The Emotional Aftermath of Surviving an Attempted Intimate Partner Homicide

Abstract

While the issue of intimate partner homicide (IPH) has gained increasing focus, research that pinpoints the experiences of women who survived an attempted IPH is limited. Specifically, studies that aim to understand the aftermath of surviving such incidents are scarce. Thus, the aim of the present study was to explore the emotional experience of IPH survivors following the attack. An interpretive phenomenological analysis was used to analyze the narratives of 11 women who had survived an attempted homicide by their partner. Four major themes emerged: Living between dichotomies: A fragmented identity; Embodied fear: A fear that will not go away; The loss of future: A life divided; and The loneliness of surviving the “unsurvivable.” Utilizing the ambiguous loss theory to examine the emotional ramifications of IPH indicates that survivors navigate persistent confusion and struggle to comprehend the loss. This involves challenges in moving forward and achieving resolution, conflicting emotions related to the loss, minimal recognition of the grief, and limited support from the social environment.

Intimate partner homicide (IPH) has been cited as the leading cause of homicide among female victims (United Nations Office on Drugs and Crime [UNODC], 2019). Indeed, lethal violence against women accounts for approximately 20% of the estimated annual homicide deaths worldwide (McPhedran et al., 2018). Moreover, of all IPH victims, 82% are women (UNODC, 2019). In this context, in recent years, the issue of IPH survivors has gained increasing academic interest (Evans et al., 2018; McPhedran et al., 2018; Nicolaidis et al., 2003; Weil, 2017). However, the literature continues to use a variety of names and definitions to describe the phenomenon. Names include, inter alia, attempted IPH survivors, failed femicide, and near-lethal violence (Johnson & Zitzmann, 2020; Vatnar & Bjørkly, 2013; Weil, 2016). Definitions include: a subjective definition relying on the survivor’s perception of whether or not her life was in danger during the violent attack (Vatnar & Bjørkly, 2013); a legal definition drawing on police records that classified the event as an “attempted homicide” (Farr, 2002; Nicolaidis et al., 2003); and a medical definition relying on health records showing that the injuries sustained by the survivor were life threatening (Weil, 2016).

Following this diversity in terminology and definitions, the purpose of the studies, as presented by researchers in this field, often varies. For example, some researchers viewed studies on IPH survivors as an analog for studying lethal violence because they provide the rare opportunity to hear stories that most of the victims are not alive to tell (McPhedran et al., 2018). These studies focused primarily on understanding the dynamics that led to the violent incident (Harden et al., 2019; Nicolaidis et al., 2003; Santucci, 2021; Weil, 2016). Other studies tended to focus less on the past and centered on the experiences of women who survived the homicide attempt, including the subsequent changes in their lives, their experiences with medical and law enforcement personnel, and their financial and residential issues (Azevedo & Dutra, 2015; Farr, 2002; Thomas et al., 2014).

However, little is known about the emotional world of women who managed to survive an attempted homicide by their intimate partner. Although posttraumatic stress disorder, depression, and anxiety are the most prevalent mental health consequences of intimate partner violence (IPV) (Waller et al., 2023; White et al., 2024), there is a paucity of research, to date, concerning the unique emotional aspects of surviving IPH.

The aim of the present study was to address this gap by gaining insight into the emotional experience of IPH survivors following the attack, thereby enhancing understanding of survivors’ needs and shedding light on the meaning of being survivors of near-lethal violence.

The Aftermath of Violence Victimization

Surviving acts of violence, including attempted murder, is a harrowing experience that can have profound and lasting effects on the individual involved (Carman et al., 2023). Although each survivor’s experience is unique, some emotions and challenges seem to be common to most survivors, regardless of the background to the violent incident. For example, survivors often experience intense trauma after being close to death or suffering harm (Fernández-Fillol et al., 2024; Skinner et al., 2019). They may have posttraumatic stress disorder (PTSD), expressed in nightmares, flashbacks, heightened anxiety, heightened vigilance, and a constant sense of threat (Carman et al., 2023; Ellis et al., 2023). Survivors may carry physical injuries and scars as a constant reminder of the traumatic event, which can impact their self-esteem and body image (Mekeres et al., 2023). In addition, some individuals may have difficulty trusting people, especially if the perpetrator was known to them, potentially leading to feelings of isolation and affecting their relationships with family and friends (Revranchea et al., 2023).

Most of the available literature focusing on the aftermath of violence victimization targeted experiences of near-lethal violence among children (Katz, 2013), political conflict survivors (Bragin, 2007), and crime victims (Fritzon & Ridgway, 2001). Only few studies sought to examine the aftermath of near-lethal violence in IPV cases (Farr, 2002; Nicolaidis et al., 2003; Thomas et al., 2014; Weil, 2016). The current study seeks to add to this body of knowledge by attempting to understand the experiences of female IPH survivors.

