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THE ROLE OF SOCIAL SUPPORT AND FAMILY RELATIONSHIPS IN WOMEN'S RESPONSES TO BATTERING. By: Rose, Linda E.; Campbell, Jacquelyn. Health Care for Women International, Jan/Feb2000, Vol. 21 Issue 1, p27-39, 13p; DOI: 10.1080/073993300245384; (AN 2738805)
Investigations of social support have documented its multidimensional nature. Most researchers agree that social support includes two broad types: instrumental support and emotional support, depending upon the type of assistance provided (Dean & Lin, 1977). Further, social support can be viewed as coping assistance because it helps the person to identify and use specific coping strategies (Thoits, 1986). Social support for battered women may (a) help the woman reinterpret the abuse as not her fault; (b) help the woman alter the environment of the abuse by providing shelter, money, and the like; (c) help the woman deal with the emotions associated with the abuse, such as depression or anxiety (Arias, Lyons, & Street, 1997); and (d) offer affirmation and reassurance that helps the woman seek and use accurate information about the abuse and the abuser. Social support has been investigated in relation to battering and depression (Campbell, Sullivan, & Davidson, 1995) and battering and posttraumatic stress disorder (Astin, Lawrence, & Foy, 1993). Campbell, Sullivan, and Davidson (1995) found that battered women were less depressed when they were satisfied with the quality of the social support they received. Nurius, Furrey, and Berliner (1992) suggest the overall effects of such help may be to bolster the woman's self-esteem and sense of mastery that will in turn help her to develop alternative coping responses and ultimately resolve the abusive situation.
Sources of both types of support can be "informal" (family, friends, kin) or "formal" (health professionals, religious leaders, shelter personnel). However, the presence of large social networks and relationships with professionals does not mean that women will use these networks and relationships to resolve violence in an intimate relationship. Numerous factors may impede active seeking and use of support from family networks in particular, including the fact that the abuser is the person who in most circumstances would be considered the primary source of support (Hoff, 1990). Arias, Lyons, and Street (1997) found that women who attributed the abuse to the partner also felt a lack of spousal support in the marriage. Other family members may refrain from or feel ambivalent about providing support to the woman because of divided loyalties. Further, the mother--daughter relationship has been described as a pivotal aspect of the daughters' behavioral responses to a variety of life events (Boyd, Guthrie, Pohl, Whitmarsh, & Henderson, 1994).
Thirty-one women were included in this analysis. They ranged in age from 18 to 53; mean age was 32.5 years. The mean educational level was 13.5 years and mean number of children was 2. They were predominantly African American (74%) and of lower socioeconomic status. At the time of the study, they all resided in the large urban American city where the study took place. They were recruited for the study through an advertisement that stated we were looking for women "who had problems in an intimate relationship."
Three semistructured interviews were done that focused on the relationship with the partner, the women's perceptions of how they related to other people, and the way that they viewed themselves. They were asked to describe their families, their neighborhood, and their cultural group. Specific problems in the relationship were explored as were the women's responses to them.
Social support was investigated in the following ways. At Time 3 women were asked who they had talked to in the last 6 months about the relationship and how effective that was in helping them deal with the abuse. Open-ended questions at Times 1 and 2 focused on women's descriptions of themselves to themselves and in relation to other people. These self-descriptions added greatly to our understanding of the personal factors related to support seeking and some of the personal constraints against use of support sources. The women were encouraged to provide detailed responses to the questions, and probes were used when appropriate to elicit in-depth responses.
All interviews were transcribed verbatim. For the analysis reported here, the transcribed interviews were read in their entirety. Content analysis was guided by the theoretical perspective of social support. For example, responses describing emotional and informational support were examined. Manifest analysis was done to identify emergent themes that elucidated contextual themes related to social support and the experience of being abused. In reading the data, we initially focused on answers to the question, "who do you talk to" but expanded our analysis to other areas of the interview that focused on the women's responses to the abuse over time. These areas were chosen because they illuminated the complexity of each woman's relationships with others and why she viewed these relationships as supportive or nonsupportive. During initial stages in the analysis the investigators identified key responses that seemed to be recurring across cases and that were influential in how the women used others for support. We examined and reflected on the meanings of those responses and their significance to the overall experience for the women. Themes were discussed until consensus was reached regarding meaning.
