 One woman, Connie, is included in both categories.
98 As part of my initial research proposal, I listed several hypotheses related to the types of contextual factors I would fin d associated with men's violence against women and with women's violence against men. First, I hypothesized that the previous use of physical/sexual violence, aggression, isolation, and/or other controlling behaviors within the relationship would be assoc iated with men's violence against women. Although substantiated, the support for this premise was weaker than I anticipated. While almost all of the men who engaged in a pattern of controlling behaviors against their partners were also violent (at least minimally so) these men accounted for only half of all relationships in which men used violence. The fact that these patterned control behaviors were present in half of the relationships involving male to female violence makes this the most commonly asso ciated factor, and is important from the standpoint of developing future prevention and intervention strategies; yet, it also means we need to look at other factors that may influence men's violence toward women. Likewise, I also predicted that women's vi olence against men would be associated with having experienced prior acts of physical/sexual violence, aggression, isolation, or other controlling behaviors from current or previous partners. The support for this assumption appears stronger: ten out of th e sixteen women who intentionally used physical violence had, at some point in their lives, been the recipients of male violence, either from an intimate partner or from childhood sexual abuse; 30 of those, seven experienced those behaviors from the partner they assaulted (and another woman, Megan, had not been physically assaulted by her boyfriend, but he was clearly controlling in 30 I did not include Mary in this count, because the only reason for categoriz ing her as a perpetrator and recipient of violence was because she recounted two events in which the "violence" used was unintentional.
99 other ways). In making this observation, I am not justifying the behaviors of these women, who in some cases behaved very viol ently towards partners who had not been physically aggressive with them. Rather, in identifying this as a characteristic common to women who engage in violence, I argue that when we consider the nature of women's violence, how to prevent it, and how to in tervene when necessary, this is clearly an issue we need to address Violence In The Context Of Control In the previous section, I concluded that men's violence towards women is not always coercive or controlling, nor is women's use of violence predominan tly a reaction to men's use of multiple controlling or coercive behaviors. However, we cannot completely dismiss any association between male controlling behaviors and IPV either In over 40 percent of the relationships in which women spoke of using viol ence, it was against a controlling partner, making this the most commonly shared factor of any identified. Moreover, in all but one relationship (Megan's), the partner in question was also physically aggressive against the participant, and four participan ts described being part of a physical altercation with the partner immediately prior to their use of violence: Rochelle was wrestling with her husband who had grabbed a thermos away from her; Brenda grabbed her boyfriend's arm when he grabbed hers, and had to shove him out of the way before she could leave the room; both Regan and Kellsey said they had been physically blocked from leaving the room during an argument. Thus, although women did not use violence only against controlling partners, this happened frequently enough that it must be considered when looking for factors that may predispose women to engage in violent behaviors. Likewise, while approximately half of the examples of men's
100 violence towards women did not appear to involve an accompanying p attern of coercive behaviors, half of them did, pointing to an overlap common enough to require acknowledgement and understanding. In a related theme, many participants talked about violence that occurred when one partner tried to leave the room during an argument. On the receiving end, some women described being grabbed by their partner, but at least as often they recounted times when they reacted by shoving or even hitting after trying to leave the room and being physically stopped. Rarely, however, d id the women say they had tried to prevent their male partner from exiting. Kellsey admitted that she and her ex fiancÂŽ "traded off" when one tried to leave and the other tried to stop them, but Marisol is the only participant who described using this tac tic as the primary aggressor, which fits with her use of other controlling behaviors against her husband. Interestingly, this dynamic was not limited to relationships with controlling partners; both Sandra and Jenny described lashing out when their otherw ise non controlling husbands blocked their exit. More often than not, participants said they didn't feel frightened by their partner's behaviors, but admitted that being prevented from leaving increased their (usually already high) level of anger Psychia tric Diagnoses And Treatment One of the most interesting themes that emerged from the data was the perceived association between mental illness and violence. Seven women stated that either they or their partners had been diagnosed with a psychiatric condi tion, and several others "thought" a past partner may have suffered from one. Among the women who disclosed their own struggles with mental illness, all had engaged in at least one violent action
101 (although Raelynne's actions were limited to spitting). Sa ndra, Lorraine, and Raelynne, whose use of violence was minor and/or situation specific, reported being treated for depression and/or anxiety disorders. Both Raelynne and Lorraine talked at some length about the ways in which psychotherapy and pharmacothe rapy had improved their current situations; for example, Raelynne explained that she recognizes how the trauma from her past may have influenced her interactions with her current husband. Given the increasing commonality of diagnoses of depression and/o r anxiety, especially in women in the U.S. (the prevalence of depression among women ranged from 8% 9.5% from 2005 2008) ( NIMH, 2012 ) it may be more surprising that only three women disclosed their own experience with clinical depression. Of grea ter interest, however is the observation that both women who engaged in excessively violent and controlling behaviors were diagnosed with seemingly severe psychiatric disorders on top of histories of childhood sexual abuse and incest. Marisol had no idea that she was bipolar until she sought psychological help for her behaviors, which she knew were unacceptable but couldn't seem to control. Although she is unwilling to use her disease as a justification for her violence, she has come to recognize the syne rgistic effects her bipolar condition and history of physical and sexual victimization have had on her thought process and actions. For Karen, struggling with feelings of deep depression, anxiety, and mood swings has been a life long problem. Diagnose d with "emotional regulation problems" that she said are similar to but "not classic bipolar disorder," she described experiencing suicidal thoughts starting around age 11, eating disorders, and daily anxiety. She did not say how old she was when she was initially diagnosed, but indicated that much of her marriage
102 has centered around attempting to treat her mental health issues, and she disclosed using physical violence against her husband for much of that time. A year or two ago, while recovering from a painful back surgery, a series of intense arguments combined with such strong homicidal and suicidal thoughts that she presented at a local emergency room, where they instituted a 72 hour psychiatric hold. She indicated that a change in medication seems t o have helped, although she continues to fight to control her emotions and behaviors on a daily basis. The belief that medication can reduce if not eliminate IPV (at least in certain circumstances) was echoed by Rochelle, who described nearly miraculo us changes in her husband after he began taking an antidepressant. Her association between the behavior changes and pharmacotherapy was reinforced when she observed a reemergence of his verbal aggression and need for control after he stopped taking his me dication (and the subsequent improvement following his resumption): I could tell by his behavior that he had stopped taking [his antidepressant], and my deal with him, because he was so opposed to taking medication was, "Look, I don't care how you contr ol your mood. You can do it with antidepressants, you can do it with Benadryl, you can do it with standing on your head, hypnotherapy, whatever it takes. You can control that part. But I control whether or not I live in this situation" And so when he saw how much his behavior really did change [when he was] off of the medication in 2008, he's never tried to stop taking it since. And, in fact, in the last six months, they've increased his dosage, and he says he loves it and it does make a big differen ce. The relationship between IPV and mental illness is a contentious topic within the field, and gaining a clear overview of the relationship is difficult. Domestic violence advocates often deny any causal link, asking why, if certain psychiatric condit ions contribute to violent behavior, are these behaviors only directed towards partners or
103 family members, and not also exhibited in the workplace or grocery store? Although a substantial amount of research suggests an association between various mental i llnesses and partner violence, much of that research has been cross sectional, relied on institutionalized populations, looked exclusively at victimization, and/or used differing methodologies and definitions of the key variables ( Friedman & Loue, 2007 ; Howard et al., 2010 ; Prospero & Kim, 2009 ) Addi tionally, while some research suggests that certain conditions may be contributing factors for men but not for women (and vice versa), others find very little differences between genders ( Prospero & Kim, 2009 ) Forming any conclusions about the directionality of the association is even more difficult, particularly when experiences of trauma intersect with men tal illnesses. For example, looking at Karen's story, it is impossible to sort out whether her childhood experiences with physical and sexual abuse, her underlying psychiatric condition, other personality characteristics, or a synergistic reaction between any and all of them has been the driving force behind her violent behaviors. Because the primary focus of this dissertation is not to sort out the relationship between IPV and mental illness but rather to call attention to it as a recurring theme among this sample of participants, I did not undertake an exhaustive review and analysis. However, the significance of this finding is clear: despite the messages given by many lay domestic violence educators and advocates that, "mental illness does not cause domestic violence," we should consider how certain (particularly common) mental health conditions may or may not influence or be associated with the perpetration of IPV by both men and women i f we are going to truly understand the dynamic between gender an d partner violence. It seems possible that rather than being a manifestation of the
104 mental illness per se, factors associated with the illness (e.g., a sense of powerless or lack of self worth that may accompany depression) could be directly related to IPV Furthermore, from the perspective of developing treatment modalities, even if we agree that mental illness is not a necessary cause of IPV, additional research in this area could strengthen the creation of clinical protocols that provide guidance to ment al health practitioners and domestic violence advocates in appropriate responses when these issues intersect. The Relationship b etween Emasculation And Violence. Although these data cannot fully address this topic, it is worth noting that in the original research proposal, I also hypothesized that men's use of violence would be associated with perceived emasculation or loss of power directed at them by their female partner. Although some participants' stories hint that a loss of power or control may have preceded specific violent attacks, without hearing men discuss similar situations in their own words, I cannot comfortably draw conclusions about their intentions or per ceptions. For example, Juanita described how several of her most violent fights with h er husband occurred just after he was laid off from a well paying job, placing Juanita in the position of sole breadwinner (and cutting their household income by more than half). These fights were generally sparked by disagreements about "sex or money," b oth of which he perceived Juanita as controlling. When she instigated clear limits on his spending (and even threatened to cancel his ATM card) and pushed him to apply for a particular job, his response was clear: Y ou can't tell me what to do In all of t hese situations, he could easily have perceived Juanita as taking the power that had been his, and resenting her for it. However, these perceptions are based only on Juanita's recounting of events, and are
105 filtered through my own female lens; without hear ing men describe their own impressions of the situations in which they used violence, it would be irresponsible to form any generalizable impressions. Given that other investigators have suggested this connection between the fulfillment of gender roles l oss of masculine power, and IPV (especially in some culturally specific contexts) ( Bui & Morash, 2008 ; J. C. Campbell, 1999 ; Hautzinger, 2007 ; Peralta, Tuttle, & Steele, 2010 ) paying close attention to how men recount violence and probing when nece ssary could provide genuinely useful results when further research is conducted Discussion: "It's The Same, But Different" Thoughts on the relat ionship between control, gender, violence, and public health In many respects, these data reinforce several o f the feminist arguments about the gendered nature of power in heterosexual relationships, and are supported by other studies suggesting that women experience coercive control from men at higher rates than men do from women ( Tanha, Beck, Figueredo, & Raghavan, 2010 ) The fact that roughly half of all participants described having at least one male partner attempt or succeed at systematically usurping their autonomy supports the assertion that the gendered imbalan ce in power in larger society continues to translate into gendered imbalances of power in intimate relationships. In Maya's case, the imbalance was obvious: growing up in a traditional South Asian Indian family, her role of wife and mother was culturally prescribed and included accepting her husband's authority over most family matters. Although few other women described such explicit adoption of conventional gender roles, nonetheless, many reflected on feeling the need to nurture or fix the relationship, reflective of women's traditional position in the family. Connie,
106 whose outward persona expressed confidence and command, realized that she relinquished her own power to avoid conflict. "[G]rowing up, I had always been a pleaser, like the fixer. So I fe lt like I needed to resolve it and fix it and make it right and make it better, so we wouldn't do that anymore." Conversely, although some strains of feminist thought suggest the power differential between men and women makes women's use of violence mos t likely defensive in nature, the stories of the women in my sample contest that notion. Few -if any -women truly used violence in self defense, including in situations when they were responding to a partner's verbal or physical aggression, and approx imately half of the women who were physically violent did so against partners who did not appear to act in coercive or controlling ways. Even when participants did engage physically with controlling partners, their descriptions of the events suggest that these actions were as likely to be about reclaiming some of the authority or power they felt they had lost as they were about defending themselves. For example, several women described shoving their partners so they could leave the room; although none tho ught that they were in immediate danger, they expressed an overwhelming need to get away. At first, Kellsey labeled her actions as "self defense," but later rephrased this: He was yelling, calling me names and blocking the door. Like I was trying to leav e the bedroom to get out of the house because I just felt like, T his is too intense. I need to get out." And I guess I didn't feel like he would hurt me right then, but I just felt like L et me out. I need out of here and you're blocking my way. Move!" And I asked him to move and he wouldn't move. So I guess maybe self defense isn't the right word, but something similar to that. It wasn't like "push you down the stairs to really hurt you." It was just like, "I need you to move right now. You're in my way and you won't let me out."
107 Even if the women themselves did not specifically identify this as the motivation for their aggression, it had the effect of creating a more even playing field, so to speak. For example, when Megan shoved her boyfriend, it was after months of denigrating comments, and she described his reaction as stunned: "It threw him off. I like, it shocked him. Cause I actually defended myself" Part of taking a feminist standpoint approach to research involves ackn owledging that our participants' perspectives on their experiences are as critical to understanding violence in relationships as are our interpretations of those experiences As much as I believe that these data show a connection between gender, coercive control, and vi olence, I must also acknowledge that almost half of the women in my sample described using or receiving violence in relationships with no indication of male control or coercive behaviors. Although I am reluctant to argue that these experiences should be e xamined in isolation from the discussion of gender and power, it is also important to see these situations for what they appear to be: examples of relationships in which violent behaviors occurred either outside of any context of coercive control, or where women (in the cases of Marisol and Karen), not men, present as the primary controlling partner. 31 With the clear exception of Karen and Marisol, whose stories are unique for a number of reasons, most of the violent exchanges in non male controlled relat ionships resemble Johnson's description of common couple violence : one time or isolated events, 31 Graham Kevan and Archer explored women's use of violence. Interestingly, although they found a weak association betwe en women's fear of being physically hurt by a partner and their use of violence and stronger association between women's use of violence and their partner's use of violence, when they examined the construct of control, they found an association between wom en's use of controlling behaviors and women's violence, but they did not even assess men's use of controlling behaviors ( Graham Kevan & Archer, 2005 )
108 generally the culmination of an argument that escalated, involving relatively minor forms of violence. Only a few participants who perpetrated or experienced v iolence outside of a controlling relationship described a different dynamic. For example, Sandra, who suffers from depression and anxiety, acknowledged shoving her husband when he tried to prevent her from leaving the room because of her history of self h arm; while his behavior may appear controlling on the surface, Sandra clearly believed that the underlying intent was to protect her from herself. One of the claims made by family conflict theorists is that, as a society, we appear much more tolerant wh en women behave violently towards men than when men do so towards women ( Straus, 2005 ) ; this construct was apparent in the attitudes of several of the women. Joanie described her relationship with her husband as one of shared power: they both have tempers and get angry, but they both generally respect the feelings and w ishes of the other. However, she is very up front and not apologetic in the least about lashing out physically towards him, especially when they fight: I try to match his anger. I'm never afraid, oh my gosh, because I've hit [my husband] and [am] like, "Oh, you make me so mad." And he doesn't hit back. Sometimes I wish he would so I could hit him back harder, because that's when I'm in the throes of like "Let's brawl. I am mad at you!" She describes several incidents when she hit him or threw objects at him, and each time, her tone was dismissive, as if to say this is no big deal, it's just how I am. On a similar note, Lorraine expressed more embarrassment over destroying a knick knack her husband got from an ex girlfriend than when she shoved him in to a wall after the two pornography incidents, and Maya was clear that her husband's transgressions had been so egregious they warranted her slap. Regan offered an interesting explanation for her tendency to rough house or be physically aggressive with he r boyfriends: growing up with two older
109 brothers, she learned to be "punchy" at an early age, which transferred to how she reacted to her partners, and although her actions were generally shrouded in play, she admitted it could get aggressive. In reflecti ng on my own reaction to these stories, it has become obvious how easily this bias is reinforced. Although the larger context of Juanita's relationship is complex, she described one situation in which she threw a frozen chicken at her husband. She had ju st worked a full day, fetched the kids from school, taken care of her mother's cat, and stopped at the grocery store, while he had spent the day playing video games in the living room. As she was cooking dinner, he made a comment about the meal not being ready, and she exploded, literally letting the poultry fly. On the surface, the irony of the story is humorous (as is the image of a frozen chicken flying across the room), and when I described this incident to a fellow anti violence specialist during a p rofessional conference, we both laughed out loud. However, would we have had the same reaction if the genders of the participants had been switched, and if not, what does this mean about our acceptance of at least some forms of women's violence? In her r eview of the recent controversies surrounding IPV research, Langhinrichsen Rohling highlighted this as a bias with several negative implications, including the possibility that it could ultimately result in higher levels of violence for both women and men ( Langhinrichsen Rohling, 2010 ) More to the point, how does this discrepancy in acceptance add weight to the claims that men are battered as frequently as women or to the recent anti feminist arguments to repeal the National Violence Against Women Act or to defund local shelters and advocacy programs?