Female Intimate Partner Homicide Survivors

The existing literature provides important but relatively limited insight into the experiences of IPH survivors, most of which are focused on the events that led up to the violent incident and on the incident itself. For example, Farr (2002) and Nicolaidis et al. (2003) interviewed 38 women who were survivors of attempted homicide by an intimate partner. These studies identified that jealousy, threats, and stalking preceded the attack and that most of the attacks occurred when the participants tried to end the relationship. Similarly, Evans et al. (2018) examined two case studies with female IPH survivors. Two common themes emerged from the case studies as predictors of the attack: normalized experiences of violence and experiences of psychological abuse prior to the IPH attempt. In addition, Santucci (2021) focused on the help-seeking behaviors of attempted IPH survivors before the violent incident and found multiple forms of early warning signs such as abuse, jealousy, and controlling behaviors and recommended some help-seeking behaviors. Weil (2016) interviewed three migrant IPH survivors who described a long history of domestic violence prior to the attempted homicide as well as reluctance to report their abuse to the authorities.

An exception to these findings is a small group of studies that went beyond the incident itself and addressed some aspects of the aftermath of being an IPH survivor. For example, Farr (2002) reported that most of the participants were satisfied with the medical care they received following the violent incident; however, they experienced financial, occupational, and residential instability, adding to the challenges of overcoming the trauma. Similar findings were observed by Thomas et al. (2014), who studied women who survived near-lethal strangulation by their partners and described feelings of entrapment, fear, and altered behaviors.

Ambiguous Loss as a Theoretical Framework for Understanding the Experiences of Attempted IPH Survivors

Stressful life events are often layered with multiple losses, both tangible, for example, financial and relationship losses, and intangible, for example, loss of safety, security, identity, future hopes, and dreams (Harris, 2019). Some of these losses evoke grief responses that are often overlooked, based on the common assumption that grief occurs only in response to a death (Harris, 2019; Papa et al., 2014). Ambiguous loss is an unclear loss that defies resolution or closure and creates prolonged confusion (Boss, 2000). This theory suggests that when loss lacks clarity or closure, it is often unvalidated, leading to a sense of uncertainty and ongoing grief (Boss, 2007). The theory referred to two common situations of ambiguous loss—cases of physical presence but psychological absence such as dementia or physical absence but psychological presence such as kidnapping. In addition, many have used the ambiguous loss framework to describe various situations of non-death loss (Germany, 2020; Mendenhall & Boss, 2022), illustrating instances of more symbolic losses, including loss of self, roles, and identity (Harris & Winokuer, 2019; Lockton et al., 2020). From this viewpoint, ambiguous loss can cover a wide spectrum of experiences, differing in intensity and significance (Flynn, 2015). In line with this view, survivors of traumatic events often face profound losses associated with a disruption or break in their ongoing sense of self and life narrative. These changes in their sense of continuity are often a result of an altered perception of safety and loss of identity and roles within their personal and social spheres. Ambiguous loss theory may be appropriate for studying individuals who survived an attempted IPH since it preserves one of the core features of this theory, which is the inability to determine whether an individual’s continuity persists or has been disrupted (Ali, 2015). The ambiguity concerning the continuity of life may be a central theme for survivors of attempted IPH as well as other less tangible losses such as the loss of security and safety and the loss of social support and validation (Azevedo & Dutra, 2015; Boira & Nudelman, 2018; Farr, 2002; Thomas et al., 2014).

The Current Study

The current study was conducted in Israel. According to the Israel Observatory on Femicide (IOF), in 2023, the country witnessed 22 instances of gender-based violence resulting in the deaths of women, all committed by men. The majority of these crimes were carried out by men who had been in a relationship with the victim (IOF, 2023). These figures demonstrate an escalating pattern of IPH cases in Israel over the last decade, even amid heightened awareness of the issue (Weil, 2021). Research suggests that in Israel, a country with a diverse society comprising various ethnic communities, each possessing unique cultural and social dynamics, IPH and domestic violence are influenced by cultural contexts, including family honor, social stigma, and the accessibility of support services (Ne’eman-Haviv, 2021; Weil, 2016, 2021). Among the IPH victims in 2023, approximately half were Jewish, while 41% belonged to the Arab sector, including Druze, Bedouin, and Muslim women (IOF, 2023). To date, the annual number of attempted IPH survivors in Israel is not known, and the survivors are typically being treated by the police and welfare agencies as women who suffer from IPV.

