Module 1: Forms and dynamics of domestic violence

5. Victims of domestic violence

Image by Gerd Altmann on Pixabay

The terms victim/survivor refer to people who are experiencing domestic violence (victim) or have experienced domestic violence (survivors). The use of those terms also reflect the terminology used in legal processes.

Description: The video explains who is affected by domestic violence.
  • Victims of domestic violence come from all social, cultural, economic, and religious backgrounds with different age, gender and sexual orientation, including people with disabilities. It is important to understand, that there is NO “typical victim”.
  • Domestic violence is often seen as something “happening to others”. People who are not affected often do not understand why the victim is not leaving the abuser and why he/she does not tell anybody.

Victims in the dynamics of domestic violence in relationships

Domestic violence in relationships follows a certain dynamic pattern. The following video explains this in more detail.

Description: This video shows types of abusive behaviour within a relationship through the story of John and Jane. Please keep in mind that victims and perpetrators of domestic violence come from all social, cultural, economic, and religious backgrounds with different age, gender and sexual orientation including people with disabilities.

Further tasks for reflection
Please watch the video and answer the questions on the following images. You will find the answers on the next slide after the question.

Cycle of violence

It’s important to mention that not every abusive relationship adheres to this cyclical pattern. The cycle of violence, however, serves as a useful framework to understand the experiences of both, the victim and the abusive partner, and the complexity of domestic violence.
The circle of domestic violence is often predictable and can consist of three phases, even though domestic violence does not always is a linear process:

Tension building
  • Tension builds over ordinary domestic issues; verbal abuse starts to emerge.
  • In response, the victim attempts to manage the situation by pleasing the perpetrator, yielding to his/her demands or avoiding confrontation, mistakenly believing that such actions will prevent further escalation.
  • Over time, the tension escalates until it reaches a critical point, leading to the explosion.
Violent episode
  • This escalation is often triggered either by an external event or the emotional state of the perpetrator, rather than being influenced by a wrong victim’s behavior.
  • As a result, the beginning of the violent episode remains unpredictable and lies beyond the victim’s control.
Honeymoon phase
  • The perpetrator may experience feelings of shame concerning his/her actions.
  • Her/she shows remorse and attempt to downplay the severity of the violence, often shifting blame onto the victim.
  • Subsequently, the perpetrator may display affectionate and kind behaviour, coupled with apologies, acts of generosity, and helpfulness. They genuinely strive to convince the victim that the violence will never recur.
  • This display of affectionate and contrite behaviour serves to reinforce the emotional connection between the partners and is likely to persuade the victim that leaving the relationship is unnecessary.

Find more information on victim-blaming in Module 8.

Diverse spectrum of victim groups

Some people can belong to multiple groups and, as a consequence, may experience a heightened risk or vulnerability. These groups may include but are not limited to:

Men as victims
Image by kjpargeter on freepik

It is essential to recognise that males can also be victims of domestic violence. While the majority of victims are female, one should not overlook the fact that men can also experience domestic violence in their relationships. Unfortunately, male victims often go underreported and remain invisible, especially in the media. Stereotypes and prejudices surrounding gender roles can further contribute to the underrepresentation of male victims in statistics and discourage them from seeking help or speaking out about their experiences.

Case study: Men as victims

4:34 p.m. Argument in the parking lot of a shopping mall

An outcry from Mrs. E. is audible when her head hits the roof of the car above the driver’s entrance. Passers-by then notice a loud argument and scuffle between the couple. When the couple gets into the car to start driving, a driver blocks them with her vehicle. Mr. E. then flees.

4:37 p.m. Emergency call at the emergency control centre

One of the bystanders calls the police.

4:50 p.m. Police car arrives on scene

The report of Mrs. E. and the witnesses cannot fully clarify what happened. Witnesses say that they have seen that Mr. E. was violent towards Mrs. E. HOWEVER, Mrs. E. said that they had merely argued, whereupon she got into the car frantically and injured her head. They continued to fight afterwards and wanted to drive home but were prevented from doing so. Mr. E. had probably fled in panic, because of the violent verbal attacks by bystanders.