In presenting our findings from this study, we recognize the complexities of the abusive situation for women and the dynamics of social support. We chose to organize our findings in the following way. First, we report the women's sources of support and the helpfulness of these sources of support. Second, we discuss constraints affecting seeking support from support sources. Third, because the women did not consistently identify family members as sources of support, we examined more closely the women's perceptions' of quality of family relationships and social support. Fourth, women's responses about friends as supportive suggested that relating to friends was influenced by the women's sense of self. Finally, we present findings of the relationship of support and the women's responses to battering.
The women identified primarily emotional support from informal (family, friends) sources and sometimes from formal (professional) support usually described as "having someone to talk to," or having a sense that they would be listened to. Girlfriends were identified most often as a source of this emotional support (17/31 or 54.8%). Mothers were identified as the person they talked to by 9 of the women (29%), and sisters were identified by 3 women as sources of support. The women who used these sources of support were asked to quantify the degree of helpfulness they experienced, from 0% to 100%. Their responses varied, ranging from 100% for 2 women who talked to their mothers to no help for 2 women who talked to their partners or their partner's family. The helpfulness of talking to girlfriends, however, was markedly different from all other sources of support. All the women who identified a girlfriend as someone with whom they talked said that it was at least 50% helpful, and the majority identified that it was 75%-100% helpful. The majority of women (87%) identified more than one source of support.
Formal (professional) sources of support were used infrequently (34% of the women) and when they were it was primarily for emotional support. For example, 3 women talked to their pastor or a counselor at church and found that very helpful. Only 1 woman was in a support group, and 2 women identified God as a major source of emotional support. Two women receiving therapy for depression identified their therapist as the main source of emotional support. In all these cases, they reported that the support they received was very effective. Only 1 woman identified her physician as someone she talked to, and that was a positive experience for her. His support was characterized by his comment to her: "He told me, 'He [spouse] would come back in your life and be sweet until something sets him off.' He told me, 'You are not the problem.'"
None of the women described themselves as completely satisfied with the amount of support they were receiving. We examined their responses more closely to determine the constraints against seeking or receiving support or both from others. Six women did not identify anyone as someone they could turn to about the abuse. The remainder identified some sources of support but either found them unsatisfactory or felt there were constraints in using or seeking out additional sources of support. There were characteristics of their relationships with others that were similar: family was abusive; spouse restricted them in talking to anyone; they lacked trust in others; and in several cases there was severe abuse characterized by either beatings during pregnancy, threats to stab with a knife, and direct physical abuse and verbal threats to kill. In each of these cases, the reported lack of support was essentially unchanged from Times 2 to 3.
Contextual factors acted as constraints in seeking support even from women who identified that they had someone with whom they could talk. These factors were as follows: (a) perceptions of cultural/environmental/ societal sanctions against leaving the abusive relationship; (b) a pattern of "cautious" relating to others because of mistrust and fear; and (c) forced isolation/isolating self. These factors were not independent of one another, and each woman might experience any or all of them as a constraint to receiving effective support from others.
A woman who described herself as well-educated, employed, and a professional remained in the abusive relationship at Time 3. She described her relationship with many friends as "distant." She did not want to respond to their inquiries. She perceived that there were cultural sanctions against leaving her partner because the abuse was not physical: "There's a lot out there that [says] Black women should tolerate lousy behavior in Black men. People would say, 'Why would you leave him? He's cute. He doesn't beat you, he has a job, and he's well educated.'" Further, these women identified a societal sanction against leaving a marriage, because, as one woman noted, there is a stigma against single women, there is pressure to "have somebody," and society does not actively promote alternatives to staying in the abusive relationship.