110 One aspect of t hese data that I must be forthright about is that they come from an unusually well educated set of women, all of whom are employed and the majority of whom are white. As such, they bring with them both the perspectives and experiences of women who have (a nd expect to have) a higher level of status and power compared to many other groups of women. It may not be surprising that in many cases, the highest levels of violence and control asserted against them happened earlier in their lives, often before or du ring their college or graduate school years (when their economic circumstances were at their worst). With a few exceptions, these women did not describe situations as serious as those Johnson uses to describe intimate terrorism. This may also contribute to their own use of physically aggressive behaviors, and to the fact that in most cases, the women ended the relationships before the violence or control became more severe. Had this been a sample of women with less social status and fewer resources, thei r stories may have been markedly different. As I described in earlier chapters, there are numerous theories about the nature of IPV and the role of gender and control. Family conflict researchers such as Donald Dutton and Murray Straus argue that because "general" populations of men and women respond similarly when asked about their use of violent tactics, women and men must be equally violent, despite the emphasis traditionally placed on seeing IPV as an issue of "violence against women" ( D. G. Dutton, 2012 ; Straus, 2008 ) Feminist researchers counter this, asserting that without looking at the context of th ose relationship, the overall influence of gender on power, and the significantly higher levels of female morbidity and mortality, we will miss the forest for the trees ( Dobash & Dobash, 2004 ; Reed, et al., 2010 ; Stark, 2010 ) Yet others agree with some variation on Johnson's take on the
111 debate, that there ar e different types of violence, and that these differences are a) most likely gendered, and b) show that both of the camps are "right" (but incomplete) in their own ways ( Emery, 2011 ) I come to this debate wearing numerous hats. As a sometimes "rationalist" scientist, I look at the quantitative data cited by the Family Conflict camp -as well as my own quantitative findings -and agree with some of their conclusions: when asked usi ng specific tools, women in the United States disclose the use of certain forms of violence against male partners at rates similar to men. As an avowed feminist, however, I also assert that any exploration of violence between men and women must include a careful analysis of gender and power, both at the individual and societal level. Finally, as a public health professional, I try to step back from both philosophical camps and ask, "So what? What is the impact of violence on individuals and communities, and what do we need to understand about violence so we may effectively intervene and prevent those negative outcomes?" Typically, when public health professionals approach common threats to health (e.g., heart disease, obesity, communicable diseases), we examine individual and population based etiologies that all contribute to that single outcome, and develop research driven strategies to eliminate the causes or reduce the risks. To some extent, we have done the same with IPV: we have attempted to identif y a group of factors that lead to violence in relationships and developed related prevention and intervention strategies, most frequently rooted in feminist theory because women appear to suffer the brunt of morbidity and mortality. But what if this appro ach is missing something: what if IPV is not a single phenomenon, but rather multiple phenomena that look alike in the end (one
112 partner using violent behaviors against the other), but that have separate etiologies? If that is the case, we can hardly expec t strategies based on our understanding of one kind of IPV to be effective against all types of IPV any more than we can expect that the same approach to treating heartburn should work for gallstones, just because the symptoms often present as the same. In many respects, of the theories discussed here, Johnson's model comes the closest to recognizing that there may be different types of violence (for an in depth critique of Johnson's framework based on my findings, see Chapter 6) In proposing that some violence is more related to the dynamics of power and control and that other violence is more "situational" or results when a particular conflict situation escalates, Johnson has identified what seems to be a core distinction. In reviewing my own intervie ws, I certainly heard stories in which the outcome was the same (a hit, a push, a thrown object), but the control dynamic between partners was remarkably different. Therefore, reflecting on my data, I support Johnson's assertion that at least two differe nt phenomena are at play: controlling violence, or what he refers to as "intimate terrorism" or "coercive/controlling violence," and non controlling or "situational" violence. Using a public health lens, however, I think the model needs to be taken a step further Rather than looking solely at the act of violence and categorizing it "coercive/controlling" or "situational" (or looking at the perpetrator and assigning him/her a typological label), we need to consider the overall dynamic between the partners : is the relationship itself one in which an imbalance in power results in one partner becoming the subject of the other's controlling behaviors, or is it one in which (on the whole) power is more or less equally shared? Looking at this from the perspecti ve of
113 harm, even when no physical violence is present, coercive/controlling relationships have a high propensity to cause harm to the recipient (or victim) of that control. Consider Regan, the young woman who abandoned family and friends, quit her job, and moved to a small town she hated to live with a boyfriend who actively perpetuated her isolation and convinced her that she was unlovable to anyone but him. The psychological trauma she experienced as a result of that relationship warrants some type of pu blic health response as much as Raelynne did when she was pushed down the stairs even if the specifics of the response are less emergent and the trauma less immediately life threatening This is hardly news: across the IPV literature, researchers have d ocumented that battered women themselves often cite the psychological control and emotional trauma as being worse than physical violence ( Follingstad, Rutled ge, Berg, Hause, & Polek, 1990 ; Lawrence, Yoon, Langer, & Ro, 2009 ) Bruises (generally) heal on their own, but the loss of self worth and confidence are harder to recover. Based on my interviews with women and the literature surrounding control and violence ( Emery, 2011 ; Graham Kevan & Archer, 20 03 ; Simmons, Lehmann, & Cobb, 2008 ; Tanha, et al., 2010 ) Figure 5.1 tries to build on the work of Johnson, Stark, and others to illustrate thes e potential multiple causal pathways and show how relationships grounded in a pattern of coercion or control may or may not include physical violence, and that physical violence may or may not always happen in a context of coercive control; however, both p hysical violence and coercive control have the potential to lead to similar physical and emotional ailments. I use the term "terroristic" violence to represent violence (and threats of violence) that is directly intended to control the
114 Figure 5. 1 Public Health Model of Controlling & Non Controlling Relationships victim's behaviors; this is the stereotypical image of "wife battering" and most closely resembles Johnson's "intimate terrorism" category. However, my data sug gest that within controlling relationships, violence can be used in ways that (at least initially) are not intended to reinforce the other controlling tactics; think of Connie, who was pushed into a wall once in the heat of a disagreement, or Maya, who sai d the only time her husband physically attacked her was when she was trying to protect their kids from him. 32 Shifting focus to non controlling relationships, the majority of violence I found resembled Johnson's description of situational couple violence Although Figure 5.1 shows these categories as separate and definite, my data suggest they may be transitory and mutable : what may start as a non controlling relationship can become controlling and vice versa. Over the course of Juanita's 32 This is not to say that acts of violence that start off as more "situational" in controlling relationships will not become terroristic and/or used to reinforce other controlling behaviors eventually. However, in my sample, many women left the relations hip or made other changes prior to this happening. Non-Controlling Relationships Controlling Relationships No Physical Violence No Physical Violence Physical Violence Physical Violence Negative Physical/ Emotional Outcomes No Negative Physical/ Emotional Outcomes Negative Emotional Outcomes Negative Physical/ Emotional Outcomes Situational Other Terrorism Other Negative Physical/ Emotional Outcomes Interventions With Physically Violent Controlling Relationships Should Include Lethality Assessment Intervention A Intervention B Intervention C Intervention D Intervention E
115 relationship, for example, her husband acted controlling and violent in earlier years, but as time went on, she claimed a larger share of the power, and the relationship came closer to resembling a mutual battle for control. Then, following the stillbirth of their chil d, they decided they both needed to change their behaviors, and, according to Juanita they have worked together as partners with no further incidents of violence or significant conflict. Similarly, what may start as non terroristic violence may easily de velop into terroristic violence as the perpetrator recognizes its utility. As I discuss later, one reason I may have found so little terroristic violence is because these women were able to end controlling relationships before th e violence morphed into so mething more extreme. Finally, rather than considering IPV as a single phenomenon, I am suggesting that we may need to shift our thinking and see it as a series of closely related outcomes that sometimes look alike, but that have different etiologies. The notion that IPV is not a unitary phenomenon is not new. Indeed, the premise of Johnson's typologies rest s o n the idea that common couple violence is substantively different from intimate terrorism o r coercive/controlling violence (see Chapter 6) Emery takes this a step further, observing that the level of power held by each member of the relationship is as important (or more i mportant) in defining the type of IPV as is the motivation for control: An act of violence by a more powerful partner often aims at maintaining or augmenting that power, while an act of violence by the partner with less power may express dissatisfaction with and aim at changing the prevailing power dynamic in the relationship, either to a more even distribution of power or to dispr oportionate power in the heads of the perpetrator. On the other hand if a violent act within a relationship relatively equal in power aims at changing the power dynamic, it must aim at the accrual of disproportionate power to the perpetrator. Although th ese violent acts may appear together in predictable patterns, it makes no sense to discus s them in the same terms. Acts of domestic violence have a fundamentally different meaning and probable etiology depending on whether they are perpetrated by a power of more, less, or relative equal power. ( Emery, 2011, p. 530 )
116 Unlike Emery, who limits his construct of "domestic violence" to power gained by physical force, the data from my interviews suggest that the basis for that power can rest in a partner's use of other controlling behaviors and physical force may or may not be used as a method to reinforce the control This model also suggests that different types of violence and control may require different intervention and prevention focuses (an area beyond the scope of this dissertation but one that is currently being debated and researched across disciplines). For example, if investigators find that male instigat ed violence in male controlled relationships is more firmly associated with beliefs about gender roles and male privilege than is physical violence in non controlling relationships, then different approaches to prevention and intervention would be warrante d. From a public health perspective, one of the most troublesome aspects of this aspect of the model is whether or how to respond to non control based violence that results in no physical or emotional ramifications on health. While some could argue that all violence requires some form of intervention, given its propensity to repeat or escalate into something more sever e or harmful, the need to prioritize resources may mean that very minor forms of violence, especially actions that are difficult to disting uish as violent (such as when Mary gently slugged her boyfriend in the arm at the end of a joke, or when Jackie threw a rubber spatula or spoon at her husband to get his attention) do not result in the same intensity of intervention that more severe forms of violence (either controlling or non controlling) probably do. Finally, if we are to develop effective interventions, we must come to agreement over what we mean by violence and control. Is any action taken with the intent to harm another person viol ent? What about actions that were not intended to hurt, but that have
117 that outcome? Or actions that have the potential to harm, regardless of whether that harm was intended or even if it manifests? Is violence always physical in nature, or do we include emotional or psychological harm? The field becomes even more confusing when we add less specific terms, such as "abuse," to the mix. Does "abuse" include actions that are physically violent in nature, or does it refer to non physical behaviors that resul t in harm? Is all physical violence abusive? Does abuse have to result in harm, or is a behavior abusive if it has the potential to limit the subject's agency or to result in harm? Is all abuse violent? And so on, and so on. Likewise, despite the nu mber of excellent definitions of control that have been coined, additional questions remain. Is a behavior controlling if it is not accompanied by an overt threat to physical well being? What about behaviors that could be controlling if used as part of a pattern, but not when used individually? If the behavior does not have the intended outcome of changing the recipient s behavior, is it still controlling? As researchers and program developers, we cannot design specific prevention and intervention progr ams for every individual or couple; thus, some generalizations about the nature of IPV must be made. However, without recognizing the role that power, gender, and control may play in relationships, and without examining whether or not different etiologica l factors lead to similar looking outcomes, we are likely to continue to create ineffective responses, and the ongoing physical and psychological repercussions will continue.
118 CHAPTER VI SITUATIONAL OR COERCIVE? A Discussion About Johnson and Research Qu estion 4 RQ4: Can violence in heterosexual intimate relationships as identified using the Revised Conflicts Tactics Scale (CTS2) be clearly distinguished as "situational" or "coercive/controlling" when examined using qualitative in depth interviews with p articipants? Research Question 4 refers to Johnson's efforts to quantitatively identify and categorize IPV into four separate typologies: situational or common couple violence (CCV) coercive/controlling or intimate partner terrorism (IT), violent resista nce, and mutual control, with the primary focus on CCV and IT (which Johnson argues constitute the majority of IPV). 33 As described earlier, Johnson created this framework in an attempt to illustrate that not all violent situations are the same; rather, we need to examine them "by the extent to which the perpetrator and his or her partner use violence in order to attempt to control the relationship" and that the type of violence should be defined based on the "control context in which the violence is embedd ed." ( Johnson, 2008 ) Thu s, Johnson's primary interest appears to lay in identifying the purpose of the violence. In relationships where one partner exerts a tremendous amount of control over the other, he assumes that the purpose of the violence is to reinforce that control (or, in the case of violent resistance, to resist that control). Even when both partners exhibit behaviors suggesting a battle for control (mutual control), the violence is still seen as being used in the service of gaining and maintaining the upper hand. On the flip side, 33 For the sake of developing a shorthand (and because I have used the terms "situational" and "coercive/controlling" outside of the immediate context of Johnson's categories), I will refer to these as "com mon couple violence" (CCV) and intimate terrorism (IT).
119 when violence occurs between partners who are not exceptionally controlling, Johnson assumes the violence is used in an isolated manner related to that specific situation. Relying primarily on secondary data sets that include indicators of controlling behaviors, Johnson's approach to determining whether violence is used in an IT or CCV manner has been to measure the types and amounts of controlling behaviors exhibited by both partners based on whatever control scale was included in the orig inal research. 34 Using a cluster analysis to distinguish high control from low control, he classifies the relationships: physical violence in relationships where individuals report few examples of controlling behaviors is considered CCV, and violence in re lationships with higher numbers of controlling behaviors is considered IT or violent resistance (depending on whether the controlling or controlled partner is perpetrating the violence) ( Johnson, 2008 ) When I considered informally "testing" Johnson's categorizations by using quali tative interviews, I hypothesized I would find a broad continuum of controlling behaviors and that identifying relationships in which one partner was clearly controlling would be difficult; although relationships that fall at either end of the spectrum may be simple to spot, I assumed that making sense of the power dynamics in the couples who fell in between would be complicated. Not only was I skeptical that I could easily classify the relationships into these categories, I was even more skeptical that an y quantitative scale (of reasonable size) could do any better. Because I was concerned about the length of the CTS2 combined with my additional questions, I did not include 34 For example, he completed a secondary analysis on the National Violence Against Women survey, which asked seven questions about control that were adapted from the Canadian Violence Against Women Sur vey and "closely resemble items included in the Psychological Maltreatment of Women survey. See Figure 6.1 (Johnson pg 93).
