Victims and survivors of what we used to call domestic violence, and now call intimate personal violence (IPV), have long known that the effects of abuse lasted years beyond the abuse itself. The impact of abuse is far-reaching, whether the abuse be physical or psychological.

Not much research had been done on the health consequences of psychological battering until recently. Most research had focused on physical abuse and injuries and paid little attention to health problems that stemmed from non-injury abuse. The health consequences of long-term psychological abuse seemed to be ignored.

In the year 2000, Dr. Ann Coker and colleagues published the results of their survey of 1,152 women who sought medical care from family medicine clinics. The researchers found that a whopping 53.6% of these women had experienced some type of IPV at some point in their lifetimes. For most, the abuse was experienced at around the age of 22.

What distinguished Coker's research from previous research was that she and colleagues examined not only physical abuse but also psychological abuse. The researchers found that 13.6% of the women surveyed had experienced psychological IPV without any form of physical IPV.

Psychological violence is defined as psychological battering, or emotional abuse. This type of violence is characterized by the victims' continuous feelings of susceptibility to danger, loss of power and control, and entrapment.

Dr. Coker and colleagues found that when compared to women who never experienced IPV, women who experienced psychological IPV were significantly more likely to report their physical and mental health to be poor. They also reported ten adverse health outcomes arising from their psychological battering.

The ten bad health outcomes associated with psychological battering in intimate partner violence settings were these:

• Disability that prevented work
• Arthritis
• Chronic pain
• Migraine and other frequent headaches
• Onset of stammering
• Sexually transmitted infections
• Chronic pelvic pain
• Stomach ulcers
• Spastic colon (irritable bowel syndrome)
• Frequent indigestion, diarrhea, or constipation

Coker and colleagues found psychological IPV to be as strongly associated with the majority of adverse health outcomes as physical IPV was. Another significant finding was that 87.5% of women who reported abuse of any kind were in only one relationship characterized by IPV.

If you have suffered from psychological battering, you may have identified with some of the ten health consequences listed above.

Ellen Taliaferro, MD, is the author of a book called "WellWriting for Health After Trauma and Abuse." This book tells you how to use personal writing, or "directed" (topic-specific) journaling, to overcome past abuse and move your life and health forward.

Research by psychologist James Pennebaker from the University of Texas in Austin and others in the healthcare field has proven that directed personal writing can be a therapeutic tool. Pennebaker and others have show that the positive effects of writing can help discharge negative and harmful emotions associated with past trauma.

Dr. Taliaferro's book gives directions you can easily follow as you write your way toward better health. It's a gentle book you can use every day and it shows you what questions you may need to answer in your search for better health.

Ellen Taliaferro is a former Professor of Surgery at the University of Texas Southwestern Medical Center. She was the founder of the Violence Intervention and Prevention Center at Parkland Hospital in Dallas, Texas. The Center was the first in the nation to offer medical care to victims of violence.

Following is a link to the "WellWriting" book and others by Dr. Taliaferro.