Adult Domestic Violence:
The Alcohol Connection

The following address was first given by Theresa M. Zubretsky
Director of Human Services Policy and Planning
New York State Office for the Prevention of Domestic Violence
October 19, 1995 - Saratoga, New York

My interest in the relationship between domestic violence and substance abuse was prompted by my experiences working in both fields, first as the director of a residential and non-residential domestic violence program and later as part of the New York State Council on Alcoholism and Other Drug Addictions.

I discovered that people in the two fields really knew very little about each other, and what we thought we knew was often riddled with misconceptions about the other system. From each side, we were very often working with families struggling with the "other" problem and not only were we not talking with each other, but worse, we were often doing things in the interests of sobriety that undermined safety, and in the interests of safety that undermined sobriety. I think one battered woman's observation about her own recovery sums up the urgency of the need for us to work together. She said, "As an alcoholic, AA and treatment saved my life. But as a battered woman, it nearly killed me."

We need to understand what she meant by that. It's a real dilemma that we've created. In seeking recovery, chemically dependent battered women may become further endangered; and in seeking safety, we often limit women's access to help because of their chemical dependency. We can do better than that. Frankly, we have to. Because until we do, it's battered women and their children who will continue to pay the heaviest price.

Every day, we learn more and more about the tremendous impact of alcohol and other drugs on women's lives. Four million women experience problems with alcohol - two million with cocaine. And with seventy percent of prescriptions for tranquilizers, sedatives and stimulants being written for women - it's no wonder that women are twice as likely as men to become addicted to prescription drugs in combination with alcohol - a dangerous and often fatal combination.

Women suffer more serious health problems from alcohol and other drug abuse than men. They can consume much lower levels of alcohol than men and still get sick and die of liver disease. Alcohol increases women's risk of breast cancer, menstrual and circulatory disorders and a host of other health-related illnesses.

As women who are involved with substances emerge from the shadows, however, they pay a different kind of price for their increased visibility. Women who drink heavily are stigmatized as sexually promiscuous; as neglectful mothers; and as embarrassments to their husbands. Those who are pregnant are sent to jail. In society's eyes, women with alcohol problems are outcasts - they have failed to fulfill their "appropriate" social roles.

The disdain with which society looks upon addicted women may explain why, despite the increased risks associated with women's substance abuse, the problems women experience related to alcohol and other drugs continue to be viewed less seriously than men's. Until fairly recently, research about women and addiction was virtually non-existent. It also wasn't until recently that discrete treatment services for women began to be developed based on the radical notion that women are different than men, that they need an array of comprehensive services more extensive than one that merely focuses on alcohol and other drug use. Many factors affect a woman's substance abuse problems (victimization is one of those factors), and while there is an encouraging trend to attend to the interrelationships among the woman, the treatment program, and the community, such "relational" models of treatment for women are still few and far between.

Domestic violence takes an even more profound toll on the lives of women. It is the most serious criminal justice issue facing women today, occurring more frequently than any other crime in this country. According to the FBI, every 15 seconds, a woman is beaten by her male partner. There are over two million reported victims each year; but only about one in ten cases of domestic violence ever gets reported.

Domestic violence is the leading public health issue facing women today, causing more injury to women in America than auto accidents, muggings and rapes combined. Statistically speaking, a woman is safer on the street than she is in her own home. Domestic violence has been correlated with chronic pain, and a wide variety of stress-related physical symptoms including sleep and appetite disturbances, gynecological problems, miscarriage and other pregnancy complications and, of course, substance abuse.

Battering and addiction are devitalizing and killing women every day. In both of these fields, we are battling barriers in our communities and in existing systems that not only prevent women from getting the help that they need, but which frequently revictimize the very women we are trying to assist. In the next hour, I'm going to talk about some of the things that frustrate our efforts to promote both safety and sobriety for victims of domestic violence. I hope that it will be the beginning of a continuing dialogue that will improve our understanding of the issues and that will lead to better communication, coordination and collaboration between our service systems.

To that end, I also want to make a request. My plan this morning is to reflect as best I can what I've learned from the collective experience of battered and formerly battered women, battered women's advocates, batterers intervention specialists and my own fifteen years in the field. Some of what I say may very well conflict with your own views or experiences. My request is that whether or not what I say resonates with your experience, let's keep talking. Because one thing I am sure about is that we're all committed to doing what we can to ensure the safety of those who reach out to us for help. Fostering a constructive and respectful dialogue is what I understand this conference is about and it's an effort which I'm honored to have been invited to participate in.