Women were asked about cultural attitudes toward (a) the importance of the wife and mother roles for women and (b) men hitting women. Ten (32%) women identified an adverse impact of society's messages to women. Several women felt strongly that women were still told they "needed to be in a relationship with a man." Finally, there was a clear pattern of women perceiving that their cultural group valued the wife/mother role as most important for a woman. When asked the extent to which they perceived that American culture sanctioned men hitting women, their responses reflected a perceived lack of societal support to change the battering situation. Only 1 woman felt that the extent was 0%. The majority of women's responses ranged from 25% to 90%.
One woman stayed in the relationship because the alternative was being alone. This woman lacked family and friend support and was reluctant to leave her partner because "he was her family" and she did not want to be left alone. She acknowledged that she wanted to dissolve the relationship with him but was reluctant to do so: "He has filled in for me when I haven't had a family. I will be all alone if I don't have him." Another woman felt she needed a relationship because of the unsafe conditions of her neighborhood: gunshots could be heard 24 hours a day, houses were burglarized, and so on. She lived there with five children, worked shift work, and felt she had to hang on to the relationship for her own safety.
Another woman's situation illustrates the role of these societal/environmental contexts. This woman had few financial or personal resources and had no support from family. She was in a situation of severe abuse. She endured forced sex, physical beatings, and threats to kill during a 20-year relationship with her partner. She described her role in the relationship as "just going through the motions." Her self-concept was one of constant abuse: "I have been abused all of my life." She stayed in the relationship because of her children. Her support was extremely limited: She said of her mother, "she blames me for all the bad that happened" during her childhood when her father sexually abused her. During initial interviews she identified no one as a source of support. By Time 3 she was talking to one friend and she found that extremely useful. Despite this support, her goal remained "to continue to try to make the marriage work" by doing what her partner told her to do.
The women described their careful consideration of potential new relationships and a cautious approach toward old ones. Experiences with their partners led to fear and mistrust toward others, especially in establishing new relationships with men. Feelings of insecurity, ambivalence about becoming close to anyone new, and patterns of "closing up" around other people were described by the women who had little support. They felt reluctant to forge new relationships or to reach out to current ones in order to gain support. The majority of the women described themselves in relation to other people in positive terms, such as "caring," "generous," "kind," "enjoyable to be around," and the like. However, they tempered these positives with negatives. For example, one woman said, "I consider myself a talented, intelligent woman who enjoys being with people. I want to receive affirmation and care as well. Outwardly, I am confident, but I am usually feeling unsure and insecure in actuality. I am afraid to let people know that."
For some of these women the isolation they experienced was forced upon them as a direct result of the partner's control over who they saw and with whom they spent their time. Although the number of women who described this was small (n = 3), the intensity of the impact of the isolation was evident. "I go out with other people, but I hide my car" one woman said. Other women talked about a sense of being controlled by their partner because of his jealousy and the aftermath of bouts of jealousy, such as demanding obedience, threatening suicide, and restricting contact with others by erasing phone messages. For others, the forced isolation created a sense of shame or fear related to the abuse. A more complex and prevalent pattern was the perception of self as isolative, of defining self as "hard to get to know" or being uncomfortable around other people. Eight of the women referred to themselves in this way.
In addition to the complex interplay of isolation forced by the partner and the woman seeing self as isolative, other contextual factors were identified as influencing isolation and lack of support. Length of the relationship, quality of pre-existing relationships within the family, and negative experiences with support seeking in the past affected women who became more isolated and less willing to seek support. In particular, the notion of seeing self as an isolative person may reflect the altered identity and sense of disempowerment identified by Smith, Tessaro, and Earp (1995). These investigators noted that the women in their study were "transformed" by the messages sent by the abusers and they began to describe themselves in negative terms. More importantly, as these investigators noted, the women's habitual behavioral responses were changed to be congruent with the batterer's wishes, in this case, isolation from potential supporters and entrapment in the relationship (Smith et al., 1995).
