Healing: a qualitative study of women recovering from abusive relationships with men

Healing After Gender-Based Violence: A Qualitative Metasynthesis Using Meta-Ethnography

Gender-based violence (GBV) is a significant violation of human rights, requiring specific understanding of how individuals heal and recover after these experiences. This article reports on findings of a qualitative metasynthesis that examined the nature of healing after GBV through the perspectives of female-identifying survivors. Empirical studies were identified by a search of peer-reviewed articles via electronic databases. Studies were included for review if they were available in the English language, reported on qualitative studies that directly engaged female-identifying survivors of GBV, and were aiming to understand the GBV healing journey, process, or goals. After our initial search, 1,107 articles were reviewed by title and abstract and 47 articles were reviewed for full text. Twenty-six peer-reviewed articles were included for the review and were analyzed using meta-ethnography. Key findings included the recovery journey as a nonlinear, iterative experience that requires active engagement and patience. Healing was composed of (1) trauma processing and reexamination, (2) managing negative states, (3) rebuilding the self, (4) connecting with others, and (5) regaining hope and power. "Shifts" or "turning points" are also mentioned which catalyzed healing prioritization. This article aggregates and examines the scientific literature to date on GBV healing and provides articulation of the limitations, gaps in evidence, and areas for intervention. The article considers implications for future research, policy, and practice and, in particular, focuses our attention on the need to expand our knowledge of alternative recovery pathways and mechanisms for healing.

Impacts of Male Intimate Partner Violence on Women: A Life Course Perspective

The nature and extent of the impacts of intimate partner violence (IPV) on victims are well documented, particularly male partner violence against women. However, less is known about how these impacts might change over time, including their legacy after women leave an abusive relationship and the lasting effects in their later lives. The purpose of this study was to examine women’s experiences of IPV at different stages over their life courses. Interviews with a cohort of 18 older women who had left an abusive relationship were analysed using thematic narrative analysis and the findings were presented according to trajectories, transitions, and turning points over their life courses. When in the relationship, the women experienced direct impacts on their physical, mental, social, and financial wellbeing. During separation, many experienced continued abuse and housing, legal, and financial stress. Life after separation was marked by loneliness, trauma, financial insecurity, and damaged relationships. Some women reached a turning point in their recovery through helping others. Understanding these impacts can inform interventions during each stage. Crisis support is critical when women are in an abusive relationship and during the dangerous phase of separation. Interventions can also assist women’s longer-term wellbeing and help them recover through post-traumatic growth.

Themes of Healing and Posttraumatic Growth in Women Survivors' Narratives of Intimate Partner Violence

Research on the effects of intimate partner violence (IPV) on women demonstrates the significant physical, emotional, psychological, and spiritual consequences of this form of interpersonal trauma. It is well documented that experiencing IPV can have devastating consequences to women's physical and mental health, overall well-being, and quality of life, as well as that of their children's. However, a small, predominantly qualitative body of research exists on women's experience of and capacity for healing from the effects of IPV, but more research is needed to advance theory and practice in this important area. This study applied secondary analysis to an existing data set to answer the question, "What are the themes of healing and posttraumatic growth in ten diverse women's narratives of IPV?" Lengthy, detailed interview transcripts were rigorously subjected to inductive and deductive thematic analysis, which revealed three overarching themes, and six subthemes, of healing and posttraumatic growth in women's narratives: Awareness and Insight (subthemes: Discerning the Self and Understanding Relationships), Renewal and Reconstruction (subthemes: [Re]building the Self and Redefining Relationships), and Transformation and Meaning (subthemes: New Perspectives and Finding Purpose Through Helping Others). Findings further revealed that women's healing from the effects of IPV involves a multidimensional, personalized, nonlinear, and often transformative process that operates within themselves and through relationships. Practitioners working with women who have experienced IPV should consider survivors' potential for healing and target appropriate intervention strategies. Additional qualitative and longitudinal research with diverse populations would deepen understanding of the dynamics, variables, and circumstances that impact healing and posttraumatic growth for women exposed to IPV.

Overcoming Abuse: A Phenomenological Investigation of the Journey to Recovery From Past Intimate Partner Violence

To date, minimal research has focused on the recovery process for survivors of intimate partner violence (IPV). This study utilized a phenomenological methodology to understand the lived experiences of survivors of IPV ( N = 123) who had overcome abusive relationships and created violence-free and meaningful lives. The researchers aimed to understand key factors involved in their recovery processes. Results indicated two main processes in the IPV recovery process: intrapersonal processes and interpersonal processes. Intrapersonal processes included (a) regaining and recreating one's identity, (b) embracing the freedom and power to direct one's own life, (c) healing from the mental and physical health symptoms of the abuse, (d) fostering acceptance and forgiveness with self and abuser, (e) education and examination of abusive relationships, (f) determining whether and how to enter new intimate relationships, and (g) acknowledging the long-term process of overcoming abuse. Interpersonal processes included themes of (a) building positive social support and relationships and (b) using ones' experiences with abuse to help others. Results of the present study are presented, and implications for practitioners are discussed.