The police officers took down the statements and personal details of the witnesses and of Mrs. E. During this process, Mrs. E. is also asked questions which serve to assess the danger of being attacked again. Mrs. E. refuses a medical examination and is informed of the possibility of having her injury documented in a violence protection outpatient clinic in the following days in a legally secure, cost-free and, if necessary, anonymous manner. After Mrs. E. has been informed about her victim rights, one of the two policemen sensitively addresses the issue of domestic violence and points out the possibilities of specialised counselling and the proactive approach. Mrs. E. listens to these hints and the explanation of police protection options (judicial protection order according to the Protection against Violence Act, approaching endangered persons, expulsion, accommodation in a women’s shelter), but remains firm that everything is fine at home. She refuses any support and the information flyer offered to her. Since the overall circumstances indicate a case of domestic violence, the police officers inform Mrs. E. that they are initiating an investigation against her husband for physical injury and hand her a victim protection leaflet with the police’s case number.

Mrs. E. finally makes her way home alone and, because of her head injury, by public transport.

7:14 p.m. Emergency call in the control center

An emergency call is received at the control centre from neighbours due to disturbing noise in Mr. and Mrs. E.’s apartment.

7:35 p.m. Police intervention in the apartment of couple E. 

Two police cars arrive at the address of the couple since the afternoon’s operation and the address of couple E. are already stored in the police system. The police officers assume that there could be another incident of domestic violence. The police crew entering the apartment immediately see that the couple and Mrs. E.’s mother are intoxicated. When questioned separately, all three parties trivialize the incident and state that they were upset that Mr. E. had fled in the afternoon, leaving his wife alone with the police and a head injury. As there are no visible injuries either to Mr. E. and Mrs. E.’s mother, and there are no concrete indications of a criminal offence, those present are urged to remain calm and are informed that if the police are called in again, a report of an administrative offence will be made for disturbing noise.

9:44 p.m. Emergency call in the operations centre

Again, an emergency call from the neighbours for disturbing the peace. The neighbours say, “Things are really getting lively next door. I think they’re having another one of their problems.”

10:10 p.m. Police action at the home of couple E. 

Due to the suspicion that this is a case of domestic violence, two police cars arrive again. Among them are police officers from the previous operation in the apartment of family E. They find that the degree of alcohol intoxication of couple E. as well as of Mrs. E.’s mother seems to be much higher compared to the previous visit. Furthermore, all those present show traces of blood, injuries to hands, arms, and face. Mr. E.’s injuries are particularly serious.         

Once again, all three persons are heard separately, whereby Mrs. E. and her mother state that Mr. E. began to become violent towards them and they had to defend themselves.

Mr. E. breaks down crying in front of an official and says that he could not stand the violence by his wife and mother-in-law which had been going on for years and that he did not know what else to do that evening but to become violent as well. In spite of his strong intoxication, Mr. E. appears credible and provides conclusive information about the crime and the violence to date.

Mrs. E. and her mother are confronted with the information provided by Mr. E., whereupon they react verbally in a very aggressive manner, and both want to attack Mr. E. in order to “show him what it means to spread such lies about them”. Further violent assaults on Mr. E. can be prevented by the police forces deployed.

Mr. E. wants to leave the apartment and can only be accommodated in a homeless shelter due to the lack of a special accommodation for men as victims of domestic violence. He would like to contact a counselling centre for men affected by domestic violence the very next day and have his injuries documented in an outpatient violence protection clinic. In contrast to Mrs. E. and her mother, he agrees to immediate medical treatment of his injuries. To treat his injuries, Mr. E. is driven to the nearest hospital by an ambulance car. From there, he goes to the emergency shelter on his own. Once again both women reaffirm that they only “had to defend themselves” against the attacks of Mr. E. As a result, the police assesses the risk of Mr. E. becoming the victim of violent assaults by his wife and her mother again as very likely.

In the following days and weeks

In the course of further investigations, the witnesses of the first argument in the parking lot and a neighbour of the E. family are questioned by the police. Mr. E. makes an extensive statement to the police, in which he again describes the development and successive increase in violence against him, as well as his fear that someone may discover that he is a victim of violence in his relationship.

