'· Sci. Law ( 1 9 7 9 ) V o l . 1 9 , N o . 1
Printed
in Great
Britain
19
The Aetiology of Repeated Serious Physical Assaults by Husbands on Wives (Wife Battering) J
- J. GAYFORD,
M B , B S , M R C Psych,
DPM
Consultant Psychiatrist, Warlingham Park Hospital, Surrey
SUMMARY Aetiological factors were s t u d i e d in 1 0 0 b a t t e r e d wwes, w h o c a m e from a wide social a n d e d u c a t i o n a l P e c t r u m , with a q u a r t e r witnessing family violence their c h i l d h o o d . Nearly half h a d b e e n deprived of t least o n e p a r e n t before t h e age of 1 5 years, a n d there was an association b e t w e e n c h i l d h o o d u n h a p p i «s a n d a d u l t a t t e m p t e d suicides. Psychiatric s y m p t o m s were f r e q u e n t l y t r e a t e d b y general prac titioners, b u t nearly half n e e d e d f u r t h e r p s y c h i a t r i c . ' P - A small sub-group of w o m e n had an e x t r a sturbed social a n d sexual h i s t o r y . H u s b a n d s requently violent while d r u n k ; j e a l o u s y , imprisont , u n e m p l o y m e n t , p r o m i s c u i t y a n d g a m b l i n g were et possible aetiological factors r e p o r t e d in t h e m e n .
s
l n
a
n
e
n
INTRODUCTION
Th terms 'battered wife', marital or conjugal Violence and even 'tortured wife' have all been sed loosely with emotive objectives, so it is first necessary to define the terms. n e
u
Marital or conjugal violence: Spouses are violent each other, or the violence may be in one direction only. This covers all degrees of Physical assault from a trivial single incident to Peated serious attacks. t o
re
Battered wife: This term should be reserved for any woman w h o has been subjected to e r e , deliberate, repeated demonstrable physiinjury from her marital partner (Gayford, ?5a,b). To rtured wife: If this term is to be used at all should be restricted to cases where there is Premeditated infliction of physical injury per formed in a sadistic setting. Sev
C a l
l 9
11
Husbands may be subjected to marital Violence, but it is extremely uncommon for hem to move into the battered class, and ireported for them to be subjected to torture. {
Ur
Cobbe (1878) saw the aetiology of wife battering as alcohol intoxication, jealousy, heteropathy and sheer friction caused by over crowding and social deprivation. She defines heteropathy as the opposite to sympathy, where the sight of pain and suffering induces the desire to destroy rather than help. Schultz (1960) tries to explain the psychodynamics of men imprisoned for attempting t o kill their wives. He hypothesized that they had dominant rejecting mothers, producing passive men who tried to avoid conflict, but who married women like their mothers, with whom they developed a hostility-dependency relationship, with aggressive outbursts when support was withdrawn. Snell et al. (1964) continue this theme of projecting the women as the cause of the violence to which they are subjected. Faulk (1974) concludes that men over 40 who are violent to their wives for the first time are more likely to suffer from a psychotic disorder, and from his small sample tries to define five types of men. Scott (1974) presents the Royal College of Psychiatrists' report to the Depart ment of Health and Social Services on battered wives and suggests possible factors like immature and psychopathic personality, jealousy, drug and alcohol abuse. He feels that sadomasochism has little part to play as do other psychiatric disorders, but sees prostitution as sexually provoking and suggests possible cultural factors. A close relationship with the battered baby syndrome is also postulated. This was confirm ed by the Royal Scottish Society for the Prevention of Cruelty to Children (1974), who also stress the history of heavy drinking in husbands and a background of violence on both sides of the family. Hanks and Rosenbaum
20
Med. Sci. Law (1979) Vol. 1 9 , N o . 1
(1977) concluded from a small study of women who lived with violent alcoholic men that the more violent her parental relationship, the more violent her marriage or cohabitation. General information and mode of presenta tion have been reported (Gayford, 1975a, b), some attempt has been made at classification (Gayford, 1976) and the psychodynamics dis cussed (Gayford, 1978). Historical aspects and problems confronting the battered wife are outlined (Gayford, 1977a, b), but as yet there is no account of the aetiology, backed by a reasonably sized survey. MATERIAL AND METHOD
