Understanding battered woman syndrome.

It has been more than 15 years since I first testified as an expert witness using Battered Woman Syndrome (BWS) to explain the psychological state of mind of a woman who killed her abusive partner in self-defense. In that 1977 case, Miriam Grieg, a Billings, Montana, woman, called the police after shooting her husband six times as he lay in their bed. After beating her severely, he had thrown the gun at her, shouting, "If you don't shoot me, I will kill you with this gun." Accustomed to doing what he ordered for fear of further abuse, Miriam shot him with all the hollow-point bullets in the gun.

Before the police entered the bedroom, she warned them in what they later described as a terrified voice, "Be careful, he has a lot of guns in there. He's going to be very angry and will shoot you." Obviously, she didn't believe that he could have died, despite the devastating scene that lay behind that door.

Miriam was charged with murder. After hearing testimony about the psychological effects of battering, an all-woman jury in Yellowstone County, Montana, found her not guilty.

Meanwhile, in Washington, D.C., a soft-spoken, pregnant nurse named Beverly Ibn-Tamas had shot and killed her husband when he was about to beat her. After years of abuse, she feared for her unborn child's safety. As the police took her to the homicide division, she was confused. Why were they taking her there, she asked them, when her husband could never die?

I performed a clinical evaluation of Beverly and planned to testify at her murder trial that she was suffering from BWS. The D.C. federal court judge did not admit my testimony, ruling that it was not based on standard medical/psychological evidence.(1) Over the next several years, appellate courts finally set rules permitting testimony on BWS,(2) but it was too late for Beverly, who was convicted of second-degree murder and sentenced to two years in prison.

Today, the testimony has been accepted in courts in every state. Some state legislatures have codified legal decisions about its admissibility, and governors have used it to grant clemency to convicted women serving long sentences. In addition to self-defense cases, the testimony has also proved useful in a variety of situations:

* Criminal courts use it to convict batterers even when the victims are too scared to testify against them.

* The testimony can explain how BWS can be a mitigating factor in cases where women are accused of helping their batterers commit crimes.

* Civil courts permit testimony on BWS to settle possible coercive-contract disputes and to prove liability and damages in domestic tort and other civil cases.

* Family courts hear the testimony to make decisions about the validity of property distribution and child custody and visitation arrangements.

* Wills of battered women have been challenged by using BWS testimony to show that a woman suffering from the syndrome was incompetent when she drew up the document. Even more common, BWS testimony has been used to deny a batterer rights to property when he has killed the woman after a long history of abuse.

* Attorneys representing child abuse victims who kill their abusers use an adapted version to mitigate guilt and to seek lesser sentences.(3)

* Assault victims who have suffered psychological damages also use a modified version of the testimony, as do some sexual harassment victims who bring discrimination cases under Title VII.

What Is BWS?

The definition of Battered Woman Syndrome is different in law and psychology, sometimes causing confusion for expert witnesses who are not specially trained in working with abuse victims. The legal system uses BWS to describe both the clinical syndrome and the dynamics of the battering relationship, while mental health professionals use the clinical syndrome to design treatment plans.4

Research has shown that many battered women experience a collection of symptoms that have come to be called a syndrome,(5) and mental health providers who testify as experts must incorporate these symptoms into whatever diagnostic system they use. The most popular is the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), published in 1994 by the American Psychiatric Association.

In psychology, BWS is a recognized subcategory of post-traumatic stress disorder (PTSD), although it is not listed by name in DSM-IV. (Neither are other recognized forms of PTSD like Combat Veteran's Syndrome; Rape Trauma Syndrome; Battered Child Syndrome; and syndromes arising from disasters like earthquakes, plane crashes, and fires.) Instead, the diagnosis is constructed, using the DSM-IV methods on how to determine when it applies. These criteria do not include descriptions of the dynamics of battering relationships.

Although having a subcategory named BWS explicitly listed in DSM-IV would be less confusing for the legal system, it is more useful for mental health practitioners to use the criteria for identifying PTSD to define a large variety of syndromes produced by trauma, some of which are just being studied today. BWS is listed separately in the International Classification of Diseases, published by the World Health Organization in 1980. This reference is used around the world but is not as popular in the United States as in other countries.

