Marta Boczkowska, Mateusz Banaszkiewicz, Mariusz Zięba Women who experience violence – an interpretative phenomenological analysis of the post-traumatic adaptation proces
Tytuł: Women who experience violence – an interpretative phenomenological analysis of the post-traumatic adaptation proces
Autorzy: Marta Boczkowska, Mateusz Banaszkiewicz, Mariusz Zięba
The Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5; American Psychiatric Association, 2013) defines a traumatic event as an individual experience of an extremely stressful event characterized by a threat to one’s life or integrity or that of another individual. Experiencing violence certainly belongs in this category. A traumatic event can give rise to a whole range of deep and long-lasting changes in somatic and psychic functioning (Zawadzki & Strelau, 2008). Research conducted in a group of women suggests that experiencing abuse alters their self-perception, sense of security and results in loss of trust (Sleutel, 1998). Studies of women who have experienced abusive relationships have compared their situation to that of a prisoner (Painter & Dutton, 1985; Moss et al., 1997). Experiencing physical violence is also related to a sense of fear and hopelessness, which is often associated with post-traumatic stress disorder (Koss et al., 2003). O’Leary, Alday and Ickovics (1998) described three categories of potential long-term consequence of exposure to trauma:
- survival: functioning of the individual is worse than before the trauma; – recovery;
- thriving (post-traumatic growth): functioning of the individual is better than before the trauma.
Violence can have these three long-term consequences and it is worth considering the factors that could affect regaining of equilibrium and post-traumatic growth.
Coping with experience of violence includes the identification process and redefinition of convictions. According to Janoff-Bulman (1992, 2006), one of the important effects of trauma is that the individual questions and revises previously held fundamental views about him or herself and the world, and the further consequences of trauma – such as regaining one’s equilibrium or post-traumatic growth – depend on the level of those convictions. One’s fundamental views on oneself and the world also affect one’s choice and application of strategy for handling stress (Ai & Park, 2005).
Strategies for handling stress are a substantial factor in the post-traumatic readaptation process (Tedeschi & Calhoun, 2007). The most adaptive strategies are task-focused or involve acceptance, positive re-evaluation and religious coping (Pargament, 1997; Linley & Joseph, 2004). An increasing number of studies argue that coping strategies focused on giving meaning to one’s experience play a significant role in adjustment to a traumatic event (Park & Folkman, 1997; Schwarzer & Knoll, 2003; Załuski, 2014).
Folkman (2008) pointed out that when coping with difficult circumstances people draw on their spiritual or religious convictions and sense of fairness. Folkman and Moskowitz (2000) claimed that coping strategies relying on meaningfulness generate positive emotions, particularly during exposure to intense stress.
Taylor (1984) highlighted that delusions and positive illusions play a material role in the process of effective adaptation. Taylor’s cognitive adaptation theory underlines that adjustment relies on three actions: a) a search for meaning in the experience that is related to the need to identify causes of and effects of the crisis; b) gaining a sense of mastery (which is related to attempts to regain perceived control of a threat so that it does not recur); c) regaining or boosting self-esteem through downward comparisons, i.e. comparing oneself to individuals in a similar or worse condition. These actions are intended to restore or improve previous psychological functioning. The process of cognitive adaptation described above contributes to redefinition of events so that they are perceived in a more positive light (Taylor, 1984). Łosiak (1999) pointed out, however, that the potentially positive impact of delusions and their relevance should be considered in context and not regarded as universal.
Many studies have shown that creating narratives about tough life events has a positive impact on post-traumatic readaptation. Such narratives enable the individual to order and combine single events into a coherent life story (McAdams, 2001). Traumas can be interpreted as chapters of one’s life, in a way that bolsters changes in one’s fundamental convictions (McAdams, 1985, 2012; Tedeschi & Calhoun, 1996; McAdams & Bowman, 2001).
The existing research on the post-traumatic adaptation process provide ample information on the significance of individual traits such as personality and temperament (Davis, Nolen-Hoeksema, & Larson, 1998; Linley & Joseph, 2004) but that there have been no studies describing specific, materially meaningful mechanisms of cognitive reconstruction or reinterpretation of traumatic events as part of the readjustment process.
