Physical abuse - Causes, symptoms and treatment. MF.

Physical violence is a one-time or repeated deliberate act against another person( a family member, subordinate, child, etc.) committed in addition to the will and desire of the victim. The act itself is an unlawful act of a person or group of persons, carried out with the help of physical influence - rape. The definition of violence is a political concept that changes over time. Each society creates characteristic for its time interpretations of violence and establishes norms and penalties in case of their violation. Violent actions can take a physical, psychological, sexual or economic form of influence.

Violence is one way of expressing individual or group aggression that threatens the loss of life, health, violates dignity, physical integrity, freedom, harms physical or mental health, and causes suffering and moral damage to the victim. This behavior is characterized by aggressiveness and is destructive in relation to another person.

Causes of the emergence of an antisocial disorder( the appearance of violence)

- Impaired sense of identity, people's distrust.
- Provocative behavior and aggression on the part of the victim.
- Overwork, emotional and professional stress.
- Not a suitable profession, financial difficulties.
- Uncertainty, low self-esteem.
- Alcoholism and unemployment in the family.
- Chronic feeling of emptiness and boredom.
- Adaptation disorders( limited ability to effectively overcome daily difficulties).
- Chronic sadness, depression, feelings of rejection and loneliness, a tendency to isolation, sensitivity.
- Impulsivity( uncontrollable outbursts of anger).
- Anxiety, anxiety, emotional instability.
- Lack of communication, hostility towards others.
- Criminal past( drugs, prostitution, crime).
- Financial difficulties, helplessness.
- Emotional disorders, mental illness.
- Organic brain damage, epilepsy.

Causes of violence by children in relation to other children and adults:

- The destructive influence of peers.
- The influence of computer games.
- The Decay of the Family.
- Aggression in the family, cruel treatment of children.
- Negative impact of television, video, cinema, the Internet.

Diagnosis

Physical violence always carries the risk of injury and loss of life. Forcible actions are kicks, claps, punches and kicks, tweaks, bites, beatings, and the use of weapons. Everything that happens is always accompanied by psychological pressure.

There are two types of violence characterized by emotional state:

- Spontaneous violence( hot) - characterized by anger, rage, aggression. It is expressed in various forms: screaming, fisticuffs, compulsive( uncontrolled) behavior, violent infliction of pain. The basis is anger, which is born from one's own impotence and frustration in life. During an unintended violence, a feeling of anger and fury accumulated. As a result, there is a loss of control of emotions and control over behavior. This kind of violence appears and disappears fairly quickly, is the most expressive.

- Intentionally( cold) violence - its cause is not anger, anger or intention to cause harm. The peculiarity of this type of violence is that the criminal wants to achieve a certain goal by his actions. Cold violence is the deliberate realization of revenge. Very often the rapist takes violent actions to realize his own convictions, philosophy, faith and ideology.

Violence happens direct is an act of overwhelming use of physical strength and psychological pressure. Realization is a direct way, directly from the rapist to the victim. Indirect( not direct) violence - is the opposite of direct violence. It does not include physical violence or assault. Actions are often masked by natural behavior, they are difficult to recognize. This form of violence exists secretly in society, politics, culture, and the family.

Sexual violence. This form of behavior is coercion to sexual contact against a partner's will( rape), unacceptable sexual practices, forcing to watch pornographic films, shooting during sex, criticizing a partner's sexual behavior, blackmail and coercion into sex life, coercion to have sex with others, sadisticforms of sexual activity, demonstrative jealousy, etc.

Violence in the family takes place in all societies and cultures. Families where this happens, carefully hide their problems. Violence occurs usually "behind a closed door".Many victims have suffered from violence for many years and continue to withhold it. They blame themselves for being victims, getting used to this situation. One of the reasons is that they have reconciled themselves to fate and believe that they must endure pain, do not tell anyone, the victims feel sorry to condemn the rapist. They interpret the aggression to themselves like this: "I'm not good", "I'm the cause of anger", "I did something wrong", "My partner is upset, I need to support him."Victims are unable to understand where the boundary between normal and violent behavior, which has long been different from all legal and social norms, is passing.

Violence among children and adolescents. The phenomenon of violence affects almost every area of ​​human life in every age group. Increasingly, there is aggression among children and adolescents, especially in the school environment. According to statistics, 15-17% of children met with violence. The scientists calculated that on average the child is from 7 to 8 years old, he observes so many scenes of violence on the screen that, in order to see this in reality, he must be a criminal in 580 years. Until the age of 18, a teenager sees 8-11 thousand video killings. Thus, the mass media - cinema, television, video, the Internet, magazines for young people - strongly influence the progress of violence and aggression among adolescents.