The forensic medical report of the violence protection outpatient clinic is also included in the investigation, which supports the course of events as described by Mr. E. Mrs. E. and her mother only make statements regarding the criminal charges of assault against Mr. E. In doing so, they stick to their original version that Mr. E. caused the escalation of violence but become entangled in contradictions which are documented. With regard to their charge of grievous bodily harm against Mr. E., both make use of their right to refuse to give evidence.

Mr. E. seeks advice from a specialised counselling centre for men affected by domestic violence. He is granted the sole use of the marital home.

After four weeks, the police investigations are concluded with the result that Mr. E. has apparently been a victim of violence by his wife and her mother for years. Both incidents are sent to the Special Department for Cases of Domestic Violence of the District Attorney’s Office for further decision.

Task of reflection

(1) Examine your own attitudes and beliefs about male victims of domestic violence. Reflect on any biases you might hold and consider ways to be more supportive and empathetic towards victims of domestic violence (DV).
(2) Analyse cultural norms and beliefs surrounding masculinity and how those can discourage male victims from reporting DV or seeking help. Reflect on ways to challenge and redefine harmful gender stereotypes that can hinder support for male victims.
(3) Consider the intersection of other identities such as race, ethnicity, sexual orientation, and socioeconomic status with male victimisation.

People with disability, impairment and mental illness

Women with disabilities are 2 to 5 times more
likely to be victims of violence than
non-disabled women, including sexual and
reproductive abuse, such as forced sterilisation.

Individuals with disability or a long-standing illness are more than twice as likely to experience some form of domestic violence than individuals with no disability or long-standing illness

If you don’t see the video here, please use another browser or click here:

“Intimate partners or family members often act as carers and this position of power can be exploited leading to widespread and pervasive means of coercive control and social isolation.” (1)

Globally, 8 in 10 autistic women and 78% of autistic non-binary people experienced sexual violence, with more than half happening more than once

eucap, 2023

Here you can find as an example a factsheet with data on violence against autistic people.

Source: SafeLives: Spotlight Report – Disabled Survivors Too: Disabled people and domestic abuse, 2017

LGBTQIA+ Community

In the LGBTQIA+ (Lesbian, Gay, Bisexual, Transsexual/Transgender, Queer, Intersexual und Asexual) community, intimate partner violence can take on unique forms. For instance, one partner might use “outing” or threatening to disclose the other partner’s sexual orientation or gender identity as a means of abuse. This not only inflicts harm but also creates a barrier that hinders the victim from seeking help.

Moreover, LGBTQIA+ victims of domestic violence may have prior experiences of physical or psychological trauma, such as bullying or hate crimes. Transgender victims, in particular, are at higher risk of encountering specific forms of intimate partner violence, including threats, intimidation, harassment within the context of their abusive relationship.

If you don’t see the video here, please use another browser or click here:

Further tasks for reflection
(1)   Why are LGBTQIA+ people among the most vulnerable group of victims of domestic violence?
(2)   Think what barriers may exist of accessing support for victims of domestic violence in the health sector.

Find more information on the representation of LGBTIQ+ in the media in Module 8.

Refugees and migrants

People who do not possess citizenship or any official documentation may be at a greater risk due to various factors such as language barriers, social isolation, limited access to information or financial resources, cultural norms, and the fear of being deported.

In cases of domestic violence, immigrants often decide not to report such incidents because they fear the potential immigration consequences. Their immigration status can also hinder their access to essential support services.

Source: WWP European Network

If you don’t see a slideshow here, please click here or use another browser.

Case Study: Victim with an immigration background

Nora is a 34-year-old woman with an immigrant background. She has lived here in your country for three years with her parents and sisters. Nora married Peter two years ago. Peter is the son of a family friend of Nora’s parents. Nora’s family comes from a patriarchal culture where the community comes before the individual.

Nora’s marriage with Peter was a relief for Nora’s family since in their culture a woman at Nora’s age should not be single. However, quite soon after Nora and Peter got married, Peter started to control her everyday behaviour. Peter does not let Nora see her friends or go anywhere without him. A mandatory language course is the only place where Nora can go alone.

