7 Young Adulthood 191The following case example will be used to illustrate the physical, social,
and psychological consequences of living through the experience of IPV.
Jane was a 37-year-old mother of two children, an 8-year-old son and a
3-year-old daughter, when she first sought counseling. She was married to her
husband for 15 years and over the previous 8 years he had become increasingly
abusive to her, both emotionally and physically. Three days prior to calling for
a counseling appointment, he became dangerously violent toward her after she
told him that she wanted to separate from him. In front of their children, he
viciously beat her and told her that the only way she would ever leave the house
was “in a box.” She managed to get away from him and run to a neighbor’s
house, who then called the police. After her first session with her worker where
she learned about her civil and legal options, she obtained a Protection from
Abuse order to keep him from returning to their home, and she filed criminal
charges against him through the Police Department. During her first appoint-
ment with this social worker, she was clearly suffering from the symptoms of
acute stress disorder, which became a diagnosis of PTSD after 1 month of contin-
ued symptoms of reliving the event in the forms of nightmares and flashbacks,
and symptoms of hyperarousal, particularly heightened anxiety reactions.
Physical Development
During her first session with me, Jane was still suffering from the aftermath of
the beating she received 4 days earlier. She had multiple bruises on her torso
and arms and legs, and she flinched whenever she moved because of pain she
felt in the area of her lower ribs. On the night of the abuse, she had been to the
emergency room. In addition to her initial injuries, Jane became quite physi-
cally ill with a serious virus within the month following the assault, requiring
several nights in the hospital. Her immune system may have been compro-
mised by the prolonged state of physiological hyperarousal that resulted from
the traumatic beating she suffered.
There is a clear biological impact of trauma on the nervous system,
including the brain (Le Doux, 2003). More specifically, in the event of a threat,
the amygdala in the limbic system of the brain turns on two systems: one to
mobilize the body to flee or fight through release of adrenaline and cortisol,
and one to return the body to normal (Rothschild, 2000). In PTSD, it appears
that the second system is not functioning properly. The brain loses the abil-
ity to turn off the alarm reaction, which then causes the chronic hyperarousal
seen in PTSD, including increased pulse and respiration, muscle tension, and
chronic anxiety. Higher and more prolonged levels of cortisol in the blood-
stream (like those associated with chronic stress) have been shown to have
negative effects such as: lowered immunity and inflammatory responses
in the body and slowed wound healing (Ebrecht et al., 2004). According to
Campbell (2002), victims of IPV report more headaches, back pain, abdominal
pain, pelvic pain, gynecological problems, and gastrointestinal issues. Cerulli,
Poleshuck, Raimondi, Veale, and Chin (2012) conducted qualitative research
and reported that female victims of IPV described constant fatigue and muscle
pain, and immune dysfunction. “The inscription of pain on their bodies served
as constant reminders of abuse, in turn triggering continual emotional and