120 any of the commonly used control scales in Phase One, but I compared the verbal na rratives of my participants to the questions asked in the National Violence Against Women Survey (NVAWS), which Johnson has also used and anticipated how they might have responded based on what I knew about their experiences. 35 What I found generated more q uestions than conclusions. Although the amount of control that individuals exhibited did exist on a continuum (spanning the range of highly controlling relationships to non controlling or minimally controlling relationships), I also identified clear disti nctions between relationships that appeared to be highly controlling and those that were more equitable. What was more surprising was finding that most of the relationships I classified earlier as "controlling" based on the interview narrative could have been identified as "highly controlling" based on Johnson's cluster analysis of the NVAWS questions. 36 Using Scales To Ascertain Control Although this dissertation was not intended to specifically test Johnson's methodology or the accuracy of any of the con trol scales he refers to, it seems important to note that while this scale produced a "list" of controlling relationships that was very similar to my own categorization, a broader look at the data suggests that Johnson's approach may not correctly identify all types of controlling relationships. The most obvious example was its inability to account for cultural differences. Maya's husband did not resort to many of the behaviors described on the NVAWS control scale, but after 35 I made this determination based on information the participants shared. For example, if they described a partner calling them fat or stupid, I considered the answer to "makes you feel inadequate" as positive. 36 Johnson determined that if a participant answered three or more of the control scale questions positively, s/he was in a "highly controlling" relationship; two or fewer, and the relationship was "low control" ( Johnson, 2008 )
121 talking with Maya for just a f ew minutes, it became clear that he dictated the behaviors of both Maya and their kids. After he was previously denied a U.S. visa, he completed and submitted her application to grad school and then insisted that she go in hopes of securing a spousal visa ; initially, she did not want to move away from her children and family, but she did so to retain marital harmony. He has terrorized their two teenage boys throughout their lives, punishing them physically when they disobey his orders. Over the years, he spent much of his income on luxury items, yet always became angry when Maya complained that he was not contributing enough to general household expenses. One evening, he even created a scene of throwing his dinner in the trash (if not at Maya who appear ed to hedge at this question ) when he did not like it. It was clear from our conversation that Maya has spent a tremendous amount of energy trying to pacify his demands and/or work around them, reminding me that in India, divorce has not traditionally bee n an option. Aside from shouting at her (and causing her to feel dismissed as inadequate at times), Maya did not describe her husband engaging in any of the other behaviors mentioned in the control scale included in the NVAWS. Had this scale been used to determine high or low levels of control in a relationship, Maya's marriage would most likely have been considered to be based in a "low control" dynamic, which was clearly not the case. 37 Other participants described experiences that may or may not have b een identified by the control scale. Regan never directly stated that her ex boyfriend tried to prevent her from having access to "family income," yet he coerced her to quit her job, which 37 The psychological aggression scale on the CTS2 revealed only minor aggression from either Maya or her husband (actions which roughly two thirds to three quarters of participants reported).
122 ensured a level of financial dependence on him. Rochelle never de scribed her husband as doing more than shouting at her and making her feel inadequate, yet he continues to control the emotional tenor of the family, has frightened her enough that she leaves the house with her daughter whenever she senses he is in a bad m ood, and manages to manipulate her into sex by twisting the communication skills they learned in counseling to suit his needs. Sandra's first boyfriend threatened to commit suicide if she didn't drop everything and go see him. None of these behaviors are captured on the NVAWS control scale, suggesting that using a quantitative scale may underreport "highly controlling" relationships. On the flip side, some relationships that I determined were less controlling (based on the overall dynamic between the cou ple) might have been classified as "highly controlling" using the questions from the NVAWS scale. Raelynne's current husband, for example, has used many of those behaviors, but Raelynne refuses to put up with it. He clearly suffers from extreme jealousy, shouts at her, and has made her feel inadequate. However, as much as his behaviors anger her, only rarely do they result in her doing or not doin g something They are frequently situation specific: he has no problem with her spending time with frien ds or family, but he is extremely bothered when she goes to a bar after work because (in his mind) it insinuates she is there to pick up men. She also admitted that there were times when her own actions likely contributed to his behaviors, such as lying t o him about going out to a bar or not calling home when she stayed out significantly later than she planned. Along a similar line, Wendy's ex boyfriend certainly demonstrated the potential to become controlling, but she did not describe any type of establ ished pattern on his part, nor were her own behaviors curtailed. Although he
123 complained when she dressed in a short skirt for a college dance when he was not accompanying her, she did not change clothes; when she was offered an internship across the state he used guilt to attempt to get her to stay, but she didn't. Moreover, Wendy chose to end the relationship before any of his controlling tactics could become established patterns. Are Highly Controlling Relationships "Terroristic ? Despite these few ex amples of divergence, as I stated earlier, I was surprised to see how closely Johnson's methods resulted in the same list of "highly controlling" relationships as my qualitative analysis did. Thus, although I did find that the controlling behaviors that p articipants and their partners used fell along a continuum, I nonetheless must conclude that it is possible to discern highly controlling or coercive relationships from those that display a more equitable division of power. But does this mean that the use of violence in all of these controlling relationships is intimate terrorism? Based on Johnson's methodology, that would be the logical conclusion. However, when I stepped back from the specific control questions and began reviewing his narrative descrip tion of IT, I found that his portrait did not fit the experiences of most of the participants who had an excessively controlling partner. In A Typology of Domestic Violence Johnson (2008) lays out a strong argument supporting his theory. When discuss ing the construct of intimate terrorism he paints a picture of extreme and excessive amounts of physical, psychological, and economic control: Intimate terrorism is about violent, coercive control. The intimate terrorist uses physical violence in combina tion with a variety of other control tactics to exercise general, coercive control over his partner. This powerful combination of violence with a general pattern of control is
124 terrorizing because once a controlling partner has been violent, all of his oth er controlling actions take on the threat of violence. A look, a yell, a quiet warning, even an ostensibly benign request can have the emotional impact of a physical assault ( p. 28 ) He illustrated his definition using traditional examples of batterer behavior from the Power and Control Wheel: women who were denied bank accounts or credit cards by their husbands, who had their entire support system driven away, and who were intimidated into a state of near paralysis ( Johnson, 20 08 ) 38 The physical violence and accompanying threats reinforce the control: [He will] show her what might happen if she doesn't behave. Scream at her. Swear at her. Let her see his rage. Smash things. Or maybe a little cold viciousness will make his point. Kick her cat. Hang her dog. That ought to make her think twice before she decides not to do as he says. Or threaten her. Threaten to hit her, or beat her, or pull her hair out, or burn her. Or tell her he'll kill her, maybe the kids, too. ( p. 9 ) However, the level of intimidation, physical violence, and all encompassing daily control that the women in my sample described rarely approached this extremity. While several women acknowledged receiving constant telephone calls from their partners when they were socializing with others, none of them recalled being barraged with calls or electronic messages at work that they were expected to respond to immediately. Nobody described having to arrive home at a certain time or being denied access to money or having their lives o r the lives of their children, family, or friends threatened (aside from Regan, when her first ex boyfriend held her cat hostage and Kellsey, when her boyfriend tossed her dog outside by the scruff of its neck after it had an accident ). With the exception of Becky, who said that her first husband beat her, raped her, and denigrated 38 The Power and Control Wheel is a com monly used depiction of domestic violence often used by advocates to show how physical violence reinforces other controlling behaviors. Johnson's image was adapted from Ellen Pence and Michael Paymar's Education Groups for Men who Batter: The Duluth Mode l
125 her whenever possible, none of the other women I spoke with described living with the level of on going terror and physical fear Johnson described. 39 What did fit with Johnson 's IT definition were women's experiences with "psychological attacks designed to destroy her self confidence and convince her she has no viable alternatives to the relationship" ( Johnson, 2008, p. 27 ) Regan, Kellsey, Megan, Rochelle, Brenda, and likely oth ers were all called sluts or whores, told they were stupid or incompetent, and convinced that the disharmony in the relationship was entirely their fault. However, there was little indication that the women themselves perceived the physical violence they experienced as "reinforcing" these attacks on their mental wellbeing. Although Regan was talked into moving to a small town away from her family, harassed her into quitting her job, and convinced that she was stupid, her boyfriend's only act of physical v iolence appeared to be grabbing her once when they were arguing and throwing her clothing and belongings at her. Moreover, when he indicated he wanted to stay in that town past his contracted date, Regan told him that was not part of the deal and left. S he never sounded terrified that he would hurt her (if anything, she said that her background in martial arts made her more likely to be able to physically harm him), and while she depended on him for immediate financial and emotional support, the fact that she was able to leave suggests she had access to outside resources and the ability to earn a living on her own Yet, despite these internal and external strengths, he established a tremendous amount of control over her 39 Both Raelynne and Marisol described being the victim of multiple severe physical assaults, but Raelynne claimed she was never frightened of her boyfriend, and Marisol left the relationship after the second attack, which she said did terrify her.
126 Other women revealed similar expe riences. Kellsey's fiancÂŽ was more physically controlling than many of the other men described by the women in my sample but even then, the stereotypical pattern of threats, intimidation, and financial control were not part of her story; rather, he told her she was weak and disgusting called her stupid, and manipulated her with guilt. Likewise, Brenda said she was not actually frightened of her boyfriend, despite his occasional use of violence, but she was more concerned that he would do or say somethin g that both of them would regret. Meanwhile, he gained control of her life by manipulating her emotions: for example, by insinuating that she didn't understand what being in a relationship was about if she didn't allow him to go with her to every doctor o r dental appointment. "Mild Intimate Terrorism?" One of Johnson's arguments is that when using quantitative methods to identify IPV, IT will show up in clinical samples along with more severe examples of CCV, whereas the majority of partner violence foun d in general population samples will be minor or less severe forms of CCV. Given that my larger sampling frame was not clinical, supporters of Johnson could argue that the reason I'm not finding many examples of classic IT is because I'm looking in the wr ong place; had my sample been one that included more women whose lives intersected with domestic violence services or law enforcement (and included a less affluent population) I would have seen higher levels of violence and coercion. While I do not dis pute the validity of this statement, it does not explain why half of the twenty two women I interviewed described past or current partners who engaged in patterns of psychologically controlling behaviors. One possible explanation is that in
127 our interviews I asked women to talk about all of their most significant relationships, whereas many of the larger scale quantitative surveys ask explicitly (or implicitly) about current or "most recent" relationships only. Given that the prevalence of IPV is much hig her when examining "lifetime" rates compared with "past year" incidences, had these quantitative surveys clearly asked women who appeared to have experienced CCV only to describe their experiences in multiple relationships, they may have uncovered a higher prevalence of controlling behaviors, too. 40 A more likely possibility is that many of the women I interviewed ended the relationships before they could become the intensively controlling and violent dynamic that Johnson characterizes as IT and that res ult in women seeking services. Among the group of women who were involved with controlling men, only three remained involved with their controlling partner, and of those, only Maya and Rochelle appeared to have no intention of ending the relationship unle ss the level of violence or control increased drastically (furthermore, at the time of the interview, Maya and her husband lived on separate continents ). 41 Most women in this group indicated that the relationship had lasted less than five years, and only t hree had ever been married to their controlling partner (four shared a child in common). Domestic violence advocates often remark that, for some men, "the marriage license is a hitting license," suggesting that only after the relationship has been made pe rmanent do some men become controlling and violent 40 For example, the NIPVSVS asks participants about multiple relationships, and reports levels of psychological aggression at similar levels to my study ( Black, et al., 2011 ) 41 At the time of the interview, Brenda was still involved with her boyfriend, but described serious reservations about the relationship and thought th at talking about it during the interview might help clarify her decision stay or leave Although I do not know if she ended the relationship it sounded like she was coming to that conclusion when we parted and I referred her to a local advocacy organizat ion.
128 (Becky described that very phenomenon when referring to her first marriage) ( Johnson, 2008, p. 34 ; Stets & Straus, 1989 ) The majority of participants had high levels of education, their own sources of income, and external psychological support, increasing their ability to break off a relationship before separation became too complicated ; moreover, many appear to hold cultural expectations of gender equality While it may be impossible to prove that a particular outcome didn't happen, it seems conceivable that, had these participants remained in a relationship with their controlling partner, the co ntrol and violence could have escalated until it started to resemble Johnson's description of IT. Johnson's typologies provide essentially two options for classifying the majority of these relationships: CCV or IT; thus, if we do not consider the violen ce in these relationships to be terroristic, does that mean we must consider it situational or common couple violence? That label seems equally inappropriate: the obvious imbalance in power and pattern of other controlling behaviors makes the impact of Ro chelle nearly being hit very different from the time Ellen was grabbed by her boyfriend outside a bar or when Jackie threw a kitchen spoon at her husband. This criticism of Johnson's discrete categorizations is echoed by Emery, who makes a similar observa tion about women's violence: There is no theoretical or empirical reason to suppose that all men who possess control use violence or even the threat of violence to achieve that control. In Johnson's (2008) classification system, a woman who uses violence to oppose control by a verbally abus[ive] but non violent man must be classified as a perpetrator of situational couple violence. Yet the act bears a strong conceptual and intuitive resemblance to violent resistance' ( Emery, 2011, p. 527 ) Given the ability of in depth interviews to generate more detailed and nuanced information than quantitative surveys, it seems possible that these data point to a different
129 dynamic entirely, or possibly to the construct of "mild intimate terrorism" or "pre intimate terrorism." The differentiation in this area is ripe for further research. The Right Tool For The Job Despite my observations on the limitations of Johnson's a pproach to identifying and defining controlling violence, I am not concluding that his findings or conclusions should be discounted. When seeking to understand what violence and control look like at a population level, I agree that his methods may produce an accurate general picture of how "domestic violence" presents on a community wide level, and based on my own research, his conclusions about gender and control appear accurate. Obviously, conducting in depth interviews would be infeasible on such a lar ge scale, and understanding the nuances between "mild intimate terrorism" and more severe terrorism may be unnecessary for community level resource allocation or other planning purposes. However, if we are seeking to understand the dynamics involved with IPV so that we may more accurately describe the phenomenon in the literature and tailor clinical interventions more appropriately, then we may need to pay attention to the subtle differences in controlling behaviors that can emerge from qualitative researc h methods. In the following chapter, I provide a detailed analysis of the strengths and limitations I encountered with both approaches to IPV research, arguing that, in the long run, how we define the scope of our research must determine the methodology; anything else is the proverbial tail that wags the dog.
130 CHAPTER VII USING NARRATIVES TO INTERPRET NUMBERS Mixing Methods in IPV Research "Well, it's very different talking about something than it is checking a box. So, a qualitative chat is quite di fferent than sitting around thinking "how often did this happen, how often did that happen," so I think they are two quite different processes and I'm using a different part of my brain." (Jackie, 41) As I described earlier, my original research goals wer e "to develop a broader understanding of the types and meanings of violence as identified by the CTS2," and "to bring men's and women's voices and stories about experiences of violence to the forefront" as a way of illustrating those meanings. This chapte r highlights the ways in which using qualitative narratives to interpret quantitative instruments addresses important gaps in our current understanding of IPV and generates new questions and directions for research. Not only was I able to explore what wom en meant when they responded positively to questions about violence on the most commonly used IPV measurement tool, I also learned about events that were not captured by the CTS2, discovered differences in how women interpreted the purpose of the survey an d its questions, and, most significantly, gained a picture of the various contexts in which events took place. A direct comparison of participants' narrative stories and their CTS2 answers shows that fully half (n=11) of these women varied their response s (at least slightly) from one format to the other. Sometimes the divergences were minor (reporting moderately more or less violence), but in other cases, the qualitative data deviated substantially from the quantitative results. Whether or not these dif ferent research methods identified higher
131 or lower rates of IPV is disputable, depending on the construct of IPV used and on the interpretation of the qualitative data (which, in this case, were not intended to measure prevalence). The following chapter i llustrates how these different methodological approaches revealed distinct types of information about IPV within the group of women I interviewed. Although I detected several limitations of the CTS2 as an instrument, I argue that quantitative methods in g eneral are particularly useful for gaining a broad picture of violence in large samples of individuals, as long as the structure of the survey or scale matches the definition of IPV being considered. Moreover, I strongly believe that the qualitative metho ds I used in combination with the CTS2 enabled detection of subtle patterns of controlling behaviors that emerged in a non clinical sample, providing insight into the quantitative results. Rather than seeing these findings as contradictory, as they have s o often been viewed in the past, I argue that they are compl e mentary and are necessary to allow us to expand our understanding of relationship violence. Contradictions, Context, And Consistency When The Qualitative Didn't Match The Quantitative Becaus e I used a participant selection explanatory model for this research, I completed the analysis in a sequential manner, allowing the results of the quantitative phase to guide the participant selection and interview questions for the qualitative phase ( Creswell & Plano Clark, 2007, p. 142 ) In analyzing my interview data, I initially examined the field notes and transcripts without considering respondents' CTS2 answers; later, I included these as variables in the qualitative data, comparing what they reported on the survey t o what they stated in the interviews. Five women described using violent behaviors during interviews that were never captured on the CTS2, including two women
132 who used these tactics more frequently than reported. One woman reported perpetrating violence recently on the survey, but denied this when asked. Two others indicated they had been recipients of violence from a past or current partner, yet during the qualitative interviews, both women said that had never happened. Five women described receiving v iolence or threats of violence from a previous relationship that were never captured by the CTS2. Finally, in at least two situations, when women described an incident they reported on the CTS2, the verbal description differed from the survey (for example on the CTS2, Rochelle indicated that her husband physically assaulted her ; however, when she described this during the interview, she said that her husband tried to slap her, but that she moved out of the way). Table 7.1 provides a few detailed examples of the types of inconsistencies found between the responses on the CTS2 and the qualitative data. What Table 7.1 does not adequately show is the differences between some women's CTS2 responses and the level of non violent control that existed in those re lationships. Kellsey is probably the most extreme example of this. Looking at her CTS2 responses, she appears to be an extremely violent person: she was both recipient and perpetrator of multiple forms of minor and severe physical violence and she was t he sole perpetrator of other forms of minor physical aggression However, as she described her ex fiancÂŽ, it became clear that he used numerous physical and emotional control tactics against her that were not captured by the CTS2, including holding her do wn against her will or tickling her well past the point she told him to stop.