Peter takes away Nora’s debit card and takes loans under her name. When Nora tries to resist, Peter turns violent and abuses her. Peter threatens to send Nora back to her home country.
Nora discloses the situation to her parents, asking for help. First, the parents take Peter’s violent behaviour seriously, but suddenly Nora’s father passes away. Nora’s grieving mother is not capable of standing against Peter’s will on her own.

At the same time, Peter spreads rumours about Nora’s immorality in order to justify the claims of his violent actions to their community. The rumours humiliate Nora’s family. The community pressures Nora’s mother and her sisters’ families to clear their name.

Nora’s mother begs Nora to stay with Peter to calm the situation and her sisters ask her not to bother their mother with the issue any more. Nora feels that she is responsible for the violence and her family’s reputation, and accepts that divorcing Peter is out of the question.

Over time, the violence gets more serious and more frequent. On one occasion, Peter strangles Nora for so long that she loses consciousness. After the strangulation, she starts to have speech impairment issues especially in stressful situations. Nora feels isolated, helpless and depressed.

Peter has threatened to share some private pictures of Nora in public if Nora ‘ruins his reputations as a husband’, as he puts it. Nora feels anxious since she cannot talk to anyone – even her family – about her feelings.

Task for reflection
This was the story of Nora. Please think about the following questions:

(1) What types of domestic violence is Nora experiencing?
(2) Which acts, situations or conditions endanger Nora?
(3) Which situations described in the case study you consider unfortunate but not for your business as a frontline responder?

Children and youth

Picture from Gerd Altmann by Pixabay

“Globally, it is estimated that up to 1 billion children aged 2–17 years, have experienced physical, sexual, or emotional violence or neglect in the past year”

Global prevalence of past-year violence against children: a systematic review and minimum estimates. Hillis S, Mercy J, Amobi A, Kress H. Pediatrics 2016; 137(3): e20154079.

Violence against children has lifelong impacts on health and well-being of children. Children in domestic violence relationships experience significant trauma, even if they are witnessing violence within the family:

  • It can result in negative coping and health risk behaviours (misuse alcohol and drugs, higher rates of anxiety, depression, other mental health problems and suicide).
  • It can Impair brain and nervous system development (negatively affects cognitive development and reduced educational achievements).
  • It can increase the risk of becoming a victim and/or a perpetrator later on.

Source: WHO Violence against children

The following case study is illustrating this:

Case study: Domestic violence has a negative impact on children

Gabby married her husband Nick after a long relationship and shortly thereafter moved to her husband’s family farm. The couple was happy at the farm and soon had their first child. During the pregnancy Nick’s behaviour began to change and by the time their daughter was born the relationship did not ‘feel’ as it had before. Nick seemed withdrawn and spent long periods of time by himself. He began to remind Gabby of Nick’s father who had always been a stern presence in his life.

Nick’s behaviour became threatening and controlling, especially in relation to money and social contact. He was increasingly aggressive in arguments and would often shout and throw objects around the room. Gabby thought that, because he wasn’t physically hurting her, his behaviour did not qualify as abuse. Nick did not show much interest in their daughter, Jane, except when in public, where he would appear to be a doting and loving father.

Jane was generally a well-behaved child, however, Gabby found that she was unable to leave her with anyone else. Jane would cry and become visibly distressed when Gabby handed her to someone else to be nursed. This was stressful for Gabby, and also meant that her social activities were limited further.

Jane took a long time to crawl, walk and begin talking. Her sleeping patterns were interrupted, and Gabby often did not sleep through the night, even when Jane was over 12 months of age. When Jane did begin to talk, she developed a stutter, and this further impeded her speech development. Gabby worried about Jane a lot. Their family doctor told her that this was normal for some children and that, if the speech problems persisted, she could always send Jane to a specialist at a later date.

After a number of years, Nick’s behaviour became unacceptable to Gabby. During arguments he would now hold on to the rifle that he had for farming purposes, and Gabby found this very threatening. On a number of occasions, items that Nick threw hit Gabby and she was increasingly afraid for their daughter. Gabby decided to leave and consulted the local women’s service, who assisted her to get an intervention order against Nick.

