“My Body Came Between Us”

Abstract

Women with physical disabilities are at high risk of intimate partner violence. In addition they are subject to inaccurate stereotypes, including challenges to their gender identities. Like other assaulted women, they may reframe the violence they experience in order to reduce stigmatization. Nineteen formerly abused women with disabilities discussed their coping strategies and reasons for remaining in abusive relationships. Results were content analyzed using feminist and Interactionist lenses. Respondents used neutralization strategies common to abused women but incorporated disability-specific elements. Accounts tended to bolster a stereotypically feminine (gendered, nurturant, or sexual) identity. Policy and clinical implications are discussed.

People with physical disabilities, including sensory and neurological impairments, are the fastest growing minority group in the United States. Partner abuse is a widespread social problem, with approximately one in four women being abused within intimate relationships. Women with disabilities are physically, sexually, and emotionally abused more often than their nondisabled counterparts (Brownridge, 2006), most frequently by romantic partners (Smith, 2008). Abusive actions may take disability-specific forms such as withholding food and mobility supplies or threatening partners with institutionalization (Plummer & Findley, 2012). This can result in depression, anxiety, suicidality, and additional health conditions (Hassouneh-Phillips & McNeff, 2005).

Most of the few studies of women with disabilities are focused on those with cognitive impairments; these have documented alarming rates of physical, and particularly sexual, abuse. For example, girls with developmental disabilities are 4–8 times more likely than nondisabled peers to be sexually abused, mostly by caretakers (Martin et al., 2006; Plummer & Findley, 2012). Vulnerability factors include an inability to comprehend acts as abuse, exposure to multiple caregivers, difficulty in making crime reports, and habitual submission to authority (Goodley, 2010). Similarly, women with emotional disabilities are twice as likely as women without them to have been physically, sexually, and emotionally abused since their diagnoses; almost 100% are raped, repeatedly, if they become homeless (Hidday, Swartz, Swanson, Borum, & Wagner, 1999; Plummer & Findley, 2012). However, there is less information on abused women with physical/sensory/neurological disabilities in conjunction with average cognitive/emotional status to inform policy and treatment. This population is different in that they possess the capacity to deliberately select partners and apprehend the nature of abuse; however, they may lack the resources and strength to defend themselves (Brownridge, 2006).

Because many women are physically weaker than their partners, researchers and policy makers may assume that physical disability does not have a sizeable influence on partner abuse dynamics. In addition, women with physical disabilities may be more capable of hiding abuse from investigators (Smith, 2008). One phenomenon that is particularly underresearched is the cognitive strategies women with physical disabilities utilize to cope with abuse by romantic partners. Without understanding these, it may be difficult for social workers to recognize and intervene with partner abuse among this population. This is important for all practitioners, not only for those who specialize in domestic violence work.

Symbolic Interaction, Disability, and Gender

Symbolic interaction theory evaluates how societal norms, stereotypes, and judgments affect stigmatized or “othered” groups—such as women with disabilities. It explores how such groups internalize (absorb and accept) negative stereotypes about themselves and take actions to manage others’ preceptions of them (Goffman, 1963; Hewitt, 2003). In this perspective, individuals will go to great lengths to disguise, minimize, compensate for, or deny socially unacceptable aspects of themselves (Goffman, 1963); such efforts are known as “accounts.” Symbolic interactionists have studied accounts of people with HIV/AIDS/herpes, gays, and lesbians, people with psychiatric labels, welfare recipients, childless couples, people with visible and hidden disabilities, and other stigmatized groups. Passing (pretending to be like others), covering (making excuses for the difference), and embracing a negative identity are among the strategies that have been identified (Evans-Lacko, Brohan, Moitaba, & Thorncroft, 2012; Goffman, 1963; Halzenbuehler, Phelan, & Link, 2013; Hewitt, 2003; Saewyc et al., 2006).

Women with physical disabilities, like women in general, are affected by powerful social expectations concerning their physical size, shape, and gracefulness (Wolf, 2002); with bodies that deviate from the prescribed ideal, they are are subject to negative evaluation by self and others (Banks, 2010; Wendell, 2006). In addition, victims of partner violence are often negatively judged and held responsible (Ullman, 2010); thus, it can be said that partner-abused women with physical disabilities are dually stigmatized.

As a result of this dual stigmatization, they may be motivated to develop cognitive and other survival strategies. According to symbolic interactionists, disability is a primary hallmark of identity that may supersede even race or gender (Goffman, 1959). Feminist disability theorists view women with disabilities as doubly vulnerable, living in a society that is both ableist and patriarchal. In addition, ableism and sexism interact to create unique forms of oppression (Wehbi & Lakkis, 2010). Gender roles are accomplished through the performance of specific activities from which many women with disabilities are excluded (Banks, 2010). Womanhood may therefore be an achieved status for them (Dotson, Stinson, & Christian, 2003). They are stereotyped as child-like, passive, unable to parent; frustrating to caregivers; cognitively impaired; and having little to offer in a relationship (Galvin, 2005; Hassouneh-Phillips & McNeff, 2005). Although it has been argued that women with disabilities are “doubly feminized” (as a result of the weakness and passivity ascribed to both categories), in fact they are perceived largely as eunuchs (Cheng, 2009). In this context, successful marriages may confirm the heteronormativity of women with disabilities—while failed ones may reinforce perceptions of them as asexual and degendered (Galvin, 2005).

