Date of Award

12-2005

Degree Type

Dissertation

Degree Name

Doctor of Philosophy

Major

Nursing

Major Professor

Joanne M. Hall

Committee Members

Julia Malia, Sandra Thomas, Janet Witucki-Brown

Abstract

Women who are in intimate partner abusive relationships undergo a change process, which is a spectrum of emotional and behavioral responses to violence that is identifiable in stages. The end result is that women terminate their relationships or renegotiate their circumstances to halt the violence: Treatment protocol for abused women is shifting to individualized intervention based on these stages. Leaving and returning to an abusive relationship is a predominant theme in the change process that has not been investigated.

The present study examined this forgotten leave-return process in a sample of forgotten women. Grounded theory methodology was utilized to describe the experiences of 18 primarily homeless, African American women with a history of substance use, who had left and returned to an intimate partner abusive relationship multiple times. Data were collected by audio taped, semi-structured interview.

Central to women's experiences was mitigating danger. The key components of mitigating danger are: (1) coming to know abuse as danger; (2) how knowing motivates leaving and (3) the continuity of danger incurred by leaving. The prevailing contextual condition that influenced coming to know danger was the abuser's substance use. Experiencing abuse within this context influenced perception that violent episodes were more severe, frequent and unpredictable. Protective leaving, which is accompanied by returning, is a reflection of this unpredictability.

Because the experiences of these women did not include the progression of cognitive change as reported in extant research, protective leaving indicates that a readiness to terminate abusive relationships may exist. Their entrapment was influenced by economic deprivation, which was a consequence of socialized and forced poverty. Because of economic deprivation, women's choices for survival external to the relationship were often relegated to their informal networks, which was associated with danger continuity. This danger continuity was a powerful motivator for returning to their relationships.

Services that are designed to protect abused women offer minimal protection to these women. The most utilized source of formal help was police. However, over time women experienced erosion of this formal system and other support sources. Their permanent leaving simulated banishment from all support networks. This research has implications for treatment of abused women and resource development. Key findings are discussed in relation to health policy, nursing practice, future research, and theory development.

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