133 Table 7.1 Examples of Inconsistencies Between Qualitative and Quantitative Results Name Quant: Perp Quant: Receive Interview observations that di ffer or were not revealed on CTS2 Regan Minor Physical Minor sexual Severe sexual Minor physical Recent BF very controlling Shoved recent BF b/c she wanted to leave room R oughhoused" w/ multiple BFs, including recent Raped as teenager but not by past two BFs ; Separation violence w/ old BF CTS answers cover multiple relationships Raelynne Minor physical Severe physical Spit at old BF ( unreported minor physical) Minor physical violence with current husband Minor and severe violence with past BF Past BF extremely violent and controlling Juanita Minor Physical Minor Sexual Severe Sexual Minor Physical Severe Sexual Described perpetrating more violent acts than captured by CTS (e.g. threw frozen chicken at husband). Rochelle Minor sexual Severe Sexual Minor Physical Severe Physical Shov ed chair into husband's s hin while physically fighting; Said that husband's slap (the incident she referred to on CTS2) did not connect, but emphasized fear and feeling of threat; Husband extremely sexually manipulative using guilt Husband controlling Ma ry Minor physical Minor Sexual Not in controlling relationship Husband did not throw vase, but accidently knocked it Consensually agreed to sex although it was not desired Becky Minor Physical Claimed she has never used physical violence against curren t husband; Ex husband was extremely violent (pushed her down stairs, etc.). Never described using physical violence against ex husband. "Something About That Must Have Convinced Me That's All You Wanted..." One of the earliest discoveries in the inte rview process was the multitude of ways in which women interpreted the language on the CTS2. Throughout the survey, respondents were asked to distinguish between events that occurred in the past year and
134 those that occurred before but prior to the past ye ar. 42 However, the published CTS2 instructions provide no parameters on how far into the past respondents should try to remember or whether they should limit their answers to events that happened only with their current or most recent partner or whether the y should consider their entire relationship history (Straus, et al 2003) After the first few interviews, it became apparent that different participants used different reference points. At least three women whose CTS2 results suggested they had perpetr ated but not received violence disclosed stories about earlier partners who had been physically violent against them on multiple occasions. Other women clearly referenced experiences from multiple relationships, including Regan, a woman in her thirties wh ose CTS2 score included information about a sexual assault that happened when she was a teenager rather than with a recent partner Despite repeated reminders about the timeframe in which that event happened, some respondents referred to incidents that h appened long ago when reporting "past year" events, suggesting that the ability of the CTS2 to provide an accurate "score" for past year violence in this group may be compromised. In some situations, this may have been a simple inaccuracy of memory, parti cularly when events occurred in the same relationship over a number of years. However, when I sought clarification of the timeline with three participants, they all said that at least one of the incidents they had marked on the CTS as happening in the pas t year had actually occurred several years in the past with a different partner. For example, according to her CTS2 answers, Connie had been shoved twice in the year before she completed the survey, when she had been dating one 42 In addition to laying out the timeframe in the introductory instructions, the on line version I used included a reminder of the timeframe in the wording of each answer.
135 particular man; however, wh en I asked her about those two times, she said that only one of those incidents happened with this recent ex boyfriend, and that the other incident took place a long time ago when she was married to her first husband. While it's possible that the inconsist encies related to time could be caused by recall bias during the interviews (meaning the CTS2 responses were more accurate because they were completed closer to the time of the event) the frequency of these inconsistencies combined with the observation tha t different women used different timeframes and relationship parameters in their responses raises some concern over the accuracy of any interpretation of CTS2 results without further explanation. The CTS2 was designed to calculate a past year violence sco re based on the reported frequency of the events as well as a longer term prevalence score that counts whether or not an event has ever happened, even if it was longer ago than the past year. Given the inconsistencies in how women answered these questions I question the accuracy of either score. Not only could past year scores be an over estimate (e.g., when respondents counted every event as "past year" even when it happened years earlier), but lifetime prevalence scores would be affected if some women limited their responses to a single, most recent relationship and others included events that happened with multiple partners over the course of their lifetimes. This is not necessarily a flaw of all quantitative surveys measuring IPV. The recent NIP SVS is a random digit dial land and cell phone survey of over 18,000 men and women across the United States. Like the CTS2, the survey included behavior specific questions that assessed physical and sexual violence, as well as stalking behaviors and psych ological aggression. Unlike the CTS2, however, violent events were
136 linked to individual partners ( Black, et al., 2011 ) In addition to allowing researchers to gather information about perpetrators, by asking participants to think about the events that happened with each partner, it is likely that the timeline of even ts is more accurate and that recall is more complete. Including What Wasn't Counted Not only did the qualitative interviews allow me to sort out what events happened, when, and with whom, but I also learned about numerous incidents of physical or psycho logical aggression that were never reported on the CTS2. For example, because Marisol limited her CTS2 responses to her current relationship, in which she has been the sole perpetrator of violence, the only way I learned about an ex boyfriend who had been severely violent towards her (including attempting to strangle her when she refused to give him money) was by following up with an off handed comment she made about dating a few "champs." While her experience as a victim in one relationship does not neg ate her perpetration of violence in the other, by learning about both relationships I gained a more comprehensive picture of Marisol and of some of the factors that may have influenced her behaviors. Depending on how the data are being used, this may be m ore or less important to know, but if participants are classified for life as "victims," "perpetrators," or "both" based only on the survey findings, the overall picture of the sample may be inaccurate. Across the sample, seven of the twenty two interview ees mentioned violent behaviors (either their own or a partner's) that were not reported on the CTS2. Some, like Brenda and Rochelle, reported their partner's actions towards them on the on line survey, and I only learned about their own violent behaviors towards those same partners
137 during the interviews. Others indicated that violence had occurred, but underreported the amount. For example, Juanita's CTS2 answers acknowledged grabbing her husband once; however, during the interview, she recounted punchi ng him in the face because he would not let her leave a room and hitting him with a frozen chicken she threw at him from across the room. Likewise, Brenda's CTS2 answers suggested that her boyfriend grabbed her twice in the last year, but as she narrated the details of the relationship, it became clear that he had grabbed her more than twice over the course of the relationship (and probably in the past year). Whether this underreporting is due to recall bias when completing the survey or other reasons ent irely (see below), the information that was left out changes our understanding of the violence that was reported. Finally, no written survey could ever capture the variety of ways that violence can manifest. Although the response options on the CTS2 iden tified the majority of events participants relayed in person, at least three women described violent incidents that had no comparable answer on the CTS2, and thus were left out. For example, Kellsey 's CTS2 results paint her as the more physically aggressi ve partner. However, in person, she described how her ex fiancÂŽ used to hold her down against her will, would not cease tickling her when asked, and trapped her in blankets until she cried; when these events are included in the mix, the situation looks ve ry different. The time Rochelle shoved a chair into her husband's shin while they were fighting and Raelynne's decision to spit in her boyfriend's face could be seen in a similar light. In all three examples, the actions may not have been seen as serious or even violent, yet all formed part of a larger pattern of behaviors that should be examined comprehensively to fully understand or even measure violence.
138 Context And Control Context is critical. When the researcher and the respondent perceive the mean ing of a question differently (or when the researcher assumes that all events involving the same behavior are the same), data can easily be misinterpreted or missed. For example, because the CTS2 is contextualized as a survey inquiring about everyday conf lict between partners, when Mary reported that she had never hit her partner, she may not have even considered the playful punch on the arm that she gave her husband at the end of a joke as relevant, since it was not perpetrated as part of a "conflict." H owever, if a researcher wants to know about any type of forceful physical contact regardless of its perceived nature (which appears to be the case in some of the Family Conflict literature), then Mary's punch would be missed, and the researcher's data woul d not tell the story s/he was looking for. 43 Although that particular omission may be of minimal concern, a more critical example of contextual confusion might be Mary's answer to having an object thrown at her. Although her CTS2 score indicated that her husband had done this, when I asked her to describe the situation, she relayed a scenario that was very different than what I imagined. Although the event was part of a conflict, she described her husband as madly gesturing with his hands, knocking a vase over and sending it flying across the room at her. She was clear that she did not think this had been intentional, but without that clarification about the context and details of situation, I could easily have assumed that her husband had purposefully th rown something at her with the intention of hurting or scaring her. 43 It may be equally problematic if the researcher does not consider this ty pe of hitting to be violent, but the participant answers positively. Hamby, one of the authors of the CTS2, acknowledged that this type of "false positive" is a likely source of error with the survey, and admitted that may be more common among women than men ( Hamby, 2009 )
139 Because this research focuses on understanding the meaning of and context behind specific violent events (rather than centering solely on the violent event itself), digging below the surf ace of answers is essential. One of the clear findings from this study has been the recognition that behaviors that appear to be the same can differ in terms of gender, power, and other characteristics, yet if we rely only on a written survey or only on i nterviews with a few individuals, we miss this complexity. Both Katrina and Regan indicated that they pushed or shoved a partner on their CTS2 responses; in both cases, those were the only acts of "perpetration" that either listed. However, by asking eac h woman to describe the event in question, it became apparent that the two incidents were hardly similar at all. When Katrina shoved her husband, it was because he made a loud and annoying noise and she responded by getting upset, shoving him, and leaving the room. But when Regan shoved her ex boyfriend, it was in the context of an extremely controlling relationship and in direct response to his standing in the doorway and not allowing her to leave the room. Regardless of whether someone is ever "justifi ed" in pushing or shoving another person, what comes out of a deeper examination of these two events is how they may look similar, but have very different meanings and, most likely, require very different intervention strategies. The women I spoke with d escribed a vast array of non physical actions that both they and their partners used, shedding light on the power dynamics that underlie the relationships. Kellsey described her boyfriend becoming upset and using guilt if she wanted to read during a long car ride; Regan was coaxed into moving far away from friends and family; and several participants were told that they didn't understand "love" if they did not want to include their partner in every aspect of their lives. Others recalled
140 being asked for th eir opinions and then ignored, being told that they were lucky to be loved, and being called a whore and a slut. Rochelle described the way that her husband would yell at her, bringing up one problem after another and never allowing her to deal with the f irst before bombarding her with the second and the third. Regan's boyfriend convinced her that their relationship troubles stemmed from her inability to communicate. Likewise, women described their own non vio lent but controlling b ehaviors: threatening t o cut up a husband's ATM card, demanding that he stop socializing with friends, or accusing him of not loving her because he wasn't around when she was upset. By asking participants to tell the stories of their relationships and not just about the vio lence I identified other elements of the relationship that place the violent events in a larger context. Joanie, who has a history of hitting and throwing things at her husband, described herself and her husband as having passionate tempers, but also re called how they look out for each other, respect each other's feelings, and work together to raise their kids in a loving home. As inappropriate and potentially injurious as Joanie's behaviors have been, they appear to differ in meaning from Marisol's, wh ose need to hold on to her husband was so strong that she hit and threw things at her husband if he walked out of the room during an argument or if she felt threatened by another woman's friendship. Brenda, who also hit and shoved her boyfriend, did so on ly after being grabbed forcefully and blocked from leaving the room during fights, which were often about whether she would go to a doctor's appointment alone or see friends without him. In all three examples, the violence itself was the same (hitting and /or throwing objects at), but the non violent behaviors formed a context that drastically changed the meaning of those behaviors. Without understanding these contextual details, all three
141 women would receive the same categorization label: perpetrator. "Ar e You Sure You Have The Right Survey?" Finally, there were a few participants who appeared so surprised to learn that they had responded positively to a question about violent behavior that the only explanation seems to be simple respondent error. In thr ee separate situations, when I asked a participant about a particular incident she reported on the CTS2, she stared at me with a puzzled look and responded with some variation on the question I said that?" For example, Lauren was stunned when I told her she had reported being in a relationship where she had been grabbed, and where she and her partner yelled and swore at each other. (L) I'm just thinking, uh, of any relationship where I would have characterized it as yelling and insulting and swearing at t he other one. (AV) Okay. (L) I mean, I had a, the only thing, it wasn't a relationship. The only time I've ever been really sworn at was by a roommate. And I didn't swear back at him. So that's just what I'm like. (Lauren, 49) In Lauren's situation, it wasn't just that she denied using or receiving violence, but she denied being involved in any relationship where physical or psychological abuse existed. Jackie was equally puzzled when I asked her about the time her partner tried to strangle her "Are y ou sure you have the right survey?" she asked. In some respects, these outright denials are the most confusing. Although it is possible these are instances of recall bias, it seems unlikely that someone would forget an experience as severe as attempted strangulation. It's also possible that the women who denied these events simply did not want to discuss them in person; one of the documented advantages of on line surveys (especially when compared to in person interviews) is the sense of anonymity, part icularly related to sensitive topics ( Bowling,
142 2005 ; Duffy, Smith, Terhanian, & Bremer, 2005 ; Parsons, 2007 ) However, each of the three women who had no idea why they responded as they did on the CTS2 had been up front and detailed about other aspects of their relationships, including situations that pa inted them in a less than flattering light. For at least one participant, carelessness appeared to combine with the survey format to result in several false positive responses. As someone who tries to help other researchers, Jackie said that she had alre ady completed four other on line surveys that morning prior to taking the CTS2. While survey exhaustion may be a factor regardless of the number of questionnaires completed in a sitting or whether they are administered on line, using pen and paper, or ver bally, the ease with which computers enable researchers to reach large numbers of people may increase the likelihood that participants become over saturated with questionnaires. In Jackie's case, this seems like a strong possibility, and should be kept in mind when analyzing future data gathered through on line mechanisms. Additionally, although many experts conclude that web based and paper based surveys provide comparable results, there is some indication that on line surveys may be more susceptible to m easurement errors simply because of the nature of the on line format ( Greenlaw & Brown Welty, 2009 ; Leung & Kember, 2005 ; Manfreda, Batagelj, & Vehovar, 2002 ) Aside from the ease with which individuals with no survey development training can create them, the ease with which participants can complete th em also becomes problematic. As Manfreda ( 2002 ) observed, Internet users tend to read the screen quickly, scanning the survey "with their fin gers on the mouse ready to click on through to the next thing," making it easy to select an answer in error. Later in
143 the interview, Jackie admitted that she completed the survey quickly and may not have read the questions carefully; for example, when I as ked her about throwing objects that could hurt, she thought for a moment, and then said, "I might have skim read it and not read, at each other.' I might have read have you thrown things.' Yea, I've thrown things, including my temper" Another indication that her response might have been accidental was the location of her incorrect answers: in each case, the response Jackie selected was listed immediately above the answers she said she meant to select, increasing the likelihood that her efforts to finish quickly resulted in her inadvertently clicking on the wrong answer. Whether or not this explains other participants' errors is unclear, but after learning about Jackie's tendencies, I began to ask other participants about their survey completion habits, a lthough nobody else admitted to completing the survey in Jackie's record speed. Considering Multiple Perspectives Standpoint theory reminds us of the importance of understanding the events we study as more than "behaviors" reported by impersonal research s ubjects, but as the experiences of individuals. It also reminds us that our own biases and preconceptions may influence how we understand those experiences, and that as researchers, we have the power to assign meaning to events, even when they are not our own. If Wendy's interpretation was that her boyfriend grabbed her only because he wanted her to stay and finish a discussion and not as a threat, then I have a responsibility to Wendy to acknowledge her perspective, even if I believe the behavior was con trolling threatening, and inappropriate. Although my ultimate conclusion about the nature of that exchange may not change at all, by considering Wendy's perspective as I form my own, my
144 conclusions are based on a more comprehensive understanding of the s ituation, and with a conscious recognition of the power I hold to assign meaning to someone else's experience. Furthermore, feminist standpoint theory suggests that all knowledge is "socially situated," and that we cannot truly understand someone's ex perience without seeing and hearing it from her own perspective; "r esearch must begin from concrete experience rather than abstract concepts" ( Swigonski, 1994, p. 4 ) This is a particularly important construct when considering the role of power between men and women in general and in heterosexual IPV in particular. As someone outside of Regan's relationship, I could easily view her decision to quit her job as a sign of weakness and wonder why she could not see how controlling her ex boyfriend was. However, this perspective is void of any consideration of the reality that Regan was living at the time: she was alone in a small town having gone a gainst the wishes of her family to be with her boyfriend. Additionally, she was convinced (based on her historical experiences and her boyfriend's constant comments) that she was responsible for the problems, that she did not understand how adult relation ships functioned, and that she was lucky to have this boyfriend at all. As the dominated member of the relationship, she may have been unable to see the control exerted by her boyfriend at the time, but by granting her the opportunity to describe her exper iences, we can gain a more complete picture of the situation. By taking the time to try to see the situation based on the reality she was living (rather than our own perspective on that reality), we have a more comprehensive picture of those events and th e meanings behind the behaviors that accompanied them.