Women are expected to have superior intuition, resulting in good relationship choices (Friedan & Quindlan, 1997); therefore, rape and battering by familiars may be viewed as indicators that important characteristics (of victims) are lacking. The intersecting stigmas of female gender, disability, and victimization may cause women with disabilities to tolerate more severe abuse for longer periods and reduce their willingness to report it (Banks, 2010). Instead, they may use stigma management strategies to remain in relationships while preserving self-esteem and social acceptability (Plummer & Findley, 2012).

Stigma Management Strategies Among Victimized Women

There have been some studies of stigma management strategies used by nondisabled female victims of violence. Karen Weiss (2011) identified specific interpretations of rape used by survivors in ongoing relationships with their perpetrators. These included denying the rapist’s violent intent, doubting that the acts were criminal, denying their own innocence, and rejecting a victim identity. Similarly, Warshaw (1994) found high levels of reframing among raped female college students. Mason and Palvirenti (2013) found that domestic violence was “papered over” by female refugees in the interests of community survival. Such stigma management strategies arise in the context of social, economic, and political oppression.

The stigma management strategies of women with physical disabilities may be similar to those of nondisabled women. However, if abusers’ tactics—and victims’ barriers to help seeking—can be disability specific, then accounts of abusive relationships may be disability specific as well. No research to date has focused on accounts of abused women with physical disabilities coping with partner violence. Such narratives may illuminate how these women view themselves and their situations. Understanding their perspectives may help social workers devlop effective interventions for this population.

Method and Data

This investigation was part of a larger study, based in a mid-sized city in New York state in the United States. It investigated the coping mechanisms and experiences of crime victims with all types of disabilities: physical, cognitive, and emotional. Recruitment efforts for the larger study took place between September and November 2005. Interviews occurred between December 2005 and February 2006. Participants were solicited through a radio and print advertising campaign. Compensation (US$20.00), transportation, and refreshments were offered. Efforts also included group solicitations from professionals at victim assistance and disability service organizations. To avoid issues of stigmatization and terminological ambiguity, advertisements described (but did not label) specific abusive behaviors and requested participation from people having difficulty with various activities of daily living; the terms rape, domestic violence, and disability were not used. In order to be eligible, participants had to be free of (no longer living with, dating, or stalked by) their ex-partner for at least 1 year. This was to minimize retraumatization of survivors. Counseling was made available through the local victim assistance agency to anyone needing it after the interview. In addition, the researcher is a trained disability counselor with background in assisting surivors. The participants signed informed consent documents after they understood the purposes and parameters of the research.

The larger qualitative study, conducted with a small team of investigators, assessed how people with various disabilities (physical, cognitive, and/or emotional) perceived community supports following victimization. There was little emphasis on their subjective appraisals of relationships, actual experiences of violence, or coping mechanisms outside of reporting the crimes. This researcher decided, based on the paucity of research on (coping strategies of) women with physical disabilities, to conduct additional interviews with members of this population. Demographic data were already available. The researcher approached potential participants by telephone to determine their willingness to participate in additional, more in-depth interviews. Having already established a professional relationship with the author, most (19 of the 25) agreed. Some data from the original interviews were utilized in conjunction with further open-ended questions to elucidate how participants had viewed their abusive relationships. An additional US$20.00 was paid to these participants who were also offered counseling in the event that they needed it. They were interviewed using a semistructured protocol at a place convenient to them—most commonly in their homes or workplaces (13) but occasionally at the crime victim support agency (6). Interviews took place from January through March 2006 and ranged from 75 to 120 min, with an average of 100 min. Interviews were audiotaped with permission and transcribed verbatim. The researcher also took notes after each session, including nonverbal cues that accompanied the narratives.

In this exploratory study, the researcher asked open-ended questions designed to initiate discussion of a broad number of topics rather than evoke targeted responses. In each interview, the author relied on probing follow-up questions that were unique to the content of the conversations. Among topics discussed were participants’ feelings and thoughts about the relationship and the abuse; actions of partners which had bothered them the most; what had kept them in the relationship; what they had told others; how others had viewed the abuse; and what they had told themselves in order to survive the relationships.

Analysis

Qualitative analysis is appropriate for exploratory research when it is important to grasp the meanings and nuances of a complex topic like violence against women. After interviews were transcribed, core themes emerged from multiple reads of the interview data (Rubin & Rubin, 1995). The narratives were content analyzed and examined for both manifest and latent content (Miles & Huberman, 1994). To accomplish this, the following steps were undertaken: The first consisted of open and axial coding (Strauss & Corbin, 1998). Then a meta-matrix that compiled descriptive data from each case into a standard format (Miles & Huberman, 1994) was constructed. Following that was a search for patterns among the variables; qualitative software (ATLAS.ti, version 6) aided in its identification. The final step was to uncover themes that could answer the research question: What accounts had been invoked to cope with partner violence? Patterns were then used to construct a typology. Although the emergent themes are experientially interrelated, each will be discussed separately for analytic clarity.