Once Gabby had taken Jane away from Nick, her behaviour changed. Jane’s development seemed to speed up and Gabby couldn’t understand why. As part of her counselling at a local women’s service, she discussed this issue, and her counsellor recognised the developmental delay, stutter, irritation, and separation anxiety as effects of Jane’s previously abusive situation.

This can be seen as a missed opportunity for identifying family violence. If the family doctor would have asked Gabby or Nick (who had presented with chronic back pain) about their relationship, about what was happening to the family, and specifically to Jane, the situation could have been identified much earlier.

Further tasks for reflection
(1) What could have been done better by those involved?
(2) Take a moment to consider which agencies and professionals should have been involved in supporting and/or providing services to Gabby from the beginning.

Adapted from a case study from RACGP (2014): Abuse and Violence: Working with our patients in general practice


“Around 1 in 6 people 60 years and older
experienced some form of abuse in community
settings during the past year”

WHO, 2022

Perpetrators might be:

  • Children, other family members, and spouses as well as
  • Staff e.g., at nursing homes or assisted living facilities

Challenges in Reporting:

  • Fear of facing further abuse
  • Growing dependence on caregivers
  • In growing age, the willingness and capability to escape from abusive relationships decrease.

Remember: Elderly victims of domestic violence may be reluctant to disclose abuse. They may be ashamed or embarrassed or they want to help and protect their abusive child. Reporting domestic violence to the police may cause them to lose the most significant relationship in their lives.

Case Study: Elder abuse

Winnie, aged 69 years, lives by herself in a small country town. She has been a patient of yours for a number of years. She has severe arthritis and requires more and more help with the activities of daily living. Even with regular visits from community services, she finds it difficult to cope, but she is adamant that she doesn’t want to go to the regional hospital.

Eventually, she moves in with her daughter and husband and their young sons. The neighbours begin to complain about the noise. Since Winnie has moved in, there is not much space in the house and the children are fighting more often, they are shouting and playing outside more often. Winnie’s daughter does not receive any help from her sisters and is expected to cope with the increased washing, cooking and other duties without complaint.

When you make house calls to Winnie you notice that she has marks and bruises on her arms and upper torso. These are explained away by her daughter, who says that she is becoming clumsier and keeps knocking into things, also Winnie is taking blood thinners. Winnie just shakes her head and says nothing, when you ask her if everything is okay at home, even when you speak to her in private. You are worried about pressing the issue since you do not want to upset anybody by raising a false alarm.

Adapted from a case study from RACGP (2014): Abuse and Violence: Working with our patients in general practice

Further tasks for reflection
Discuss the case study.
(1) What would you do when being Winnie´s physician in this situation?
(2) What are the main risk factors for Winnie to suffer from domestic violence?

Pregnant women

“1 in 4 women experience physical and/or
sexual violence during pregnancy in Europe”

Image by Freepik

Pregnancy can act as a catalyst for domestic violence and ongoing violence may escalate during pregnancy or in the postpartum period. Experiencing domestic violence while pregnant poses serious risks to both the mother and the unborn child. The chances of miscarriage, infections, premature birth, and harm or even death to the baby are heightened in such situations.

Furthermore, domestic violence during pregnancy can have significant emotional and mental health consequences. The stress and anxiety caused by the presence of domestic violence can adversely impact the baby’s development, as well as the well-being of the mother.

6. Perpetrators of domestic violence

In cases of DV it is also important to have a closer look at the role of the perpetrator. The cycle of violence cannot not be interrupted if perpetrators are left out. Therefore, there are institutions and authorities (probation services, prison release services, men’s counselling centres, prisons) that specialise in working with male and female perpetrators; women can be perpetrators, too.

“The campaign to end domestic violence needs the voices of men as well as women, challenging the cultural, economic and political context in which we all experience the world”

HRH, the Duchess of Cornwall at the Women of the World Festival (March 2020), National Centre for Domestic Violence, UK

A perpetrator is a person who commits, or knowingly allows, acts of abuse, neglect, or exploitation to occur. An act can also be triggered by a third party.

The video explains who the perpetrators of domestic violence are.

Who is the perpetrator?