Experts evaluating victims who might be suffering from BWS look for two major groups of symptoms: (1) the fight-or-flight response and (2) changes in cognitive abilities, judgment, and memory.

Fight or flight. This response has been measured in psychology since the early 1900s. When people are frightened or perceive danger, their autonomic nervous system becomes activated and they enter a state of "hypervigilance" in which the mind and body prepare to deal with the danger. The heart beats faster and breathing changes, other physiological changes occur, and feelings of anxiety increase. The person may become irritable and find it difficult to concentrate. The person may also experience panic attacks if he or she has experienced this danger many times before. This state of high arousal and anxiety constitutes the fight response.

The flight response is characterized by avoidance mechanisms and numbing of emotions. Denial, repression, dissociation, and minimization are the psychological terms that describe unconscious ways of not dealing with what is really occurring. Changes in interpersonal relationships and the belief that the future is short appear during this phase.

Sometimes a person experiences a "seesaw" effect in which the anxiety rises until it gets too high, and then the avoidance and numbing set in. Other times the person experiences these symptoms simultaneously, creating contradictory emotions that seem difficult to explain. Some victims may get stuck in one mode more than the other.

Although battered women are often pictured as passive and unskilled, many have successful careers and can express their angry feelings when they are not afraid they will be harmed. Some even engage in aggressive behaviors toward their abusers and others, taking risks that they might be hurt worse but needing the psychological boost that fighting back or defending themselves or others gives them.

Changes in cognitive or thinking abilities, judgment, and memory. Many women reexperience the abuse in their minds either spontaneously, during nightmares, or when they are exposed to familiar stimuti. This might occur, for example, when a person is sitting quietly or watching TV or driving past a place where an abusive incident occurred.

These experiences are so vivid that many women respond as if the abuse were really happening all over again. This reaction will make the perception of danger from subsequent abuse more vivid. The next time the woman believes violence is imminent, especially if she perceives the danger as life threatening, she may go into a dissociative or other mental state and take what she sees as necessary lifesaving actions--including killing the batterer--that she would not take under ordinary circumstances. She will likely do this without thinking through the consequences. Her only goal in this state is to stop the actual or anticipated violent attack.

Sometimes it is difficult for the woman to tell the difference between memories of past abuse and current threats, making her experience of fear and perception of danger even more intense. Memories of abusive incidents may disappear and reappear at different times. Although the mechanism by which this happens is not known, the fact is that sometimes the woman remembers what happened to her and sometimes she does not. Her confused thinking and propensity to go off on tangents when telling a story are ways of keeping the memories of the abuse from being too painful.

In most legal decisions, BWS has been broadened to include descriptions of the dynamics of abuse as well as the psychological impact it has on a victim. Courts may admit testimony about "learned helplessness"--the victim's inability to predict whether what she does will protect herself from further abuse--and about the cycle of violence, which includes a tension-building stage, a battering incident, and a period of loving contrition by the abuser.

With all these elements being discussed, there has been much confusion in the courts about what exactly constitutes the syndrome. When BWS testimony was first introduced, trial courts barred it by challenging its research methodology. This ceased when the American Psychological Association issued an amicus brief supporting the testimony's scientific foundations.6

At least one recent commentator has suggested redefining BWS to standardize how the term is used so that psychologists, attorneys, and judges will know what is meant by the testimony. The definition is still evolving, though, so it may be too soon to codify one.

Dynamics of Abuse

There is no model victim of domestic violence. Abuse occurs across every race, ethnic background, educational level, and socioeconomic group. Despite recent claims in the media that estimates of the extent of violence against women are exaggerated--claims that misrepresent the findings of a few studies--most victims of domestic violence are indeed women and children.(8) Even the elderly who are abused are predominantly women, most of whom are abused by their male partners and sons and not their caretakers, although that is certainly a problem, too.

