I had a young female patient in her mid 20’s at a general hospital who I noticed had mood swings, one day she would be happy and joyful and the next she would be miserable and aggressive. At first I didn’t think there would be any reason behind it because many patients’ moods are not consistent because it is natural for them to feel a bit frustrated being for a long period in hospital. I discussed with her doctor and he did not have much information besides the basic social history of the patient.
One day when they patient was in a better mood I took the opportunity to dig a bit deeper into what the patient was all about in terms of her social history. It turned out that her husband in an alcoholic and on drugs. She has not spoken to anyone about this as she kept it to herself out of fear and shame. Her husband would verbally abuse her about her physical appearance, her efforts at home not being good enough, and having 4 children (1 not being his biological child). There were numerous nights where he would not return home or he would steal her money. This put her under loads of stress (emotionally and psychologically) for the past year and a half. She struggles to manage her time and effort between her children, job and managing the house.
For me this was tough because I had no idea what to say. I had no experience in this type of situation. However, Physiotherapists work closely with patients who are possibly victims of abuse. I identified her signs and symptoms of emotional/psychological abuse with depression, mood swings and tearfulness. Before doing anything I notified social work by writing a referral letter explaining what I have heard from the patient. Smith and Segal (2016) defines domestic abuse also known as spousal abuse when one person in an intimate relationship or marriage tries to dominate and control the other person. They further explain that the aim of emotional abuse is to chip away at your feelings of self-worth and independence. Emotional abuse includes verbal abuse such as yelling, name-calling, blaming, and shaming. Isolation, intimidation, and controlling behavior also fall under emotional abuse (Smith and Segal, 2016). The victim of emotional abuse may feel that there is no way out of the relationship, or that without your abusive partner you have nothing (Smith and Segal, 2016). The booklet by Children Family Services (2003) helped me understand a bit more on what domestic abuse is, the signs and symptoms, what us as health care providers should look out for and how we can help victims of abuse. It also provides options to victims on how to deal with the situation of abuse.
Reflecting on this situation I think I lacked the knowledge of how to deal with scnarios of abuse. Physiotherapists are also psychologists, social workers and mentors to a certain extent. I feel like if I had known a bit more I could have possibly spoken to the patient about the problem and provide options for her to use in dealing with the situation. Furthermore, victims of abuse need help to get out, they’ve often been isolated from their family and friends. We as health care providers need to help them escape an abusive situation and begin healing.
Children Family Services. (2003). Breaking the silence: A handbook for victims of domestic violence. Retrieved from http://dhhs.ne.gov/children_family_services/Documents/2003silence.pdf
Smith, M., & Segal, J. (2016). Domestic Violence and Abuse: Signs of Abuse and Abusive Relationships. Retrieved from http://www.helpguide.org/articles/abuse/domestic-violence-and-abuse.htm