Decision to Leave Scale: Perceived Reasons to Stay in or Leave Violent Relationships

The 30-item Decision to Leave Scale (DLS) was developed with 631 college women and 420 college women and women in shelters. Seven DLS subscales emerged for concerns in deciding to stay or leave: Fear of Loneliness, Child Care Needs, Financial Problems, Social Embarrassment, Poor Social Support, Fear of Harm, Hopes Things Change. Mean internal reliability was .73, mean test-retest reliability was .70. Discriminant validity was demonstrated by expected associations between DLS concerns and self-esteem, children, and violence. Criterion validity was demonstrated by greater DLS concerns for women in shelters than for college women. Women in violent relationships who decided to stay reported more Fear of Loneliness than women who decided to leave.

Engendering independence while living with purpose: women's lives after leaving abusive intimate partners

PURPOSE

The purpose of this study was to determine the common meanings a history of violence has for women out of abusive and violent relationships with an intimate male partner for 5 or more years.

SPECIFIC AIMS

To describe the common meanings and shared practices of women who left violent and abusive heterosexual intimate relationships 5 or more years ago, the challenges they face in their current lives, and the resources they use to meet those challenges. An additional aim is to elucidate practical advice they have for others who want to be supportive of the efforts of women recovering from intimate partner violence.

METHODS

An interpretive phenomenological approach using Heideggerian hermeneutics was utilized. Approval of the University Social Sciences Institutional Review Board was obtained. Participants were recruited by means of fliers distributed through a domestic violence listserv and through postings in health clinics in western New York. Interviews were recorded and transcribed. A hermeneutic team approach was used for analysis and interpretation of texts.

RESULTS

Twenty-one women of various ages, ethnicities, and backgrounds, who self-identified as being out of abusive relationships for 5 or more years, were interviewed. Six themes were identified: developing and maintaining self reliance; negotiating relationships; creating a safe and supportive environment; challenging societal roles and expectations; nurturing the self; and protecting the children. Engendering independence while living with purpose was the constitutive pattern that unified the themes.

CONCLUSIONS

Women can successfully establish productive, meaningful lives after violence and will fiercely protect and maintain their independence as they negotiate relationships and developmental challenges throughout their lives. A need for control of their lives and difficulty trusting others remain a lasting legacy of living with a history of violence.

CLINICAL RELEVANCE

This is the first study that examines women's lives 5 or more years after leaving violent and abusive relationships. Findings indicate that women can successfully leave violent and abusive relationships, and challenge the widely accepted notion that women do not leave.

Recovery experiences of Taiwanese women after terminating abusive relationships: a phenomenology study

This article describes the recovery experiences of women who had suffered intimate partner violence in Taiwan. A phenomenological study design using semi-structured interviews was used to obtain data from a purposive sample of eight women. Colaizzi's approach to narrative analysis was applied. Findings indicate that "reconstructing the self" emerged as the essence of the women's recovery experiences. Four themes were identified: Feeling shame, creating mastery, recognizing the imperfect self, and embodying the self by helping others. Understanding the recovery experience is an important step in effectively assisting women to recover from abusive relationships and to reconstruct their lives.

Exploring the meaning and role of spirituality for women survivors of intimate partner abuse

Literature on trauma, coping and spirituality has introduced new questions about protective factors in the healing process for intimate partner abuse survivors (IPA). This qualitative study explores the relationship between spirituality and IPA with three focus groups of twenty-two women IPA survivors residing in a shelter. A content analysis revealed central themes that explicate the meaning and role spirituality plays for participants. Viewed as a salient dimension, spirituality provides strength, influences outcomes and assists in the regulation of behavioral responses in a positive manner in terms of participants' traumatic IPA victimization. Practice implications are discussed.

The lived experience of women in abusive relationships who sought spiritual guidance

Women in abusive relationships have recognized the silence of religious institutions and clergy in addressing intimate partner violence. The old message, that women are to blame when family dysfunction occurs, remains evident in society. The objective of this qualitative study was to describe the experience of abused women attempting to decrease their spiritual distress and obtain spiritual guidance from their religious leaders. The findings revealed that clergy were not helpful in alleviating the women's spiritual distress or intervening in the violence. Four themes that epitomized the negative outcomes of the help-seeking behavior were spiritual suffering, devaluation, loss, and powerlessness.

Meaning of INSIGHT participation among women who have experienced intimate partner violence

This phenomenological study explored the meaning that women with violent partners found in participating in a 20-week group cognitive therapy program called INSIGHT. Through a two-step interview process, ten women who had experienced intimate partner violence described what it meant to them to decide to participate in INSIGHT; what was meaningful about the program; and what influence the program had on their lives. Findings indicated an overarching theme that described a process of Rescuing Self. This study adds support for the utility of interventions, such as INSIGHT, that nurture self-emergence among women who have experienced intimate partner violence.