• Often teenagers endure their aggression to school, trying to avenge the absence of a happy childhood, due to parents' lack of affection.
• The school is a prototype of the social environment and should prepare the child for normal functioning in society. This is the place of intensive socialization, identification of oneself in relations with adults, building their own hierarchy of values. The policy of many schools is forcing children to learn, but, as a rule, every compulsion for an action gives rise to a protest. The manifestation of this can be aggression and violence.
• A very common phenomenon when teenagers fall in love with a school, thereby becoming more vulnerable to criticism against them. If teachers mock the feelings of a schoolboy in the presence of classmates, focus on the poor performance of the lover, irony about the topic of love, then the student's well-being is broken, there is no joy in communicating with friends and peers. It is also not acceptable for a teacher to mock a schoolboy in the presence of a class( call lazy, ignorant, stupid).
• Children who do not get support at home can seek recognition in various informal groups that usually have a negative impact. The importance of forming groups for peers is very high when it comes to the process of socialization. The right group creates a kind of arena for the clash of social processes. The group can include children from different backgrounds. This makes it possible to compare many aspects of life, to exchange cultural elements. A company of teenagers with equal partners will positively influence the child, since it is formed at the expense of common tastes and interests.

How to prevent violence

• It is compulsory to intervene in the scandals of police and medical workers.
• For every case of violence, call the hotline.
• Contact the shelters and help centers, get free legal advice.
• Look at the situation differently, recognize yourself as a victim.
• Prepare yourself for an attack, review your behavior( perhaps it is provocative).
• In case of an attack, it is better to escape;if it is not possible, then scream.
• Try to get independence from your partner( in financial or housing matters).
• To learn more about human rights:

- No one has the right to force you into unacceptable behavior.
- The law protects you and you are entitled to any help.
- You must protect yourself from violence and its consequences.

It's worth limiting yourself to viewing scenes that contain violence. Currently, there are very often various screen images of violence: sharp and shocking images, computer games( with destructive content or murders).In the process, the viewer in a bondage associates himself with the character as a killer, then aggression can go beyond the screen image.

The role of the educator or teacher in preventing violence is to immunize children from the negative impact of the media. In time to identify and protect children from such incidents in school, as well as outside it.

Preventive measures by the state.

• Creating a "one-stop-shop" principle for victims of violence.
• Anonymous counseling.
• Dissemination of information on violence( brochures, articles in print)
• Establishment of rehabilitation centers and temporary shelters for victims of violence.
• Improvement of the legislative framework.
• Involving volunteers to identify, prevent and combat violence.

Prevention by parents.

Parents should intervene in all matters and interests of children, since proper family relationships are not sufficient for the child's educational environment. It is necessary to watch that children watch on TV, how they spend their free time, with whom they communicate. But often, due to strong employment, there is no time for this and it turns out that mom and dad are absent from the child's life. Parents should be more tolerant of aggressive behavior of children, participate in training activities, set a certain penalty for any signs of aggression.

. How to recognize the propensity to violence and when to consult a doctor.

. Should be alerted:

• Lack of respect for social norms.
• Misrepresentation of their actions.
• People inclined to violence do not use the previous experience, they do not think about the consequences of their behavior.
• Low tolerance for what is happening, lack of control over emotions and actions. Aggression, lack of fear.
• Getting pleasure from hurting others.
• Neglect and indifference to the feelings of others.
• The tendency to manipulate others, playing at the highest senses.
• Impossibility to maintain a strong relationship with a partner.
• High threshold of excitement and fear.
• Emotional coldness and lack of emotions.
• The tendency to abuse of surfactants.
• No sense of guilt, sympathy, shame, responsibility, morality, lack of conscience.
• Not the ability to delay needs( sexual, food, etc)
• Antisocial behavior.
• Inability to plan the future( focus on the present tense) and predict the consequences of their actions.
• There is a lack of understanding.
• Do not see the boundary between reality and fiction, truth and lies.
• Atypical( unusual) reaction to alcohol.
• They often blackmail with suicide.

In children:

• Pugilism, spitefulness, indifference to encouragement and punishment.
• Reject important people in their lives( parents, grandparents, teachers).
• Frequent failures in school, shoots( from home, from school).
• Self-harm( including attempted suicide).
• In the case of a predisposition to sexual abuse: very mobile and active during a conversation related to sex, are engaged in finding younger children to satisfy their own sexual activity. They think that they have certain secrets connected with sex.

If you have several symptoms from the above, you should contact a specialist( psychiatrist, psychologist, psychotherapist).The presence of these signs reveals only a predisposition of the person to the disease, but such people are not yet criminals. With timely care, it is possible to prevent the development of the disease.