One hundred women claiming and showing evidence of being battered wives were inter viewed. Eighty-nine of them were seen at Chiswick Women's Aid in 1974 and the re mainder were seen in general psychiatric consultation, some being specially referred by general practitioners and social workers. Prior to the interview all had either completed or been helped by lay interviewers from the hostel to complete a questionnaire. Where information was available from other sources this was used to check the content of the questionnaire and interview. In all the cases seen at Chiswick Women's Aid the women were observed over a period of weeks, which in itself produced supplementary information. No distinction was made between marriage and cohabitation, but in every case the couple had lived together as man and wife for at least a year. There were, in fact, 85 married women and 15 cohabiting. All women had to have been subjected to at least three episodes of violence for inclusion in this survey. RESULTS Violent family background
Twenty-three women saw their fathers being violent to their mothers or other members of the family in their childhood; in 19 cases this violence extended to the subject herself. Four teen women claimed to have been subjected to violence from their mothers. Where it was possible for women to give an account of their parents' general behaviour, 27% saw their fathers as aggressive and 25% said the same of their mothers.
Seventy-two women claimed they had dis cussed childhood experiences with their husband or cohabitee, 30 (41.6%) of the men had spoken of their father's violence and 5 (6.9%) said the same of their mother. According to the women, one third of the men had served prison sentences for violent offences. Country of origin
The nationality of the battered wives, their hus bands or cohabitees and women's parents are shown in Table I, together with the predicted percentage of each sex that would be expected according to the. Registrar General's Census for 1971 (Registrar General, 1973). Parental deprivation
Only 65% of women were brought up by both parents to the age of 15 years. In 19 cases the parents had divorced or separated by that time; 12 had been brought up mostly by step-parents, 4 by a stepmother and 3 by a stepfather. Eleven women were brought up by a single parent, 7 by mother and 2 by father alone. Seven women were reared by other relatives and 6 spent most of their childhood in institutional care. The parents of 5 women never lived together. Battered wives tended to come from large families with women having a mean of 3-3 siblings, which took no account of half-siblings. Twenty-seven women were one of 6 or more children and one woman was one of 16 children. Social class and family employment
Of the 87 women with whom it was possible to make a reasonable estimate of their parents' social class, 2% seemed definitely to be of social class I and 60% social class IV or V. The occupations of the husbands or cohabitees showed that 6% were social class I and 65% social class IV or V. Half of these husbands had no employment problems, but one third were either never employed or frequently unem ployed. Education and work records of battered wives
One third of women left school passing examinations of which 4 had gained 'A' levels
Gayford: Aetiology of Wife Battering
21
Table I. T h e nationality of b a t t e r e d wives, their p a r e n t s , h u s b a n d s or c o h a b i t e e s and t h e predicted p e r c e n t a g e of each sex from t h e general p o p u l a t i o n of t h e United Kingdom Husbands
Battered wives Nationality United K i n g d o m Republic of Ireland West Indian O t h e r Nationalities TOTAL
or Mothers cohabitees Fathers W o m e n in of of of United battered battered battered Kingdom wives wives wives
Men in United Kingdom
(%)
(%)
(%)
(%)
(%)
(%)
66 17 9 8
61 20 8 11
92 1 1 6
55 21 14 10
56 23 10 11
91
100
100
100
100*
100
100*
2 1 6
* Based on a sample of 9 8 as t h e nationality of 2 of t h e m o t h e r s a n d 2 of t h e fathers of t h e b a t t e r e d wives was u n k n o w n .
