Research That Matters (January 17 - 20, 2008)

Purpose: Despite mental health professionals' best efforts to provide quality intervention to women attempting to extricate themselves from violent relationships and lead violence-free lives we know little about the course of final stage recovery or healing from the effects of IPV. Most interventions focus on symptom reduction and the restoration of ego-equilibrium such that women are able to live independently of their abuser. But post-shelter studies (Rowbottom et al 2005) report that women experience long-term mental health issues and often return to their abuser or enter into newly abusive relationships.

Borrowing from the work of anthropologists Arthur van Gennep (1906) and Victor Turner (1969), who examined cross-cultural transition rites that normalize and institutionalize social identity or social position changes, we hypothesized that healing from intimate partner violence, (operationalized as effective self-care, behavioral autonomy, relationship stability, and a sense of self focused on present and future accomplishments rather than past experiences with trauma), constituted a rite of passage that entailed completion of three stages – separation, liminality, and incorporation each of which paralleled necessary shifts in women's social and self-constructed identity. Most interventions leave women in a state of liminality in which they have left their old social roles and life ways (life with an abuser) yet are unable to define themselves in terms other than the violence and trauma they experienced (e.g. “survivor of abuse” or “victim of abuse”). They thus maintain psychic investment in an identity marked by deficit, debility, or a social problem and enact this identity within their relationships. Support groups may inadvertently sustain liminality by keeping women's psychic focus on their trauma. Unhealed, many women remain vulnerable to violating relationships and continue to experience long-term mental and physical health problems.

Methods: This study integrated semi-structured (protocol) and life history interviews with structured interviews to test the rite-of-passage hypothesis by tracking the cultural, cognitive, and emotional changes among two groups of ethnically, economically and developmentally diverse women some of whom enrolled in a long-term violence intervention and support program designed to facilitate self-constructed identity transformation (n=25) and some of whom did not (n=20). Transcribed protocol and life history interviews were analyzed (using ATLAS-ti) for thematic patterns in cognitive and identity shifts as well as changes in life story themes. Structured interviews were analyzed using correspondence analysis and OLS regression models to determine the scalability of the hypothesized healing progression.

Results: Women described movement through liminality by reference to six sequential cognitive ‘shifts,' in which they moved from “victim”/“survivor” to “thriver” self-defined as independent, worthy, differentiated and whole. A correspondence analysis of healing items revealed a progression in healing among women in the intervention group (coefficient of reproducability: .875) but not for those not participating (coefficient of reproducibility: .476).

Conclusions and Implications: This study suggests an alternative intervention paradigm to those currently working with IPV survivors by defining a final stage women must complete in order to be fully recovered or healed from the effects of trauma. This study also offers a reproducible intervention model for practitioners.