You know, battered women and chemically dependent women have a lot in common. Both often experience tremendous guilt, shame, despair, lack of support, isolation, uncertainty and confusion. Battered women and chemically dependent women are often confronted with a system (formal and informal) that blames them and holds them responsible for their situation.

Battered and chemically dependent women are frequently not believed - neither is considered a particularly "credible" source of information. Both fear judgment regarding their mothering and face very real risks of losing their children to a system that deems them "unfit".

For women who are both battered and chemically dependent, you can take this list of issues and increase its impact - not by merely doubling it - there's more of a synergistic impact on women with both problems. For example, battered women who are also chemically dependent face an enormous lack of emergency services. Where does a woman go in the middle of the night if she has been drinking and has children in tow, and it's not safe for her to stay in her own home?

A battered woman's addiction provides her partner with yet another weapon he can use as a means to control her. "If you leave me, I'll see to it that you don't get custody of the kids. No judge is going to give a drunk like you custody."

Her drinking or drugging may also become the excuse for his violence. "If you weren't such a lush, such a junkie, this wouldn't be happening."

Drug-addicted battered women are more likely to internalize blame for the violence and are more likely to be blamed by others. In fact, here's a classic example of a double standard regarding alcohol use: victims who are drinking are more likely to be blamed for their own victimization; but batterers who are drinking are less likely to be blamed for their violence.

So, what does a chemically dependent battered woman confront when, despite the formidable barriers, and with some reserve of fortitude and courage that I can only try to imagine, she reaches out to us for help? All too frequently, she confronts a system utterly unprepared to meet her dual needs for safety and sobriety.

When there is a lack of information about domestic violence in the substance abuse treatment system, many of the signs of domestic violence which emerge during the course of an individual's treatment can be completely overlooked or otherwise misinterpreted. In general, helping interventionists tend to see and understand people and their behavior through their own familiar framework.

I was reminded of this point just this past weekend when my brother recounted an incident that occurred one summer during my college years. I was living with two of my brothers in my parents' house while they vacationed at the shore. I came home one night after dark, no one home, and heard a rustling in the attic. Now, independent I may have been. Stupid I wasn't. I fled, called my brother and the police and converged back at the house shortly after. Two police officers responded and cautiously entered the house, guns drawn and raised. They searched the first floor, and the basement; moved up the stairs to the second floor landing, searched my parents' bedroom and the bathroom. The door was closed to the room on the left and they cautiously opened it.

What a sight! The room was in complete disarray. Drawers were half open with clothes hanging out and strewn across the floor and furniture. The mattress was half off the bed, the bed linens lay in a crumpled heap on the floor. Wall decorations were hanging all lopsided. Books, papers, odds and ends everywhere. Eying the scene, one of the officers turned his partner with a grave look on his face, and said, "Something definitely happened here." His partner, looking concerned, nodded in agreement. At that moment, my brother bounded up the stairs, "Oh, no, no", he said. "That's my room. It always looks like that."

The officers had no way of knowing that Oscar Madison was a John Zubretsky wannabe. They entered our house armed with the tools of their trade; not just the guns, but their experience, their training, their investigative skills, and their duty to protect us. So, when they stood surveying my brother's bedroom, they saw a ransacked room. What to my brother was a cozy little refuge, to them was an obvious crime scene. They saw the scene through their own professional lens. (The intruder, by the way, turned out to be a bat - to my immense relief and, I might add, to the officers' ultimate amusement.)

We're all susceptible to interpreting a given scene through our own individual lens with the tools that we have available. Give me a hammer and everything starts looking like a nail. In the case of chemical dependency counselors, the addictions "lens", if you will, can sometimes prevent them from identifying violence as the root of a wide variety of presenting problems they frequently encounter. And their responses, therefore, can be devoid of safety-related interventions.

For example, take a case in which what the counselor sees is a female client, Sarah, who is not following through on her treatment plan. She's not making all of her meetings and still hasn't gotten herself a sponsor. She missed an appointment with her aftercare counselor. And she mumbles an excuse that she hasn't been able to get adequate child care to do the things she's supposed to be doing.

What the counselor may think is that these failures are symptoms of Sarah's resistance. She's not taking her sobriety seriously. Not ready or willing to put down the drink or the drug.

