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When I was in high school, I had my first exposure to the reality of domestic violence. Tom Santoro spoke to my class about his daughter, Lisa, who was killed by her ex-boyfriend in the summer of 1994, just after graduating high school. No one suspected that she had been in an abusive relationship until it was too late.

Mr. Santoro traveled to high schools and colleges sharing his daughter’s story and trying to end dating violence. His heart-wrenching account has haunted me all these years. Now, as a professional counselor, I have an even deeper understanding of how critical it is to know the signs of domestic violence.

This month is Domestic Violence Awareness Month. Images and stories from film and TV help shape our perception of what domestic violence looks like. But unfortunately, domestic violence doesn’t exist only in the latest episode of Criminal Minds. High-profile incidents of domestic violence, such as that of NFL player Ray Rice (the charges against him have been dropped), have brought the reality of domestic violence to center stage. And one in four women will experience domestic violence in her lifetime, while more than four million women will experience physical assault or rape by their partners, according to Safe Horizons, a national victims’ assistance organization.

Even more tragic, most incidents of domestic violence are never reported. And only 34 percent of individuals received medical care for injuries from their intimate partners, as reported by the National Coalition Against Domestic Violence. Learning the signs of domestic violence and how you can help a friend in danger is a crucial first step toward ensuring that victims of domestic violence receive the help they desperately need.

What Is Domestic Violence?

Domestic violence is based on a pattern of power and control behaviors established by one intimate partner over the other, according to the NCADV. Typically, an abusive relationship is established over time. It starts with behaviors that are dismissed as “caring” or “protective.” These behaviors escalate to more violent and extreme actions over time. Women between the ages of 18 and 24 are most often abused by an intimate partner, as reported by the NCADV. But domestic violence is not limited to this age range nor are women the only victims. Children and men can also be victims of domestic violence.

The American Psychological Association identified common risk factors that increase the likelihood that someone is at risk for being a victim of domestic violence. These common risk factors include being poor, less educated, female, drug-dependent, and living in a high-poverty neighborhood. It is important to remember that having these risk factors doesn’t mean a person has a 100 percent chance of being a victim of domestic violence. Conversely, many people who are victims do not fit this profile.

Who Is at Risk?

The APA identified common risk factors that increase the chances of someone becoming an abuser. These risk factors include low income, low academic achievement, aggressive behavior as a youth, displaying anger or hostility, prior history of abuse, emotional dependence and insecurity, belief in strict gender roles, desire for power and control in relationships, and being a victim of child physical or psychological abuse.

The NCADV also compiled an extensive list of common characteristics of abusers. These include extreme jealousy, possessiveness, unpredictability, bad temper, cruelty to animals, and being known as a “nice person” between episodes of violence. If you notice these characteristics in a friend’s partner, they could be warning signs that he or she is an abuser.

Types of Domestic Abuse

Physical violence is usually what we think of when we think of domestic violence. But abuse includes emotional, psychological, and financial control as well. Signs of physical abuse include hitting, kicking, restraining, and the use of a weapon. The Advocates for Human Rights organization notes that physical abuse does not always result in an injury that has to be treated (e.g. being hit but no bruise forms).

Psychological abuse includes the use of intimidation, isolation, and threats to control behavior. For example, the abuser may keep the victim away from friends and family. Nikki, a former victim of domestic violence, says that this was one of the tactics her ex-husband used.

“He had isolated me from family and friends,” she says. “The only person who knew what was going on was my psychiatrist.” Emotional abuse often includes name calling aimed at chipping away at their partner’s self-worth. Nikki’s ex would build her up, saying she was strong and beautiful, but “he would call me a fat f***ing b**** in the next breath,” she says.

Financial abuse can include restricting the partner’s access to money to increase dependence on the abuser. If someone you know is unsure if she is a victim of abuse, the American Congress of Obstetricians and Gynecologists offers a simple online checklist to help them assess. The Office on Women’s Health, U.S. Department of Health and Human Services also has an online guide listing common signs of abuse and the qualities of a healthy relationship versus an unhealthy one.

Signs of Domestic Abuse

If you suspect that someone you know is a victim of domestic violence, keep an eye out for some of the common signs. Typical signs include physical injuries, such as bruises or cuts. Victims often try to explain them away by saying they are “clumsy,” according to AARDVARC (An Abuse, Rape, and Domestic Violence Aid Recourse Collection). To avoid embarrassment or being asked to account for her injuries, a victim might miss school or work or be frequently late.