145 This approach has implications beyond the interpretation of data. Even if Jackie's actions meet the technical criteria for violence she clearly did not consider throwing a kitchen spoon at her husb and as being violent; she merely wanted to get his attention so that he would "wake up and stop reading the newspaper." In all likelihood, Jackie (and probably her husband) would laugh off any standard "domestic violence" intervention based on this inciden t. Quantitative surveys rarely if ever allow for this level of interpretation, yet to create effective prevention and intervention strategies, we must be able to acknowledge that events can be interpreted or experienced differently, depending on the p articipants involved, the context of the actions, and the perceptions of both the perpetrator and recipient. Strategies that are only based on the viewpoint of the individual designing or running them run the risk of missing the needs of the participant(s ). The Place Of The CTS/CTS2 In IPV Research Earlier in this chapter, I highlighted numerous examples of contradictions between what participants said in interviews and what they reported on the computer based version of the CTS2. In many respects, thi s surprised me; according to the authors, the scales all have relatively high reliability scores (ranging from Cronbach's alpha of 0.79 for the psychological aggression scale to 0.95 for the injury scale) and have been validated through use in hundreds of studies in a wide variety of populations and communities ( Straus, et al., 2003 ) Admittedly, in several cases, the differences were minor and would not have altered the overall prevalence of violence when the responses were aggregated within and across individuals (for example although Juanita reported engaging in several minor physical altercations with her husband that were not included
146 on the CTS2, because she reported at least one incident, her status as a perpetrator would not change). Moreover, given that there was no d etectable direction in which the data were skewed, when used in large samples, some of the errors I detected are likely to "even out" in the end. However, several themes emerged that lead me to question our ability to understand and interpret the results that emerge from the CTS2. Previously, I showed that the inconsistencies in women's understanding of the time frame parameters led to some women limiting responses to their most recent partner while other included events that occurred across multiple rel ationships; this alone raises questions about the accuracy of prevalence data, particularly outside of past year incidents. 44 Even if we assume that these inconsistencies balance out over large samples, we are left with the question of what these numbers a ctually signify. Do they represent women's experiences in their most recent or current relationship, or do they reflect occurrences across the lifetime? Moreover, although past year data include information about frequency of incidents, long term data ca nnot not differentiate between events that happened a single time and those that happened frequently, forcing us to give one time incidents the same weight as multiple ones. In addition to the limitations imposed by the structure of the survey, several individual questions are worded in ways that can be interpreted in significantly different ways. Two questions on the minor sexual coercion scale stood out as particularly 44 The prevalence of past year violence may be more accurate because recall bias is limited and in many cases, the past year relationship is also the most current one. Although I detected at least one woman whose past year answers included violence from a p revious relationship, that may have been a chance finding. However, I still question the a ccuracy of the incidence scores.
147 problematic. While some women who responded positively to questions about engaging in sexual acts when they didn't want to (but were not forced) recalled specific times when their partners used overtly manipulative tactics to coerce them into having sex (such as telling them it would be their fault if they ended up divorced), other women described situations in which they had negotiated, but consensual, sex. For example, both Lorraine and Sandra (who answered this question positively) admitted they have little sex drive partially due to antidepressant use, but both maintain sexual relati onships because they recognize that this level of intimacy is important to their husbands. Likewise, when asked about being made to or making a partner have unsafe sex nobody who said this had happened could describe a specific incident, although a few sa id this was something they eventually negotiated because their partners didn't enjoy using them or because one or both partners were interested in sex when condoms were not available. None of the participants suggested that they or their partners had enga ged in intentional reproductive coercion, or even that they felt unable to refuse their partners' requests. Admittedly, these questions were among the most sensitive that I asked, and many women appeared uncomfortable by them; it is possible that they un deremphasized the coercion that was involved in these situations for various reasons. In at least three cases, however, positive answers to one or both of these questions were the only indication of physical violence or sexual coercion that emerged from t he CTS2, and in all three situations, the participants described sexual relations that were negotiated, but clearly consensual. Thus, the question arises as to how accurately these specific questions reflect the construct of sexual coercion, particularly in the absence of other signs of victimization.
148 Despite these limitations, the authors of the CTS/CTS2 have provided researchers with one of the first models for asking about experiences with relationship violence (particularly physical violence). The survey uses non judgmental and descriptive language, and the inclusion of questions about negotiation skills helps to normalize the questions about violence and injury. In recent years, however, the depth of research in this field has grown, as has the nee d for more nuanced approaches to measuring violence. As I describe in greater detail below, the CTS2 was not designed to measure controlling behaviors within relationships (although several of the questions on the psychological aggression scale ask about controlling behaviors) nor can it describe the amount of violence that occurs with individual partners or patterns of violence with the same partner. Additionally, new examples of physical and sexual coercion have emerged from the literature that had not been identified when the CTS2 was introduced in 1996, including reproductive coercion and controlling behaviors that are greatly facilitated by new technologies. Thus, while the CTS2 may continue to be a useful research tool for questions related to th e general use of violent behaviors in intimate relationships (and extremely useful as a clinical instrument) it may not be appropriate for use as a stand alone method if we are interested in understanding the patterns of relationship violence that are com mon in communities and specific populations. Newer instruments such as the National Violence Against Women Survey and, most recently, the NSIPSV, have incorporated modified versions of the CTS scales into more comprehensive tools that inquire about other controlling behaviors, outcomes beyond physical injuries, and the use of technology. Moreover, these instruments are structured so that individual events are
149 associated with individual perpetrators, allowing researchers and planners to more accurately lin k the level of violence and patterns of control to negative outcomes as well as providing participants with a structure that may help t o reduce recall bias and error. The Bottom Line: A Discussion On Qualitative, Quantitative, And Mixing Methods In IPV Res earch As I was in the process of writing this chapter, one of my advisors asked, W ould it be possible to ask a straightforward research question such as what is the prevalence of IPV or what is the relative percent of IPV com mitted by women compared to me n a nd show how substantive conclusions differ when using quantitative verses qualitative methods?" In a reflection of my non committal nature, my first thought was N o way!" and my next was W ell, it depends." The bottom line is that our ability to meas ure prevalence or incidence of IPV depends as much on how we define that variable as on the specific methodology used. If we stick with a very incident based definition, such as "IPV is any physical or sexual violence that occurs between intimate partners ," then it seems possible to count the number of violent events that respondents report, whether the method used is a standard survey or in person interviews. For example, setting aside the fact that my interviews were not designed to assess the prevalenc e of violence (and may not include all the experiences participants have had), according to the CTS2, thirteen of the twenty two women in my sample (59 percent) said they engaged in physical violence against an intimate partner at some point in time. Howe ver, when I asked each woman about those experiences, I found one person, Becky, who had no idea why she checked that box on the survey and said that the experience never happened. On the face of it, it seems likely
150 that this was simple misclassification due to a participant error when completing the survey and that in this case, the CTS2 overestimated the amount of violence that the women in the sample perpetrated. However, over the course of the interviews, I heard several women admit to violent acts th at were not captured on the CTS2, including four women who described hitting or grabbing their partner, despite reporting no history of physical aggression on the CTS2. Thus, if we merely focus on counting the number of women who admitted to ever using ph ysical violence, the prevalence identified through the in person interviews was actually higher than that revealed by the CTS2. However this conclusion is meaningful only if we are defining all types of violent behaviors as "IPV" regardless of the context of power and control within the relationship. If we are instead concerned with violence that is used as one part of a pattern of controlling behaviors intended to gain and maintain control over an intimate partner, then we see an extremely different pict ure. For example, of the four women who described engaging in violent actions but who were not identified as violent by the CTS2, one of them was Mary, whose sole incident of violence was playfully hitting her husband at the end of a joke. This hardly re flects the type of situation most of us would consider aggressive, much less violent. The other three women all used physical tactics within the context of a male controlled relationship: a) Raelynne, whose violence consisted of spitting on her boyfriend afte r he spit on her; this same boyfriend had hit her and pushed her down the stairs on previous occasions, and went on to beat her badly enough that she regained consciousness in an ambulance.
151 b) Rochelle, who used her foot to drag a chair into her husband's shi n when they were "tussling" over a thermos; previously, this husband's reaction to her refusal to finish some gardening caused so much fear that she ran from the room, locked two doors between herself and her husband, and thought she might need to call 911 c) Brenda, who admitted to both hitting and shoving her boyfriend, but only directly in response to him on occasions when he forcefully grabbed her arm or blocked her from leaving a room during an argument; at least once, he left bruises where he grabbed he r, and another time he twisted her arm because she had possession of the television remote. Thus, in all four of these situations, the women who described using physically aggressive behaviors against male partners were most likely not primary perpetrators of IPV. Figures 7. 1 and 7. 2 show the accuracy of the CTS2 at identifying women's use of violence and receipt of violence (based on interview data) and illustrate how much of the violence happened within male controlled or female controlled relationships. Even if we look only at female perpetrated violence that was reported on the CTS2 (Figure 7. 1 ), roughly one third of those described these events as occurring within the context of male controlled relationships; when asked to describe the specific incide nts, two of these women (Kellsey and Regan) described situations when they shoved a partner out of the way only after they had been physically blocked from leaving a room during a heated argument. Of the remaining eight women, six were clearly violent aga inst non controlling male partners in situations that reflect Johnson's description of "situational
152 Figure 7.1 Women's Perpetration of Violence Figure 7.2 Women's Receipt of Violence Total Sample N=22 Interview Not Confirm n=2 Interview Confirm n=2 Interview Indicated Incident Violent n=12 Unreported, 2 nd incident, male control n =1 Male Control n=2 Male Non Control n=5 Male Control n=7 CTS2 Positive n=18 CTS2 Negative n=4 Error n=2 Interview Indicated Incident Not Violent n=4 Total Sample N=22 Interview Not Confirm n=4 Interview Confirm n=5 Interview Not Confirm n=1 Interview Confirm n=12 Male Non Control n =1 Male Control n =3 Male Non Control n =8 Male Control n =4 Female Non Control n =6 Female Control n =2 CTS2 Positive n=13 CTS2 Negative n=9
153 violence," and the remaining two (Karen and Mari sol) were clearly the primary perpetrators of a pattern of physical and emotionally controlling behaviors. Looking at the prevalence breakdown in this way, we see two women who could be considered primary perpetrators of IPV (9%), seven women who responde d violently to controlling male partners (32%), and seven women who engaged in non controlling physical violence (or "situational" violence) (32%). This breakdown has a very different meaning than merely saying that 73 percent of the women (n=16) were eve r violent against male partners. These differences are equally valid when analyzing women's receipt of violent behaviors. On the surface, it appears that the CTS2 overestimated women's reports of violent victimization (Figure 7.2). Of the twenty two wome n in this qualitative sample, eighteen said on the written survey that they had been recipients of male partner violence. When interviewed, two of those eighteen (Jackie and Lauren) indicated they marked that answer in error, but two other women (Marisol and Becky) who had indicated no experience with physical victimization had, indeed, been on the receiving end of severe violence from an ex husband and an ex boyfriend (suggesting that the overall prevalence of receiving violence remained the same at 82 pe rcent). However, when looking more closely at the participants' descriptions of the violence they reported on the CTS2, one woman (Mary) stated that she didn't think her husband had actually thrown an object at her intentionally, but that he had knocked i t off the table when waving his arms in the middle of an argument. Additionally, three other women reported that their only experience with victimization were incidents of minor sexual coercion (as described above), and when questioned about those inciden ts, all three described scenarios where
154 sex was not desired or when condoms were not readily available, and all unhesitatingly said the sexual acts themselves were wholly consensual. However, one of these women (Sandra) said that she completed the CTS2 wit h her current relationship in mind, but revealed that in her late high school and early college years, she was involved with a boyfriend who both hit and punched her on occasion. Thus, rather than eighteen women ever having been on the receiving end of vi olence, fifteen women were confirmed to have been physically assaulted (68 percent). Looking closely at these fifteen women, ten described the same men who used physical violence as also engaging in patterns of other controlling behaviors, and one woman (Karen) admitted that she was the primary aggressor, and that her husband's violence was generally in response to her own attacks. Only four of these women described being on the receiving end of situational violence that was not part of a larger pattern of control. In other words, 18 percent of the sample had been the recipient of situational violence, 5 percent of the sample received violence that was perpetrated in what they termed as self defense, and 45 percent of the sample had been victims of phys ical violence that was part of a larger controlling relationship. I should emphasize that at least one large caveat surrounds the above analysis: as I mentioned earlier, the interviews I conducted were not intended to measure the actual prevalence of v iolence in the sample but rather to explain the circumstances surrounding incidents that were reported on the CTS2. While I do not believe that any of the participants blatantly fabricated events, the conversations may not have included all of their expe riences. Even when I asked women if they could think of any examples of times when they or their partners had pushed or shoved or grabbed the other, I did not do
155 so with the intention of precisely counting each incident. I did not deliberately ask each o f them to consider every relationship chronologically or present them with a calendar that might have improved the accuracy of their memories. Rather, I focused on understanding the dynamics surrounding their primary relationships in general and the relat ionships that encompassed the events they referred to on the CTS in particular. What I think this exploration does illustrate is the importance of recognizing the strengths and limitations of different research methodologies. In this case, although it might be possible to ascertain IPV prevalence using either qualitative or quantitative methods, the exact nature of what is being measured must be clearly laid out from the start, and any approach must be designed to answer the question specifically. Usin g qualitative means, I might have been able to provide a precise count of the experiences of my participants had I asked different questions and included techniques intended to increase the accuracy of their memories. Likewise, using quantitative means, I may have been able to determine the level of other psychologically aggressive and controlling behaviors and identify those with higher levels of partner control, if I had included appropriate and validated questions such as the NIPSVS does and used a simi lar approach as Johnson to identify "controlling" and "non controlling" indicators. Scientists who hold extremely positivistic views may argue that when different methods generate different answers to research questions, one of those approaches is by def inition flawed and the findings invalid. However, what seems more important than whether we get the same results using different methods is whether or not the methods we choose are appropriate for answering the questions at hand. In the case of IPV resear ch, we should ask ourselves what aspect of IPV are we concerned with, why, and
156 how do we intend to use the findings once we are finished. For example, if we are concerned with large scale public health or law enforcement planning and/or policy development then quantitative instruments may provide extremely useful information at a population level, even if they are not precise at an individual level. I nstruments such as the NIPSVS may be able to provide us with data that are generalizable enough to apply to communities and nuanced enough to suggest the types of prevention and intervention strategies that should be implemented. In fact, quantitative methods likely accomplish these goals with more efficacy and more effectively than most qualitative metho ds can. In general, qualitative research is time consuming, involving direct contact with individuals or groups (and including all the "messiness" that comes with this) and entailing extensive analytical processes that cannot be completed using mathematic al formulas. In order to gather enough data to be able to make accurate assertions about the prevalence or incidence of violence on a community level, thousands of hours could be spent conducting interviews or focus groups and sorting the data carefully e nough that specific behaviors could be accurately categorized and counted. Qualitative methods, on the other hand, are extremely useful for understanding the meaning of these quantitative findings. In this research, for example, I was able to show that lumping together all violent behaviors such as the CTS2 does may tell us how many people are grabbing or shoving a partner, but tells us nothing about why people do that, what responses might be appropriate, or if any response is even needed. 45 45 I should stress that my research on its own does not suggest specific intervention strategies, but rather substantiates the need t o approach different types of IPV from different intervention perspectives.