What the counselor may not see is that ever since Sarah's been in treatment, her husband's violence and controlling behavior has been getting worse. He's been reneging on providing child care and has refused her the money for a sitter as a way of preventing her from keeping meetings and appointments. He leaves her a list every morning before he leaves for work of the errands and tasks he expects her to do that day and it seems the list is getting longer and longer. He's begun to share his concern that Sarah's being away from home so much has been really hard on the kids. He tells her she's selfish and self-absorbed. And Sarah walks on eggshells, trying to keep the peace so that maybe she won't get hit.

What the counselor may not see is that the price Sarah is paying in her attempts to get sober is the price of her safety.

Or, take the case in which what the counselor sees is a male client, Tom, an executive who's been following through on every leg of his treatment plan - ninety meetings in ninety days, attending all of his appointments and group sessions and family sessions. His wife comes in with him, but she never says very much. The last time they came in together, Tom reported that his wife had urged him to attend a party with her, pressured him even and he agreed to go. What she'd failed to mention was that it was a cocktail party. When they arrived, Tom was immediately surrounded by alcoholic beverages of infinite variety.

What the counselor may think is that this is a classic case of attempted sabotage. Here's a woman, threatened by the implications of her husband's newfound sobriety on her role in the family, making attempts to undermine his recovery.

What the counselor may not see is that Tom has been violent and controlling with his wife of nine years for the duration of the relationship. She didn't say much in the family sessions because she had learned that the less she said, the less likely she was to be beaten up for it later on. Since her husband had been in treatment, she had been trying hard not to rock the boat or get him upset because he would yell at her - scream at her - and tell her that she was threatening his sobriety. He told her that if she really loved him, she'd be more supportive and he used the things she had said in the family sessions as proof of her disloyalty and non-support.

And he'd hit her, only now that he was in treatment, he'd say that it was because he was under a lot of stress and feeling like he wanted to pick up. Or he'd hit her and apologize, saying he should have gone to a meeting that day.

His wife began to realize that the violence was worse since Tom got into treatment. He had been less violent toward her and the children when he was drinking. So, sure, she got him to go to the cocktail party, hoping that if he slipped, if he picked up, she and her children would be more safe.

What we "see" is not always the whole picture. Sometimes it's merely a lack of information that clouds the view, not having the awareness that violence takes a tremendous toll on the lives of countless numbers of families in our treatment programs. Not having an awareness of the direct implications of that violence on our clients' abilities to get sober. Sometimes, however, what clouds the view is not so much a lack of information as much as it is misinformation.

One common misunderstanding is the widespread belief that domestic violence is a problem rooted in individual pathology, of batterers, or perhaps even worse, of victims. In the case of batterers, a batterer is seen as someone who has a hard time keeping his temper. Or is under a lot of stress. Or insecure. Perhaps provoked. Someone who lacks social skills. A drinker. A drugger. And lately, even genetics is taking the rap. But battering isn't caused by any of those things. It isn't about anger. It's not about stress or insecurity. It's not a result of drinking or drugging. It's about control.

When we listen to battered and formerly battered women tell their stories, the types of violence and coercion they endure - isolation, threats, degradation, and induced debility and exhaustion - reads less like a list of batterers' social skills deficits and a whole lot more like an Amnesty International list of the coercive tactics used in human torture - to control another person - to break someone's spirit.

Isolation is a mechanism of control which deprives a victim of social support and decreases her ability to resist. Battered women tell us, Threats are a mechanism of control which cultivate anxiety, despair and FEAR. Women tell us, Degradation is a way to damage a person's self worth and make them question their own capabilities and desirability. And finally, induced debility and exhaustion is a way to weaken one's mental and physical ability to resist. And, of course, there's the physical abuse - assaults that are often life-threatening. In fact, 1/3 of all reported physical assaults on battered women involve the use of a weapon. And they experience sexual violence. Rape. Sexual degradation. Forced unprotected sex. Once assaulted, the threat is always there that it could happen again.

Battering isn't a series of isolated blow-ups. It's not a symptom of an "impulse control" problem. It is a process of deliberate intimidation. These are not by and large men who are generally violent. The majority of batterers are exclusively coercive and violent in the privacy of their homes - with their female partners. The majority of them don't drink and don't drug. How a man who batters deals with stress, his feelings and conflict depends entirely upon whom he's dealing with.