I n
GCE. Seventeen studied at a grammar school d 9 had private or convent education. After aving school an overlapping one third went ° with further studies, of which 8 started "ursing and 6 teacher training, but the majority this group attended secretarial courses. While 7 of the women never worked in paid mpl yment, 32 stayed in one job for more than * years. Although 28 only worked for the ''nancial consideration, 36 claimed they had gained job satisfaction ar,
le
n
o f
e
0
p
claimed that they really wanted to kill them selves and 14 frankly admitted they had only wanted to draw attention to their plight with the hope of outside help. As would be expected there was a correlation between women making suicidal attempts and those seeking psychiatric help ( χ = 7.28, d.f. = 1, P < 0 0 1 ) . Prescrip tion of antidepressants and tranquillizers by general practitioners, although commonly associ ated with suicidal attempts, did not reach significance. 2
*Ych •atric history
Alcohol and drug abuse
°f the women interviewed 46 admitted they d received a psychiatric consultation on at 'east one occasion; 21 had received treatment for t°r depression with antidepressants and/or ECT.
Twenty women admitted they used alcohol to enjoy the intoxicating and disinhibiting effects; only 14 admitted to drunkenness on more than the isolated occasion. According to the women, drunkenness was extremely com mon among the men with 52 being in this state at least on a weekly basis; for a further 22 this was still quite a frequent occurrence. For 44 women their husband's drunkenness was associated with his violence. While 12 women admitted to experience with cannabis, 8 had taken drugs to experience the central effects. This included the full range of drugs from benzodiazepines, barbiturates, methaqualone, amphetamines and lysergic acid. Two had experienced the effects of opium alkaloids or methadrone illicitly on at least one occasion, but had not become addicted. Infor mation about drug abuse was not available for
a
w
o had suffered from a puerperal psychosis, had been admitted to an alcoholic unit and had submitted to a leucotomy. The remainhad mixed diagnoses of reactive depression to marital problems or personality dis° * r. In addition, 71 had been treated with tidepressants or tranquillizers by their general Petitioners. e r
U e
r
Printed
in Great
Britain
19
The Aetiology of Repeated Serious Physical Assaults by Husbands on Wives (Wife Battering) J
- J. GAYFORD,
M B , B S , M R C Psych,
DPM
Consultant Psychiatrist, Warlingham Park Hospital, Surrey
SUMMARY Aetiological factors were s t u d i e d in 1 0 0 b a t t e r e d wwes, w h o c a m e from a wide social a n d e d u c a t i o n a l P e c t r u m , with a q u a r t e r witnessing family violence their c h i l d h o o d . Nearly half h a d b e e n deprived of t least o n e p a r e n t before t h e age of 1 5 years, a n d there was an association b e t w e e n c h i l d h o o d u n h a p p i «s a n d a d u l t a t t e m p t e d suicides. Psychiatric s y m p t o m s were f r e q u e n t l y t r e a t e d b y general prac titioners, b u t nearly half n e e d e d f u r t h e r p s y c h i a t r i c . ' P - A small sub-group of w o m e n had an e x t r a sturbed social a n d sexual h i s t o r y . H u s b a n d s requently violent while d r u n k ; j e a l o u s y , imprisont , u n e m p l o y m e n t , p r o m i s c u i t y a n d g a m b l i n g were et possible aetiological factors r e p o r t e d in t h e m e n .