Chieko's story: giving voice to survivors of wife abuse

Chieko's story relates in narrative form the childhood and early adult experiences of a Japanese woman who is learning to heal and rebuild her life after growing up in a violent home and ending an abusive marriage. This exemplar illustrates major processes and themes that emerged from a cross-cultural qualitative study of family violence. It also portrays universal aspects of this significant and pervasive health and social issue. This in-depth analysis and commentary on one woman's story that could have occurred almost anywhere uncovers hidden aspects contributing to the recidivism of this phenomenon. This story conveys hope for the many women and children who have no voice and for the clinicians who work with them.

Moving From Surviving to Thriving: African American Women Recovering From Intimate Male Partner Abuse

In this ethnographic study, a womanist framework was used to investigate the process of recovery from domestic violence. A purposive sample of African American women (N= 21) was interviewed to gain understanding of their recovery process. Survivorship-thriving was the overarching process. Six themes related to survivorship-thriving were identified: (a) Sharing secrets/Shattering silences—sharing information about the abuse with others; (b) Reclaiming the Self—defining oneself separate from abuser and society; (c) Renewing the Spirit—nurturing and restoring the spiritual and emotional self; (d) Self-healing through Forgiveness—forgiving their partners for the abuse and violence; (e) Finding Inspiration in the Future—looking to the future with optimism; and (f) Self-generativity by Engaging in Social Activism—participating in prosocial activities to promote social change. This article presents recovery oriented towards survivorship—thriving as a transformative process overall characterized by resilience and self-generativity. This represents more than just recovery as return to homeostasis or “back to normal.” Implications for survivor-informed practices are included.

Flexibility: a concept analysis

Flexibility is a quality that is deemed essential for nursing as the healthcare environment escalates into greater complexity. The word "flexibility" appears in nursing literature addressing the need to prepare for the next millennium, yet the concept of flexibility is rarely defined. Other disciplines, such as engineering, have struggled for years and continue to struggle to achieve conceptual clarity with regard to flexibility. A concept analysis using Rodgers' evolutionary method was undertaken to understand the meaning of flexibility.

Negative life experiences, depression, and immune function in abused and nonabused women

Abuse of women by their intimate partner is a staggering national problem. Abused women have a higher number of medically unexplained somatic symptoms, more functional disability, a lower self-rating of general health, and higher health care utilization when compared to nonabused women. The authors' purpose in this study was to examine differences in occurrences of negative life experiences, level of depression, and T-cell function between abused and nonabused women. The sample consisted of abused women (n = 12) and nonabused women (n = 12). Hypotheses tested were (1) abused women will have more negative life experiences than nonabused women, (2) abused women will have higher levels of depression than nonabused women, and (3) abused women will have reduced T-cell function compared to nonabused women. A cross-sectional cohort design was used to compare differences in negative life experiences, levels of depression, and T-cell function. Independent sample t-tests were performed comparing the abused versus nonabused women on the dependent measures. Significant differences were found between the groups for negative life experiences (LES; t = 2.29, p < 0.05), level of depression (BDI; t = 3.48, p < 0.01), and T-cell function (TMR; t = -5.62, p < 0.01). These findings are descriptive and do not establish causal links. However, this is an inquiry into the psychological and biobehavioral responses of women experiencing abuse and their potential health problems. The study shows that abused women reported more negative life experiences, experienced higher levels of depression, and experienced lower T-cell function when compared with nonabused women.

Trauma history of sheltered battered women

The purpose of this nursing research was to describe the trauma experience of sheltered battered women. Trauma history was operationalized as the participant's experience with traumatic life events in general (Trauma History Questionnaire [B. L. Green, 1995]) and with battering specifically (Conflict Tactics Scale, including a Physical Injury Severity scale). A convenience sample of 50 ethnically diverse women in the San Francisco Bay area was obtained from those residing in 2 shelters. Participants had experienced an average of 8.1 +/- 4.6 traumatic events (battering and nonbattering) over the course of their lives. Analysis of relationships between selected biopsychosocial and trauma history variables revealed the importance and beneficial effects of spiritual beliefs to many sheltered battered women.

Women's experiences of abuse: a review of qualitative research

This article reviews qualitative research published within the past 15 years based on women's first person accounts of their abuse experiences. Battered women's accounts of their experiences in abusive relationships aid in understanding why they stay, how they cope, and how others can help. Women's views of the emotional consequences of battering, the process of leaving, and the impact of social systems and community resources were consistent. Other themes in the literature were abuse in pregnancy, women who fight back, substance use, sex after beatings, family origins, and women who are elderly, minority, or from other cultures. Future research is needed on minority and affluent women, as well as the role of batterer's patriarchal attitudes and religious beliefs. Practice suggestions include expanding screening and parent education to pediatricians' offices and schools.