Results

Participants’ disabilities included head trauma, muscular dystrophy, stroke, congestive heart failure, asthma, Tourette’s syndrome, epilepsy, spina bifida, spinal cord injury, spinal stenosis, cerebral palsy, and multiple sclerosis. Most (12) had more than one disability. None had serious intellectual impairments, though some (2) had difficulty with articulation, dyslexia, or attention-deficit disorder. Some (5) also had anxiety or depression for which they had sought counseling. Abuse experienced included rape, molestation, stalking, physical assault, and domestic violence; most (15) had been the victim of more than one crime. Perpetrators were male partners with or without documented disabilities. Most subjects were aged 40–65 (13), two were in their 20s and four were in their 30s. Most (15) identifed as Caucasian; two were of Hispanic origin (Puerto Rican and Mexican); and two identified as African American. All were (apparently) heterosexual. Although the research focused on crimes experienced in adulthood, 12 had known histories of criminal victimization in childhood.

Among the women interviewed, gender role identity, victimization, and disability intersected in complex ways. Cognitive mechanisms for reducing distress and maintaining a positive identity were used by many respondents—both in the past and, occasionally, during the course of the interviews. The data are not suitable to assess the “objective” accuracy of the women’s claims but to provide a standpoint for understanding how they interpreted experiences of partner violence in everyday life. The following excerpts from narratives illustrate emergent themes regarding (a) victims’ use of accounts and (b) positive identities they negotiated. Narratives were distributed into the following categories or general themes: My disability caused the abuse; the abuser is/was disabled; the abuse was accidental; the abuse was bearable; and the abuse was protective. Each category is accompanied by a statement from one of the narratives, which captures its essence.

“Man and Woman are of One Body—But in Our Case it Was Broken”

The Disability Caused the Abuse

Although perpetrators may deliberately seek out women with physical disabilities because they are easy to overpower (Martin et al., 2006), over a third of participants framed their disabilities, or the effects thereof, as unexpected hurdles that could not have been anticipated. This led to guilt over their “unattractiveness,” restrictions their bodies imposed on their partners’ lifestyles, the stigma partners experienced for having a disabled lover, or their inability to engage in specific sexual acts. In their eyes, the disability victimized both themselves and their partners. Many framed abuse as an inevitable outgrowth of living with a disabled person. This occurred even among sexually active women or those who contributed to the household income. Most had already felt unworthy of love (as a result of previous messages about their disability)—and the abuser’s words confirmed this. Such was the case with Delores, a woman with mild cerebral palsy acutely aware that she did not meet social standards of attractiveness:

God says man and woman are of one body—but in our case it was broken (laughs). Nick took my appearance like an attack on him…One day he says “Let’s see if I can make you even uglier—and he slugged me.” (Dolores, 42, cerebral palsy, dyslexia, low vision.)

Nick used Delores’ departure from typical standards of femininity as an excuse to treat her in a demeaning fashion. Throughout the marriage, she had framed his behavior as a response to stress brought on by her physiology, rather than a reflection of his own damaged character. By so doing she was able to remain in the relationship for several years while negotiating a self-identity (devoted, enduring, kind) consistent with traditional notions of femininity. Nick’s attitude is not uncommon; other researchers have identified feelings of disgust, pity, anger, and fear toward the bodies of women with disabilities (Cheng, 2009; Galvin, 2005). Abusive men who do not feel this way can still leverage common negative perceptions to gain power over a woman with a disability. It is a common tactic of abusive partners to frame a woman’s appearance as unacceptable to lower her self-esteem, induce guilt, and instill a fear of abandonment that can be exploited for purposes of control (Barnet, Miller-Perrin, & Perrin, 2005). Although “caregiver stress” is a real issue (Cheng, 2009), it is not a justification for rape and battering.

Nick had negotiated a role with Dolores as translator, explaining what was “really going on” in the social world around them. This is a common stance abusers took in regard to victims whose perceptions are often doubted (Barnet et al., 2005). However, she began to question his authority, and her own accounts, when he asked her to engage in prostitution.

Nick…wanted me to sleep with other men to bring in a little extra money; I said ‘Come on, how can you expect me to do that when nobody else would want me?’ He said, ‘You’re wrong, there are plenty of perverts out there who’d get a kick out of sleeping with you…I was shocked. I started to wonder if he was a pervert too—or some kind of criminal mind.

Nick’s implication that sexual relations with a disabled woman is “perverted” may have been intended to hurt Delores; however, it reflects a common attitude of some men and women in our society (Cheng, 2009; Richards, Tepper, Whipple, & Komasirak, 1997). Up to that point, Dolores had framed her lack of femininity as the cause of her abuse. However, Nick’s request was so inconsistent with this frame that it shattered her adherence to it. She then viewed Nick as having problems of his own, which was consistent with her belief that no normal man would be in a relationship with her. She was later able, with support, to exit the relationship.

It is commonplace for victims of partner violence to assume responsibility for having engaged in unwise actions. This allows them to believe that, by altering their behavior, they can end the violence (Barnet et al., 2005). In contrast, study participants rarely believed their own actions caused the abuse; rather, their mere embodiment was an incitement to violence and there was little they could do to affect the outcome. Bethany, a 36-year-old woman with multiple sclerosis, felt that her disability was an imposition on her husband; as a result, she she felt obligated to sacrifice her home-based physical, speech, and occupational therapies.

Bob felt he could handle being with me, but he over- reached himself. I should’ve warned him away…I knew better…I mean, what normal wife would have all these professionals coming to the house and putting their hands all over her? All in the line of duty, but still—my body was for him alone…he was paying a heavy price for my problems and it didn’t seem fair. So I ended the therapies.

