Family Violence Explained

Overview

Family violence — also called domestic abuse or domestic violence — is when one person in a close relationship uses fear, force or control to hurt another person. It can happen between current or former partners, and also between parents and children, siblings, adult children and older parents, or other relatives. It is not only hitting. It includes emotional abuse (name-calling, constant criticism, mind games), sexual abuse, money control (keeping you short of cash, blocking you from working), and digital control (checking your phone, tracking where you go, sending threats). The key point is that one person is using power over another, so the other person feels scared or controlled.

Yes, it is very common. Global health estimates suggest about 1 in 3 women worldwide have experienced physical or sexual violence from a partner at some point in their life. Men, older people and children are also affected, though it is often reported less. Because it is so common, many health services now ask all patients about safety at home as a routine question.

Anyone can be affected — any age, gender, income, religion, culture or background. It happens in wealthy and poor households, in cities and in rural areas, and in relationships of every kind. Some people face extra barriers to getting help, such as disability, being pregnant, having young children, being financially dependent, not speaking the local language, or having an insecure immigration status. None of these things cause abuse — the person causing harm is always responsible.

Symptoms

Common symptoms

• Unexplained bruises, cuts, burns or injuries — or explanations that don't quite fit
• Frequent 'accidents' or trips to different clinics and hospitals
• Fear, jumpiness, or feeling you have to 'watch what you say' at home
• Being blamed for everything, put down, humiliated or told you are worthless
• Feeling isolated — a partner controls who you see, where you go, your phone or your money
• Threats, including threats to hurt you, your children or pets, or to share private photos
• Sexual pressure or being forced into sex when you don't want it
• Sleep problems, headaches, stomach pain, panic, low mood or constant anxiety
• A partner who insists on being in the room during appointments or answers for you
• Feeling you need permission for everyday things like seeing friends, working or spending money

Symptoms in children

• Bedwetting, sleep problems, nightmares or going back to younger behaviours
• Clinginess, being very watchful, or flinching when adults move quickly
• Headaches or stomach aches with no clear medical cause
• Trouble at school: falling grades, not wanting to go, trouble concentrating
• Anger outbursts, hitting out, or being very withdrawn and quiet
• Blaming themselves or trying to 'keep the peace' at home
• In teenagers: self-harm, risky behaviour, anxiety, depression or problems with food
• Being hurt directly, or being used by one adult to control the other

Symptoms in older adults

• Injuries or bruises that are not explained, or not explained in a believable way
• Not getting enough food or drink, or looking unwashed or neglected
• Missing medicines, or medicines being given wrongly or withheld
• Money going missing, unusual bank activity, or pressure to change a will
• Sudden confusion, fear or anxiety around a particular relative or carer
• Not being allowed to see friends, family or health workers alone
• A relative or carer who speaks for them, answers every question, or won't leave the room

Causes

Main causes

• The core cause is a choice to use power and control over another person — not 'losing your temper', stress, or the behaviour of the person being hurt
• Beliefs that one partner is entitled to control the other, often learned from family or community patterns
• Alcohol and drugs can make violence more frequent or severe, but they do not cause it and are not an excuse
• Growing up in a home where violence was normal can increase the chance that someone repeats it — but most people who grew up with abuse do not abuse others
• Isolation and secrecy let abuse continue, which is why abusers often cut people off from friends and family

Risk factors

• Separation or a partner trying to leave — this is a particularly high-risk time
• Pregnancy and the first year after birth
• Disability or long-term illness, which can increase dependence on a carer
• Financial strain or housing insecurity — these add pressure but never justify abuse
• Harmful alcohol or drug use by the person causing harm
• A history of violence in the family the person grew up in
• Insecurity around immigration status, language barriers or social isolation, which make it harder to seek help
• Mental health difficulties in the person causing harm, especially untreated trauma or personality difficulties
• Being young, or being in a new or very intense relationship

When to see a doctor

See a doctor urgently if:

• You have any injury, however minor it seems — some injuries get worse and need checking
• You have been strangled or choked, even if you have no marks
• You have been sexually assaulted or pressured into sex
• You feel in danger going home, or the violence is getting worse
• You are pregnant and violence has occurred
• You are having thoughts of ending your life or harming yourself

Book a routine appointment if:

• You feel unsafe, controlled or frightened at home and want to talk it through
• You have ongoing anxiety, low mood, nightmares or trouble sleeping
• You want help making a safety plan or understanding your options
• You would like a sexual health check, contraception advice or a pregnancy test
• You are worried about how a child in the home is doing
• You are worried about an older relative, neighbour or friend

Diagnosis

There is no single test for family violence. A doctor, nurse or other trusted professional makes sense of the situation by listening to you, often asking simple questions like 'Do you feel safe at home?' or 'Has anyone hurt or frightened you?'. They may ask gently about injuries, sexual health, mood and sleep, and whether children in the home are safe. They may offer a private examination of any injuries, with your consent, and record what they find — this can be helpful later if you decide to report to the police, but you can say no. Nothing happens without your agreement.

Tests that may be done

• A short conversation about safety at home, sometimes using a simple checklist
• A physical examination of any injuries, only with your consent
• X-rays or scans if there might be a fracture or internal injury
• A check after strangulation, which can cause hidden injury even without marks
• Screening for sexually transmitted infections and a pregnancy test, if relevant
• Simple questions about mood, sleep and anxiety to see what support would help
• A discussion about whether any children or vulnerable adults in the home are safe

What to expect at your appointment

Expect a calm, private conversation, usually with the option to speak without your partner present — you can ask for this at reception. Interpretation services are free in most health settings. You will be given information about local support services and helped to make a safety plan if you want one. You will not be forced to do anything, and you can bring a friend or family member with you for support if you prefer. If you are not ready to talk, you can simply take the information and come back when you are.