The women made efforts to reach out for support, but in many cases it was with great reluctance or trepidation as they anticipated the response they would get. In some cases their fears were confirmed and they ceased reaching out. For example, a 36-year-old African American woman was in a relationship for one-and-a-half years at the time of the first interview; she experienced both physical beating and emotional abuse. She initially decided to isolate herself from her family because "I am afraid that they will find out what is happening to me." At Time 2 she still had talked to no one about the abuse and by Time 3 her depression had increased. In spite of the fact that she had left the relationship by Time 3, she was still being harassed. She finally decided to let her family know she needed help. She acknowledged how hard it was to ask for help: "I never asked and none was offered to me." She identified a number of friends and "good friendships" but did not talk to them about the abuse. She was also one of a few women who called the police for assistance but found they were not helpful. Her partner was never arrested and the police were so slow in coming that she left before they arrived. She did not pursue this avenue of support and was not encouraged by the police to do so. Her decision to leave the relationship by Time 3 had little to do with outside influences; she left because of changes she saw in herself: more drinking, more arguing, and feeling that she had changed.
The women did not consistently identify family members as sources of support. They were asked specifically about relationships with their mothers and fathers, since only a small number said they talked to their parents about the abuse. More than one-third (39%) of the women had witnessed their mothers being abused or were aware that abuse had occurred. Three women had been abused by their fathers or stepfathers during childhood. In these cases, they did not seek out support from these family members. Others described changing relationships with parents over time. Earlier conflicts were dealt with and in many cases they came to a point where the parents were supportive of the abused woman.
Some women felt their mother's needs were greater than their own, either because of age or the mother's own history of abuse. An illustrative case was one 38-year-old woman whose relationship with her mother was based on her mother's dependency needs, rather than her own needs for support. This woman's father was an alcoholic who abused her mother. She was raised to believe that the most important role for women is to be a wife and mother, and that it was acceptable for men to hit their wives. The focus of her relationship with her mother was on helping her mother rather than her mother helping her. She had no support; instead she focused all her energies on her children: "Everything I do is centered around my children. I want them to have what I did not have. I am a Black struggling mother. I want to be a role model for my daughter. I want her to know that welfare is not everything." At Time 2 she could not identify anyone she could talk to for support, and her low self-esteem was evident in her remark that she "could be a better person than she is," because she puts up with things, for example, her husband "running around with other women." At Time 3 she had forged several new friendships, she felt closer to her daughter who was at college, and she acknowledged she felt stronger in the relationship with her partner, stating that she "puts up with it because she still loves him."
None of the women specifically identified their father as someone they talked to about the abuse. For the majority (67%) relationships with their fathers were described in negative terms, such as "stormy," "cold," and "I don't know him." Seven of these women described extreme situations with fathers as they were growing up: fathers were alcoholic, drug abusing, or perpetrators of physical or sexual abuse in the family.
The ways in which friends were seen as a source of support seemed related to the abused woman's sense of self. Most women identified one or two friends, usually other women, as helpful to them. However, the decision to seek support in this way was carefully considered. The pattern of isolating, discussed above, was noted here by the women who described aspects of themselves that they thought hampered support seeking. For example, one woman described her relating to others this way: "I'm always looking out for other people--sometimes short changing myself. It's hard for me to talk about intimate things." In these cases, potential sources of support were limited by the women's perceptions of themselves and their comfort level with others. For the women who saw themselves as surviving the abuse by ending the relationship, they described a different, more positive perspective of themselves and the support they received from relationships with others. As one woman described it, "the relationship has been bad, but I have emerged from the experience with the realization that there are people who genuinely care about me and my children. I feel more confident and determined to move forward with my life."
Whereas many of the women described themselves in positive terms, many others portrayed themselves in ways that were ambivalent and tempered. One woman said she was "an average Black female" who doesn't speak up for herself a lot. She went on to describe her relating to others as "pretty good. I get along good with people, but I'm no good around too many people." Others say they appear more confident than they really were. Another asked, "Is it possible to be anxious all the time.'?"
