Gewalt und ihre Folgen E-Book

• Herausgeber: Books on Demand
• Kategorie: Geisteswissenschaft
• Sprache: Deutsch

Seitenzahl: 177

Veröffentlichungsjahr: 2022

Beschreibung

Das Traumatisierungen - speziell sexuelle Gewalt - langfristige seelische Folgen hinterlassen, ist bekannt. Die Frage lautet, wie kann damit umgegangen werden. Nicht immer ist es möglich, wie in westlichen Ländern, eine Psychotherapie einzuleiten. Hier werden andere Möglichkeiten des Umgangs mit erlittener Gewalt aufgezeigt. Ein weiterer Aspekt des Buches ist, dass nicht nur seelische, sondern auch körperliche Auswirkungen sexueller Gewalt möglich sind. Zwar ist bekannt, dass auch Männern sexuelle Gewalt widerfahren kann, Studien zu deren körperlichen Folgen stehen noch aus.

Leseprobe

Inhalt

VORWORT

KINIKANWO I. GREEN / ROSEMARY OGU

Consequences of Violence against Women A Coup against Women’s Health

Introduction

1.1 Methodology

1.2 Result and Discussion

1.3 Types of Violence

Consequences of Violence against Women

2.1. Physical Health Consequences

2.2. Gynecological and Reproductive Health Consequences

2.3. Mental and Emotional Health Consequences

2.4. Children‘s Health And Wellbeing Consequences

Conclusion

KARSTEN GIERTZ

Wohnungslosigkeit, psychische Erkrankungen und Trauma

Einleitung

Wohnungslosigkeit in Europa und Deutschland

Erkenntnisse aus der psychiatrischen Wohnungslosenforschung

3.1 Häufigkeit psychischer Erkrankungen bei wohnungslosen Menschen

3.2 Traumatische Erfahrungen und Wohnungslosigkeit

3.3 Inanspruchnahme psychosozialer und psychiatrischer Versorgung

Konsequenzen für die psychiatrische und psychosoziale Versorgung und Bedeutung potentieller Traumatisierung

VERENA KOLBE

Häusliche Gewalt gegen Männer

Einleitung

Fallbeispiel

Medizinisch-therapeutische Relevanz

Fallbeispiel

Fazit

Anlage

MARTINA MERTEN

Therapien und Fallbeispiele bei Schwertraumatisierten auf den Philippinen

Philippinen als „Hotspot“ für Online Sexual Exploitation of Children (OSEC)

Begrenztes Angebot an staatlichen und privaten Reha-Einrichtungen

Arten von Traumata und Verhaltensauffälligkeiten

Therapieansätze auf den Philippinen

Erklärungsansätze für hohe OSEC-Prävalenz auf den Philippinen

Prävention und Bekämpfung: Eine neue Ära hat begonnen

INGRID BRAUNBARTH

„Leibhaftige“ Traumabewältigung Wie der Körper vom Feind zum Verbündeten wird

Wozu den Körper einbeziehen?

Wie zeigen sich die Symptome von Traumafolgestörungen im leiblichen und zwischenmenschlichen Erleben und Verhalten?

2.1 Deregulierung des autonomen Nervensystems

2.2 Die Sinne

2.3 Intrusionen, Flash-backs, Körpererinnerungen

2.4 Der Körper als vermeintlicher Feind

2.5 Verlust des Vertrauens und der Bindungsfähigkeit

2.6 Täterintrojekte und destruktive Glaubenssätze

Welche Ziele und Mittel sind durch die Körperorientierung möglich?

Behandlungsprinzipien

Jürgen Dittmar im Gespräch mit Barbara Bojack

Experteninterview zum Thema Umgang mit Folgeschäden nach Trauma

Wie kann sich der Umgang mit Folgeschäden nach Trauma gestalten?

Fallen besondere Verhaltensweisen bei Menschen auf, die ein Trauma erlitten haben?

Wie betrachtet man die Problematik von diagnostischer Seite?

