[6 min read]
- In Washington State, approximately 43% of women and 30% of men report experiencing intimate partner violence at some point in a relationship.
- The terms domestic violence and domestic abuse are often used interchangably, but there are subtle differences. Abuse can be ongoing and may include emotional manipulation, financial control, intimidation, and other non-physical tactics.
- If we feel unsafe in a domestic situation, it's vital to create a plan and reach out for help.
- A Providence Swedish behavioral health expert shares more guidance for proetcting ourselves and our loved ones.
Domestic violence remains a pervasive and harrowing issue affecting countless individuals and families across the United States. Despite increased awareness and ongoing efforts to combat the problem, recent statistics highlight the alarming prevalence and devastating effects of domestic violence. Nationwide, one in four women and one in seven men report experiencing severe intimate partner violence at some point in their lives, leading to both immediate physical harm and long-term psychological damage.
In Washington State, the numbers are equally concerning; approximately 43% of women and 30% of men have experienced intimate partner violence, according to the Washington State Coalition Against Domestic Violence. This crisis impacts families and individuals, and tears at the fabric of communities, leading to economic burdens and public health crises. Organizations, hotlines, and shelters offer crucial support for those facing these challenges, providing safety plans, legal assistance, and emotional support to victims.
To learn more about domestic violence and abuse, we spoke with Janarthan Sivaratnam, Ph.D, a psychologist with Providence Swedish South Lake Union Primary Care who offered suggestions for identifying what's really going on, checking in with our own behavior, and where to turn for help if we are in crisis.
Does domestic violence have to be between people who are in a romantic relationship or within a family relationship? Can it be between platonic friends or housemates?
Domestic violence can happen between people who are not in a romantic relationship or family, such as platonic friends or housemates, but who live together. It is not limited to couples or family members. If someone you live with—whether a friend, roommate, or anyone else—hurts you physically, threatens you, or tries to control you, that can be considered domestic violence. Research shows that violence can occur between people who know each other well, even if they are not dating or related. There have been several studies that have showed that people could be hurt by non-romantic contacts in their life, including friends or acquaintances, and sometimes this happened in shared living spaces. Another study highlights that domestic violence is not just about romantic partners, but can include anyone living together who uses abuse or threats to control another person. Individuals experiencing behaviors such as being aggressed upon, being controlled or coerced, harassed, intimidated, or isolated can all be considered DV-related behaviors depending on the surrounding context. If you feel unsafe or threatened by someone you live with, it is important to seek help.
Is there a difference between domestic violence and domestic abuse?
Domestic violence and domestic abuse are closely related terms, often used interchangeably, but there are subtle distinctions in their definitions and usage.
- Domestic violence typically refers to acts of physical violence, sexual violence, psychological abuse, or stalking perpetrated by a family member or intimate partner (although as we discussed in the previous question, it’s not necessarily limited to those relationships). It can include a range of behaviors, including physical assault, threats, and other forms of violence within domestic or familial relationships. The term is often used in legal and clinical contexts to denote physical acts of harm, but definitions in the medicine can also include psychological and sexual abuse.
- Domestic abuse is a broader term that includes not only physical violence but also patterns of psychological, economic, and sexual coercion, as well as controlling behaviors that may or may not involve physical harm. Abuse can be ongoing and may include emotional manipulation, financial control, intimidation, and other non-physical tactics that can make someone feel stuck or isolated relationship.
How can we tell the difference between a conflict and abuse in a domestic situation?
A conflict in a domestic situation involves disagreements or arguments between partners, but abuse is characterized by a pattern of behaviors where one person seeks to control, intimidate, or harm the other. The key distinction is that conflict is generally mutual and can be resolved through communication, whereas abuse involves an imbalance of power, fear, and repeated harmful actions.
More specifically, abuse is identified by behaviors such as physical violence, threats, humiliation, controlling access to money or resources, isolating the person from friends or family, and making the person feel afraid or powerless. These actions are not just part of a disagreement—they are intended to dominate or entrap the other person and often escalate over time. In contrast, healthy conflict does not involve fear, coercion, or ongoing harm.
Asking yourself questions such as "do you ever feel afraid of your partner/the other person?" or "has this person tried to control you or threatened you?" can help distinguish abuse from conflict. Abuse may be physical, emotional, psychological, or financial, and often leaves the victim feeling trapped or unsafe. If you feel uncertain about what your situation is, it can be helpful to talk to a trusted person in your life – whether it be a friend, family member, or medical professional.
What are some of the significant impacts of long-term domestic abuse?
Long-term domestic abuse—whether physical or non-physical—has profound and wide-ranging impacts on physical, mental and social health for victims and their families.
- Physical effects include injuries (e.g., fractures, traumatic brain injury), chronic pain, and increased risk of chronic diseases (e.g., cardiovascular disease). Victims are also at higher risk for sexually transmitted infections, pregnancy complications, and even homicide, with intimate partners responsible for a significant proportion of female homicides globally.