s
l n
a
n
e
n
INTRODUCTION
Th terms 'battered wife', marital or conjugal Violence and even 'tortured wife' have all been sed loosely with emotive objectives, so it is first necessary to define the terms. n e
u
Marital or conjugal violence: Spouses are violent each other, or the violence may be in one direction only. This covers all degrees of Physical assault from a trivial single incident to Peated serious attacks. t o
re
Battered wife: This term should be reserved for any woman w h o has been subjected to e r e , deliberate, repeated demonstrable physiinjury from her marital partner (Gayford, ?5a,b). To rtured wife: If this term is to be used at all should be restricted to cases where there is Premeditated infliction of physical injury per formed in a sadistic setting. Sev
C a l
l 9
11
Husbands may be subjected to marital Violence, but it is extremely uncommon for hem to move into the battered class, and ireported for them to be subjected to torture. {
Ur
Cobbe (1878) saw the aetiology of wife battering as alcohol intoxication, jealousy, heteropathy and sheer friction caused by over crowding and social deprivation. She defines heteropathy as the opposite to sympathy, where the sight of pain and suffering induces the desire to destroy rather than help. Schultz (1960) tries to explain the psychodynamics of men imprisoned for attempting t o kill their wives. He hypothesized that they had dominant rejecting mothers, producing passive men who tried to avoid conflict, but who married women like their mothers, with whom they developed a hostility-dependency relationship, with aggressive outbursts when support was withdrawn. Snell et al. (1964) continue this theme of projecting the women as the cause of the violence to which they are subjected. Faulk (1974) concludes that men over 40 who are violent to their wives for the first time are more likely to suffer from a psychotic disorder, and from his small sample tries to define five types of men. Scott (1974) presents the Royal College of Psychiatrists' report to the Depart ment of Health and Social Services on battered wives and suggests possible factors like immature and psychopathic personality, jealousy, drug and alcohol abuse. He feels that sadomasochism has little part to play as do other psychiatric disorders, but sees prostitution as sexually provoking and suggests possible cultural factors. A close relationship with the battered baby syndrome is also postulated. This was confirm ed by the Royal Scottish Society for the Prevention of Cruelty to Children (1974), who also stress the history of heavy drinking in husbands and a background of violence on both sides of the family. Hanks and Rosenbaum
20
Med. Sci. Law (1979) Vol. 1 9 , N o . 1
(1977) concluded from a small study of women who lived with violent alcoholic men that the more violent her parental relationship, the more violent her marriage or cohabitation. General information and mode of presenta tion have been reported (Gayford, 1975a, b), some attempt has been made at classification (Gayford, 1976) and the psychodynamics dis cussed (Gayford, 1978). Historical aspects and problems confronting the battered wife are outlined (Gayford, 1977a, b), but as yet there is no account of the aetiology, backed by a reasonably sized survey. MATERIAL AND METHOD
One hundred women claiming and showing evidence of being battered wives were inter viewed. Eighty-nine of them were seen at Chiswick Women's Aid in 1974 and the re mainder were seen in general psychiatric consultation, some being specially referred by general practitioners and social workers. Prior to the interview all had either completed or been helped by lay interviewers from the hostel to complete a questionnaire. Where information was available from other sources this was used to check the content of the questionnaire and interview. In all the cases seen at Chiswick Women's Aid the women were observed over a period of weeks, which in itself produced supplementary information. No distinction was made between marriage and cohabitation, but in every case the couple had lived together as man and wife for at least a year. There were, in fact, 85 married women and 15 cohabiting. All women had to have been subjected to at least three episodes of violence for inclusion in this survey. RESULTS Violent family background
Twenty-three women saw their fathers being violent to their mothers or other members of the family in their childhood; in 19 cases this violence extended to the subject herself. Four teen women claimed to have been subjected to violence from their mothers. Where it was possible for women to give an account of their parents' general behaviour, 27% saw their fathers as aggressive and 25% said the same of their mothers.