ULRIKE WICHTMANN

Erste Hilfe für traumatisierte Menschen Weichenstellung in der Stabilisierungsphase nach Flucht und Gewalterfahrungen

Einleitung

Erste Hilfe für traumatisierte Menschen

2.1 Trauma-Definition nach dem DSM-IV

2.2 Helfen als antitraumatische Haltung

2.3 Komplikationen beim Helfen

Zusammenfassung

3.1 Anmerkungen zur alltäglich transportierten Gewalt in den Medien

Anhang

Übungen

BARBARA BOJACK

Folgen von traumatischen Belastungen in der Kindheit am Beispiel des Diabetes

BARBARA BOJACK

Frühe Traumatisierung und Folgen zum Beispiel Demenz

Einführung

Folgen von Belastungen in der Kindheit und Risiko für psychische und somatische Erkrankungen

2.1 Vorstellung vom Mechanismus

2.2 Begriffsklärung

2.3 Vorkommen von Traumatisierung

2.4 Befunde

2.5 Befunde bei den bildgebenden Verfahren und bei Laboruntersuchungen

2.6 Verlauf der Symptomatik bei PTBS

2.7 Vorstellung von der Dynamik

2.8 Was sind mögliche Risikofaktoren?

2.9 Was sind Schutzfaktoren?

2.10 Traumareaktivierung

2.11 Weshalb sollte die PTBS behandelt werden?

2.12 Möglichkeiten der Behandlung

Schluss

SCHLUSSBETRACHTUNG

VORWORT

Gewalt gegenüber anderen Menschen, um die es hier geht, geschieht vielfach im Verborgenen, so gegenüber Kindern, Frauen und Männern.

Wahrscheinlich bedingt durch Scham und Schuld kommt sie relativ selten ans Tageslicht. Häufig spielen auch Hierarchien eine Rolle, die Übergriffe zulassen.

Insofern bildet sich quasi ein vor Öffentlichmachung „schützender“ Rahmen oder Raum um das Geschehen.

Dies zeigt sich im Familienclan, der sich wie eine schützende Wagenburg, aus der nichts herausdringen oder hereinkommen soll, um die Betroffenen bildet ebenso wie in der katholischen Kirche (Dreßing et al., 2018). Letztere ist es gewohnt, ihre Taten zu vertuschen, zu verheimlichen, zu ignorieren und zu verschweigen. Erst vor etwa einem Jahr wurden die bislang geheim gehaltenen Archive den Forschern für einige Tage im Vatikan zu Rom geöffnet, um dann wieder geschlossen zu werden.

Z. B. der Bischof in Köln gibt zwar eine Untersuchung im Zusammenhang mit dem Missbrauch in Auftrag, ist aber keinesfalls bereit, die Ergebnisse zu veröffentlichen (Bayerischer Rundfunk, 2020). Ein üblicher Umgang. Hier weiß der Kölner Bischof, sich durch die Regeln und Gesetze der Kirche geschützt und in üblicher Weise von den gewohnten Geheimhaltungsregeln umgeben und geborgen.

In diesem Buch werden die Folgen, also die der Gewalt folgenden Erkrankungen auf psychischem und somatischem Gebiet dargelegt.

Eine bislang wenig beachtete Opfergruppe wird vorgestellt: die Männer. Es gibt wenig Studien dazu, eine wichtige ist die Studie Gewalt gegen Männer (Gewalt gegen Männer in Deutschland, 2004). Es gibt ein großes Dunkelfeld, das Ausmaß ist noch unklar.

Mittlerweile steigt die Zahl der Einrichtungen, die Menschen nach Traumatisierung behandeln.

Vielfach ist es jedoch nicht möglich, den Traumatisierten eine Behandlung anzubieten, da die Zahl der Patienten zu hoch ist oder einfach die notwendigen Ressourcen fehlen. Dies gilt besonders für die Opfer des Sextourismus nach Asien und die Darsteller in Film, Videos und in Medien, die sich dafür häufig nicht nur freiwillig und zwanglos zur Verfügung stellen.

Dass Behandlung möglich ist, auf welchen verschiedenen Wegen und mit welchen Methoden, wird hier aufgezeigt.