Cases of development and treatment of victims of mental illness

Postpartum depression - is found in victims, if there were sexual harassment in childhood. The cause of the disease is that the victim remembers harassment and feels with a bad mother. The disorder is corrected by psychotherapy.

Bipolar disorder - when a woman experienced domestic violence from her husband. In the treatment use antidepressants, drugs leveling mood( carbamazepine, melepsin).

Depression( short-term or chronic) - the development of the disease causes not only violence, but also procedures related to use( litigation, contacts with a rapist in the courtroom and in the police station, places where it happened, investigative experiments, etc.).The main form of assistance to these people is individual and group psychotherapy, pharmacotherapy with antidepressants. The help of a psychiatrist( including pharmacological) becomes necessary when symptoms interfere with the therapeutic process. If victims do not seek help, in an attempt to escape from a stressful situation, they most often resort to alcohol. Dependence may develop, and this will seriously impede further treatment and rehabilitation.

Organic brain diseases - head injuries resulting from physical violence cause irreversible changes in the central nervous system. Such as cerebral hemorrhage, then develops posttraumatic epilepsy and other brain dysfunctions. The forecast is unfavorable. Patients are treated mainly in psychiatric hospitals.

Treatment, rehabilitation of a victim

It is quite difficult to identify and treat victims of violent acts, as it often happens that violence never leaves the apartment walls and its manifestations are carefully hidden by the victims themselves. Even the closest family and neighbors do not know about what is happening next to them. According to statistics, most victims are embarrassed that others learn, are afraid of misunderstanding, gossip or the fact that their actions will not bring the desired effect.

Violence is closely linked to dependence on surfactants( psychoactive substances of alcohol and drugs) and disclosing such details before the law can be lost work and thus prosperity in the family.

The psychologist should put a lot of effort to convince the victim of violence that the situation itself is not such, to help the victim recognize that she needs help. To say that there are ways to combat violence and it is worth trusting law enforcement agencies.

Unfortunately, people in our country are afraid to apply for psychiatric care, but recently the situation has begun to change for the better, especially in large cities. The following available forms of psychological assistance to victims of violence can be identified:

• Consultation is a meeting whose main goal is to identify a problem and then contact a more specialized specialist.
• Psychological advice - can be a phone call or a letter, online consultation. The goal is to get information and solve the problem.
• Psychotherapy is a regular psychological support aimed at understanding the sources of symptoms of the psychological discomfort and suffering of the victim. The duration of therapy and its intensity depends on the severity of the disease. Psychotherapy is a set of methods for treating various disorders, psychological problems. The goal of psychotherapy is to eliminate post-traumatic symptoms.

The most popular are:

- Individual psychotherapy - when a patient alone with a therapist finds a solution to their problems.
- Group psychotherapy, in which several people with similar problems.
Treatment involves interaction between team members, support for each other, joint search for solutions to problems.
- Family psychotherapy - this is a meeting of the therapist with the whole family. During the sessions, family relations, family structure, and communication with other people are analyzed.

Treatment of an antisocial disorder( addiction to violence)

Treatment of the disease is very difficult because the abuser does not feel any motivation for treatment. Excluded the independent treatment of such a patient to the doctor. Placement in a medical institution becomes possible only when the abuser tries to avoid punishment. Fear of justice only temporarily stops him from antisocial actions. In all other cases, patients are delivered to doctors by law enforcement agencies for the purpose of compulsory treatment or psychiatric examination.

The psychopath suffers because of her own imperfection and refuses to acknowledge it. He can not be honest and sincere with a psychotherapist. This makes it difficult to collect an anamnesis( history) of life and disease. Attempts to treat such a patient are of little effect.

Elimination of aggressive behavior in abusers occurs through cognitive psychotherapy. The dependence of the patient on violence, as a rule, is connected with the fact that he does not know how to react properly to ridicule, overcome embarrassment, does not ask for help. The psychotherapist helps the patient to acquire the appropriate experience to resolve conflict and stressful situations that cause outbreaks of aggression and violence.

- Consequences of violence

- injury or death of people,
- threat to personal freedom,
- harm to physical, mental and social well-being,
- pain, suffering, destruction,
- loss of moral values,
- depression, anxiety,
- lowself-esteem,
- self-doubt and self-reliance,
- lack of mood,
- mental illness,
- poor performance,
- disruption of socialization and adaptation in adolescence,
- negative impact on the spiritual developmentie,
- affected passively cope with stress,
- self-incriminating thoughts,
- alcohol abuse.

Doctor psychiatrist Kondratenko NA