157 Furthermo re, by asking narrow questions designed to detect these nuances, we can inform future quantitative research: rather than looking only at violent acts, we need to find ways to differentiate between types of violence. At the very least, qualitative findings like these can illustrate the limitations of quantitative work, not in order to invalidate it, but so that it can be understood within the context of its design. Additionally, if the intention of a study is to make determinations about individuals on a smaller scale level, then qualitative methods may generate more accurate information. As my research revealed, surveys that may provide statistically sound information when large numbers of results are aggregated can be subject to error at the individual level. Thus, if my goal is to understand the experiences of a class of 50 students, I may be able to elicit more authentic information through interviews that allow me to confirm responses and probe for additional information. Clinically, this is partic ularly important when assigning individuals to intervention programs or even determining the types of services that should be made available in a specific school or organization. Finally, we need to recognize that the nature of an issue as complex as I PV requires us to use these methods cyclically, allowing each to inform the other. Just as the CTS2 has been criticized for its narrow focus on violent acts, when qualitative research is conducted in isolation from the larger picture, investigators are eq ually likely to miss the forest for the trees, particularly when we focus on extremely narrow questions or topics. On one hand, we need to be able to quantify the scope of the problem: how many people use violence? What types of behaviors do they enact? How many people are injured? What are the large scale consequences? This provides the larger context in which more
158 nuanced questions can be asked: is all violence the same? Do men use violence for different reasons than women? What are the differences and how might these inform prevention strategies? Each methodological perspective must use the discoveries of the other if we intend to develop enough of an understanding of IPV to ultimately develop effective prevention and intervention strategies. I n terms of my specific questions about gender, violence, and control, the use of mixed approaches illustrates this methodological synergy. At the heart of the Family Conflict perspective is the argument that heterosexual IPV is very common and that women are responsible for as much of the violence as men. Taken at face value, many of my findings support this: the CTS2 data show high levels of experience with partner violence (even in this well educated professional community) and indicate that women perpe trate a substantial amount of that violence. Moreover, the qualitative findings suggest that a substantial portion of female perpetrated violence is not done in clear self defense, and much of it occurs in the absence of a controlling male partner. On th e flip side, this research also provides strong support for feminist theorists who claim that men's violence against women is inherently different from women's violence against men due to the gendered inequities in power: half of the women I talked with de scribed relationships in which their male partners engaged in a pattern of controlling or coercive behaviors, and when these women discussed their own use of violence, it was often in response to these control tactics. Additionally, men were substantially more likely to engage in controlling behaviors compared to women: over half of the men who used violence against a participant engaged in this controlling pattern of behavior (n=10), whereas only two women described their own patterned use of control.
159 By using the same individuals in both phases of this research, I have attempted to address two primary points of divergence between the two perspectives: the generalization that feminist research is based only on the most extreme examples of IPV, and that family conflict research merely counts violent acts without contextualizing them. In choosing my interview participants, I selected women whose CTS2 responses indicated high levels of violence (in terms of severity, type, and frequency) as well as those w ho reported low levels of relatively mild violence. By then contextualizing those responses, I concluded that in many cases, the CTS2 responses appear to accurately describe the levels of violence and control in relationships, but that in other instances they did not. For example, Katrina, Wendy, and Ellen reported single examples of mild acts of violence, and the data from the interviews suggest that these were, indeed, minor incidents in generally non controlling relationships; likewise, both Karen and Marisol reported perpetrating extremely high levels of violence against male partners, and the interviews confirmed that they had both engaged in patterns of extremely controlling and violent behaviors. In contrast, Connie only reported being pushed and g rabbed one time, but a closer look at the relationship revealed a very controlling male partner, and while Jackie's CTS2 responses indicated she had been a victim of attempted strangulation, in person she admitted that was an error and that her only experi ence with violence was the time she threw a kitchen spoon at her husband. In conclusion, I believe that the combination of quantitative and qualitative methods has enabled me to take a small step forward in filling the gap between feminist and family conf lict theorists. In the following and final chapter, I will discuss both the
160 strengths and limitations present in this research as well as outline possible directions for future research that emerge from this work.
161 CHAPTER VIII CONCLUSIONS AND FINAL D ISCUSSION When my undergraduate students struggle with ending a paper, I often suggest they go back to the beginning to remind themselves of their original research question; after numerous attempts to draw this dissertation to a close, this seemed like good advice. In the opening chapter, I stated that the primary goal of my research was to build on existing quantitative findings to determine if theories supporting gender symmetry are validated by data from qualitative, in depth interviews with a sampl e of individuals who report the existence of violence in a current or past heterosexual relationship. After mo nths of deliberation and debate m y final conclusion is no absolute gender symmetry is not a valid theory unless we choose to ignore the role t hat other controlling behaviors play and their apparent association with gender. In a 2010 commentary, Evan Stark draws a distinction between what he characterizes as "partner abuse" and "fights." Partner abuse, particularly in Western societies where eq uality between partners is the norm, constitutes a "non voluntary establishment of unreciprocated authority by one party over the other," or a "patterned subjugation" of one partner over the other. "Fights," he continues, involve the "widespread propensit y for individuals or couples to use violence when they fight, to express jealousy, frustration or anger, settle conflicts, or to negotiate power differences" (202). Based on my data, I conclude that the only way theories of gender symmetry hold any validi ty is if we merge both categories together and consider the violence that occurs in either situation to be the same.
162 One of the ways that family violence theorists find support for their claims is by pointing to research that looks at specific acts of v iolence rather than at patterns of abuse. However, as Stark ( 2010 ) observes, Except in the relatively rare instances involving extreme violence, to understand whether and how the use of force in relationships contributes to abuse, we have to set violent acts in their historical context, consider the co occurrences of other coercive and controlling tactics, take the subjective experience of those who are targeted into accou nt, whether they experience themselves as victimized and seek outside assistance, for instance, and assess individual and societal harms that extend beyond physical injury, fear, or psychological trauma (202) A significant amount of research cited as pro of of gender symmetry ignores these contexts or co occurrences, or measures them in such a limited way as to dismiss the synergistic effects of multiple variables. However, when I look across the accounts of women from my sample, the importance of these f actors becomes clear. Women like Kellsey, Regan, Maya, and Rochelle described male partners who engaged in a pattern of isolation, dominance, verbal aggression, and manipulation; the violence they received and perpetrated happened within this larger conte xt, and even if the physically aggressive behaviors only occurred one time or were of minimal severity the alternative control tactics were recurring. Their experiences within these relationships were markedly different in tenor from those described by E llen, who was shocked by the one time her boyfriend shoved her after a confrontation in a bar or Katrina, who was already on edge and erupted when her husband made a distasteful noise. What I appreciate about Stark's position is that he acknowledges tha t female to male violence exists, and that it happens outside of the context of abuse or control. This was certainly the case among many of the women I spoke with. In addition to Katrina, Lorraine shoved her husband (hard) into a wall after he repeatedly engaged in behavior
163 she found offensive and which he previously agreed to cease. Jackie threw a spoon across the room at her husband, and Juanita threw a chicken. Yet, if we follow Stark's argument, this type of violence is different not because it is i nconsequential or acceptable, but because "special societal attention is merited by coercion that occurs in the context of and reinforces inequality, in this case gender inequality" ( Stark, 2010, p. 202 ) This position, he continues, "reflects the fact that coercion in the context of structural inequality has different dynamics and individual and societal consequences even when it is b i directional than the use of force among relative equals" (202). This said, however, I cannot conclude that all instances of male to female violence in intimate relationships are necessarily rooted in this structural inequality. Because several of th e women who experienced one time acts of violence at the hands of an otherwise non abusive boyfriend ended the relationship soon thereafter, I cannot know if these relationships would have become increasingly controlling. However, when Ellen reflected on the relationship she had left, she felt strongly that she, not he, held the bulk of the power in the partnership, and that if she had decided to remain with him, the violent behavior he exhibited that one time would not have become a pattern. One aspec t of this debate that I find ironic is how frequently scientists from both sides of the ideological divide misrepresent data (both their own and their opponents ) in ways that are rooted in theoretical beliefs, yet call out the other side for doing the sam e thing. For example, the CTS 2 and instruments like it report how often men and women say they have used violent behaviors against intimate partners. However, when researchers interpret what these results mean, each person assum es that these numbers are reflective of his or her own personal, philosophical, or professional images of
164 heterosexual relationship violence; this is where, to one extent or another, individuals from all sides of the debate err. By not acknowledging that power and gender likely pl ay a significant role in heterosexual IPV, by insisting that the only "methodologically sound" approaches to measuring these constructs are statistical, or by simply claiming that those forces are irrelevant (that they are products of feminist "groupthink, red herrings that distract from the real issue of violence) adherents of the family violence research perspective essentially argue that IPV happens on an even playing field, that all hits are the same. ( D. G. Dutton & Nicholls, 2005 ) Likewise, when feminist researchers and advocates denounce the results of these studies as inhe rently flawed rather than recognizing that women, particularly in Western societies where women's social and economic status and power have increased in recent decades can and do use violence against partners in non defensive ways, they come equally close to asserting that all IPV resembles their own perspective: that women are inherently the victims of male control, that they are almost never primary perpetrators, and that men's violence against women is terroristic while women's violence against men is d efensive or reactive. As Ross and Babcock (2010) summed up, "both camps have only part of the entire picture." Contributions To The Field One of my intentions has been to demonstrate that multiple tools, approaches, and theoretical perspectives are need ed when attempting to understand an issue as complex as heterosexual IPV. By administering the CTS2 to over 350 women and men in a medical research community, I have shown:
165 a) That members of an extremely well educated, heavily white, professional community report perpetrating and receiving violent behaviors from heterosexual partners at rates roughly comparable to other national studies; and b) That in this community, men and women acknowledge perpetrating and receiving physical (although likely not sexual) vi olence at similar rates By themselves, these results are interesting Although my participants were not randomly selected (rather, they were individuals who were interested in research and self selected to participate), they were not asked to participat e because of their past experiences with violence and in fact represent a demographic that is rarely examined in the IPV literature Also, while lower numbers of male responses made it difficult to stratify based on gender and may have hidden some true d ifferences these findings support the existing research suggesting that men and women use minor forms of violence against partners at nearly equal rates and that the likelihood of injury from these minor acts is similar By themselves, however, these d ata tell an incomplete story. If taken at face value with no further investigation, the CTS2 results appear to support the argument that intimate partner violence is completely non gendered, that it is symmetrical between men and women Aside from the pe rpetration of sexually coercive behaviors I found no statistically significant differences between men's and women's use or receipt of physical violence, and if we relax the significance cutoff to p < 0.10, we see that in the past year, women, not men, we re the ones who were more likely to state that they had perpetrated physical violence. Although this answer may be satisfactory to those whose definition of intimate partner violence is limited to "any act of physical aggression between members of an inti mate partnership regardless of context, intent, or dyadic dynamic," for many of
166 us who have worked as advocates, police officers, and researchers in this field, this perspective is both overly simplistic and unrealistic. When we look at how both men and w omen responded to the additional questions about controlling behaviors on the quantitative survey two important findings emerged. First, after controlling for previous experiences with physical violence, women were substantially more likely to report hav ing felt afraid of a partner suggesting that even when physical threats were not present, something their partner said or did caused women, more often than men, to feel fear Second, although women were more likely to acknowledge that they had probably p revented a partner from seeing friends or family at some point in their lives, they were also more likely to report that they had been prevented from seeing others; even when physical violence was controlled for, this finding remained significant at the ge nerally accepted p < 0.05 level Notably t he interviews I conducted with 22 women who reported various experiences with violence on the CTS2 (some as perpetrators only, some as recipients only, and many who reported both perpetration and victimization) s upport this conclusion. Among these women, half described having at least one relationship with a man who employed a pattern of non violent controlling behaviors against them; in all but one of these controlling relationships, these men were also physica lly violent. Moreover, when I compared women's descriptions of men's behaviors and their descriptions of their own behaviors, it was apparent that men were much more likely to engage in patterns of controlling behaviors than women: only two women (compare d to 11 male partners) clearly perpetrated a pattern of control. Finally, when I looked closely at women's experiences and perceptions, the violence that happened within in the context of a male
167 controlled relationship was discernably more severe, more te rrifying, and in the case of women's violence, more reactive than violence in non controlling relationships. That said, I also found evidence that both women and men perpetrated and received violence outside of obviously controlling relationships; in fact half of the violence committed by or against women occurred in relationships that were neither male nor female controlled. This finding goes against some feminist arguments that claim violence against women by intimate male partners is predominantly due to patriarchal imbalances in power, and that most violence perpetrated by women against male intimate partners is in reaction to this imbalance. Rather, I discovered that violence in intimate relationships can be situational and not part of a larger camp aign to gain and maintain control. Moreover, these behaviors appear to support the family conflict paradigm which suggests that IPV results when everyday conflicts build to a tipping point, and the individuals involved perceive no non violent outlets ( Gelles & Strau s, 1979 ) It should be clearly understood, however, that this does not support claims of gender symmetry; if only half of the violence fell outside of a context of control, half of it fell within that context the vast majority within a dynamic of male authority and control. Thus, while these findings may suggest that gender and gender based power cannot account for all IPV, it likely plays a role in a substantial amount of IPV. Ultimately, this is a conclusion that neither "side" will find satisfyi ng. In many respects, the data drawn from my i nterviews and from the additional quantitative questions about additional controlling behaviors support the basic tene ts of Johnson's model: that power and control are critical considerations when studying IPV and that gender (male) is likely a predictor of patterned control. My findings differ from