The radio show This American Life recently shared the powerful story of a teenager, “Rainy” (not her real name), who was the victim of intimate partner violence for several years. In her story, she chronicles how she missed more and more school as her relationship progressed until she was at risk for being unable to graduate on time. Other warning signs include increasing isolation; either extremely low self-esteem (they think they deserve the treatment they are getting) or high self-esteem (they believe that if they find the “magic cure,” they can change their abuser for the better); and changes in personality, such as becoming quieter or more nervous.

Myths About Domestic Violence

There is no typical victim of domestic violence (though there are risk factors). Many people wonder why a victim can’t “just leave” the relationship. The answer is that the cycle of abuse in play is extremely powerful. It is a dangerous cycle, as shown in this commonly used Power and Control Wheel. In a common domestic violence cycle, as described by NCADV, there are periods of relative calm in the relationship. Each calm period is followed by a buildup of tension and then a violent reaction. Rainy described how each time she returned to her boyfriend, he would at first be sweet and attentive. But over time, he would return to threats and physical, emotional, and psychological abuse. Rainy says:

“He was verbally abusive way before he became physically abusive. The bruises clear up, but words stick with you, and they change how you act. He would tell me, ‘You’re boring, you’re awkward, you’re the weirdest of the weird, you’ll never fit in anywhere.’ I believed him. I didn’t talk to anyone anymore, including my mom. I started coming home late or not at all.”

Abusers often use threats to intimidate their victims to keep them from leaving. An abuser might threaten to harm the couple’s children if the victim tries to leave. Or the abuser might restrict the victim’s access to money. The victim often feels trapped and is afraid to leave or may believe that it’s wrong to leave. Nikki says, “I knew the end was coming, but I was terrified. I had been with this man since graduating college. Now, I was 30, almost 31. I had never had another relationship. I had only ever lived on my own for about six to eight months. I had lost my job the previous year.” But after a violent fight, Nikki says it was her psychiatrist’s advice to leave that helped her to finally end the relationship.

How You Can Help

I was recently chatting with a coworker who said she was concerned that an acquaintance of hers might be a victim of domestic violence. Like many of us, she wasn’t sure what to do. If someone you know is a victim, there are several ways you can help.

Be there for her, and listen to her. Because abusers often isolate their victims, try to maintain your relationship with your friend. Nikki says:

“My ex-husband was pretty much the only person in my life. Abusers isolate the victim. My advice would be if you see a family member either isolating themselves or being isolated by an abuser, do anything you can to keep that relationship going. Send cards. Make calls. Texts. Go to lunch if you can.”

Remind her that she doesn’t deserve the abuse. Stress that you are there to help her. Help her to “see something in her that neither she nor her abuser sees: strength,” Nikki says.

Domestic Abuse Intervention Services compiled a dos and don’ts checklist to guide you when helping your friend. While it’s tempting to feel frustrated that she won’t just leave, be patient because the decision may take some time. Provide her with the National Domestic Violence Hotline number—1-800-787-3224—and website: Because abusers are controlling, they often track their victims’ use of technology (cell phones, browser history, etc.). So encourage your friend to call the hotline from a landline or a public phone. The National Resource Center on Domestic Violence has a technology use guide for victims of domestic violence.

You can also help your friend develop a safety plan similar to the one by the NCADV. Elements of a safety plan, as recommended by the APA, include helping your friend identify safe areas of the house to hide that have phone access. Help her memorize the numbers for hotlines, the police, and shelters ahead of time. And pack a bag with clothes, medicine, and important documents. Have her leave it in a safe place in the house or with a trusted friend. Both you and your friend can call the hotline at any time to ask about the resources available in your area.

Watching a friend in an abusive relationship can be painful and frustrating. But remember that because a victim often feels trapped, alone, and isolated, being there as a support system for her can make all the difference. Keep your eye out for signs that someone might be the victim of domestic violence. And don’t be afraid to reach out to her. You may be the only way out that she has been looking for.

Special thanks to Nikki for bravely sharing her story as a victim of domestic violence for this article.

Photo Credit: Nikoline L. Rasmussen