Possessiveness and isolation are common among abusive partners (Brownridge, 2006). Women with physical disabilities may need to meet with a variety of care providers, which can lead to an escalation of violence by partners. Bethany did not identify Bob’s possessiveness as problematic; she engaged in characterological self-blame for allowing him to take on an “impossible burden” (living with a woman with a disability) when she “knew better.” The most culpable party of all, however, was her body. Bethany, like other participants, externalized her body and viewed it as a third party interfering with an otherwise viable relationship. This is consistent with previous findings on disabled womens’ dissociation from, and disavowal of, their bodies (Galvin, 2005; Wendell, 2006). Bethany could not heal her disabled body; instead, she tried to limit its influence by surrendering her medical care. However, the abuse only escalated.

Accounts that attribute relationship problems to “deformed” or unacceptable bodies are not atypical among women in our society; nondisabled women (and their associates) may blame failed marriages on their weight gain or facial aging (Wolf, 2002). Among women with physical disabilities, this may be more central to how they frame the loss of a relationship.

Catherine, who appeared confident on the outside, disparaged her body in discussions of partner violence. Her husband was violent physically, emotionally, and sexually. She explained that she “really tried” to be a good sexual partner but her body let both of them down.

Bill really lost the sex lottery with me. There were positions I just couldn’t do. My legs are stiff, and I have lousy range of motion. I couldn’t stand up against the wall or do the other tricks he got from porno. He was frustrated like any normal man…I wanted to get it right, but my body came between us… When he left, I figured my love life was over for good (Catherine, 42, cerebral palsy).

Catherine, like others, was quick to describe her abuser as “normal” and justify his distaste for her body. Research indicates that women with physical disabilities may disqualify themselves from engaging in erotic activities (Hassouneh-Phillips & McNeff, 2005). Catherine was eager to participate but felt too much pressure to “get it right” to enjoy the experience. She attributed this problem (lack of satisfaction) to her disability—rather than her husband’s apparently insensitive (and possibly coercive) behavior. Aware that pornography was shaping his expectations, she felt unable to compete with thec nondisabled models. Although people with disabilities experience sexual pleasure, this often takes nontraditional, experimental, and unique forms that develop within close partnerships (Dotson et al., 2003; Wendell, 2006). However, Catherine never questioned Bill’s sexual norms or negotiated an alternative model of love making; instead, her erotic potential was colonized.

“He Is Broken, and I Am the Healer” The Abuser is Disabled

Some participants had employed accounts framing their abuser as disabled, broken, or damaged—and therefore deserving of for bearance. Women who employed a romantic discourse conveyed that, with hard work, they could transform abusive men into good partners (Hayes & Jeffries, 2013). This may be particularly common among women with disabilities, for whom discourses of “damage” and “rehabilitation” are ubiquitous.

He was as strong as an ox but a little comment could bowl him right over. That’s how I knew he was the weak one even though I am the so-called cripple” (Melanie, 46, multiple sclerosis; physical and emotional abuse).

You look at the Tin Man, you can’t tell he’s missing a heart. You look at Joe and he seems fine too. But he’s a broken man. I’m not sure even the Wizard of Oz could put him back together. I sure as Hell tried. But I’m broken too…(Claudia, 52, spina bifida; sexual and emotional abuse)

Few of the women had overtly disabled partners, most described subclinical or “invisible” disabilities. Most negotiated self-identifies as loyal, altruistic caretakers—accounts which downplayed both their disabilities and the reality of violence in the relationships. Christine, 51, has spina bifida, a poised bank teller who ambulates with a wheelchair, she called the police when her husband’s violence escalated. After the incident she swore she would never do so again:

The officer came to the house…All he saw was a crazy woman in a chair and a normal healthy man. So there they were, two regular guys shooting the breeze, and there I was, a hysterical sobbing cripple in a wheelchair. He told the cop I was “on the rag.” Furniture was knocked over—which of course I couldn’t reach…Don looked good on the outside but he was nuts on the inside from a head injury… One day it finally occurred to me: He’s broken, and I’m the healer.

In Christine’s account, the officer is presented with common stereotypes about women (hysterical, “on the rag”) as well as of persons with disabilities (out of control, noncredible) and accepts them in an apparent spirit of male bonding. This resulted in an absence of legal action and cemented her sense of helplessness. She negotiated a self-image as compassionate and strong in framing her husband as the “broken” party. In identifying herself as a “healer” doing what women do, her gender identity was highlighted and her disability identity mitigated. As Hayes and Jeffries (2013) assert, romantic discourses proliferate among abused women for whom suffering may be conflated with love. Christine, like many women with disabilities, had been framed as “the broken one,” so assuming the mantle of healer may have restored a sense of competency.

“One Little Push and I Fall Over” The Abuse was Accidental

Some respondents had reasoned that, if they were of normal size and strength, the abuse would not have hurt them. Thus, their disability, rather than the abuser’s intent, resulted in harm.

All you have to do is breathe on me too hard and I feel it. So I should lock myself in a closet? No, I get out and live in the world, and it hurts. People slap me on the back, just being friendly—and I flinch. So with someone up close and personal, I’m going to get a little sore. I deal with it.(Judy, 58, multiple sclerosis; physical and sexual abuse)

Women with disabilities are familiar with accidents: objects break, equipment malfunctions, and their bodies do not always behave as planned. Therefore, it is not surprising that some women framed the abuse in this way. When partners harmed them with disability-related devices (such as wheelchairs or canes), some participants described the problem as an equipment malfunction. This was supported when abusers later apologized for their behavior and deplored having hurt a woman with a disability. Jennifer is a 52-year-old woman with spina bifida and dyslexia dependent on her husband for physical care. She came to frame a rape by him as an accident:

First I told Sue about it. Even with her it was hard to spit it out. I stuttered and stammered and went off on tangents…If had to tell a cop sitting there with a gun I ’d really freak; Joe had one when he forced me to you know what (laughs) But…I started to wonder: what if my communication disorder was the problem? He could’ve thought I meant yes, when I really meant no.