A forthcoming report of the American Psychological Association Task Force on Violence and the Family reviewed the research and cites the power differences between men and women as an important factor in understanding the psychology of abuse. Violence is learned behavior by men, who use it to get what they believe they are entitled to from women.(9) The Psychological dynamics are similar in most forms of violence against women and children.(10)

Many people who do not understand the dynamics of domestic violence ask, "Why don't battered women leave?" The answer is that leaving does not stop the violence. Most men who batter are terrified at the thought of separation, and they continue to stalk and harass their victims even after the women leave. In fact, a battered woman's life may be in more danger after she leaves than while living with her abuser.(11)

Special programs to help these men deal with the dysfunctional thinking that propels their obsessive-compulsive behavior are now available. One stabilization program designed for abusive men has a companion program that teaches their partners how to become more empowered.(12)

Continued violence against women who have left their abusers may be facilitated by child custody and visitation arrangements that expose both mother and child to greater harm. It is not unusual for an abusive man to demand custody of the child as a way to retain power and control over the woman. Although some of these fathers demonstrate acceptable parenting skills, these are the rare cases. More often, these children are continuously exposed to different parenting values, high-conflict situations, and a role model of bully behavior and intimidation that teaches them to take unfair advantage of other people.

When alcohol and other drug abuse are involved, the children often develop serious emotional difficulties that may be expressed through aggressive and violent behavior in the community. Boys exposed to fathers who batter their mothers are 700 times more likely to use violence in their own fives. If a boy was abused himself, it raises the risk factor to 1,000 times that of the boy who did not experience abuse.(13)

Questioning the Victim

How can an attorney use this information about the psychology and dynamics of abuse to assist a client? Sometimes the first challenge is to figure out whose story is the more accurate one. Because many people know about the benefits of using Battered Woman Syndrome in legal cases, attorneys must use care in evaluating abuse claims. Familiarity with the dynamics of abuse and its impact will be the best guide for attorneys investigating allegations of domestic violence.

Of course, the alleged abuser's protestations of innocence are not sufficient to dismiss the victim's claims. Many men insist they did not commit violence, even though domestic violence courts tend to sentence offenders to rehabilitation rather than long prison terms. Interestingly, many batterers later admit to having done what they were accused of but In claim that they didn't define their behavior as abuse. This was certainly true in the case of former Denver Broncos football player Vance Johnson, whose recent television appearances and new book detail his story.(14)

It is important to remember that the way victims are questioned may make a difference in the reliability of the information the lawyer receives. Most victim have lost their ability to perceive neutrality. As they see it, either a person is with them or against them. Attorneys must show they can empathize with the victim or she will not be forthcoming in revealing information. Attorneys who use "bully" tactics to try to speed up the process or to get a recalcitrant woman to follow orders will find that the woman reacts to this behavior in much the same way as she did to the batterer's psychological intimidation. Bullying will result in more PTSD symptoms rather than the desired behavior.

The best way to gain the woman's cooperation is to take the time to calmly explain the issues and what she needs to do until it is clear that she fully understands. Even the brightest woman can be so anxious that she does not hear or comprehend everything being said. She may be too embarrassed to admit this, perhaps fearing someone will accuse her of being stupid or incompetent, as the batterer has done on many occasions.

Working with Experts

Most victims of violence have been harmed in a way that makes representing them more difficult than representing other clients. Client management may be easier with consultation from a psychologist who the attorney may or may not call as an expert witness. Sometimes, a good assessment early in a civil case can document damages and then let the victim heal as the case winds through the courts.

If a client seems to be deteriorating, she may need to seek immediate psychotherapy rather than wait until she can afford it. Most communities have battered women's or rape victims' advocates who can provide these services free of charge or on a sliding scale or make appropriate recommendations. The attorney should help the client locate these services and encourage her to use them.

It is important to keep in mind that in most states the doctor-patient privilege applies only to licensed professionals. If the client works with an unlicensed therapist, their communications may not be protected by confidentiality and records may be more easily subpoenaed. Ethics guidelines now suggest that the forensic experts and treating therapists may sometimes have to be different people to avoid even the appearance or suggestion of conflicting interests.(15)

When selecting an expert to perform a psychological evaluation, the attorney should, of course, look for one with specialized knowledge and training. The generalist psychologist is often not sufficiently familiar with BWS to provide much help.

Good interviewing skills are also important for an expert who is trying to get reliable information from abuse victims. Most women will not discuss their shameful secrets with an expert who does not have these skills. Some victims may prefer to talk with a woman psychologist, especially if there was sexual abuse, but not all women can provide fair and unbiased evaluations. The results will depend on the personal characteristics, knowledge, and training of the individual expert.