Overall, in Israel, as well as in other jurisdictions, there is limited understanding of the survivor’s experience in cases of attempted IPH, as noted by McPhedran et al. (2018), who stated that current research has focused on the perpetrators rather than the victims. Similarly, Weil (2017) found that there is a lack of research devoted to understanding the survivors of attempted femicide and that most of the reviewed studies focused on the male offenders. In addition, since most studies focused on the relationship dynamics prior to the incident, and to the violent incident itself, little is known about its aftermath, including the emotional world of women who had survived IPH, as well as their wishes and needs and the way they evolve over time. Finally, it has been claimed that research on attempted IPH is primarily quantitative and that qualitative studies on the topic may produce some meaningful insights into survivor’s motives and relationships (Weil, 2017). Thus, the aim of the current study was to address these gaps by focusing on the emotional experience of post-attack IPH survivors while pinpointing the unique aspects of being an IPH survivor. The research question was as follows: How do IPH survivors understand their inner world and navigate their emotional world following the violent incident?

Method

An interpretive phenomenological analysis (IPA) (Smith et al., 2009) was chosen for this study. This qualitative methodology is devoted to exploring participants’ lived experiences, understandings, and perceptions. Hence, it is compatible for studying groups that are often silenced and marginalized (Avieli, 2023; Miner-Romanoff, 2015), such as the current study population.

Participants and Sample

The research sample included 11 participants, all women aged between 28 and 62 (M = 41.8). The participants were purposefully selected (Patton, 2015) according to the following inclusion criteria: women who had been violently attacked by their partner (a husband or a boyfriend) with the intent to kill or, at least, to cause life-threatening injuries; and women whose cases were classified as “attempted murder” in either police documents, court documents, or hospital documents. In most cases (9 out of 11), participants had all three types of documents that named them survivors of attempted murder and showed them to the researcher at the beginning of the interview. In addition, all the participants identified themselves as attempted IPH survivors.

Participants’ socio-demographic information as well as information regarding their injuries is presented in a group format to prevent identification (Morse & Coulehan, 2015) (see Appendix A).

Data Collection

Data collection was performed via in-depth, semi-structured, phenomenological interviews using an interview guide (Pietkiewicz & Smith, 2014), which addressed the following categories: the relationship prior to the violent incident and the homicide attempt (e.g., Can you describe your relationship with your ex-partner? What happened on the day of the attack? How did you feel about your ex-partner and your relationship with him? How do you explain the attack?); the events and consequential feelings during the days following the attack (e.g., How did you feel when you were at the hospital? Who was there with you? Describe the first month after the attack—what occupied your thoughts? What did it feel like?); and the long-term emotional consequences of surviving an attempted IPH (e.g., Can you describe your thoughts and feelings throughout an average day in your current life? What do you feel is the most difficult thing for you now? How have your feelings changed during the time that has passed since the attack?).

Procedure

Participants were recruited, and interviews were conducted in accordance with the recommendations for performing sensitive research, as suggested by Corbin and Morse (2003) and Melville (2016). Due to the highly sensitive nature of the topic, the researcher reached out only to women who had already come forward with their stories. This study was approved by the University’s Research Ethics Committee (IRB) (approval no. AU-SOC-HA-20220709). All participants provided written informed consent prior to enrollment in the study. Following the approval of the study by the IRB committee, the researcher, who is a social worker and a criminologist with an extensive background in conducting interviews with survivors of trauma and abuse, scanned social networks (e.g., Facebook groups, Instagram, and Twitter) and television and newspaper articles in which attempted IPH survivors shared their stories. These women were approached and asked if they would be willing to participate in the study. A preliminary telephone call took place with 16 women who expressed interest. In this preliminary conversation, the researcher explained that she was interested in listening to and learning about the women’s experiences. The researcher was able to address participants’ suspicions and fears about the study, to ensure the women’s sense of safety, and to determine whether these women fit the study’s sampling criteria. Five of these preliminary conversations did not lead to the women’s participation: Two were not interested, two did not meet the inclusion criteria, and one did not turn up for the interview at the designated time and place.

In the next step, face-to-face interviews were scheduled with 11 participants. The interviews were conducted at the participants’ locations of choice, in most cases the participant’s home. The duration of each interview depended on the women’s individual needs and abilities and was usually between 1.5 and 2.5 hr. Each interviewee signed a written consent form that included assurance of confidentiality and the option of discontinuing the interview at any time without penalty. The interviewer paid special attention to the participants’ emotions expressed during the interview, particularly any erratic or uneasy reactions, and sought for process consent throughout the interview (Kavanaugh & Ayres, 1998). The interviews were audio-recorded and transcribed verbatim. Additional measures taken to protect the participants’ anonymity and confidentiality were changing all identifying details and keeping all the collected data in a password-protected computer.