Denn nur was bekannt gemacht wird, kann bearbeitet und einer Behandlung zugänglich werden.

Barbara Bojack im Sommer 2021

Literaturverzeichnis

Bayerischer Rundfunk (2020). Wie Kardinal Woelki an der Missbrauchsaufarbeitung scheitert. Online : https://www.br.de/nachrichten/deutschland-welt/wie-kardinal-woelki-an-der-missbrauchsaufarbeitung-scheitert, SKZi2TF. (25.01.2021).

Dreßing, H., Salize, H. J., Dölling, D. & Hermann, D. (2018). Sexueller Missbrauch an Minderjährigen durch katholische Priester, Diakone und männliche Ordensangehörige im Bereich der Deutschen Bischofskonferenz. Mannheim, Heidelberg, Gießen.

Bundesministerium für Familie, Senioren, Frauen und Jugend (2004). Gewalt gegen Männer in Deutschladn. Personale Gewaltwiderfahrnisse von Männern in Deutschland. Pilostudie.

Consequences of Violence against WomenA Coup against Women’s Health

KINIKANWO I. GREEN ROSEMARY OGU

1. Introduction

Violence against women has remained a severe global challenge involving all regions and socio-economic classes. The United Nations regards it as an infringement of the human rights of women, particularly regarding their rights to equal opportunity, safety, autonomy, integrity, and dignity (United Nations, 2020).

It is profoundly entrenched in our socio-economic and cultural norms and results in disparity in power between men and women. Violence is, therefore, both a demonstration of gender inequality and a means to maintain the power disparity (Watts, C. & Zimmerman, C., 2002). It is characterized by a tradition of silence and denunciation of the seriousness of the health implication of abuse. Also, powerful institutions that should promote gender parity like the state, families, and law enforcement agencies often conspire to maintain the practice of violence against women (Heise et al., 1994))

Unfortunately, some societies still view violence against women as a corrective means by the male folks to ensure an age-long societal norm of male dominance is maintained and practiced.

Globally, and in Nigeria, there is a gross under-reporting of violence against women (Bojack, B. & Heitmeier, T., 2016; Fawole et al., 2005; Aimakhu et al., 2004; Ikeme, A. C. & Ezegwui, H. U., 2003; Okemgbo et al., 2002). The incidence in Nigeria varies between regions, with a range of 11-79 % (Bojack, B. & Heitmeier, T., 2016; Fawole et al., 2005, Aimakhu et al., 2004; Ikeme, A. C. & Ezegwui, H. U., 2003).This wide range is because there is no consensus method for estimating and reporting violence against women. According to the WHO, surveys around the world reveal about 10-69 % of women report being physically assaulted by an intimate male partner at some point in their lives (Bojack, B. & Heitmeier, T., 2016). The UN Declaration on the Elimination of Violence Against Women defines violence against women as any act of gender-based violence that results in or is likely to result in, physical, sexual, or psychological harm or suffering to women (United Nations, 1993). This declaration regards violence as acts that cause or can cause damage and injury. It further highlights the opinion that these acts are deeply entrenched in sex inequality.

Practically, the term violence against women includes a spectrum of harmful acts targeted at women and girls, ranging from sex-selective abortion to the abuse of elderly women.

It also includes specific forms of abuse such as female genital cutting, dowry deaths, acid throwing, and honor killings (the murder of women who have allegedly brought shame to their family) that are explicit to certain regions and geographical locations. In addition, it includes other forms of violence that are prevalent globally, such as domestic violence and rape.

There is a wide range of potential perpetrators of these harmful acts. Ironically by people who should be protective of their loved ones. They include spouses and partners, parents, other relatives, neighbors, teachers, employers, and law enforcement agents.

Violence against women is not only a demonstration of sex disparity but also serves to maintain this unequal balance of power. In some instances, culprits deliberately use violence as a tool for intimidation. For example, violence by intimate partners is often used to demonstrate and impose a man’s position as head of the family or relationship. In some other forms of violence, the subordination of women might not be the perpetrator’s overt motivation but is nevertheless an outcome of his actions. For example, a man who rapes a woman whom he judges to be sexually provoking might justify his action as a suitable penalty for her indiscretion of socially determined rules of female behavior.