As is the case with victims of domestic violence, abusers can be anyone and come from every age, sex, socioeconomic, racial, ethnic, occupational, educational, and religious group. Perpetrators are not always angry and hostile, but can be charming, agreeable, and kind. They differ in patterns of abuse and levels of dangerousness.

If you don’t see the video here, please use another browser or click here:

Why do individuals become abusive?

DV is multi-factored: the presence of these factor can increase the risk for DV- but every perpetrator and victim do have their individual profile of risks.

  • Personal, situational, and socio-cultural factors influence the likelihood of someone becoming violent.
  • Certain factors like alcohol or drug abuse, gender roles, past trauma, pregnancy and just have given birth and experiences of childhood abuse can increase the risk of domestic violence.
  • In one-dimensional, monodirectional violence dynamics, it is easy to distinguish between the victim and perpetrator, often seen in abusive relationships or heat-of-the-moment assaults.
  • However, some relationships involve bidirectional violence, where both individuals engage in violence at different times, making it challenging to differentiate between the perpetrator and the victim.
  • Bidirectional violence is more common in relationships where addiction problems exist on both sides.
The wheel of Power and Control

In domestic violence a pattern of tactics is used by perpetrators to gain or maintain power and control over victims and in cases of IPV to keep them in the relationship. The complexity is not easy to show in a single picture, however the power and control well first introduce in 1984 by the Domestic Abuse Intervention Project in Duluth, MN is a good way to better understand the dynamics within DV relationships. The inside of the wheel makes up subtle, continual behaviors over time, while the outer ring represents physical and sexual violence.(1)

Copyright by the Domestic Abuse Intervention Project
202 East Superior Street, Duluth, MN, 55802
If you don’t see the video here, please use another browser or click here:

Relationship between children and the perpetrator and its impact

Image by on Freepik

Children are often seen as the “unseen” or “invisible” victims within families affected by domestic violence. Children who have been subjected to domestic abuse may display physical manifestations linked to trauma and stress.

Witnessing abuse leads to a mix of emotions in children: anxiety, fear, anger, affection, loyalty, and love towards the abuser. Children may direct their anger towards the victim instead of confronting the perpetrator directly. Some children even desire a positive connection with the abuser.

Children who observe domestic violence are at an increased likelihood of entering into an abusive relationship during their adulthood, whether as the perpetrator or the victim.

Women as perpetrator

In research and literature, little attention has been paid to the role of women,
especially mothers, as perpetrators or bystanders of domestic violence.

A study (2021) has shown, that “the general population underestimates the involvement of biological mothers in child sexual abuse. The results confirm that female perpetrators account for a rather small but substantial proportion of the perpetrators of child sexual abuse. Furthermore, the results indicate that mothers play a role in sexual abuse – either as perpetrators or as bystanders – that has been underestimated so far”. (1)

Work with perpetrators

The work with perpetrators is an important element of combating domestic violence, especially intimate partner violence.

Find here an interactive map of perpetrator programmes, researchers, as well as victim support services.


Training materials to be used for a workshop or for your self-study can be found here.

Most common forms of violence in the context of domestic violence
Special types of violence in the context of domestic violence




Reproductive coercion

  • (1): Grace KT, Anderson JC (October 2018). “Reproductive Coercion: A Systematic Review”. Trauma, Violence & Abuse. 19 (4): 371–390. doi:10.1177/1524838016663935. PMC 5577387. PMID 27535921.
Diverse spectrum of victim groups

People with disability, impairment and mental illness

Elderly abuse/maltreatment

Honour-related violence

Perpetrators of domestic violence

The wheel of Power and Control

(1) Wheel of Power and Control

Women as perpetrator

(1) Gerke J, Lipke K, Fegert JM, Rassenhofer M. Mothers as perpetrators and bystanders of child sexual abuse. Child Abuse Negl. 2021 Jul;117:105068. doi: 10.1016/j.chiabu.2021.105068. Epub 2021 Apr 17. PMID: 33878645.

Relationship between children and the perpetrator and it’s impact

(1) Humphreys, C. and Houghton, C. (2008), Literature Review: Better outcomes for children and young people exposed to domestic abuse – directions for good practice, Edinburgh: Scottish Government