Data Analysis and Trustworthiness

Data analysis was performed according to IPA, as suggested by Smith et al. (2009). First, the researcher delved into the data by repeatedly reviewing the transcripts, aiming to achieve a deep familiarity with the participants’ narratives. This was followed by inductive coding, where significant statements from participants—ranging from their complex emotions toward their ex-partners, experiences of violence, and life post-attacks—were identified and interpreted. Next, the statements were organized into subthemes and quotes that distilled the essence of participants’ lived experiences. The researcher’s interpretative efforts were pivotal in uncovering the broader meanings and implications within the data, such as identifying key thoughts, feelings, and emotions that participants navigated in their daily survival struggles. Further interpretation was required as quotes were connected, clustered, and conceptualized, synthesizing the interpretative analysis across individual cases to elucidate the commonalities, differences, and intricate complexity of the studied phenomenon. As a double-hermeneutic approach, IPA is designed to interpret how participants themselves interpret and make sense of their own experiences. Thus, deductive analysis, guided by ambiguous loss theory, was then employed to expand the understanding of the findings and to enhance the researcher’s insight into the complex experiences of attempted IPH survivors. The interpretative analysis revealed distinct perspectives within the participants’ accounts. For example, some women attributed their loneliness to the rarity of their experiences, while others felt “frozen” and “stuck,” perceiving themselves as static amid a world moving forward. These nuanced distinctions were further explored through discussions with a group of qualitative research colleagues, identifying four superordinate themes that encapsulate the dominant emotions in the participants’ emotional worlds (Smith et al., 2009).

Trustworthiness was achieved as follows: First, audio-recorded interviews and their verbatim transcriptions enabled verification with the original, ensuring referential adequacy (Lincoln & Guba, 2013). Second, the researcher used bracketing to reduce preconceptions as much as possible (Chan et al., 2015). The researcher also followed Moustakas’s (1994) description, performing repeated rounds of reflection on any preconceptions or prejudgments until “an internal sense of closure” was reached (p. 89).

Findings

Four themes emerged from the participants’ narratives, unveiling some of the emotional consequences following a life-threatening attack by the intimate partner: (1) Living between dichotomies: A fragmented identity; (2) Embodied fear: A fear that will not go away; (3) The loss of future: A life divided; and (4) The loneliness of surviving the “unsurvivable.”

Theme 1—Living Between Dichotomies: A Fragmented Identity

The participants in the current study described themselves as tossed amid contrasting emotions: at one extreme, the rediscovered joy of life and feeling of self-worth, and at the other extreme, the wish they had died and feelings of remorse for having entered the relationship in the first place, as illustrated by the following quote:

So that day was the day I was reborn, I got my life back, and it is a miracle I got out of a situation that most people would die from. I knew for a fact I’m going to die; in my heart, I parted from my parents, from my sister, and then, in seconds, things changed, and I was out of the apartment. It’s something I can’t comprehend: how did I get to be so lucky? God must really love me or something … I try to keep this awareness, this happiness within me, to go back to whatever I knew about myself before, but I keep losing it, over and over again … I wish I had died, I wish his attempts had been successful, and I wouldn’t have to wake up each day and cope, and eat, and drink, and walk, and act like a normal person when I’m actually dead … (Violet, 37)

This participant described a strive to balance feelings of gratitude and appreciation for her continued existence, juxtaposed with a longing for the alternative outcome of not surviving the attack. Violet’s emphasis on such concepts as rebirth and miracle suggests that she viewed her survival as evidence of divine intervention. However, this sense of being chosen collides with the everyday experience of being a trauma survivor, often too emotionally burdened to carry out such tasks as getting up, eating, drinking, and walking. Thus, it seems that Violet oscillated between these opposing emotional poles, struggling to reconcile and integrate feelings of gratitude with existential despair, leading to a deep sense of loss of her former self (“to go back to whatever I knew about myself before”).

While some participants described dichotomous feelings about life, others described dichotomous feelings about their own survival and self-worth:

People keep saying I’m a hero. I try to be one, a hero, an inspiration, to really feel that. I think it should feel good, don’t you? … Strong, capable, smart … I overcame something unbelievable, and I managed to protect my child and put my ex in prison … there are tiny moments, really tiny ones, in which I can actually feel that pride, when most of the time I feel so stupid, so, so stupid … yes I managed to get out, but who put me there in the first place? I did. I didn’t see the danger, I left my daughter alone with a murderer; blind, and stupid, and weak, and a bad parent to put my child in this situation … So, what is real? What is real about the way I am now? I used to know that I’m a good mother. Now, I know nothing … (Lily, 28)

Lily vividly described how the complex interplay between pride and shame, heroism and failure, and self-perception and societal expectations shaped her emotional world and sense of self. While the view of her as a hero who surmounted great hardship was reflected to her from others around her, she could relate to this persona only for “tiny moments,” since most of the time she wrestled with overwhelming feelings of weakness and doubt about her abilities as a parent. Moreover, it seems that people’s perception of her as a hero, strong and capable, may invalidate her inner experience of shame and defeat. Thus, it seems that Lily mourned the loss of a solidified self as a person and a mother with the two disintegrated views of her life undermining her ability to make sense of her story and question her authentic identity.