Treatment

There is no 'cure' for abuse, because it is about someone else's behaviour — but there is a lot of help that genuinely works. Support usually focuses on three things: keeping you and any children safe, treating any injuries and health problems, and helping you heal emotionally so you can make your own choices at your own pace. Specialist domestic abuse services — often called advocacy services — are staffed by people trained to help with safety planning, housing, money, legal options and children's needs.

Self-care at home

• Think about a simple safety plan: where you would go, who you would call, and how you would get out quickly if you needed to
• Tell one person you trust — a friend, relative, colleague or doctor. Secrecy is what abuse depends on
• Keep essentials easy to reach if you can: ID, medicines, phone charger, some money, keys
• Agree a code word or text with someone you trust that means 'I need help now'
• Be careful with technology — use a device your partner doesn't have access to if you can, and consider whether location sharing or message backups could be seen
• Be kind to yourself. Rest, eat regularly, and try gentle movement like walking — stress affects sleep and appetite
• Avoid confronting the person about their behaviour while you are still deciding what to do, if that feels unsafe

Medical treatments

Treatment depends on what you need. Physical injuries are treated and documented; some injuries need follow-up to make sure they heal well. Emotional effects are treated with talking therapies — for example trauma-focused therapy or counselling — which are effective for anxiety, low mood and post-traumatic stress. Specialist advocacy workers help with practical safety planning and can connect you to housing, legal advice and financial support. Sexual health care, contraception and pregnancy support are available. If alcohol or drugs are part of the picture, confidential support is available too. Staff will never pressure you to report to the police or to leave; they will help you weigh up your options safely.

When is surgery considered?

Surgery is only needed if a specific injury requires it, such as a broken bone or internal injury. It is not a treatment for abuse itself.

Living with this condition

Living with fear is exhausting, and everyday life can feel like it is shrinking. Try to keep small connections going — a regular message to a friend, a walk, a class — because isolation makes everything harder. Many people leave and return several times before a change sticks, and that is normal; support workers are used to it and won't give up on you. Legal options like protective orders, housing advice and help with money exist in most places, and you do not have to handle them alone. Take one step at a time rather than trying to solve everything at once.

Lifestyle tips

• Build a small support network you can reach quickly — even one or two people makes a difference
• Keep important documents and a little money somewhere you can get to easily
• Learn the local support options now, before you need them
• Look after the basics: sleep, food, water and gentle movement
• Limit alcohol — it can deepen low mood and make decisions harder
• Be careful with shared accounts, phone plans and social media privacy settings
• Plan for children's needs, schools and childcare, and let their school know who is allowed to collect them

Diet and exercise

There is no special diet for this, but stress often wrecks appetite and sleep. Try to eat something at regular times, even if it is small, and keep water nearby. Gentle activity — walking, stretching, dancing around the kitchen — helps burn off the physical side of fear and improves sleep. Avoid using alcohol or extra caffeine to manage stress, as both tend to make anxiety and sleep worse.

Mental health and emotional wellbeing

Being controlled or hurt by someone close to you can leave deep marks: anxiety, depression, panic, nightmares, difficulty trusting people, and sometimes post-traumatic stress. Feeling ashamed or blaming yourself is very common, but the shame belongs with the person causing harm, not with you. These effects are treatable, and talking therapies help many people recover. Healing is not a straight line — good days and bad days are both normal. If you ever feel you might harm yourself, please reach out for crisis support right away — you deserve help in that moment.

Prevention

Family violence is not something a person being hurt can prevent — the responsibility is always with the person causing harm. But prevention does work at a wider level: teaching children about healthy relationships and consent, challenging the idea that one person should control another, supporting children who grow up around violence, reducing harmful alcohol use, and making sure people have financial and housing options so they can leave safely. On a personal level, the best protection is early support and a safety plan made before a crisis.

Screening programmes

Many health services now ask everyone a short safety question at appointments — during pregnancy, at emergency departments, at mental health visits and at routine check-ups. This is not because staff suspect you; it is because abuse is common and easy to miss. You can answer as much or as little as you like, and you can ask to speak privately.

Complications

If left untreated

• Injuries that get worse, heal badly, or cause lasting pain and disability
• Head and neck injuries, including strangulation, which can be life-threatening even without visible marks
• Long-term anxiety, depression, panic and post-traumatic stress
• Sleep problems, chronic pain, stomach and bowel problems, and headaches
• Unintended pregnancy, sexually transmitted infections, and complications in pregnancy
• Harm to children living in the home, including their emotional, school and physical wellbeing
• Loss of housing, income or work, and deepening isolation
• Increased use of alcohol or drugs as a way of coping
• In the most serious cases, severe injury or death — which is why early help matters so much

Long-term outlook

The outlook is genuinely hopeful. With support, most people's safety, health and confidence improve, and many go on to rebuild lives that feel their own again. Leaving is often a process rather than a single moment, and it can take several attempts — that is not failure, it is how change usually happens. You deserve help, and it is never too early or too late to reach out. If you are in immediate danger, call your local emergency number right away.

Find support

External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.