- Mental health consequences include depression, anxiety, post-traumatic stress disorder (PTSD), suicidal ideation and attempts, substance misuse, and reduced life satisfaction are all strongly associated with both physical and non-physical forms of abuse (including psychological, economic, and controlling behaviors). Psychological abuse and coercive control can be as damaging—or more so—than physical violence, especially when multiple forms of abuse co-occur according to research.
- Social and economic effects include impaired social functioning, isolation, difficulty maintaining employment, and increased use of healthcare services. Children exposed to domestic abuse are at risk for behavioral problems, poor academic performance, and perpetuating cycles of violence in adulthood.
What should we do if we are concerned about our own behavior toward a romantic partner or co-habitant? Is it possible to be an abuser without realizing it?
If you are concerned about your own behavior, the first step is honest self-reflection and education about what constitutes abuse. Validated tools, such as the Relationship Red Flags Scale, can help you assess your actions (or that of someone else). Seeking professional help—such as counseling or therapy—is strongly recommended, as is accessing community resources for education and support. Taking responsibility for your actions, avoiding blame-shifting, and understanding the impact on your partner are essential steps toward change.
It is possible for someone to be an abuser without fully realizing it, especially when the behaviors are subtle, psychological, or normalized within their relationship or personal history. Intimate partner violence (IPV) includes not only physical and sexual harm, but also psychological aggression, controlling behaviors, humiliation, and covert abuse—such as monitoring, restricting freedom, or gaslighting—that may not be immediately recognized as abusive by the perpetrator or even the victim. Common warning signs of abusive behavior include monitoring a partner’s activities, controlling finances or social contacts, demeaning or threatening language, possessiveness, and retaliation during conflicts.
These patterns can be overlooked or minimized, particularly by individuals who hold certain beliefs about romantic relationships, making it harder to recognize nonphysical abuse. Subtle or covert abuse may be especially damaging and is often missed by both individuals and professionals.
What should we do if we believe we are in an abusive relationship or if we are, in fact, experiencing domestic violence?
Such an important question. If you believe that you are in an abusive relationship or are experiencing domestic violence, the most important first step is to prioritize safety and develop a personal safety plan. This includes identifying safe places to go, keeping essential documents and emergency items accessible, and knowing how to contact local or national support resources. A few key things to keep in mind can include:
- Create a safety plan. This may involve preparing emergency bags, memorizing or saving important phone numbers, and identifying trusted individuals who can help. Printable safety plans are available online.
- Connect with advocacy and support services. Advocates can help with safety planning, legal options (such as protective orders), and access to shelters or financial resources. They also provide emotional support and help navigate complex decisions.
- Document the abuse. Save evidence of abusive contacts, injuries, and threats, which may be needed for legal protection.
- Access resources discreetly. If safety is a concern, request information in a way that does not put you at risk (e.g., wallet cards, online resources, or through trusted contacts).
- Know your rights. Legal protections, such as restraining orders and specific immigration options, may be available depending on your situation.
- Reach out for help. National hotlines, local shelters, and healthcare providers can offer confidential support and referrals.
Some national resources include:
- National Domestic Violence Hotline
Call: 800-799-7233 or 800-799-SAFE
- National Dating Abuse Helpline
Call: 866-331-9474
Text: "loveis" to 22522
- National Sexual Assault Hotline
Call: 800-656-4673 or 800-656-HOPE
- National Child Abuse Hotline
Call: 800-422-4453 or 800-4-A-CHILD
- National Suicide Prevention Lifeline
Call or text: 988
Some local resources include:
- The Washington State Department of Social and Health Services
The DSHS Domestic Violence Program provides support for community-based shelters, emergency counseling and legal advocacy for children and families who have experienced domestic violence.DSHS also sets minimum standards for domestic violence perpetrator programs and certifies provider programs.
Domestic Violence | DSHS - Seattle Municipal Court Resources
"The Seattle City Attorney's Office Domestic Violence Unit provides assistance and information to victims of domestic violence, including referrals to shelters, counseling, safety plans and more."
Call: 206-684-7757
- New Beginnings
"Founded in 1976, New Beginnings’ mission is to empower survivors and mobilize community awareness and action to end domestic violence. We are the only full service agency in Seattle whose primary mission is to serve domestic violence survivors. With over 40 years of established history, New Beginnings has become a leading force in the movement to end domestic violence and has grown to include a full range of services for survivors. On average, New Beginnings serves over 10,000 women, children, and men each year."
Call the 24-hour Help Line: (206) 737-0242
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If you are looking for help managing holiday stress or learning to deal with holiday stress, support is available at Providence Swedish Behavioral Health. Whether you require an in-person visit or want to consult a doctor virtually, you have options. You can also connect virtually with your provider to review your symptoms, provide instruction and follow up as needed. And with Swedish ExpressCare Virtual you can receive treatment in minutes for common conditions such as colds, flu, urinary tract infections, and more. You can use our provider directory to find a specialist or primary care physician near you.
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Anchor yourself: tips for managing big feelings in turbulent times
This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.
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