Theme 2—Embodied Fear: A Fear That Will Not Go Away

All the participants in the current study mentioned fear as a fundamental force that actively influenced their state of mind, as illustrated by the following quote:

It’s like a new being has entered my life, the fear is so concrete; it’s like carrying another person on my back, 24/7, wherever I go, whatever I do, all I think about is when will he get a hold of me … you know, it’s not just in my head, he used to harass me from prison, ask people to call me, send his family to talk to me … ask me to forgive him … and now that he is out I keep looking over my shoulder. His crazy eyes are engraved in my soul, and I know, I just know, he will come for me once again … finish the job he started … I used to think that the worst is behind me, but not knowing when it will happen is torture, the constant waiting in fear is the real torture … (Ross, 41)

Rose portrayed fear as a tangible entity, an actual weight that is a palpable presence in her life, thereby emphasizing the persistence and intrusiveness of this experience. Her description of the perpetrator and her constant fear suggest she struggles to progress in life, as the trauma remains deeply ingrained within her, much like the haunting memory of the perpetrator’s unsettling gaze etched into her soul. The pervasive threat and sense of powerlessness is described as a torment that seems to dwarf the violent incident itself since it created ongoing apprehension and uncertainty regarding the harm that will occur at an unknown time.

For some participants, fear has evolved beyond the scope of the relationship with the ex-partner and has become generalized and all-consuming, as illustrated by Camila:

Since I came back from the hospital, I have this protocol for leaving the house. It includes looking at all the security cameras, and then sending the dog out first, waiting to see if she barks, and then I leave through the back door. I park the car right next to it so I can jump right in. I never go into an elevator or into some kind of closed space alone or with only one other person, only with a crowd … everything makes me feel frightened and anxious—people, noises change … And the thing is, I can be stressed out from being alone and from being in a crowd, from the quiet and from the noise, so it’s a paradox … I always find myself calculating the best time for me to go grocery shopping or to be out in the street and which street should I walk in … (Camila, 56)

While she does not mention the direct connection to the IPH attempt, it is evident that Camila has developed an elaborated set of safety protocols and rituals following the violent incident aimed at reducing fear and anxiety. It seems that Camila’s fears have generalized beyond the interpersonal violent incident and have become an innate part of the self, thereby affecting other aspects of life (fear of crowds, fear of closed spaces). As a result, Camila’s reality is complicated and chaotic. She moves through the world while trying to avoid numerous obscure threats that form a web of dangers around her. The safety protocols helped her gain a certain amount of control; however, this control is constrained due to her conflicting fears, resulting in feelings of entrapment and a significant loss in Camila’s ability to trust her environment.

Theme 3—The Loss of Future: A Life Divided

For all the participants, the attempted IPH created a divide between the “before” and “after” phases of their lives. They all had plans, dreams, and wishes that were brutally disrupted by the violence and were replaced with great ambiguity, as illustrated by the following quote:

I was going to be a chef. I just finished culinary school when it happened and I was already cooking at private events, and I started my own small business, but obviously, it all went to the garbage, everything I wanted or worked for … he stabbed me right between the shoulder and the arm. It’s getting better, but I don’t think my hand will function like before, which is kind of important if you want to be a cook … but the other thing is that I can’t bring myself to commit to it, it’s just too hard for me now … I tried to cook for someone a few months ago and I got panicked, I felt it’s too much. I started feeling that I was going to faint, and the person who hired me was really pissed … so I feel there is no going back, or “getting my life back on track,” or all this shit people keep saying … the old tracks are burned down, I have to make my way again … (Daisy, 50)

Daisy grappled with the profound disjunction between her aspirations and the harsh reality imposed by a life-altering injury. This loss extends beyond the physical to encompass a profound sense of bereavement for a future that once seemed certain but is no longer relevant. Compounding this sense of loss is the dual burden of physical and psychological trauma. The injury serves as a constant, painful reminder of the moment her life diverged from its anticipated path, while the psychological aftermath—manifested in panic and overwhelming anxiety—underscored the invisible scars that run as deep as the physical ones. Amid this, a deep identity reevaluation occurred, driving Daisy to accept that the “old tracks” of her life are no longer navigable. This process is made more difficult by feelings of misunderstanding from others who overlook the trauma’s profound effects (“the person who hired me was really pissed”), amplifying Daisy’s sense of loneliness and highlighting the struggle to find empathy.