Women themselves frequently fail to confront the accepted norms of female behaviour set by the male folks because of the fear of being attacked or raped. Thus, women’s disproportionate status helps to create their susceptibility to violence, which in turn fuels the cruelty perpetrated against them.

This review is borne out of the need to evaluate the consequences of violence against women globally, especially in the sub-Saharan region of Africa where gross under-reporting is experienced due to cultural and religious factors.

1.1 Methodology

This review used articles from various search engines including google scholar, medline, and other computerized databases. The keywords used for the search include; violence against women, domestic violence, intimate partner violence, consequences of violence against women. Relevant articles matching these keywords were included in the review. The period under review was between 2000 to 2020.

1.2 Result and Discussion

Violence against women remains a global physical, social and mental problem affecting humanity because of the deadly culture of silence that the battered women have adopted over many generations, mainly because they have no haven.

The consequences of violence against women have been multifaceted and remained a major socio cultural and health burden. These include physical health consequences, Gynaecological health consequences, Mental and Emotional health consequences, Children health and well-being consequences.

1.3 Types of Violence

Violence against women consists of a spectrum of causes from an intrauterine environment to old age. Women experience various types of violence as captured in Table 1.

Studies have found that women are most likely to experience violence meted out by close persons, including authority figures, parents, sons, husbands, and male partners. They conclude that one of the most common forms is intimate partner violence, which can include rape, physical violence, and psychological abuse, such as alienation from close relatives and friends (Ogu, R. & Agwu, M., 2016.

Life Stage

Types

In utero/ Infancy

Infanticide; psychological and physical abuse; differential access to food and medical care

Childhood

Female genital cutting; incest and sexual abuse; psychological abuse; differential access to food, medical care, and education; prostitution; trafficking; school-related gender-based violence

Adolescence

Dating and courtship violence; economically coerced sex; sexual abuse in the workplace; rape; sexual harassment; forced prostitution; trafficking; psychological abuse; forced marriage; dowry abuse; retribution for the crimes of others

Reproductive

Intimate partner abuse; marital rape; dowry abuse; honor killings; partner homicide; psychological abuse; sexualabuse in the workplace; abuse of women with disabilities; forced prostitution; trafficking

Old age

Widow abuse; elderly abuse; rape; neglect

Table 1. Types of Violence Against WomenSource: Heise, L. (2020). Violence Against Women. The Hidden Health Burden. World Bank Discussion Paper. Washington.

2. Consequences of Violence against Women

The adverse effects of violence against women and girls cannot be over emphasized. It is a foremost cause of preventable morbidity and mortality globally. Studies show that abused women have significantly poorer physical and mental health than non-abused women (Ogu, R. & Agwu, M., 2016), World Health Organisation, 2008). Due to the health burden of violence, the focus has been expanded beyond a human rights perspective to a public health approach. This was brought to limelight during the Cairo Program of Action in 1994 and the Beijing Declaration in 1995. The World Health Assembly in May 1996 adopted the United Nations definition, and violence was declared a public health burden and a ‘gender perspective’ was adopted in its analysis. In 1999 the United Nations Population Fund acknowledged violence against girls and women exclusively a “public health priority”.

Because of this, violence against women has been acknowledged as a key determinant of health. Also, efforts have been strengthened by international human rights and health organizations to improve awareness about the distressing health consequences of violence and provide direction on how to address them (World Health Organisation, 2005).

The long-term sequelae of abuse are well recognized and differ by the presentation and degree of cruelty (physical, sexual, psychological). In severe cases this violence can lead to extreme disability or even fatality.