Jennifer practiced telling a friend about her rape, in preparation for reporting it to police. However, after realizing how difficult that process might be, she reframed the event as a misunderstanding resulting from her disability. This account spared her the pain of seeing the act as deliberate—and relieved her of responsibility to report it.

Dierdre, a slender, soft-spoken woman in her mid 50s, suffered from a heart problem and spinal stenosis. She and her ex-husband had an argument one day, which ended with her hospitalization. She had framed the event, to herself and to others, as an accident.

Mike was Italian, and talked with his hands. Sometimes he’d forget how delicate I am…one little push and I fall over…during an argument he tapped me on the back and I fell down a flight of stairs…I had to get stitches that night…I figured he was only trying to make a point and got carried away. But now I think he actually did it on purpose, since he’s…never apologized once.

Dierdre claimed that her disability caused her accidental harm. She is so frail, in this account, that an innocent “tap” can propel her down a flight of stairs. Hospital staff had believed this account and no charges were laid, nor was she offered counseling. Eventually, with the help of concerned family members, Dierdre moved out. In the absence of imminent danger, she was able to reevaluate the relationship and identify previous “accidents” as purposeful. Her interview comments included some residual minimization but recovery is a process that is often gradual.

“I’ve Been Through Worse From My Doctors” The Abuse was Bearable

Some women characterized their abuse as relatively harmless in comparison to previous negative experiences (medical procedures, therapy exercises, and ill fitting equipment) they’d endure as a result of their disability. By using accounts that framed themselves as sturdy and resilient, they could deny the severity of the abuse. In this view, disability had toughened them.

If you want someone to feel sorry for, you picked the wrong lady…My perfectly normal sister was molested; she came to me and said, How do you stay so strong? I told her I thank God every day I’m not still getting those horrible injections. (Edie, 47, spinal stenosis, low vision; physical abuse)

Accounts such as these compete with popular conceptions of these women as delicate. Several framed their victimizations as best addressed with counseling, medication, prayer, or a philosophical outlook. For some, this perspective was learned from experiences of institutional care where resident-on-resident offenses had been framed as mental illnesses or behavioral seizures and treated with medication or therapy. Mindy, a 39-year-old woman with multiple sclerosis and a history of institutional care, was physically assaulted by her husband on a regular basis.

When the slapping started, at first I was shocked. No boyfriend ever lifted a hand to me before. But… I’ve been through more than that from my doctors. One physical therapist used to torture me and you should have seen what it was like in rehab…If I was a whiner I’d ’ve been dead a long time ago. So I just…let God take care of it. (Mindy, 39; multiple sclerosis)

Mindy, like many nondisabled women who are abused, engaged in cognitive reevaluation of her situation, concluding that it was not so bad. Research shows that survivors of partner violence may compare their victimization to worst-case scenarios (e.g., sexual murder or fatal beatings) in order to reclassify their abuse as within the range of normal human experience (Weiss, 2011). These women, in contrast, made comparisons to the normal “everyday” abuses of living with a disability.

Claire is a blunt, gregarious woman with a diagnosis of epilepsy and spinal stenosis. She jokes about her disabilities, perhaps to put others at ease, and presents as if made of nails. Her history of institutionalization involved surviving “in a war zone” where violence erupted daily. She described developing a protective shell wherein “nothing bothered me unless it was really godawful.” Claire felt that her boyfriend’s behavior paled in comparison:

Joe…used his wooden leg to hit me…similar things happened to me in the group homes. The inmates used canes and hooks and chairs…The staff would refer them for counseling. So they’d go sit in a room with some nice person nodding at them. Meanwhile I’d be hiding in a closet, scared out of my mind… So being with Joe was like a kind of deja-vu…(Claire, 57; Epilepsy)

Although it is tempting to view Claire’s history as unique, it is not uncommon for residential clients with disabilities to experience ongoing abuse (Banks, 2010; Cheng, 2009). It is probable that she is an institutional trauma survivor and her partner’s violence constituted revictimization—a situation common to women with disabilities who are often abused by multiple perpetrators (Hassoiuneh-Phillips et al, 2005; Plummer & Findley, 2012). Claire’s accounts served to neutralize the behaviors of her abusive partner, with whom she stayed for 3 years. Similar accounts (of resiliency and invulnerability) proliferate among African American victims of partner abuse (Glass, 2012) who may be hesitant to trust service providers. Some responders, such as police officers and jurors, fail to believe victims who present this way because emotional distress is deemed the only credible reaction (Ullman, 2010). Women with disabilities are expected to be emotionally fragile (Dotson et al., 2003); as a result, it may be difficult for those like Claire to access needed social support.

“He Was My Hercules” The Abuser Was Protective

Several women had framed their abusers’ preoccupation with their whereabouts, suspicions about their friends, and insistence on accompanying them to appointments as being protectiveness. Because they were physically challenged, it made sense that their partner would want to keep a benevolent eye on them. However, some abusers seemed to take this to an extreme, exaggerating the severity of the disability to justify their own need for control.