While Daisy described the loss of her future in terms of work and occupation, Rosemary described the loss of family life as she had planned it:

For a short while, I felt like I finally made it, after years of looking for the right person, after all my friends were already married and had children. I had peace of mind, I was a person with a future, I had my husband and my two boys and a little apartment we managed to buy, and I felt like, like I was content … I could really see my life moving forward peacefully, in that place, with my kids next to me … and what happened, no one understands the reshuffle, the extent of chaos, and no, I'm not talking about the injuries, and post trauma, these are kind of obvious. I found myself homeless, we got separated of course, and I had to move out … I’m in a custody battle with his parents … I live at my parents’ house and lose sleep over worrying whether I might lose my kids. I can’t seem to find a job that I can hold on to, so I have financial issues … I live from one day to the next, I can’t even make plans for next week. I don’t have that privilege anymore … (Rosemary, 31)

In her narrative, Rosemary asks that we look beyond the obvious physical and social consequences and see the “reshuffle” and “chaos” that extend to affect her inner world, manifesting as sleeplessness, job instability, and financial issues which represent the ripple effect of surviving the attempted IPH. She described some profound losses—homelessness, separation, and the threat of losing custody of her children. These events signify not just material and relational losses but also a deep existential crisis, challenging her sense of security, identity, and future orientation (“I live from one day to the next, I can’t even make plans for next week”). Furthermore, Rosemary’s story underscored her profound isolation, stemming from the lack of understanding from others about her intricate circumstances (“no one understands the reshuffle”), and a significant loss of control and foresight into the future. This erodes what is often seen as a fundamental human right, deeply affecting her identity and diminishing her hope for the future.

Theme 4—The Loneliness of Surviving the “Unsurvivable”

All the participants in the study described a constant feeling of loneliness—an overwhelming feeling that was present, regardless of the amount of social support received from family and friends. One reason for this feeling, as described by the participants, is the unique nature and circumstances of being an IPH survivor:

It took me a while to understand, I mean to really comprehend, the singularity of what I’ve been through, I mean, most people who went through what I did didn’t survive, so the fact that I’m here … it is amazing, surviving the unsurvivable, but it also kind of … feels really lonely somehow … like the only people who can somehow understand my experience are actually dead, you know what I mean? And the fact is, I’m not alone; everybody around me is trying so hard to understand, but how can they, really? I saw this apocalyptic TV series where the main character survived this horrible deadly world plague. She was the only one who survived, the only one who lived through it … I cried so much when I saw that, like, this TV character was the only one who I could identify with for a very long time … (Flora, 62)

Flora drew attention to the singularity of her situation as the main reason for her feeling of loneliness. Despite being surrounded by people who attempt to understand and provide comfort, there remains a gap between her lived experiences of loneliness and the capacity of others to fully grasp the depth of her experiences. As a survivor of an “unsurvivable,” Flora is overwhelmed by the existential realization that those who could truly understand her experience are not present. Flora’s identification with a fictional survivor character illustrates the powerful mechanism of finding solace and understanding through narratives that echo one’s own experiences and highlights the lengths to which individuals go to find reflections of their own experiences and emotions.

Other participants described the loneliness resulting from the loss of their partner:

I am now able to say that I miss him. I despise him and hate him, and I miss him … for some years now, it’s been just me and him, with no one else … and I’m learning to understand that through my therapy. But he loved me … before … he was very protecting, he took care of me. I loved the way he hovered over me, it’s not a very feminist thing to say [laughing] but I’m being honest here, OK? My parents and my friends, they try to become close again, but their way of showing interest is … it’s limited, for lack of better words to describe it … they all have their own lives … (Jasmine, 33)

Jasmine, who has spent the past year in therapy, articulated a complex weave of simultaneous, conflicting emotions toward her partner, who tried to kill her. Her ability to express these conflicting feelings highlights a significant step in her journey of understanding and healing as well as the complicated process of moving forward. Her reflection on the protective nature of her partner and her appreciation of his attention, despite recognizing its potential conflict with feminist ideals, underscores the difficulty of reconciling personal emotions with societal norms. The statement “for some years now it’s been just me and him, with no one else” implies that her partner might have isolated her from others as part of the abusive dynamics leading up to the attempt on her life. Thus, Jasmine navigated the process of reconstructing these connections, grappling with the realization that the affection and attention of other people pales in comparison to that of her ex-partner.