2.1. Physical Health Consequences

Injuries from physical abuse are the most evident health impact of violence. The injuries sustained may be extremely serious and may require medical intervention. This ranges from minor bruises, welts, burns, cuts, wounds, swelling, contusions, and fractures to spleen or liver trauma and chronic disabilities. Often the women also have tufts of hair pulled out, split ear drums, black eyes, broken noses and fractures of the jaw (World Health Organisation, 2005; Eliasson, M., 1997; Coker et al.,2000; Jackson et al., 2002). Consequences of traumatic brain injury which may be a seqalae of violence against women include sleep disturbances, headaches, giddiness, depression, irritability, nervousness, changes in social or sexual behaviour, speech problems, cognitive impairment, and memory issues (Coker et al., 2000).

The head, neck, face, thorax, breasts, and abdomen are the most frequent sites of injuries followed by musculoskeletal injuries and genital injuries (Jackson et al., 2002). Battered women may present with injuries that occurred in an attempt to defend herself like fractures, dislocations, and contusions of the wrist and lower arms (Grisso et al., 2010). These physical injuries may also have secondary consequences on other chronic health conditions in women like increased rates of gastrointestinal disorders, including stomach ulcers, spastic colon, irritable bowel syndrome, gastric reflux, indigestion, and diarrhoea. Similarly, arthritis, cardiac symptoms such as hypertension and chest pain have also been associated with delayed effects of physical violence (Heise et al., 1996).

In addition to specific associations between violence and longer-term illnesses, there is evidence that abused women remain less healthy over time (Campbell, J. C., 2002; McCauley et al., 1999; Weiss et al., 2008; Silverman et al., 2007). It has been suggested that abused women‘s increased vulnerability to illness may partly be due to lowered immunity because of stress resulting from the abuse.

2.2. Gynecological and Reproductive Health Consequeces

Gynecological problems are the most consistent, long-lasting and largest health difference between battered and non-battered women (Campbell, J. C., 2002). There may be an increased risk of bacterial infection, vaginal or anal injuries, sexually transmitted infections (STIs), fibroids, sexual dysfunction, decreased sexual desire, genital irritation, pain on intercourse, chronic pelvic pain, vaginal bleeding, or infection, and urinary tract infections (McCauley et al., 1999). A nexus has been found between violence and HIV as well as with STIs. A study by Weiss et al. (Weiss et al., 2008) showed that the occurrence of sexual violence within marriage resulted in a threefold increase in women‘s risk of acquiring STIs while Silverman et al. (Silvermanet al., 2007) reported that women who experienced both physical and sexual violence were almost four times more likely than those who did not have any violence to be HIV infected. Some women are in violent relationships who are forced to engage in sexual intercourse and are unable to negotiate condom usage for fear of further abuse (Pallitto et al., 2005). Sabotage of birth control, condemnation of birth control, preventing the use of contraception, and refusal by men to use condoms, increases women’s susceptibility to HIV/AIDS, STIs and puts women at risk of unwanted pregnancy thereby leading to the adverse gynecological and reproductive outcome (Pallitto et al., 2005; Taft et al., 2004). Women in abusive relationships have more unwanted pregnancies (Silverman et al., 2007). This leads to procurement of unsafe abortions with its sequelae.

Violence before and during pregnancy has been found to have severe health implications for both mother and their unborn foetus. The main health effect specific to abuse during pregnancy is the risk of maternal or foetal death, or both from trauma (Taft et al., 2004). Other potential risks that pregnant women may encounter include miscarriage, stillbirth, pre-term labour and birth, foetal injury, foetal distress, ante partum haemorrhage, preeclampsia (Taft et al, 2004).

2.3. Mental and Emotional Health Consequences

There is a nexus between mental health problems and violence (Moracco et al., 2004). Women who are subjected to violence have a more prolonged adverse effect on their physical health. Scars on the body heal more easily while scars on the soul take much longer to fade. Studies show that female victims of abuse have an increased rate of health problems, even after abuse ends, compared to women who have never been abused (Silverman, et al., 2007; Taft et al., 2004).

Researchers show that women who are subjected to violence experience multitrauma. They often present with symptoms such as sleeping problems, anxiety, paranoia, a negative self-image, low self-confidence and depression quite a long time after the violence has ended without realizing the connection between her experience of violence and her mental health problems.