He seemed so romantic at the time. Never wanted me out of his sight, even to go run a small errand. He thought I would trip and die or something. Maybe break a hip. And I thought I was the luckiest gal in the world (Madeline, 62, cerebral palsy, epilepsy; physical abuse).

He had this idea that he needed to check my blood pressure every 30 min, so I couldn’t go very far. No exceptions, even when my daughter came to visit and we wanted to go out. It got in the way, but I thought—you know, he really cares (Elaine,72, heart disease, emotional abuse).

Some women, in response to an abuser’s negative expectations, developed difficulties they hadn’t experienced before—often referred to as “secondary” disabilities (Goodley, 2010). Rosemary, a 47-year-old part-time accountant with cerebral palsy, was one of those women:

I relied on Tim for his physical strength. He’d pick me up and carry me into the shower, or grab my wheelchair if it started to roll downhill. He was my Hercules … It got harder and harder to do anything myself—I’d drop things on the floor and stutter like a dummy…When I said I wanted to drive again…he locked me in a closet and put my cell phone out of reach…I realized I should just let him do everything. To keep the peace.

Before meeting Tim, Rosemary lived alone and managed household tasks with the help of an aide (who Tim let go). She drove, managed her money, and spoke for herself. Later, Tim assumed most household responsibilities in an apparent spirit of chivalrous devotion. Viewed from the perspective of the romantic relationship script, he was the ideal mate for a woman with a physical disability. Over time, Rosemary felt increasingly less capable of managing her affairs—mainly in his presence. Although abusive partners of nondisabled women may also exert control over many aspects of their lives (Barnet et al., 2005), autonomy is especially prized among women with physical disabilities whose capacity to live independently may be challenged. Participants found that friends and family often praised the “self-sacrifice” and “devotion” of partners like Tim, not realizing that the woman was gradually becoming de-skilled.

Negotiation of Positive Identities

Coexisting with accounts that minimized or excused abuse, participants produced self-affirming narratives related to their roles in relationships. The following excerpts could have been placed in the preceding categories but are presented separately to highlight preferred identities that emerged from the data. They provide insight into aspirations of women with physical disabilities, which social workers can address.

“They Had Man Trouble Too” One of the Girls

Some participants experienced, in sharing their abuse stories, rare feelings of sisterhood with nondisabled women. The resulting acceptance and validation strengthened their identities as women. In addition, it challenged the notion that their disabilities caused the abuse.

My counselor told me the same thing happened to her in high school…She was beat up every day by her boyfriend. I couldn’t believe it…But I felt 100% better. It made it seem like we were alike. (Betsy, 20, spina bifida, dating violence)

Normally it bothered me when [care assistant] finished my sentences, but when I told her what Tom did to me, it was cool. She understood. She knew. And when I broke down she hugged me because she was there once too. That’s when I knew we’d be OK together (Cindy, 48, multiple sclerosis; partner rape).

Susan, 32, had cerebral palsy. She sat at a desk at her sales job so her disability was rarely visible to coworkers. However, she described being acutely aware of it at all times. Abused physically and emotionally by a partner for 2 years, she felt that her disability was responsible. She recounted a spontaneous disclosure that was ground breaking in its effects:

I came off weird enough with my crutches and all—why let on that my marriage was a total mess? But one day it came pouring out when I broke down at work … it was amazing how supportive the other girls were…I think they finally saw past my disability. They had man trouble too; who knew?…We women keep it all inside.

Susan’s use of the words “we women” is revealing; she moves from being a person with a disability to one of “the girls” at the office. This amazing transformation, of her “seeing past” her disability, was accomplished through sharing gender-specific troubles. Her problems with a male partner implied heterosexual experience, countering the stereotypes about women with disabilities. She was ushered into a supportive sisterhood, which boosted her gender role identity.

“He Was My Special Needs Child” Caretaker

Persons with physical disabilities are often viewed as opportunities for others to practice, rather than receive, charity (Goffman, 1959). Disabled women are often discouraged from having children (Banks, 2010; Galvin, 2005) although doing so is a marker of traditional femininity (Friedan & Quindlen, 1997). One of the most devastating aspects of having an acquired disability is being unable to take care of former dependents (Wendell, 2006), highlighting the importance of this role. Jazz found a way to mother her partner by counseling him in times of despair; however, she was unable to put an end to his verbal and physical abuse:

He hid my phone and smashed my computer since he thought I was using them to meet other people—and I was totally isolated…I had counseling all my life, so I knew what to say. I felt like I really helped him. Until his mood turned again and I ate a fist sandwich (Jazz, 40, spina bifida; victim of physical abuse).

Cindy, in her mid-30s, was a woman whose arms had been amputated and was unable to find a job. She was financially and physically dependent on a husband prone to violent episodes. Following his outbursts, he became apologetic and attentive. She never knew in which direction his moods would take them. She coped by negotiating an identity as caretaker of an unruly child.

They said my pelvic cavity was too small and I could never have kids. This was devastating because all of my sisters have them… and I always wanted to be a Mom…They don’t let paraplegics adopt…But the funny thing is, he was like a 4-year-old throwing those fits…So I figured he was my special needs child——and I did all right with him. My sisters could never compete with that.

Cindy assumed the role of a superior caregiver able to accept an unusual amount of responsibility. She framed her husband as disabled and her sisters were no match for her in the nurturance department. After being denied the roles of mother and productive citizen, this account bolstered her self-image as a woman and neutralized her fear of danger.

