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A woman who fled her abusive boyfriend is observed sitting at a table with other women in a residential chemical dependency treatment program. Her bruised face could not be missed (Figure 11-1). The program physician asked to speak with her and learned that her boyfriend beat her when she told him that she was voluntarily entering this program. The boyfriend was also an addict and had been physically abusive to her before. The violence escalated when she said that she needed help to stop the alcohol and drugs. She left him and did not believe that he would follow her. The program management assured her that they would not let him on the premises and would do all they could to keep her safe while she was recovering. Figure 11-2 was taken 2 months later, when her face was healing along with her mind and spirit. She completed the 90-day program and is currently working and actively following a 12-step program.


Bruising caused by intimate partner violence in a woman who fled her abusive boyfriend. (Reproduced with permission from Richard P. Usatine, MD.)


Photograph of the woman in Figure 11-1 taken 2 months later. Her facial and psychological wounds are healing. (Reproduced with permission from Richard P. Usatine, MD.)


Intimate partner violence (IPV) is defined as an intimate partner's physical, emotional (stalking or psychological aggression), or sexual abuse.1 Physical violence is the intentional use of physical force with the potential for causing death, disability, injury, or harm. Physical violence includes scratching; pushing; biting; punching; use of a weapon; and use of restraints or one's body, size, or strength against another person.1 Physical violence also includes coercing another person to commit these acts. Common to all IPV forms is a pattern of coercion and control.


IPV affects about 36% of women and 29% of men in the United States during their lifetimes.2

  • An estimated 10 to 12 million men and women in the United States experience physical violence by a current or former intimate partner; more than 1 in 5 women (22.3%) and nearly 1 in 7 men (14.0%) experience severe lifetime physical violence by an intimate partner.3,4

  • Physical violence by an intimate partner can result in direct injury including death (1095 women and 241 men in 2010; Bureau of Justice, 2011), adverse psychological and social consequences, and impaired endocrine and immune systems through chronic stress and other mechanisms.5 IPV victimization also increases the odds of having a substance use disorder, particularly alcohol and cannabis, for both men and women.6

  • Lifetime stalking by an intimate partner ...

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