168 Johnson's conclusions, however, in that I found substantially more examples of male controlled relationship s than his premise would suggest especially given my n on clinical (albeit self selected) sample, and that the severity and intensity of violence in most of these relationship did not resemble his description of "intimate terrorism" or "coercive/controlling violence." As I suggested earlier, it is possible th at many women were describing some form of "pre intimate terrorism" and that the primary difference between Johnson's depiction and theirs is that these relationships ended before the control and violence had the chance to escalate. Another potential expl anation is that some relationships may be contextually controlling in nature but involve little actual violence. However, because of the control the perpetrator has established over the recipient, when violence is used, it has a different meaning than whe n similar violent acts happen in non controlling relationships (possibly a form of "mild intimate terrorism"). Obviously these data are preliminary, but they point to a direction for further research. Other questions that my research raises relate to the role that mental illness plays in controlling and/or violent relationships. This is another ongoing debate in the IPV field, and the data from my interviews are, by themselves, insufficient to contribute to the discussion. However, the frequency with whi ch my participants assumed an association between mental illness and violence perpetration suggests this is a perception that must be acknowledged and further explored. If clinical depression, severe anxiety, bi polar disorder, PTSD, and other mental heal th issues do not actually cause violent behavior in relationship, why do they anecdotally appear to co occur so frequently? Do certain conditions contribute to or exacerbate violent or controlling traits that already exist in some perpetrators or are fac tors that are related to these conditions confounding the
169 apparent association ? If someone who uses violence against a partner also has an underlying mental illness, what is the standard of care for treatment? Finally, if there is an association between certain mental health conditions and IPV, does the illness contribute to the violent behaviors, the controlling behaviors, or both? Again, the research presented here was not intended to address these questions, but it does suggest the need for further ex ploration and better explanations of these apparent associations for lay audiences The model presented in Chapter 5 is one attempt to take the premise of Johnson's work a step further by including what Emery calls "achieved control" in the evaluation of relationships and using a public health influenced lens ( Emery, 2011, p. 527 ) First, because one of the primary goals of public health is to reduce the burd en of injury and disease across populations, this model is based on the understanding that one of the primary problems with violence lay in its consequences: injury, illness, loss of work, homelessness, mental health problems, impacts on children, and (at the extreme) suicide and/or homicide. At the same time, different levels of violent behaviors are more likely to lead to more serious outcomes than others (throwing a cell phone across the room is less likely to result in permanent injury or death compare d with strangulation or attacking someone with a knife), and some violent acts result in no negative consequences ( like throwing a plastic spoon in the direction of a partner ). Looking back on my conversations with these 22 women (as well as my past work as an intimate partner violence prevention specialist), the repercussions that appeared to have the most enduring and destructive effects resulted from the psychological control many women experienced rather than from the physical violence. Many women (in cluding Raelynne, Marisol,
170 Regan, and Megan) described how past experiences in violent and controlling relationships continued to negatively impact their current ones, years after the earlier romances had ended; they suffered from depression and anxiety, t hey were mistrustful, they became violent themselves, etc. Moreover, with two notable exceptions, most of the violent behaviors that had the highest propensity for injury or death occurred in the context of a relationship driven by male control. As a re sult, rather than categorizing relationships as "violent" or "non violent" and focusing on how to lessen the first, I categorized them as "controlling" or "non controlling," observing that violent behaviors can happen in both types of relationships, but vi olence is not necessary for there to be negative effects on physical or mental wellbeing. Part of what makes this structure different from most previous work in this field is that the initial point of analysis starts at the relationship, not individual, l evel. This is not to say that both members of the relationship bear equal responsibility for the violent or controlling dynamic, nor that we should ignore individual level psychological and social influences when developing treatment plans for perpetrator s. But rather than focusing solely on the psychological make up of the perpetrator or on labeling the violent acts themselves as "situational" or "controlling," I propose stepping back and considering the larger environment of the relationship. If most o verly controlling relationships generate negative outcomes (as these data suggest), then we may want to focus intervention and prevention efforts at this level. Moreover, as I described in Chapter 5, it seems likely that physical violence within a contro lling relationship is essentially different from that which happens in a non controlling one. While both have the propensity to cause harm, the motivation for the
171 violence may be different, as is the way that violence is experienced by the recipient. Bot h Ellen and Connie were shoved by their partners, and both thought they were about to be hit. But when reflecting on the experience, Ellen doubted that her partner would have done that in any other situation (he was drunk and angry at someone at the bar). Furthermore, although she ended the relationship, it was not because she was terrified or even strongly believed he would have done something similar but because she knew the event changed her perception of him and of their relationship Connie, on the other hand, remained with her boyfriend after he shoved her but the fear that he might strike out again did not evaporate; in fact, she recounted an incident from the last weeks of their relationship when she felt sure he was going to hit her (he didn't) and she took precautions to not see him alone after they broke up. The suggestion that researchers and practitioners look beyond individual level typologies and focus on the components of relationships that may contribute to IPV is gaining populari ty, particularly among researchers and practitioners focused on perpetrator intervention. In a 2010 article, Ross and Babcock observe that although "the idea of typologies is institutively appealing and a convenient heuristic, clustering batters into grou ps is empirically flawed. An important next step may involve deconstructing such typologies in order to examine dimensionally the major factors that comprise them." They continue: Perhaps instead of attempting to predict the behavior of a batterer based on group membership or trying to tailor treatments to a particular subtype of batterer, IPV researchers could begin to extract those variables that have consistently been shown to contribute to IPV and identify specific intervention techniques for a parti cular behavior. In this way, a type of al la carte treatment menu could be tailored to fit the needs of each individual. ( Ross & Babcock, 2010, p. 197 )
172 Assessment Instruments One issue this model (as well as the overall study) raises is how professionals can recognize controlling as well as violent relations hips in various settings and for various purposes Because this dissertation was not intended to address the psychometric qualities of clinical or research instruments, an in depth discussion of the efficacy of individuals tools or specific questions that would address control is beyond the scope of this paper. However, for these types of tools to be useful in helping researchers and clinicians identify, understand, and respond to both violent and controlling relationships, efforts need to be made to dete rmine how surveys, assessments, and questionnaires can address these constructs with efficiency and accuracy Moreover, we need to recognize that a survey or set of questions that are effective at measuring a concept in a research setting will not necessar ily be appropriate for use in clinical practice, either as screening or assessment tools Instruments like the CTS2 and the NIPSVS ask specific and detailed questions and are designed to identify discrete behaviors or experiences often in an effort to me asure their occurrence within or across populations (e.g., how common is attempted strangulation in Colorado), to determine if other factors are associated with those behaviors (e.g., does alcohol use increase the risk of strangulation?), and/or to identif y outcomes associated with those behaviors (e.g., does a previous strangulation attempt increase the likelihood of homicide?). Moreover, by asking very precise questions that have been scientifically validated for consistency, researchers can draw conclus ions about common experiences with relative confidence that the responses represent the construct s they are intended to measure. Although the additional questions related to control that I added at the end of the CTS2 were merely
173 experimental, the results point to the importance of including questions related to control on IPV related research instruments. Clinicians, however, work under different circumstances. Practitioners have a finite amount of time with a patient/client, and like most screening ins truments, the tools used to identify IPV need to balance specificity, sensitivity, and brevity. Unlike research instruments designed to learn about IPV, screening instruments are intended to pinpoint the existence of violence in a patient/client's life us ing the fewest number of questions ( and/ or taking the least amount of time) as possible The questions need to be detailed enough that the meaning is understood by most people and that the behaviors they inquire about are indicative of violence (e.g.: "Wi thin the last year, have you been hit, slapped, kicked, or otherwise physically hurt by someone?") but do not necessarily need to distinguish between these behaviors unless a positive response is generated 46 When IPV has been identified, additional clinica l instruments can be useful for completing an in depth assessment of the violent circumstances. These are more detailed than screening tools and are focused on gauging the dangerousness or severity of the individual's situation in order to develop appropr iate interventions In all three types of measurement tools, the approach to ascertaining and assessing control in addition to violence necessarily differs in comprehensiveness and specificity Although the CTS2 is an example of an instrument used in bo th research and (theoretically) clinical settings that is not inclusive of questions related to control, other surveys and assessment tools do. Dutton and Goodman's work on conceptualizing 46 Question from the Abuse Assessment Screen (AAS) developed by the Nursing Research Consortium on Violence and Abuse. See Haggerty et al (2011) for a brief overview of this ins trument.
174 coercive control provides an excellent example of a comprehensive approach to measuring control which has enormous implications for both research and practice but is not, in and of itself, a tool that can be used efficiently outside of the research setting ( M. A. Dutton & Goodman, 2005 ) Likewise numerous IPV screening instruments have been developed for use in clinical settings, including Lewis O'Connor's GET SSAFEER, which incorporates questions about fear, suicide threats, and control along with inquires about physical violence and threats ( Haggerty, Hawkins, Fontenot, & Lewis O'Connor, 2011 ) Finally, Campbell's Danger Assessment provides an excellent illustration of a clinical assessment tool intended to ascertain the risk of potential homicide by aski ng about violent and controlling behaviors associated with lethal outcomes ( J. Campbell, 2007 ) Thus, while my findings in and of themselves are not indicative of specific questions that should be asked to identify controlling behaviors, they do emphasize the importance of asking these questions in research and clinical settings. Beyond Triangulation: Unique Co ntributions from a Mixed Methods Approach As I described in Chapter 3 although the most common application of mixed methods designs is to triangulate findings, my research takes an explanatory approach: rather than using the qualitative data primarily as a validation tool for the quantitative findings, I use d the interviews to gather a more detailed understanding of the meaning of the CTS2 results ( Creswell & Plano Clark, 2007 ) By conducting the qualitative phase with a group of the same participants who completed the quantitative survey, I have b een able to elaborate on the specific incidents that are included in the quantitative findings, illustrating the variety of ways this sample of survey participants interpreted the questions
175 and decided how to respond. This approach enabled me to go beyond comparing qualitative and quantitative methods (i.e ., determine if women reveal more or less violence in surveys or interviews ) and to examine what participants mean when they answer questions on a survey like the CTS2. While I argue several times that most quantitative surveys are unable to adequately reveal the complexity of violent relationships, without combining the in depth interviews with the larger quantitative study, much of what this dissertation revealed would not have been possible. From a simple process perspective, the quantitative phase provided detailed information about the qualitative s ample, enabling me to draw a group of participants with intentionally diverse experiences Additionally, I found that the ability to reference a partic ipant's CTS2 responses increased the information I obtained from the interviews ; more than once, I learned about an event (or discovered one was more violent than originally described) only after asking about specific CTS2 answers. Finally, although I exp ected to find a few subtle inconsistencies between what women reported on the CTS2 and what they described in person the frequency and contradictory nature of the discrepancies was surprising. To my knowledge, this is one of the few studies that directly matched women's CTS2 and interview responses; given the frequency with which this tool is used, this is an area that should intentionally be examined further. Despite pointing out these inconsistencies this dissertation was not intended to quest ion th e overall validity of the CTS2 or other quantitative instruments Rather, one of its goals was to illustrate the importance of using
176 caution when assuming that all positive answers to questions about violence on the CTS2 mean the same thing. For example, while 27% of men and 31% of women said they had perpetrated violence against a heterosexual partner at some point in their lifetimes, the qualitative results suggest that even only among women, what is meant by "violence" can vary, and that the violence w omen use when confronted by a controlling male partner may have very different meanings and outcomes from violence that happens when isolated conflicts get "out of hand." A lthough I am unable to draw conclusions about men's encounters with violence, it st ands to reason that they, too, may engage in violent behaviors for different reasons and manifest different responses as recipients depending on the circumstances What this suggests is that the reality of violent relationships is likely to be more compl ex than what can be drawn from the CTS2. Ultimately, the significance of this point is accentuated by the ability to link interview data with CTS2 responses ; while not randomly selected, the qualitative participants were chosen because the violence they r eported was representative of both typical and extreme experiences among the respondents. The data that surfaced from taking this approach clearly point out that an individual's CTS2 score is not necessarily reflective of their experience especially when the power dynamic surrounding the violence is considered When considered together, these findings further illustrate the importance of not drawing unequivocal conclusions about gender symmetry from CTS2 data alone
177 Engaging Men: Asymmetric Perspective s in IPV Research An additional issue that emerged from this work presents as both a finding and a limitation : the difficulty of involving men as participants in IPV research Although I suspected I would have more female than male respondents during Phas e One (given the topic as well as the knowledge that women are generally more likely to participate in research ), the size of the imbalance was surprising. Likewise, while I assumed I would have a smaller pool of men to interview compared to women, I inte ntionally included mechanisms I thought would bolster male participation: I asked a male coll eague to conduct the interviews and had him to contact male participants, mentioning my name only as the primary investigator and not as someone the participants w ould meet. After these initial efforts resulted in only two interviews, my ( male ) dissertation advisor then followed up with the remaining nineteen eligible men, urging them to participate by emphasizing the importance of including male perspectives in th is research; still, we received no additional responses. Once it became clear that neither the quantitative nor qualitative phases would include any level of gender balance I looked to see if other researchers had encountered similar difficulties. They had, especially when the research involved talking directly with men In an article reflecting on her inability to engage men in a study of friendship, Butera (2006) observed that while she found a significant amount of literature focused on "how to inter view men," very few ever discussed how to recruit them in the first place ( Butera, 2006 ) Oliffe & Mroz proposed two strategies to overcome male reluctance: offering remuneration (which I did) and using in person forms of recruitment ( most effect ively done by people the target participant knows) "because men rarely respond to
178 advertisements or emails inviting them to be interviewed about their health or illness experiences" ( Oliffe & MrÂ—z, 2005 ) When asking questions about IPV, however, this latter approach is often inappropriate, as the n ature of the topic frequently demands that participation be completely confidential. The difficulty with including men in discussions about relationship violence is not limited to research settings. While describing his struggles to engage male college stude nts in anti gender based violence activism Grove (2012) illustrates how traditional images of masculinity and feminist responses often work together to limit men's willingness to b ecome involved in sexual and domestic violence prevention efforts : A major initial barrier to men's involvement is the belief that gender based violence is a "women's issue." Men hear messages based in women's experience of rape culture. These often sound like: "Don't Rape." This message is based in an assumption that all men have the potential to rape if they are not told otherwise. However, what men hear is that all men are rapists. Given that this is not true and that no one wants to be called a bad person, it is not surprising that men respond very defensively to the topi c when presented like this. Because this perspective does not define any helping role for them, it reinforces the idea that mal e violence is a women's problem ( Grove, 2012, p. 287 ) T he impact of these messages likely serves as a barrier to men's involvement in IPV research as well as activism Men may assume that any act of physical aggression they describe will be seen as evidence that the y are batterers, or believe that discussing experiences as recipients of women's violence will threaten their image as "real men." Furthermore, men may believe that their views will be discounted, distorted, or met with hostility; traditionally, when men have been asked to participate in this dialog, it is as perpetrators of violence and rarely as recipients or as men who care about women and do not condone the use of violence in relationships.
