Why am I still having these dreams? Post Traumatic Stress in the Lives of Older Women Survivors of Intimate Partner Violence

Purpose: Based on analysis of the narratives from a phenomenological study engaging older women in reflection on aging as an embodied woman, this presentation describes post traumatic stress (PTS) secondary to intimate partner violence (IPV), in order to draw practice and research attention to this under-recognized issue in older women's mental health. Survivors of IPV are conceptualized as women in their childbearing years (Bonomi, Anderson, Reid, Carrell et al., 2007). Only recently has domestic violence been recognized as a problem for women across the lifespan (Zink, Jacobson, Regan, Pabst, 2004). Knowledge of IPV history would include screening for PTS in younger women. It is less likely that healthcare providers evaluating older women would elicit historical information about IPV that occurred thirty-to-forty years earlier. Survivors often normalize dissociative symptoms. Symptoms such as depression and anxiety, when presented by an older woman, may not be associated with PTS. Viewed through an ageist lens, these symptoms may be interpreted as the result of loneliness, or a consequence of aging. Methods: During a ten month period fifteen working poor women—African American, Latina and White--ages sixty-two-to-ninety-one; members of a senior center in a large urban apartment complex in the Northeast—were each interviewed four times for 1-to-1 ˝ hours. Loosely structured, in-depth interviews were conducted to elicit rich, textural descriptions (Wertz, 2005; Giorgi, 1997) of the lived experience of aging as an embodied woman. The digitally recorded and transcribed verbatim interviews were analyzed using phenomenological methods--reflection on and dwelling with the transcripts (through repeated reading); and clustering and imaginatively varying (associating to) emergent themes yielding the essence of aging as an embodied woman (Wertz, 2005; Giorgi, 1997). Findings: Ten core themes illuminated the dimensions of aging as an embodied woman; describing the centrality of women's bodies throughout their lives as 'self' protective and 'self' revealing; as powerless, empowered, vulnerable and resilient. One participant's question 'Why am I still having these dreams?' led to a reflective, associative journey that resulted in one of the core themes: The 'Self' Revealing Body, and to the conceptualization of the invisibility of PTS secondary to IPV. At seventy-eight, forty years after experiencing IPV, flashbacks, avoidance, intrusive recollections, and intense anxiety were unknown to her providers who treated her for what she understood as ageing-related depression and anxiety. Another participant, sixty-eight, having gained 100 pounds forty years ago to protect her 'self' from abuse by a jealous husband, avoids intimate relationships saying, 'I just don't want to be bothered no more. I'd rather be by myself.' Although she receives treatment for recurrent depression, IPV has never been raised. Conclusions: These narratives, situated in the context of the literature, suggest that under-recognized PTS secondary to IPV leads to inadequate care that compromises older women's mental health. Qualitative research that further describes this phenomenon and quantitative studies that begin to define its scope are necessary to educate and inform healthcare providers; to influence assessment protocols and develop standards of care that are inclusive of this invisible population of trauma survivors.