“The Others Will Be Virgins for Life” Object of Desire

As stated earlier, women with disabilities are often viewed as asexual—much to their social disadvantage—in contrast to many nondisabled women who feel sexually objectified to an excessive degree (Wolf, 2002). To compensate, some women with disabilities engage in sexual experimentation to prove their worthiness of erotic attention (Richards et al., 1997) and may be more likely to accept ethically questionable or dangerous conditions in negotiating an identity as love/sex object. Alice was torn between standards of sexual propriety and her self-identity, established in adolescence when nobody wanted to date her, as a “prude.”

He told me to touch it, and I really didn’t know what to do—I mean, we were in a public park where anyone could see us. He found that exciting, but I was scared of getting arrested. He said my wheelchair “turned him on” and I thought; he’s really a nut…But I was a prude growing up and I didn’t want to lose him so I went along with it (Alice, 41, cerebral palsy, partner rape).

This reputation as an asexual being is not uncommon among women with disabilities (Dotson et al., 2003; Hassouneh-Phillips & McNeff, 2005); actions may be taken to mitigate this stigmatizing identity. Sandy, a bright attractive 16-year-old with cerebral palsy, dated a married attendant at her residence for the disabled. It began as a voluntary liaison, though it involved statutory rape. Outright sexual coercion followed:

We kept it secret, but I thought: ‘who can say it’s abuse, just because I’m a client? And today’s 16 is yesterday’s 30’…Sometimes I wasn’t in the mood and he forced me. It hurt, but I figured I was the only girl from [the residence] who’d ever have sex. The others will be virgins for life … he said I was irresistible. Nobody ever said that to me and nobody will ever say it again.

Sandy was aware that society would consider theirs an abusive relationship but felt it was her only opportunity, as a female with a disability, to have a lover. Terrified of becoming her worst stereotype of a woman with a disability—a virgin for life—she allowed herself to be seduced and later raped by a man she would not have otherwise dated. When the aide was eventually fired, she moved in with him and his wife, living as his concubine/babysitter. At the time of the interview, Sandy was a 20-year-old community college student with her own apartment. After 2 years of counseling, she viewed the relationship as abusive; however, she could vividly recall her fear of being trapped in a web of social isolation as a result of her disability.

Implications for Social Work Practice

A feminist but nondisabled social worker may not fully appreciate the degree to which disability (as can be the case with race or culture) can shape a woman’s experience of partner abuse. It is important to appreciate the uniqueness of a client’s intersectional perspective (Mehrotra, 2010). Each participant attached meaning to the abuse on the basis of her sense of self, which was affected by her disability. Although the accounts resembled those of nondisabled women, disability-specific discourses shaped their perceptions and negotiations. Detecting partner abuse of women with disabilities is the first step toward intervening; initial narratives of partner-abused women, absent sufficient probing and trust building, may obscure the problem. In addition, abusers may accompany victims to appointments, presenting as ideal partners. Despite the widespread incidence of partner abuse, social workers may assume that women with disabilities do not have intimate partners (Barnet et al., 2005) or fail to use assessment tools that measure disability-specific abusive behaviors such as withholding medications, hiding crutches, or disabling wheelchairs (Plummer & Findley, 2012).

It is important for social workers to maintain an empowering and strengths-focused perspective of partner-abused women with physical disabilities. The use of accounts does not imply that (consistent with negative stereotypes) they are naive, masochistic, or live in a fantasy world (Banks, 2010; Wehbi & Lakkis, 2010); rather, accounts are attempts to cope with difficult external issues. Perpetrator characteristics are more predictive of partner violence than victim characteristics; hypermasculine men may be more attracted than other men to women with disabilities due to the latter’s perceived vulnerability (Brownridge, 2006).

Social workers are trained to respect the process of healing and begin work “where the client is.” With women using accounts, well-timed and sensitive interventions are essential (Kulkarni, Bell, & Rhodes, 2012) A strength-based, rather than deficit, approach is useful when engaging women with disabilities who may have been viewed from the medical /rehabilitation perspective as irrevocably damaged (Banks, 2010; Galvin, 2005). For example, there are strengths—such as compassion and perseverance—inherent in each category of accounts highlighted; these can be validated without supporting the abuse.

Values clarification may be useful in exploring whether it is preferable to be in a relationship that is unsafe or attain safety with the risk of loneliness. A feminist approach—involving symmetrical power relations (Kulkarni et al., 2012)—may build rapport. Ultimately a trusting working relationship may render abuse-related accounts obsolete.

Girls with disabilities are half as likely as boys to receive sexuality education—on the assumption that they will never date, marry, or procreate; this makes it difficult for them to have successful relationships (Dotson et al., 2003; Richards et al., 1997) and makes them more vulnerable to abuse. Social workers should attend to the romantic relationships of women with physical disabilities, asking not only about abuse but also about love. Although cognitively impaired women may lack capacity to consent, this does not apply to all women with disabilities (Banks, 2010). Young women should receive sexuality and relationship education and develop novel forms of sexual expression (Wendell, 2006). In order to help clients accomplish these goals, social workers may need to address their own attitudinal barriers.

Social work as a profession gives credence to the importance of wider social issues in shaping clients’ problems. We look at the “person-in-the-environment” with a view toward making institutions more responsive to vulnerable populations (Schulman, 2013). In this view, remediation of oppressive social conditions will alleviate the need for narratives that justify or minimize partner violence.