For the women who identified sources of emotional and instrumental support, they identified the impact of the support on their own "self-talk." The messages to themselves that, "I don't deserve this, I deserve better," were reinforced. For those who experienced pressure from friends or relatives to leave, they heard these messages when they were ready. Even in cases where family members were not identified as people the woman talked to, they used them for instrumental support, going to them when they finally did leave the abusive relationship. Helping to clarify goals for self and seeing the choices was a powerful result of support. Working to solve problems occurred in the context of social support, as did the process of coming to see oneself as abused (Campbell, Kub, Rose, & Nedd, 1997). When supported, women reached out for help in active ways such as calling the police and going to a shelter. Equally important, however, were the women's perceptions of their own efforts and successes in dealing with abuse.
The women in this study described a variety of relationships that provide important support. Consistent with social support literature, no one person was seen as providing all the support needed. Equally important, however, were the effects of the nature and history of the relationships and how those qualities affected the support expected by the women. In particular, each woman's relationship with her mother was considered carefully in the context of the history between mother and daughter, whether or not the mother herself had been abused, and the daughter's perception of whether she would be told to stay in the relationship. The finding that a female friend is most often the main source of support is consistent with findings from other studies (Pitula & Daugherty, 1995) and reflects a growing awareness that support should be considered from nonkin sources. These findings underscore the need to carefully analyze the sources of support and perceptions of effectiveness in order to bolster support use by abused women.
Isolation from others has been noted as a characteristic of battered women that influences the degree of psychological distress experienced (Astin et al., 1993). There were times when many of the women felt isolated or pushed into isolation either by their partner's efforts to control them or by a negative response by family and friends. Many of the women did not say that isolation was forced upon them by the partner. There was a clearer pattern of feeling cautious and insecure when relating to others. It may be that some women in the present study have internalized the forced isolation (often coming from the jealousy of the partner and his control of her efforts at independence) into a sense of self, the notion of "I'm not the sociable kind of person." We were particularly struck by their self-descriptions that communicated a positive "I am a good person" stance while also describing their sense of self in relation to others that was more cautious. Stevens and Richards (1998) documented similar responses of a woman attempting to reclaim a sense of "her own value" and a "positive sense of self" (p. 15). It may be much harder to get women to reach out to potential sources of support when they see themselves as being the helper to others, including the abusive partner. Equally important, enhancing support, particularly emotional support, to break through the isolation and provide affirmation to abused women is especially critical. Women's ability and willingness to reach out for instrumental support, such as shelters and community aid, is then much more likely. The power of emotional support given by informal networks and its link to instrumental support provided by the professional sector is a critical area for continued research. Enhancing quality of interactions with others benefits women in terms of self-esteem and active problem solving and are fruitful areas for clinical intervention (Baker, 1997).
Merritt-Gray and Wuest (1995) found in their study that women were embarrassed to admit the abuse to family and the larger community whose norms and values predicted a critical response. The participants in the present study were also constrained by what they perceived as norms against leaving the relationship or otherwise developing an independent role. The community values of "solving one's own problems," discussed by Merritt-Gray and Wuest, created an atmosphere of self-doubt and severely diminished a sense of support, which was echoed by the women in this study.
While our ability to generalize the findings reported here is limited by the small number of women participating, the findings suggest several critical points that have application to other women in abusive relationships. First, in spite of growing public awareness of the magnitude of domestic abuse, these women had a sense that the American society was not wholly supportive of their plight. Second, the sense of self that these women described was a complex portrayal of both personal strengths and perceived limitations. Third, their isolation from other relationships suggests that intervention should consider ways that battered women see themselves and their ability to forge new and satisfying relationships.
This investigation allowed the women to describe social support in the contexts of their daily lives and personal situations. These descriptions increase our understanding of the complex role that social support plays in the lives of battered women.
Received 4 March 1998; accepted 11 January 1999.
Research reported in this article supported by the National Institute for Nursing Research grant #R29NR01678.
Address correspondence to Linda Rose, assistant Professor, John Hopkins University School of Nursing, 525 North Wolfe Street, Baltimore, MD 21205