"Doctors Have Best Chance to Stop Domestic Violence,"1 was an August 25, 1999 editorial in the Seattle Times that caught my eye. Doctors in Washington state were being trained to routinely ask their patients, "Do you feel safe in your relationship?" Because of that question, lives were being saved. Lives were being changed. Due to prompting from doctors, patient calls to crisis lines and shelters suddenly (and dramatically) increased. Abused women and children were being connected to the support system they needed through their doctors. Many patients, because of their doctor's intervention, were discovering how to get help before ending up in the emergency room - or the morgue.
I was moved by the Times editorial, because I remember what it was like when I was caught in the quicksand of a domestic violence relationship years ago. Due to the enormous strain of living with abuse, I became severely depleted and developed health problems for the first time in my life. I turned to acupuncture for healing. However, because I never had marks of physical injury showing, no one ever asked me about abuse. I was too embarrassed and afraid to tell. Believe me, the expression "Don't ask, don't tell" didn't originate with gays in the military. It began with domestic violence, which is probably the most taboo subject in health care.
Though today I am completely recovered from that experience, I often wonder how much more quickly my healing would have begun if only the practitioners I'd seen in those days had been educated about domestic violence. For example, there were times when I got in my car to drive away, but I always returned because I felt I had nowhere to go. Ironically, one of the largest shelters in the nation was located less than five miles from my home, and I didn't know about it. If one of the practitioners had recognized me as a victim of abuse through routine screening and had referred me to the shelter, I would have gone. Once there, I would have been paired up with an advocate who could connect me with a support group; individual counseling; legal counsel; financial help; transitional housing; and even help navigating the criminal justice system. If the people who had treated me in the past had known how to recognize abuse and appropriately intervene, I am certain I would have gotten out much sooner, and the damage to my health (and my child) would have been far less.
| How Domestic Violence Impacts Health Definition: Domestic violence is a pattern of assaultive and coercive behaviors, including physical, sexual and psychological attacks, as well as economic coercion that adults or adolescents use against intimate partners. Most victims are women, as women are five to eight times more likely than men to be victimized by an intimate partner.1 Fatalities2
Physical Injuries
Injuries during Pregnancy
Psychological Damage
Children
With the exception of statistics on fatalities from Dawn Bradley's The Domestic Violence Sourcebook, all other facts were excerpted from the "Health Care Response to Domestic Violence Fact Sheet" produced by the National Health Resource Center, a division of the Family Violence Prevention Fund (www.fvpf.org). References
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However, back then, nobody was routinely screening for domestic violence. No one knew how. No one even realized it was a deadly serious, gargantuan public health crisis. The first shelters were established in the 1970s by grassroots organizations, but it wasn't until 1992, when Surgeon General C. Everett Koop labeled the epidemic of battering a leading national health problem, that health care providers sat up and took notice. Shortly after, the AMA officially acknowledged domestic violence and declared a national campaign against it. Since then, the AMA has been joined by other groups, including the Association of American Medical Colleges; the American Nurses Association; the American Academy of Pediatrics; the National Hispanic Medical Association; the American College of Nurse Midwives; the Gay and Lesbian Medical Association; the American Psychological Association; Physicians for a Violence-Free Society; and Physicians for Social Responsibility, to name a few.
My state association (the Oriental Medicine Association of New Mexico) recently passed a resolution supporting the training of practitioners in clinical management of domestic violence,2 and I have taught a number of workshops. Many of the practitioners who took the training are now routinely screening in their practices. Hopefully, this interest will continue to spread throughout our Oriental medicine community, and someday our national organizations will join ranks with the others who have taken an active stand against domestic violence. If every graduating student and licensed practitioner were to invest a few hours in learning how to identify cases of abuse and intervene, we could do our job as part of a larger community working to solve a huge problem.
According to Ann Jones, in her dynamic book Next Time She'll Be Dead, "We now know that all institutions to which battered women and children are likely to turn for help - hospitals, mental health facilities, social welfare service, child protective services, police, civil and criminal courts, schools, and churches - must join in a concerted effort to prevent violence before it occurs and to stop it when it does. All these community institutions must be alert to identify battered women and children and to take their part. To greatly reduce this problem will take a united community effort."3
Recently at a website about domestic violence, I saw the following question: "How many doctors does it take to stop domestic violence?" The answer? "Just one dedicated practitioner for each victim of domestic violence." We can make a difference.
References
Chronic pain afflicts over 20% of the adult population. Sadly, most MDs have essentially no education in treating pain, beyond offering a few toxic medications. Then they tend to steer people with pain away from those health practitioners who are trained. This puts the acupuncture community on the front lines for addressing this epidemic.
When the body is going through a stressful event, the sympathetic system is activated. This activation will help the body with a life-threatening situation. If this state is activated for prolonged periods of time, it starts to consume energy. These traumatic events that generate stressors in the autonomic nervous system (ANS) will eventually become internalized.
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One of the things that makes acupuncture so difficult to measure is that the medicine actually does contain some esoteric aspects. There have been numerous studies that demonstrate the neurochemical reasoning behind why acupuncture points stimulate the autonomic nervous system to enact change However, not all the benefits of TCM can easily be measured by randomized, controlled trials. But does that make them fundamentally and definitively untrue?
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