Discussion

This study sought to map the emotional landscape that characterizes women who have survived a life-threatening attack by their partners. The four themes that emerged during the analysis shed light on different emotional aspects of the experience of survival and create a holistic picture suggesting the meaning of being an attempted IPH survivor (McConnell-Henry et al., 2009). According to the current study findings, this experience is multi-layered, with fear (e.g., Embodied: A fear that will not go away), loneliness (e.g., The loneliness of surviving the “unsurvivable”), and a sense of living between torn identities (e.g., Living between dichotomies: A fragmented identity) and between two lifetimes (e.g., The loss of future: A life divided).

Analysis of the participants’ narratives from a loss perspective is viable, given that they depicted various facets of loss and bereavement. The first theme revealed through the participants’ narratives (Living between dichotomies: A fragmented identity) touches on the very core of ambiguous loss theory as it pinpoints ongoing confusion regarding the loss, which is accompanied by conflicting thoughts and emotions, such as dread and then relief, hope, and hopelessness (Harris & Gorman, 2011; Mendenhall & Boss, 2022). The participants in the current study seem to look back at their former lives, including their relationships, hopes, dreams, self-concept, and identity, and wonder whether these are still relevant to them after surviving attempted murder. In other words, the participants mourn the loss of their own selves. This loss is indeed ambiguous since they are still here, against all odds, but are hunted by a profound sense that the person who survived is unlike the old self. This creates an overwhelming dichotomy that tosses participants between contradictory emotional experiences of happiness about having to survive versus the wish to die, as well as feeling strong and competent for having overcome a near-lethal incident and feeling naïve and helpless for having been in that situation in the first place. This finding resonates with other studies that have explored the loss of self and identity in the context of ambiguous loss. While ambiguous loss typically refers to the loss of another person, some studies have extended this concept to encompass more symbolic losses, such as the loss of dreams, self, and identity (Landau & Hissett, 2008; Mitchell, 2016; Williams-Wengerd & Solheim, 2021).

Feelings of confusion and conflicting emotions, which are the hallmark of ambiguous loss (Harris & Winokuer, 2019; Mendenhall & Boss, 2022), seem also to stand at the core of the participants’ descriptions of their lives as divided into “before” and “after,” as presented by the third theme (The loss of future: A life divided). In this theme, the participants narrated their feelings of loss about not being able to continue to live the lives to which they aspired before the violent incident. This is confusing, since theoretically, once their lives were saved, there was no reason why they should not “get back on track.” However, when attempting to resume their planned life course, the participants discovered that these dreams were lost, leaving them to cope with the need to recreate their own lives. This description echoes the ambiguous loss theory concept of “frozen grief,” which refers to a situation in which a person is unable to move forward or begin the healing process (Harris & Winokuer, 2019). Boss (2000) emphasized that while loss (e.g., death) brings closure, ambiguous loss leads only to open-ended questions regarding the loss, with no prospects of closure. The inability of survivors to return to their work, home, or former daily lives was mentioned by Boira and Nudelman (2018), who explored professionals’ support for survivors of femicide and their families, and by Farr (2002), who demonstrated employment, financial, and residential instabilities in the lives of most IPH survivors who participated in her study. The findings that stress the formation of a divide between life “before” and “after” the violent incident are also consistent with trauma literature (Janoff-Bulman, 1992; Lanius et al., 2020) that often describes this rent in survivors’ lives and underscores the difficulty of bridging these two parts of life. In the case of the current study, participants appeared conflicted in relation to resuming their former lives. Their wish to do so and their inability to pick up where they left off create a sense of being stuck in limbo, the inability to go either way. In this sense, frozen grief, in this study, refers to the participants’ ongoing process of mourning, as well as to tangible aspects of their lives, such as career plans, living arrangements, and financial status, which have suffered a major setback and are now stuck and frozen. These two aspects, the emotional and the tangible, seem to be intertwined, thereby intensifying each other’s influence.

Another theme narrated by the participants refers to the way their lives are still haunted by fear of the attacker (Embodied fear: A fear that will not go away). In this theme, the participants reflect on the attempt to continue with their lives while still terrorized by the idea that their former partner will come and “finish the job,” that is, to commit the murder that did not happen. Here, ambiguous loss takes on another meaning as it refers to the ambiguity of the finiteness of the violent relationship. Since the participants’ ex-partners are still alive, and, in some cases, out of prison, the relationships are ongoing, whether as an actual connection or as an ongoing internal conversation. This relationship lacks closure, and participants seem to avoid it as much as they can, but at the same time, it has a critical influence on their daily lives as they attempt to navigate issues of fear and safety. An ongoing fear following a violent attack is often mentioned in posttrauma literature (Evans et al., 2018), as well as in research concerning the experiences of attempted homicide survivors (Valença et al., 2023) and IPH survivors (Thomas et al., 2014). These studies, like the current one, indicate the dominant role of fear in survivors’ lives, including a heightened sense of vulnerability and the psychosocial and physical consequences of living in fear (Ropeik, 2004; Turner & Hammersjö, 2024).