It may also be necessary to hire one or more experts who are specialists in specific areas, such as drug and alcohol abuse, and can offer help in putting a case together. They may function best as trial consultants, and maybe even jury consultants. They may be able to help sift through the myriad of information from medical records, social service and child protective service agencies, and other sources to find what is important and consistent with the dynamics of violence. They may be able to help interpret findings from psychological evaluations provided by the opposing counsel. Also, they may be able to assist in preparing the client for trial based on knowledge of how BWS has affected her.

The attorney should not overlook workers at battered women's shelters as sources of information. Many can provide literature and understanding of the dynamics of abuse, even if the court will not recognize them as experts.

Finally, when selecting an expert to testify at trial, the attorney should look for one who can explain BWS in simple, nonpsychological language. Sometimes this is not the person who performed the psychological evaluation.

Important Partnership

Violence against women and children is learned behavior that continues because no one stops it. When battered women or children become frightened and desperate, thinking no one will help them, homicide or suicide--or both--may be the result.

When victims of domestic abuse end up in court, the law and psychology can work together to resolve the complex issues these cases raise. It is true that the psychologist uses inductive methods of scientific inquiry to come to conclusions, and the lawyer uses deductive methods of reasoning to come to sometimes different conclusions. But the intersection of both types of inquiry can help find the truth and contribute to the solution of what is becoming one of society's most pressing problems.

Notes

(1) Ibn-Tamas v. United States, 455 A.2d 893 (D.C. 1983) (affirming trial court's decision to exclude BWS testimony). My testimony was barred even though I was then engaged in a major study of the psychological effects of battering funded by the National Institute of Mental Health. See generally LENORE WALKER, THE BATTERED WOMAN SYNDROME (1984). (2) See, e.g., People v. Aris, 264 Cal. Rptr. 167 (Ct. App. 1989), cert. denied, 1990 Cal. LEXIS 906 (Cal. Mar. 1, 1990); State v. Hundley, 693 P.2d 475 (Kan. 1985); State v. Anaya, 438 A.2d 892 (Me. 1981). (3) See generally PAUL MONES, WHEN A CHILD KILLS: ABUSED CHILDREN WHO KILL THEIR PARENTS (1991). (4) Lenore EA. Walker, Battered Woman Syndrom and Self-Defense, 6 NOTRE DAME J.L. ETHICS & PUB. POL'Y 321 (1992). (5) See general LENORE WALKER, THE BATTERED WOMAN (1979); see also WALKER, supra note 1. (6) Brief of Amicus Curiae, American Psychological Association, in Hawthorne v. State, 470 So. 2d 770 (Fla. Dist. Ct. App. 1985). (7) Mary Ann Dutton & Lisa A. Goodman, Post-traumatic Stress Disorder Among Battered Women: Analysis of legal Implications, 12 BEHAVIORAL SCI. & L. 215 (1994). (8) AMERICAN PSYCHOLOGICAL ASS'N, REPORT OF THE PRESIDENTIAL TASK FORCE ON VIOLENCE AND THE FAMILY (forthcoming 1995). (9) Id. (10) MARY P. KOSS ET AL., NO SAFE HAVEN: MALE VIOLENCE AGAINST WOMEN AT HOME, AT WORK, AND IN THE COMMUNITY (1994); LENORE E. WALKER, ABUSED WOMEN AND SURVIVOR THERAPY: A PRACTICAL GUIDE FOR THE PSYCHOTHERAPIST (1994); MONES, supra note 3. (11) Angela Browne, Violence Against Women by Male Partners: Prevalence, Outcomes, and Policy Implications, 48 AM. PSYCHOLOGIST 1077,1080 (1993). (12) LENORE E.A. WALKER & DANIEL J. SONKIN, PROGRAMS FOR DOMESTIC VIOLENCE STALKING AND HARASSMENT: STABILIZATION OF THE ABUSER AND EMPOWERMENT OF THE VICTIM (forthcoming 1995). (13) MURRAY A. STRAUS ET AL., BEHIND CLOSED DOORS: VIOLENCE IN THE AMERICAN FAMILY (1980). (14) VANCE JOHNSON, THE VANCE: THE BEGINNING AND THE END (1994). (15) WALKER, supra note 10.

Lenore E.A. Walker is a psychologist with Walker & Associates and the Domestic Violence Institute in Denver.