Broader societal implications and recommendations for social workers stem from participants’ desire for roles as sexual object, caretaker, and “one of the girls.” In order to enable women with disabilities to occupy these roles, social workers can do each of the following: (a) actively challenge, in individual or group counseling, the cultural norms of physical perfection that are so limiting to women with disabilities; (b) encourage greater interaction among people with and without disabilities (thereby reducing women with physical disabilities’ dependency on partners) by developing accessible venues; (c) develop opportunities for women with physical disabilities to mentor and care for others; and (d) provide community education that encourages public acceptance of a broader range of sexual activities—so women with physical disabilities do not have to try to force themselves into molds that do not fit.

Social workers who treat domestic violence issues may be tempted to develop separate survivor groups for women with disabilities—who may share common narratives and other coping strategies. However, affirmation from, and sisterhood with, nondisabled women may highlight survivors’ gender identities. Participants who accessed support from nondisabled women were more likely to articulate a feminist view of their situations and identify with a larger sisterhood. Social workers should give this decision careful consideration.

In the absence of ways to exit battering relationships, women may be more likely to use accounts that justify or minimize violence. Therefore, an indirect way to prevent this behavior is to restructure social institutions so that women with disabilities can realistically choose to leave abusive partners (Banks, 2010). Shelters providing aide services, grab bars, and teletype machines would make them more useful to women with physical/sensory/neurological disabilities (Martin et al., 2006). Availability of accessible transportation, living spaces, and jobs may reduce the need for women with physical disabilities to accept, and generate justifications for, abuse.

Summary and Conclusions

The ability to name partner abuse can be emancipatory (Hayes & Jeffries, 2013); however, this process may require time and safety (Kulkarni et al., 2012). The current study examined accounts of previously victimized women with physical disabilities, most of whom employed romantic discourses to frame their situations. Accounts identified were the disability caused the abuse, the abuser is disabled, the abuse was accidental, the abuse was bearable, and the abuser was protective. Valued roles included one of the girls, caretaker, and sexual object.

In contrast to the (nondisabled) participants in the study by Hayes and Jeffries (2013), some accounts of “damaged” perpetrators allowed women to remain in, rather than exit, abusive relationships. This may relate to the vulnerable self-images of some women with disabilities (Hassouneh-Phillips & McNeff, 2005) which may be projected onto their partners. By framing the perpetrator as damaged, a woman with a disability can adopt the roles of caretaker and loyal mate in a conventional narrative of romantic love (Hayes & Jeffries, 2013).

Feminist discourses on partner violence frame women as collectively subjugated by patriarchy. Although this is also the case with women with disabilities, they may view their situations through the lens of disability oppression instead. As is the case with African American women (Banks, 2010; Glass, 2012), gender may not be their primary index of self-identity. At least initially, feminist discourse may seem less relevant to them and they may turn to disability organizations rather than domestic violence and rape crisis services, for help. Although feminist-informed social workers frame their clients as empowered, credible, and capable of making their own decisions (Herz, Stroshine, & Houser, 2005; Kulkarni et al., 2012), the medical model endorsed by other social workers may frame clients as fragile and unable to live independently Cheng, 2009; Goodley, 2010). As a result, abused women with disabilities may have negative experiences in their first (and possibly only) help-seeking attempt.

Although they could now reevaluate their relationships with greater objectivity, several participants continued to view their past victimization as a result of their disability. This may be because the root of these accounts (negative stereotypes about people with disabilities) remained. Abuse-focused interventions may be only partly effective, absent broader social change that integrates people with disabilities into mainstream communities. They need alternative discourses that provide an empowering basis for their participation in society. Social workers can help them develop disability identities rooted in notions of respect, agency, and equality.

Limitations and Future Directions

This study used a relatively small sample, so caution is advised in generalizing from the results. Only one participant reported her abuse to police. Comparisons between reporting and nonreporting women, and those with acquired versus congenital disabilities, would contribute additional nuance to these findings. All of the women were purportedly heterosexual, so results may not reflect the experiences of lesbian or bisexual women; in addition, race was not explored although it has been established (e.g., Glass, 2012) that accounts can be affected by racial and ethnic norms. The interviewer is a white, middle-aged female, which may have led to poorer quality data from ethnic minority participants (Ullman, 2005). Finally, women who left relationships voluntarily may have used accounts differently than those who were abandoned. With a larger sample and the use of mixed methodology, these questions may be better addressed.

It is possible that, had the women been asked different questions, alternative narratives would have emerged. Particular questions, even when open ended, predispose people to give certain responses. Because the researcher is an apparently nondisabled female and participants may have wanted to be “one of the girls,” social desirability could have affected the results. Additional qualitative work, using researchers with and without apparent disabilities, may tease out a variety of self-perceptions that compete for attention within the minds of these women.

Of the 19 participants, 12, or about 60%, described histories of abuse in childhood or adolescence. This is not surprising, given what is known about the frequency and repetitive nature of abuse among this population—especially among those in residential care (Smith, 2008). It does, however, underscore that the coping mechanisms participants utilized in adult relationships may have originated in childhood. Further research could investigate whether women who were abused in early life respond differently (e.g., utilize more neutralization strategies) than women who do not have these histories.

Despite these drawbacks, this study uncovered some ways in which abused women with physical disabilities may view themselves and their situations. With greater attention to this issue, future research may pinpoint specific interventions for this population.