The goal of this research was to provide a phenomenological analysis of personal narratives giving meaning to the experience of violence and the relevance of that meaning to post-traumatic adaptation.
The sample was a small, highly homogenous group of seven women between 31 and 58 years of age, who had experienced physical, mental or economic abuse. All subjects received psychological and legal assistance from centers for victims of domestic violence. The domestic violence-related trauma they had experienced had taken place up to six months prior to the study. In all seven cases the perpetrator of violence was the woman’s intimate partner.
The study was conducted in accordance with the principles of interpretative phenomenological analysis (IPA). IPA is an inductive, ‘bottom up’ approach and does not rely on testing (Reid, Flowers, & Larkin, 2005). Its theoretical principles refer to idiography, phenomenology and hermeneutics (Pietkiewicz & Smith, 2012). The primary aim of IPA is to gather rich and unique information about personal experiences of a specific phenomenon (Pietkiewicz & Smith, 2012) and the method enables one to gain deep insight into how individuals give meaning to their experiences (Pietkiewicz & Smith, 2012). IPA does not rely on pre-defined hypotheses (Smith, Flowers, & Larkin, 2009) because the aim is to identify the key elements of the experience, which makes it unique (Pietkiewicz & Smith, 2012). The main principle of IPA is recognition of the significance of subjects’ personal narratives and this is why it enables the researcher to capture and describe the personal perspectives of all the research subjects (Pietkiewicz & Smith, 2012). IPA is driven by the ‘less is more’ principle and challenges the assumption that there is a linear relationship between the number of subjects and the value of research (Reid, Flowers, & Larkin, 2005). The main proponents of IPA recommend use of small samples and case studies, which enable the researcher to gather reliable qualitative data that can be analyzed in detail. The majority of IPA studies involve sample of five to ten subjects (Turpin et al., 1997; Smith, Jarman, & Osborn, 1999; Smith & Osborn, 2003; Smith, 2004). The method assumes the use of small, strictly homogenous groups as this makes it easier to gain insight into the phenomenon under investigation (Willig, 2008).
Our study identifies elements of the response to the traumatic experience of violence, by analyzing the meaning given to traumatic events in personal narratives. To do this we conducted seven indepth interviews lasting 30–60 minutes that dealt with the interviewees’ experience of violence and post-traumatic readjustment process. The female subjects of this study related e.g. the traumatic event, their best and worst moments since the traumatic event, the ways in which other people had had a positive or negative impact on their adaptation to trauma, their perception of the perpetrator and their prediction about the ultimate outcome of their traumatic experience. The subjects were asked open-ended questions to allow them to respond freely, which occasionally led to additional detailed questions about the perpetrators. The interviews were recorded and then transcribed.
Analysis and Interpretation of the Interviews
The analysis was conducted in accordance with IPA principles (Pietkiewicz & Smith, 2012). The first stage involved repeatedly listening to and reading the interviews. During this process the researchers made detailed notes about the content and emotions displayed in subjects’ responses and their own reflections on the material. All the interviews were analyzed in detail, individually. Subsequent collective analysis enabled us to identify shared and unique features of the subjects’ experiences. At the end of this stage the researchers discussed their notes in order to identify the key problems of post-traumatic re-adaptation in the group under scrutiny. During the next stage relations between the highlighted problems were examined, mainly in terms of their relevance and relationship to the post-traumatic readjustment process. Following careful analysis, the highlighted problems were classified into primary groups.
Analyzing the narratives about the process of adaptation to the trauma associated with experiencing violence resulted in specification of the following main categories:
- Agency – growing perception of personal strength;
- Positive influence of other people – provision of support;
- Negative influence of other people – lack of support or insufficient support; 4. Meaningfulness given to the perpetrator;
- Perceived control.
Below the main themes and personal narratives are presented.
Agency – Growing Perception of Personal Strength
The female victims in our sample stressed the significance of their agency when speaking about their experiences of violence and coping with violence and tended to appreciate themselves by actively dealing with the situation. They also frequently spoke about positive changes in their behavior after the traumatic event.