Seventy-two women claimed they had dis cussed childhood experiences with their husband or cohabitee, 30 (41.6%) of the men had spoken of their father's violence and 5 (6.9%) said the same of their mother. According to the women, one third of the men had served prison sentences for violent offences. Country of origin
The nationality of the battered wives, their hus bands or cohabitees and women's parents are shown in Table I, together with the predicted percentage of each sex that would be expected according to the. Registrar General's Census for 1971 (Registrar General, 1973). Parental deprivation
Only 65% of women were brought up by both parents to the age of 15 years. In 19 cases the parents had divorced or separated by that time; 12 had been brought up mostly by step-parents, 4 by a stepmother and 3 by a stepfather. Eleven women were brought up by a single parent, 7 by mother and 2 by father alone. Seven women were reared by other relatives and 6 spent most of their childhood in institutional care. The parents of 5 women never lived together. Battered wives tended to come from large families with women having a mean of 3-3 siblings, which took no account of half-siblings. Twenty-seven women were one of 6 or more children and one woman was one of 16 children. Social class and family employment
Of the 87 women with whom it was possible to make a reasonable estimate of their parents' social class, 2% seemed definitely to be of social class I and 60% social class IV or V. The occupations of the husbands or cohabitees showed that 6% were social class I and 65% social class IV or V. Half of these husbands had no employment problems, but one third were either never employed or frequently unem ployed. Education and work records of battered wives
One third of women left school passing examinations of which 4 had gained 'A' levels
Gayford: Aetiology of Wife Battering
21
Table I. T h e nationality of b a t t e r e d wives, their p a r e n t s , h u s b a n d s or c o h a b i t e e s and t h e predicted p e r c e n t a g e of each sex from t h e general p o p u l a t i o n of t h e United Kingdom Husbands
Battered wives Nationality United K i n g d o m Republic of Ireland West Indian O t h e r Nationalities TOTAL
or Mothers cohabitees Fathers W o m e n in of of of United battered battered battered Kingdom wives wives wives
Men in United Kingdom
(%)
(%)
(%)
(%)
(%)
(%)
66 17 9 8
61 20 8 11
92 1 1 6
55 21 14 10
56 23 10 11
91
100
100
100
100*
100
100*
2 1 6
* Based on a sample of 9 8 as t h e nationality of 2 of t h e m o t h e r s a n d 2 of t h e fathers of t h e b a t t e r e d wives was u n k n o w n .
I n
GCE. Seventeen studied at a grammar school d 9 had private or convent education. After aving school an overlapping one third went ° with further studies, of which 8 started "ursing and 6 teacher training, but the majority this group attended secretarial courses. While 7 of the women never worked in paid mpl yment, 32 stayed in one job for more than * years. Although 28 only worked for the ''nancial consideration, 36 claimed they had gained job satisfaction ar,
le
n
o f
e
0
p
claimed that they really wanted to kill them selves and 14 frankly admitted they had only wanted to draw attention to their plight with the hope of outside help. As would be expected there was a correlation between women making suicidal attempts and those seeking psychiatric help ( χ = 7.28, d.f. = 1, P < 0 0 1 ) . Prescrip tion of antidepressants and tranquillizers by general practitioners, although commonly associ ated with suicidal attempts, did not reach significance. 2
*Ych •atric history
Alcohol and drug abuse
°f the women interviewed 46 admitted they d received a psychiatric consultation on at 'east one occasion; 21 had received treatment for t°r depression with antidepressants and/or ECT.
Twenty women admitted they used alcohol to enjoy the intoxicating and disinhibiting effects; only 14 admitted to drunkenness on more than the isolated occasion. According to the women, drunkenness was extremely com mon among the men with 52 being in this state at least on a weekly basis; for a further 22 this was still quite a frequent occurrence. For 44 women their husband's drunkenness was associated with his violence. While 12 women admitted to experience with cannabis, 8 had taken drugs to experience the central effects. This included the full range of drugs from benzodiazepines, barbiturates, methaqualone, amphetamines and lysergic acid. Two had experienced the effects of opium alkaloids or methadrone illicitly on at least one occasion, but had not become addicted. Infor mation about drug abuse was not available for
a
w
o had suffered from a puerperal psychosis, had been admitted to an alcoholic unit and had submitted to a leucotomy. The remainhad mixed diagnoses of reactive depression to marital problems or personality dis° * r. In addition, 71 had been treated with tidepressants or tranquillizers by their general Petitioners. e r
U e
r
