Domestic Violence: A Hidden Cause of Chronic Illness

An alarming 44 percent of women say they have experienced abusive behavior from a partner. Years after the bruises from domestic violence fade, the physical effects can linger in the form of serious health problems—migraines, arthritis, even gastrointestinal disease. Our groundbreaking investigation

by Alexis Jetter
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Photograph: Photographed by Julia Fullerton-Batten

Leslie Morgan Steiner, 48, a Harvard-educated MBA and author of the 2009 best seller Crazy Love, always made sure no one saw the bruises. In her early twenties, she wore turtlenecks, even in the summer, to cover up the strangulation marks left by her first husband, who flew into rages, threatened her with loaded guns, threw her down a flight of stairs and pounded her head against walls. Twice he choked her so violently that she lost consciousness. The attacks started the week before they married and lasted until she left, nearly four years later. “For my wedding, I had 10 tiny little finger marks on my neck,” Steiner says. “I should have left him at that moment, knowing what I know now. But I didn’t call it strangulation. The violence happened about once a week. And it was random. It wasn’t tied to anything that I did or said. The worst kind of violence is when you can’t see it coming and you have no control over it. He was very clever about it.”

Today, despite being in otherwise robust health, Steiner says she has terrible short-term memory problems and arthritis in her shoulders, hands, wrists, joints and ankles—precisely where she sustained injuries 20 years ago. Until recently, she never made the connection between her ailments and her past abuse. “I thought it was just from getting older and having three kids,” she says. “I’m so grateful for getting out of the relationship that I don’t think about it in those terms. But the fear stays with you forever. The fact that I’m still afraid of running into my ex-husband even though it’s been 20 years since I’ve seen or talked to him—that’s a testament to the fact that it never leaves you. The fear gets into your bones.”

It also gets into your gut, your psyche and your heart. Like Steiner, Samone,* 44, left her husband 20 years ago; he had nearly choked her to death. She, too, thought she’d gotten away clean. She finished college, went to law school, worked as a congressional aide, raised two children as a single mother and now directs a large social service agency. But Samone carries a toxic legacy from the violence: gastrointestinal distress so severe that she feels as if she’s having a heart attack; borderline hypertension; and depression so profound that she once considered suicide. “The only thing that got me out of that depressive episode was knowing that my children needed me,” she says. But some of the cognitive deficits from the abuse continue to haunt her. Memory gaps made it impossible for her to pass the bar exam. And when she sits down every few years to write about her experiences, the intestinal pains and depression overwhelm her. “I have done everything within my power to move on from that time in my life,” she says, “and yet I feel like the abuse still has this hold on me.”

Part of this is a cumulative effect,” says Jacquelyn Campbell, a professor of public health at the Johns Hopkins School of Nursing and a pioneer in the field of DV research. “A woman comes in with a black eye, and nobody asks, ‘Where else were you injured?’ She might say, ‘He slammed my entire body against a wall.’ But doctors don’t look beyond that for a history of injury. They don’t ask, ‘Have you ever been strangled by him? Had a head injury? Had a broken bone?’ That’s what we have to be doing so that it’s not 10 years later that she’s starting to complain of memory loss.” Ideally, Campbell says, DV survivors should be given the same advice about traumatic brain injuries that professional athletes are: Rest. Don’t get hit again. For an abused woman, of course, that’s very difficult. “So as a doctor or nurse, you want to do some safety planning with her. You try to get her out of harm’s way,” says Campbell.

First published in the November 2013 issue

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