Human diseases and conditions

            The case study presented regards the accounts of a 36-old woman who is undergoing treatment for pain and reduced hearing in the left year. She is a victim of abuse from her family after the loss of a job of her husband due to being a heavy drinker.

1. What is typical behavior for a battered spouse?

            The battered spouse is likely to accept blame for the occurrences in the marriage that makes them have challenges in opening up about the experiences. The spouse conceals all the details that could lead to possible and effective intervention strategies. Most of them are vague about their history and do not give direct answers to the questions asked by the counselor or a physician. Some choose to remain silent and have some moments of grief and crying without further explanations of their condition. A battered spouse may have previous incidences of trauma that manifest in frequent instances. Such persons have low self-esteem and have feelings of guilt due to constant failure and lack of an opportunity to express their feelings and frustrations.    

2. What is the significance of the alcohol consumption and the loss of employment in the onset of abuse?

            Family violence is becoming a major public health problem and has an association with gender issues, unemployment, alcohol, and depression among others. The role of alcohol is controversial since some studies reveal that it aggravates marital difficulties while others term it as related to physical aggression some months before and after marriage. Alcohol consumption and the loss of employment are two crucial factors that are likely to lead to abuse. The loss of a job results in stressful thoughts and people claim that they drink alcohol to suppress the sorrows and negative thoughts (Deb, Gallo, Ayyagari, Fletcher & Sindelar, 2011). It’s a practical aspect since it helps to relax and relieve individuals from anxiety. However, regular drinking results in depression that make individuals make bad decisions and hence results in abuse. They may perceive their spouses as the cause of their misfortunes and hence overreact through abusing them (Rodriguez, Lasch, Chandra & Lee, 2011). 

3. Why didn’t the victim want the abuse reported?

            The victim did not want the abuse reported for fear of the repercussions from her spouse. She already accepted the blame and thought that it was unnecessary to report the matter to the authorities. The fear of more abuse and exposure to her marital problems could be a reason for not reporting the matter. Low self-esteem and guilt could also make them not to report. The battered spouse fears to testify against the abuser,  for fear of further violence in the event that the abuser is set free (Dutton, 2009). 

4. What are the legal responsibilities of your office in this situation?

            The office has legal responsibilities of contacting the law enforcement authorities and reporting the abuse. The police act urgently to make an arrest and possibly prosecute the husband in advance. The office requires initiating the legal process of handling the family violence other than providing the treatment options to the victim.  

5. What might be the reasons the victim feels she cannot leave the abusive situation?

            Many of the battered spouses do not leave the abusive spouse and have significant reasons for their decisions. In the case presented, the woman claims that she cannot leave the abusive situation. The victim lacks self-esteem and confidence and feels that they cannot take any further step other than handling the issues as they arise. Some believe that domestic violence is unavoidable in marriage; and should be part of life. The battered spouse may believe that they are the problem as repeatedly told by the abuser. The woman may also have hope for a change in many cases of abuse is remorseful after an abuse and regret of their actions. They may promise never to repeat or seek to counsel whenever necessary (Bell, Cattaneo, Goodman & Dutton, 2008). The woman may be lacking a support system, and her only close person is the abuser. The abused lady may have the belief that the society cannot believe that she undergoes through abuse and hence will suffer stigma after leaving. Other factors could be threats, economic dependence, or dangers of leaving (LaViolette & Barnett, 2013).

6. Explain the mechanics of how the impact of the slapping causes the rupture of the tympanic membrane.

            Traumatic perforation of the tympanic membrane causes pain, bleeding, hearing loss, tinnitus, and vertigo. The causes of tympanic membrane perforations are common and many that include slapping, and sticking things in the ear. The penetrating injuries on the tympanic membrane cause a dislocation of the ossicular chain, fracturing of the stapedial footplate, and displacement of the fragments on the ossicles. The result is bleeding on the perilymph fistula from the round and oval window that leads to leakage of perilymph to the middle ear and facial nerve injury (Lou, Lou & Zhang, 2012).  

7. Discuss the implications of both the abusive husband and the battered wife being patients of the practice.

            The battered wife is likely to suffer from battered woman syndrome that is a typical term referring to the experiences resulting from being battered if she does not address it appropriately. It is a mental health condition that arises from the experiences of domestic violence.  The woman is likely to suffer from depression, defeat and passiveness that she is incapable of leaving the abusive situation (Naumann, Langford, Torres, Campbell & Glass, 2009). Thus, it is necessary that she seek for clinical intervention.

            The effect of the abusive husband and the battered wife being part of the practice is the identification of a probable method of addressing the situation. The practice seeks to perform screening to the husband to identify other causative factors to the behavior. The engagement of a counselor would also be essential to advise the couple on how to address their differences without engaging in violence. The woman would benefit from regaining her self-esteem and understand how to handle such occurrences in future.

References

Bell, M. E., Cattaneo, L. B., Goodman, L. A., & Dutton, M. A. (2008). Assessing the risk of        future psychological abuse: Predicting the accuracy of battered women's predictions:       Journal of Family Violence, 23 (2), 69-80.

Deb, P., Gallo, W. T., Ayyagari, P., Fletcher, J. M., & Sindelar, J. L. (2011). The effect of job       loss on overweight and drinking: Journal of health economics, 30(2), 317-327.

Dutton, M. A. (2009). Update of the ""Battered Woman Syndrome"" Critique. Harrisburg, PA:    VAWnet, a project of the National Resource Center on Domestic Violence/Pennsylvania          Coalition Against Domestic Violence. Retrieved 12/14/2015, from    http://www.vawnet.org     

LaViolette, A. D., & Barnett, O. W. (2013). It could happen to anyone: Why battered women       stay. SAGE Publications, Incorporated.

Lou, Z. C., Lou, Z. H., & Zhang, Q. P. (2012). Traumatic tympanic membrane perforations: a       study of etiology and factors affecting the outcome: American journal of otolaryngology,      33(5), 549-555.

Naumann P, Langford D, Torres S, Campbell J, and Glass N. (2009) Women are battering in        primary care practice. Family Practice; 16: 343–352

Rodriguez, E., Lasch, K. E., Chandra, P., & Lee, J. (2011). The relation of family violence,           employment status, welfare benefits, and alcohol drinking in the United States: Western            Journal of Medicine, 174(5), 317–323.

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