179 Clearly, however, men's perspectives on IPV cannot continue to be ignored Feminist scholars and standpoint theorists often advocate that research should be both reflexive and more inclusive of women's understanding and interpretations of their experiences ; ignoring the same facets of men's experiences with IPV is b oth hypocritical and results in an incomplete picture of a phenomenon involving both men and women. Although we cannot ignore the larger social structure that historically grants men higher status and authority in both the public and private spheres neit her can we claim that this social imbalance remains so strong (at least in many Western cultures) that it explains all heterosexual relationship violence. To fully understand the intricacies of IPV, not only do we need a more complete picture than many qu antitative instruments offer but we also need a more complete picture of men's experiences as well as women's. Do men describe women using patterns of control as often as women describe men doing so? If so, what are those behaviors, how do men experienc e them, and what are the effects? When asked about their experiences with physical violence or controlling behaviors in relationships, how do they describe the larger context and power dynamic? Finally, how do the theories supporting or denying gender sy mmetry fare when men's perspectives are included in the analysis? Li mitations & Strengths Like all research projects, this dissertation is not without both limitations and strengths. One of the most obvious shortcomings lay in the selection of particip ants. Although my sampling frame was more expansive than the ubiquitous "university student" population, it was, nonetheless, a non generalizable convenience sample composed of well educated, university employed men and women. Whether this
180 introduced a d irectional bias is unclear. On one hand, because participants were notified about the study through professional channels, some people with direct experience with violent relationship may have been hesitant to participate, fearing disclosure within their workplace. On the other hand, because the sampling frame primarily consisted of people who had expressed an interest in and understanding of the importance of research, it seems equally likely those individuals who have been involved with IPV (particular ly in the past) could be uniquely drawn to assisting with this type of investigation. As mentioned earlier, one way in which this sample may have influenced the findings is related to the cultural environment of the participants. By using an academic me dical community as the setting for this research, the norms and expectations related to gender and violence are likely different from those of other communities. There are predictably stronger expectation s of gender equality among individuals whose profes sional and personal spheres include high levels of well educated women in leadership and mentoring roles expectations that can collectively contribute to lower levels of gender based violence against women (see Boyle, Georgiades, Cullen, & Racine, 2009 ; J. C. Campbell, 1999 ; Koenig, Stephenson, Ahmed, Jejee bhoy, & Campbell, 2006 ) As Campbell (1999), Hautzinger (2007) and others have suggested violence against women could be expected to be the highest in communities in which gender roles are in flux and lower in those with established norms of equality. It is certainly possible that the growing acceptance of women in medical and academic settings may have contributed to establishing a research environment in which gender equality is the standard, and one in which violence in general and terroristic IPV i n would
181 naturally be lower. Ultimately, it will be important to find ways to replicate this approach to research in other communities. This study is also potentially subject to errors in the data gathering process. Like most research on IPV, all of my d ata are self reported, and it is often assumed that people are less likely to report their own socially unacceptable behaviors or experiences. Moreover, as described earlier, if this pattern is related to gender (obviously one of the variables of interest ), it could introduce an element of bias: for example, if men consistently reported fewer experiences with violence on the CTS2, then the conclusion that men and women used equal numbers of violent behaviors is spurious. Recall error is another likely pro blem, particularly in the Phase Two interviews, where nearly a year passed between the completion of the CTS2 and the last interviews Several participants expressed trouble recalling the incidents they reported on the survey, particularly if those events happened more than a year prior to completing the CTS2. One way I addressed this issue was through the use of prompts during the interviews, and more than one person expressed surprise at remembering as much as they did. Whether this introduced any dire ctional bias is not clear, but it seems unlikely that the women would systematically remember perpetrating but not receiving violence (or vice versa). The data collection instruments themselves are also subject to limitations. As I discussed earlier, th e on line format of the CTS2 may have resulted in accuracy errors if participants "clicked" on the wrong button, as Jackie admitted to doing. While it is possible that this could have resulted in an overestimate of the overall prevalence of violence, it s eems unlikely that gender would have influenced this mistake, which was the primary variable of interest in Phase One. Shifting focus to Phase Two, however,
182 interviewer bias is always a concern in this form of research, and can result in conclusions that directly reflect the interviewer's preconceived beliefs. Although there is no way to systematically control for this, by using standpoint theory in the design of this research, I tried to acknowledge this possibility up front and include it as part of my analysis. Finally, as I discussed above, although the lack of male participants can be seen as a finding that needs to be pursued, it is also the project's most obvious limitation Clearly, this unintended reality both limited my power to detect quantitat ive gender differences (and most likely underestimated some of those that were apparent), and hampered my ability to paint a more complete picture of the role that control and gender play in violent heterosexual relationships. Future investigators need to be cognizant of the barriers to involving men in IPV research, and must identify strategies to overcome them, such as setting minimum levels of male participants or designing studies solely focused on men. Despite these limitations, a significant streng th of this project is that it addresses one of the primary critiques of previous research in this field: it is one of the few studies that included in depth interviews with participants from a non clinical sampling frame Not only were these individuals i dentified outside of domestic violence/law enforcement/legal service systems, they were overwhelmingly professional women, many with advanced degrees (or in the process of obtaining them) who were employed within a medical research community; in other word s, they represent a population whose relationships are not often examined in IPV research. Lastly the combination of methods used in this research provides us with a deeper understanding of the role that gender, violence, and control play in heterosexua l
183 relationships. Taken alone, the findings from the CTS2 suggest that the use of violent behaviors is generally symmetrical between men and women However, when we include questions about controlling behaviors in the analysis, we see that women appear m ore likely to have feared a partner because of something he did especially once actual experiences with violence are controlled Moreover, once women were asked to describe the violence they reported on the CTS2 as well as the larger dynamic of that part icular relationship, the differences between men's and women's violence within the context of control became more apparent. Additionally, by comparing responses to the quantitative and qualitative questions, this research illustrates t he myriad of ways in which respondents interpret the CTS2 questions and show s that even when two participants provide the same answer to a question, the experiences they reference can be extremely different. Although the lack of men's perspectives strongly limits the conclu sions we can draw, when we look at how women described their experiences with violence and control the quantitative data suggesting that women use minor forms of physical violence as often or more often than men takes on a new meaning (a perspective furth er reinforced by the quantitative findings related to fear ). To my knowledge, no other research has attempted to examine the underlying context of violent acts reported on quantitative surveys such as the CTS2, and these findings certainly caution against taking a "one size fits all" interpretation of the responses on these types of surveys. Future Directions As former public health practitioner, one of my long term goals is to generate information that can be used to improve our responses to IPV. While pr oposing new
184 interventions is beyond the scope of this dissertation, I firmly believe that the data emerging from this project can inform future approaches and suggest new research directions. One of those directions is to further explore the dynamics of coercive and controlling relationships. For example, I suggest that these relationships usually involve some element of harm, and therefor require attention regardless of the existence or severity of physical violence. But what is the level of harm relat ed to controlling relationships, and is it practical to attempt to identify and intervene in situations that do not appear immediately life threatening or physically injurious? Likewise, we need to look more closely at the experiences of recipients of vio lence in both controlling and non controlling relationships to confirm and further define the differences between the behaviors, outcomes, and motivations surrounding the violence. By identifying those differences (if, indeed, they exist), it may be possi ble improve on current intervention strategies and/or develop alternative approaches that incorporate an understanding of the role that gender, power, and control may or, in some cases, may not play in the use of violence and other harmful behaviors. Anoth er direction is to improve our understanding of men's experiences with relationship violence. Certainly, we have learned a tremendous amount from previous work involving men engaged in perpetrator treatment or other clinical interventions. But the data i n this dissertation suggest that violence happens frequently in relationships that are never touched by external systems (e.g., law enforcement, counseling services, etc.), and that men can be both perpetrators and recipients of violence. While research o n male experienced IPV is at best, inadequate, efforts to understand the experiences and
185 perspectives of men outside these settings have been almost non existent. Yet as I discussed above, we cannot possibly hope to effectively intervene in or prevent vi olence in relationships if we ignore one half of the partnership or make assumptions about all men based on the experiences of those mandated to batterer treatment or involved in custody battles Not only do we risk continuing to develop ineffective strat egies, but we continue to reinforce the belief that IPV is a "woman's" issue, and that men are neither wanted nor needed in the movement to stop it. Finally, and possibly most critically, we need to look more closely at the relationship between gender and control, between control and violence, and (ultimately) at the intersection of gender, violence, and control. My data suggest that men may be more likely to instigate patterns of highly controlling behaviors that limit the autonomy of their partners when compared to women. Although this finding is in line with some of the theories regarding control, violence, and gender, it is based solely on the perceptions of women, making it extremely preliminary. Likewise, while there appeared to be an association be tween relationships involving the patterned use of controlling behaviors and violence, this was a small sample that, again, did not include the experiences of men. Future research in this area must include strategies to involve men's voices and experience s in the research, and must be designed to elicit more information about patterns of controlling behavior. In conclusion, I believe that the findings reported in this dissertation support many but not all, of the arguments made by feminist scholars; mos t significantly, they reinforce the conviction that the phenomenon of IPV, in its most inclusive construction, is gendered in nature. As Stark observed,
186 [ C]oercive control is largely a male phenomenon not because men are empirically more likely to deploy the requisite tactics or are socialized to expect control,' but because inequality constrains women's options in relationships independently of their personality, mental acuity, socialization, or physical prowess. This reality is not changed because wome n check many of the same boxes on surveys as men, including the box in which they acknowledge acts of jealousy, possessiveness or control ( Stark, 2010, p. 208 ) This said, my work also suggests that a substantial amount of the violence in intimate relationships (at least here in Western societies) falls outside of the dynamic of gendered violence; rather, it is situational in nature a nd not part of an ongoing controlling dynamic. Most importantly, however, these findings illustrate that it is possible for these two theoretical paradigms to co exist. Several questions remain, and may or may not ever be satisfactorily answered using em pirical methods. Even if scholars come to an agreement that coercive and controlling violence is most likely gendered in nature, we are still left with the question of violence in non controlling relationships. Is circumstantially limited violence (what Stark referred to as "fights" and what Johnson calls "situational" or "common couple violence") different when a woman like Joanie throws a coffee maker at her husband verses when Ellen is grabbed by her boyfriend outside of a bar? Even when women perceiv e holding an equal (or greater) level of power in the relationship, how do the larger social advantages held by men affect their personal position ? The approaches we take to answering these questions and the conclusions we draw are inherently rooted in th e theoretical paradigms to which we subscribe. This is not a weakness we can assign to any particular perspective or methodology; rather it is a simple reality of all scholarly work. One final hope I have for this dissertation is that it helps us, as res earchers, become more conscious of the role that our belief systems (regardless of what they are)
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200 APPENDIX A : QUALITATIVE INTERVIEW GUIDE Please Note: This is a guide that I prepared prior to starting the interviews. I created it using the responses from one specific participant, knowing that for each participant I would modify the questions based on their answers. As with most qualitative interview guides, this proved to be a "work in progress," but what follows reflects the general format of the interviews. Introductory thank you and chit chat, what they do at Anschutz, then cover the informed c onsent paperwork. OK, so now that we're done with the formal stuff, I'd like to find out a little more about you, and talk for a bit about some of your experiences in your current and past relationships with men. Do me a favor, and if you refer to anyon e by name, please don't use last names; it's better if I can't identify them. I'm starting these interviews by asking everybody what drew them to this study? What made you respond to the list serve request to complete the written survey? What later m ade you respond to my second request for an interview? So, right now, at this moment, how would you describe your relationship status? Are you married? Dating? Etc ? [If appropriate] How long have you been with your current partner? [If appropriate] Prior to becoming involved with your current partner, were you involved in any other serious or long term relationships? Probe: were you married? Living together? Probe: how long were you involved with this person (these people)? So it sounds as if you'v e been with your current partner/husband for a long time; if you can recall, was he the person you had in mind when you filled out the conflict survey? On the survey that you completed, you indicated that there was at least one time, but not recently, whe n your partner grabbed you. About how many times do you think this kind of thing happened? [If it happened multiple times] Did it happen with different partners? Can you think back to the most recent time this happened [or "think back to when this happen ed"] and tell me what you remember about that situation? Probe: Was this with your current partner or someone in the past? Probe: Do you remember about how long ago this happened?
201 Probe: Can you remember what was going on when this happened? Were you argu ing? Do you remember what you were arguing about? Probe: Can you remember anything about how it started? Was it an isolated argument, or was it something that had been on going? For how long? What was happening just before he grabbed you? Can you tell m e how you felt when your partner grabbed you? Probe: Were you afraid? Of what? Probe: Did it make you angrier? Shocked? Probe: [If it seems like the incident was very violent/forceful] Did you have any kind of a bruise where he grabbed you or feel sore? Do you remember what you did or how you responded just after this happened? What did your partner do? How did the argument eventually end? Probe: Were you able to resolve the situation amiably? Did one of you just drop the issue? [if yes, they dropped t he issue w/o resolution] Did it ever come up again? Probe: Did either of you as far as you know continue to feel angry or bitter about the resolution? Did anything further happen related to this argument? Would you say this was one of the worst arg uments [or "fights" depending on the respondent's language] you had with this partner? [If not the worst fight] Tell me about the worst fight you had with this partner. Probe: How long ago did this happen? How long had you been with this partner? Probe: Were you yelling at each other? Did one of you insult the other? Probe: Did he grab you or do anything physical? Did you feel threatened? Afraid? Probe: Did you grab him or do anything physical? Do you think he feel threatened or afraid? [If respondent was grabbed more than this one time] Can you describe other times when your partner grabbed you? Probe: Did this happen often? Was it the same partner? Probe: Did you ever feel afraid or threatened when your partner grabbed you? Probe: What did you usual ly do when this happened? [If this does not come up in the above discussion] Now, you also stated that you also grabbed your partner at least once, although not very recently. Can you tell me about the most recent situation? Probe: Was it related to one of the arguments you mentioned earlier? Probe: How long ago did this happen? Probe: [if not obvious] Was it with your current partner or someone else?
202 Probe: Do you remember what you were arguing about? Probe: Can you tell me what you were feeling just b efore you grabbed him? Anger? Fear? Frustration? If you can remember, how did your partner respond? Probe: Do you think he was afraid? Angry? Shocked? Probe: what happened next? How was the issue eventually resolved if at all? [If this does not come u p earlier in interview] On the survey, you also indicated that at some point in the past, you had a partner try to choke or strangle you. Tell me about that incident: Probe: Was this with your current partner or someone in the past? Probe: Do you remember about how long ago this happened? Probe: Can you remember what was going on when this happened? Were you arguing? Do you remember what you were arguing about? Probe: Can you remember anything about how it started? Was it an isolated argument, or was it something that had been on going? For how long? Probe: What was happening just before he grabbed you? Can you tell me how you felt when your partner did this? Probe: Were you afraid? Probe: Did it make you angrier? Shocked? Do you remember what you di d or how you responded just after this happened? What did your partner do? Probe: Did you get away from your partner for a while? [If yes] For how long? Where did you go? Probe: Did you call someone and ask them for help? Having someone try to strangle you is pretty serious and potentially life threatening. Did you go to a doctor after this happened? Probe: Did you go to a doctor? [If no] Why not? Did you (or anyone else) contact the police? [If yes] What happened? How did the argument eventually end? Probe: Were you able to resolve the situation amiably? Did one of you just drop the issue? [if yes, they dropped the issue w/o resolution] Did it ever come up again? Probe: Did either of you as far as you know continue to feel angry or bitter about the resolution? Did anything further happen related to this argument?
203 Finally, you indicated that in the last year, someone used threats to force you into having sex when you didn't want to. If you feel OK talking about this, can you tell me a little a bout what happened? Probe [if not obvious]: Was this with your current partner? Probe: Has anything like this happened before with this partner? Probe: What were you afraid would happen if you didn't have sex? Probe [if not the same partner who physically hurt her]: have you ever felt afraid of this partner before? Has he ever done anything to hurt you or scare you? Have there been other times in any of your relationships when you felt frightened or scared of your partner? Probe: What kinds of things di d he do that scared you? Probe [if she describes a specific incident]: What did you think might happen? What did you do? Probe: How often were you frightened [or ARE you frightened of your partner]? Probe: Do you think this was/is characteristic of your r elationship? Have there been times in any of your relationships when you think you made your partner feel scared, or when you threatened him in some way? Probe [past partner]: What kinds of things do you think frightened him? What was he afraid you'd do? o Did you ever threaten him with this directly? Was it implicit? Probe [current partner]: What kinds of things do you do that you think scare him? Does he think you would physically hurt him? In any of the relationships you've told me about, do you thin k that either you or your partner had more power over the other than vice versa? Probe: Did/do either of you make most of the day to day decisions? How about the really important decisions? Probe: Do you feel like either of you made/makes most of the deci sions about money? [If yes]: Did/does one of you primarily do the book keeping but you both decide on how to spend money, or does one person control the finances completely? Did/does this feel OK to you, or do you feel like financial decisions are pretty much one sided? How do you think this affected/affects your relationship? Probe: Did/do either of you make most of the decisions about who you see, either when you are by yourselves or as a couple/family? Probe: Did/does your partner ever express jealousy about your friends or who you work with? o [if yes]: what did/does he do when he is jealous? Probe: Did/do you ever express jealously about the people he hangs out with or sees at work or socially? o [if yes]: what do you do when you feel jealousy?
204 Probe: Do you feel like either of you tried/tries to keep tabs on the other more than the other does? o [if yes]: what kinds of things do/did you/he do/? Probe [if she has children/pets or lived with her partner's children]: have you ever been frightened that he mig ht do something that would hurt the children or the pets if you did not do something? Probe: do you think you've ever made your partner feel frightened for his children/pets? Is there anything else that you can think of about any of your past or current r elationship(s) that you would be willing to share with me? Well, just before we end, I want to thank you so much for your time and willingness to talk with me about issues that are very sensitive and personal. I know some of these questions were probably difficult, but you have given me a much better understanding of why you answered some of the questions on the survey the way you did, and I am honored that you have been willing to trust me with this information. **If she is still involved with one of th e partners who hurt her or threatened to hurt her especially if this happened in the last year or she indicates that she has felt frightened of her current partner or continues to feel threatened by her ex partner: I want you to know that a few things that you mentioned make me a little [or lot] concerned for your safety. I would be happy to put you in touch with someone who can talk more with you about ways that you can be safer in your relationship or help you connect with other organizations that co uld help. I can call her/them now and you can talk with her/them from here, or if you feel safe doing so I can give you some information to take with you. If you do that, you need to keep it in a location where your partner cannot find it. Would you like either of these things to happen? This is the end of the interview, and I'm going to turn off the recorder now.