The fact that I was able to stand up to it, I’m really proud that I handled so many things, …on one occasion when I happened to be home he arrived home and started talking to me and I was like ‘Listen! Don’t talk to me, don’t talk to me at all, if you have anything to say to me, you must get a lawyer’. I said it calmly, firmly and I was also proud of this. I managed to say it calmly, I didn’t scream or cry. Before the event I used to be calm, coy and when I knew my husband was coming back home I would be tidying, cooking, putting everything in order so he wouldn’t have a reason to pick on me, but somehow there was always a reason… the proverbial soup was too salty1.
1 Fragments of interviews were directly translated from Polish.
The concept of agency is associated with satisfaction of the desire for individualization through realizing personal goals, achievements and self-development (McAdams, 1985). Studies have shown that references to agency in a personal narrative indicate a preference to adopt specific life attitudes (McAdams et al., 1996). Prominence of agency in personal narratives about important life events typically indicates a strong action and achievement orientation. Ascribing agency to oneself in relation to coping with traumatic events may indicate a tendency to seek opportunities to increase one’s sense of perceived personal strength, which is a key aspect of post-traumatic growth (Zięba, 2015).
Positive Influence of Other People – Provision of Support
The individuals who had experienced violence pointed out the significance of the positive influence of other people. Other people’s support, understanding, solidarity and reinforcement had increased their agency, motivation to change and willingness to act, as well as reducing their fear. In particular it influenced their perception of the perpetrator as guilty of doing them harm. One of them spoke about the support provided by her grandmother:
At my grandma’s. She was this kind of sun to me. She would always say: ‘Think it over’. She would say: ’You’re a young, nice girl, you can do it. You want to study at school, you’ve got all life before you for it’.
The same woman also spoke about the importance of other people’s support to her adaptation process:
I thought I couldn’t live like that and I decided to look for a job, because I was a young girl back then, shortly after my studies, I didn’t have any job after school, I wasn’t in paid work because I had a little baby at home and I decided to take some professional courses. I took a course in tram-driving, I liked it that people ride on trams so I took that course and then I said to my husband: ‘Listen, when I finish those courses and get work and get my first pay, I’ll leave you and you won’t be able to abuse me any longer’.
Negative Influence of Other People – Lack of Support or Insufficient Support
The subjects also identified other people’s lack of support as an important negative influence when talking about their experiences of violence. Sometimes other people had demonstrated indifference or increased a subject’s a sense of shame, amongst other things. It raised doubts as to legitimacy of the subjects’ convictions and strengthened the position of the perpetrators.
The worst thing is that over the course of our marriage I gradually came to have fewer and fewer friends. Few people visited us. It was this kind of home that I even had such a friend who understood me, but as for violence she didn’t help me.
Speaking about the perpetrator the same subject said:
Unfortunately, he’s a victim. He is charming, he was. He can say beautiful words and behave well. Only at the end of the year I filed a response to his petition for nofault divorce.
Research has shown that having and perceiving social support acts as a buffer against the pathological consequences of an aggravating situation. Receiving support from other people reduces one’s level of tension and makes it easier to cope with hardship. Social support is both supportive and reinforcing in crisis conditions. Individuals can receive emotional support in the form of affection, respect and understanding, or instrumental support such as information, advice or assistance in dealing with difficulties (Heszen-Niejodek & Sęk, 1997). Both emotional and instrumental support enhanced subjects’ adaptation to the trauma they had experienced. An absence or insufficiency of both forms of support resulted in difficulties in adaptation.
Narratives About the Perpetrator
There were differences in how subjects spoke about the perpetrator of the violence they had suffered and these differences seemed to be related to the course of the adaptation process. Those subjects who decidedly and clearly indicated the perpetrator while discussing their role in the family exhibited less fear, displayed greater self-respect and spoke about new adaptive behaviors. One subject spoke about the trauma she had suffered and the perpetrator:
My husband was regularly beating me. And that beating has left one of my kidneys impaired.
The same subject’s statements occasionally indicated active coping with the traumatic situation:
I stood up to all that. I decided I’d cope with it. I felt very strong then. I took the baby in my arms and I knew that I had that money and could do something about it. I felt so important then.