While other studies done on affected women show different emotional or psychiatric problems such as depression, general anxiety, post-traumatic stress disorder (PTSD), as well as drug and alcohol dependence (Moracco et al., 2004).

Other psychiatric disorders seen include borderline personality disorder, antisocial personality disorder, bipolar disorder, and schizophrenia (Moracco et al., 2004).

2.4. Children‘s Health And Wellbeing Consequences

The deleterious effect of violence is not limited to women‘s health. It affects both the health and development of all members of the family, especially children. The nutrition of the children as well as their education and development is negatively affected. Studies show that violence within the home decreased the likelihood of children being fully immunized (Jejeebhoy et al., 2010). Children of mothers who experience violence also have an increased risk of experiencing wasting or stunting, are more likely to be severely underweight for their age, or to have a low body mass index for their age (Jejeebhoy et al., 2010).

Children whose mothers experience violence may be at increased risk of emotional and behavioral problems, such as anxiety, depression, and violence towards their peers. They also have an increased rate of under-five mortality (Jejeebhoy et al., 2010; Mijatović et al., 2020).

3. Conclusion

Violence against women has become a global public health problem. The seriousness of the different forms of gender-based violence, given the magnitude of this violence and its consequences for individuals and society, makes it imperative that urgent initiatives be taken to support and protect women. A rightbased approach should be followed to protect and prevent this unnecessary morbidity and mortality that is plaguing our women.

Other interventions for prevention should also include promotion of self-sufficiency for women by reducing gender gaps in relation to employment and education, reducing levels of childhood exposure to violence; reforming discriminatory family law; strengthening women‘s economic rights, and addressing harmful use of alcohol and drugs.

Stopping this abuse will require a multifaceted approach across several sectors including education, mass media, research, international networking, the legislative system, the judiciary, and the health sector.

References

Aimakhu, CO., Olayemi, O., Iwe, CA., Oluyemi, FA., Ojoko, IE., Shoretire, KA., et al. Current causes and management of violence against women in Nigeria. J Obstet Gynaecol 2004;24:58-63.

Bojack, B. & Heitmeier, T. (2016). Sexuelle Gewalt. Coburg: ZKS-Verlag.

Campbell, J. C. Health consequences of intimate partner violence, The Lancet. Vol.359, No.9314, 2002, pp. 1331-1336.

Coker, A. L. Smith, P. H. Bethea, L. King, M. R. & McKeown, R. E. Physical Health Consequences of Physical and Psychological Intimate Partner Violence. Archives of Family Medicine, Vol.9, No. 35, 2000, pp.451-457.

Eliasson, M. (1997). Men’s violence against women. Stockholm: Natur & Kultur. https://www.rskriksforeningen.se/_filebank/faktaboken_engelska.pdf

Fawole, OI., Aderonmu, AL. & Fawole, AO. Intimate partner abuse: Wife beating among civil servants in Ibadan, Nigeria. Afr J Reprod Health 2005;9:54-64.

Grisso, J. A., Schwarz, D. F., Hirschinger, N., Sammel, M., Santanna, C., Lowe, R. A., Anderson, E., Shaw, L. M., Bethel C. A. & Teeple, L. Violent injuries among women in an urban area. http://www.hawaii.edu/hivandaids/Violent%20Injuries%20Among%20Women%20in%20an%20 Urban%20Area.pdf, abgerufen am 20.10.20

Heise, L., Pitanguy, J. & Germain, A. op.cit; S.B. Plichta, Violence and abuse: implications for women’s health. In Falik MM, Collins KS, eds. Women’s Health, the Commonwealth Fund Survey. Baltimore, MD: The Johns Hopkins University Press. 1996, pp. 237-272.

Heise, L., Pitanguy, J. & Germain, A. Violence against women: the hidden health burden

(English). World Bank discussion papers no. WDP 255. Washington, D.C.: The World Bank. https://documents.worldbank.org/en/publication/documents-reports/documentdetail/489381468740165817/violence-against-women-the-hidden-health-burden, abgerufen am 20.10.20