The fourth theme (The loneliness of surviving the “unsurvivable”) exemplifies the social dimension of being an IPH survivor, which is shadowed by a deep sense of loneliness. In the current theme, the participants were navigating life out of a relationship that, in addition to being toxic and violent, was also comforting and loving. Processing and understanding the dual feelings toward the relationship with the attacker can be difficult for both the participants and those around them, as the women may be expected to despise their former partners. Indeed, IPV literature reveals the complex and nuanced relationship between IPV survivors and their partners, acknowledging that violent relationships can include loving aspects, and that survivors of IPV are often locked in an intertwining love–violence embrace (Wallace, 2007). These studies also acknowledge that these dual aspects of the relationship often result in feelings of loneliness and confusion (Bryngeirsdottir & Halldorsdottir, 2022), as revealed in the current study. Participants who represented the current theme also mentioned feelings of loneliness due to the singularity of their experience. Ambiguous loss theory suggests that when loss is not clear or finalized and life may or may not return to the way it was before, people tend to withdraw rather than offer support to the person suffering from the loss. In addition, in such cases, there are no rituals or social rules associated with the loss; thus, affected individuals receive very little validation for their mourning (Harris & Gorman, 2011). Contrary to these assumptions, it seems that the participants narrating this theme felt that others were trying to offer support, but that this support could not resolve their feelings of loneliness. That is to say, the experience they underwent as IPH survivors was so exceptional and particular that even when others tried to offer support and validation, they failed because they could not support or validate such an unimaginable experience.

In conclusion, the findings of the current study suggest that surviving an attempted IPH marks the start of a complex journey for survivors. This journey involves navigating through ongoing confusion and struggling to understand their loss. Survivors face multiple challenges, including dealing with conflicting emotions about the loss, a lack of acknowledgment for their grief, insufficient support from their social circles, fear, and feeling as if they are caught between conflicting identities and living across two different lifetimes.

Practical Implications

The research findings point to several issues, including treatment and policy implications stemming from the participants’ experience of surviving IPH. The participants in the current study were offered the same treatment as IPV survivors. Most of the participants were offered a weekly appointment with a therapist and psychiatric intervention, if necessary. The insights from the study highlight the need for specialized treatment for survivors of homicide attempts to address the feelings of acute fear and isolation experienced by this specific group.

In addition, some of the participants highlighted feelings of loneliness in their narratives. Hearing the participants’ stories in their own voices may help professionals relate to the subjective experience of life following an IPH attempt, as perceived by this understudied group. Furthermore, mental health professionals can aid in the healing process by offering social validation, acknowledging the survivors’ experiences, and legitimizing their grief. It could be beneficial for counselors and educators to frame and process the survivors’ reactions as normal, while also offering psychoeducation about ambiguous loss and its dynamics. Trauma-informed therapy, aimed at empowering survivors and helping them rebuild their self-narratives, can assist IPH survivors in regaining control over their lives and find meaning in their experiences (Countryman-Roswurm & DiLollo, 2017; Le, 2017).

Limitations and Recommendations for Further Study

This study focused on the emotional world of IPH survivors. Their narratives did not address some other highly significant issues concerning the participants’ lives, including navigating their health following the violent incidents, family relationships including parenthood, and their journey through the justice system. Future studies are recommended to address such issues, to increase the knowledge of this marginalized population.

This study is limited in generalization ability due to its small sample size and qualitative nature. Furthermore, due to the highly sensitive nature of the study, participants were approached only in cases where individuals had already chosen to disclose their personal story. Thus, the findings may not reflect the full range of experiences relevant to IPH survivors. In addition, the study included IPH survivors who were willing to participate in qualitative research. This requires good cognitive and verbal skills, and the emotional willingness and ability to talk about the traumatic experience, hence the exclusion of those who were less suitable or willing, who may have been too depressed to be interviewed. One way to overcome these limitations may be to employ quantitative research methods, which require less good faith and cooperation from participants and are more inclusive of other potential participants who have difficulty engaging in an interview.

Finally, this study did not explore participants’ experiences based on the type of relationship or the severity of the violent incident. That is to say, it has not differentiated between participants who were in long-term and short-term relationships or between participants who had been hospitalized for weeks due to their serious injuries and others who had been discharged from the hospital after a few hours. Participants’ experiences may differ in accordance with these factors. Thus, future research could consider exploring specific sub-categories in the IPH survivor population.