The subjects’ narratives sometimes did not depict the perpetrator as an individual; he appeared as a vague, remote figure. This was not indicative of dehumanization, he was not replaced with any epithet, label; it seemed that these subjects perceived the violence as something that ‘just happened’. Speaking about their current situation and post-traumatic adaptation these subjects appeared more undecided and lost and showed lower self-esteem than the subjects who distinctly pointed at the perpetrator. One subject described her traumatic experience as follows: “There was even an axe raised above me and a little child, when the second child was born”. Speaking about how she had adapted since the trauma the same subject said: “I’m so confused that I really don’t know what to do… whether to divorce after so many years of marriage? I’m not really pleased with myself yet, because actually I haven’t done anything special”.
It is likely that the way victims speak about the perpetrator of violence signifies something about the post-traumatic re-adaptation process and as there is scant literature on this topic further investigation is required.
Rothbaum, Weisz and Snyder’s (1982) two-process model of perceived control assumes that people naturally tend to take control of the environment directly (primary control) or through psychological adaptation (secondary control). The extent to which our subjects had taken control of their environment varied. The narratives of some women were dominated by statements indicative of a perception of a fairly high influence over the environment (primary control), whereas the narratives of some other women included statements suggestive of a tendency to adjust oneself to the environment (secondary control). The following statements by subjects illustrate primary control: “I managed to survive being beaten with a belt. I was determined. Afterwards he let me be and the physical violence came to an end”. “He [the husband] never hit me after I the first time I hit him”. Some subjects’ stories described secondary control mechanisms: “I took it for granted that it is like that at home. I mean that a man is like that and beats his wife. I was simply used to it”. “I had a feeling that my husband acted unreasonably and unpredictably in many situations. I was just scared. I wanted to live”.
Rothbaum, Weisz and Snyder (1982) postulated that control is a two-process construct. The first process consists of the individual’s efforts to change the environment in accordance with his or her needs. The second process involves psychological adaptation to the environment (passivity, withdrawal, submission): the individual modifies his or her ‘self’ and adjusts his or her interpretations, attributions and convictions (Weisz, McCabe, & Denning, 1994). These two processes can occur simultaneously or independently. Effective coordination of both processes is an indicator of good adaptation. Primary control occurs when the individual is a main factor in perceived control. Secondary control occurs when the environment is a more powerful factor influencing perceived control than an individual itself. Secondary control is more likely to occur when an individual has attempted and failed to gain control by primary control mechanisms. When individuals cannot exercise primary control over their environment their need for control is not diminished (Rothbaum, Weisz, & Snyder, 1982). In our sample there was a marked discrepancy between the frequency of primary and secondary control processes, which suggests that experiencing violence disturbed our subjects’ coordination of perceived control processes. As a result, intensity of the particular process either favored or reduced adaptation.
Discussion and Conclusions
This IPA study provides a detailed picture of how a specific group of women attributed meaning to their experience of the trauma of violence. The results lead us to conclude that women whose narrative emphasized their own agency showed better adaptation to the trauma they had undergone. Social support also played a significant role in adaptation. It can also be concluded that women who showed more primary control (influence over the environment) than secondary control (passivity, withdrawal, submission) appeared to have adapted better following the traumatic experience of violence. Further exploration of female victims’ narratives about the perpetrators of violence and the meanings they attribute to their experiences would be valuable.
The method used in this study has many limitations, however. First of all, in the study we analyzed a very small sample. It resulted from an exceptionally aggravating subject of the study that is experiencing violence. Although IPA is designer for use with small groups our findings should be replicated in a more representative sample of the population of victims of domestic abuse. Moreover, in IPA it is the interviewers who interpret the narratives they hear, rather than the subjects themselves. There is a risk of failure even when trained interviewers follow common standards and coherent instructions.
Further qualitative and quantitative studies are required to improve understanding of women who experience violence and to enrich knowledge about the phenomenon of adaptation in the aftermath of trauma related to violence. Such research help organizations that support victims of violence to develop effective support programs and inform the work of professional who help victims of violence to cope with the trauma this entails.
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