As many as 20% of men in America engage in violent and controlling behavior with their partners and other family members. While victims of domestic violence can be anyone - including gays and lesbians and to a much lesser degree men who are abused by their female partners - it's no accident that women are the victims of men's violence in 91% of all adult domestic violence. The long historical and legal tradition in this country which gave men the legal right to use violence as a means to control, to discipline their wives and children and to keep the social order isn't so far behind us. In New York, it wasn't until 1977 - less than twenty years ago - that the law gave married battered women the right to press charges in criminal court. It wasn't until 10 years ago that it became a crime in this state when a man raped his wife. It wasn't until just last year that it became law that when a man commits a felony level assault against his partner or violates an existing order of protection that he has to be arrested.

There may be progress towards clearly criminalizing domestic violence, but the attitudes and beliefs that support violence against women persist. There is enormous support and a high level of tolerance in our culture for men to be violent. And there is enormous support in our culture to hold victims responsible. Domestic violence is less a problem of men's individual pathologies, than it is a problem rooted in a social and cultural legacy of male power over the lives of women and children. Batterers batter because they can and because it works - it works to control the behavior of their family members.

Another belief that can effectively distort the picture that counselors have of battered women is the one reflected in the question, "Why doesn't she just leave?", or asked even after she leaves, "Why didn't she leave sooner?"

As Ann Jones points out, "Why doesn't she just leave?" is one of those questions that doesn't call for an answer. It makes a judgment. It suggests that a woman who hasn't left isn't concerned about her safety or hasn't been active in trying to protect herself and her children. It suggests further that a battered woman has the freedom to choose to leave, and presupposes, that if she leaves, she'll be safe.

The truth is that coercion and fear make it difficult, even impossible sometimes, for women to leave or to leave safely. How "free" is a woman to choose to leave when she's been told time and again, "If you leave me, I'll kill you. Or I'll kill the kids. Or you'll never see the kids again." And the fears generated by these threats are well-grounded in fact. Leaving is by far the most dangerous time for battered women - a time when they are most likely to be assaulted and most likely to be killed. Two thirds of all women killed by their male partners are killed after they've left. Batterers are the most tenacious of criminals when it comes to the active pursuit of their victims. Every day, four or five men track down and murder women who are trying to get away from them.

If fear weren't enough of an obstacle to leaving, what about the enormous financial obstacles many women face in making the choice to leave, being forced into poverty or onto welfare. What about the fact that when women seek help from the criminal justice system, they don't always get justice. Instead they get, "What did you do to make him so angry?" or "It's just a domestic. Plea it down." Or their clergy person or minister encourages them to work harder at the marriage. Or their family and friends tell them "You made your bed". What about the pressures from children to stay with daddy? To stay in their own house, neighborhood and school. What about the cultural and language barriers? Immigrant women reluctant to come forward for fear of deportation. What about the barriers that exist for women as a result of institutionalized racism and institutionalized homophobia? What about the woman in the wheelchair who can't make it up the courthouse steps? What about the fact that when battered women do tell, they're blamed, they're not believed, they're not taken seriously?

Battered women have to confront all of the barriers that non-battered women have to face in trying to end a relationship. On top of it, they have to deal with the additional obstacles that make them afraid - and reasonably so - the threats, the coercion, and the violence.

Asking the question, "Why doesn't she just leave?" in one sweeping stroke transforms this immense social problem into an individual responsibility - which, when the victim fails to meet that responsibility, to solve the problem, we then explain through her personal pathology. But as hard as some researchers have tried, no one has found anything about battered women that makes them different from non-battered women, nothing that explains why this violence has happened to them - not their personalities, not their socio-economic status or education levels, not their cultural background, not childhood histories of victimization, not parental substance abuse, not their levels of self-esteem, not their psychological profiles - nothing. Women are not battered because they're sick, or emotionally or psychologically deficient or dysfunctional, or suffering from low self-esteem. Battered women are women who become trapped -in extraordinarily difficult and dangerous situations and often with less than adequate options.

Becoming a victim of someone else's choice to use violence and coercive behavior can happen to any woman - and does. If you're female, it is accurate to believe "it can happen to me".

Now, I know, that for many of you, your experience in working with victims of adult domestic violence may have suggested to you that the majority were victimized as children, or came from families in which there was alcohol or other drug abuse. But please do not make assumptions about who battered women are based on your clinical samples. In substance abuse treatment settings, I would expect that the majority of chemically dependent women will also have a history of childhood victimization. There's a huge correlation between the two. So, when one of these women is also an adult victim of adult domestic violence, it's an easy leap to perceive a correlation between childhood victimization, or family of origin distress, and her adult victimization. But when we step back and look at all battered women, rather than at clinical samples, those connections just don't hold up. There's only one risk factor for being a battered woman - and that's being female.

It's not hard to imagine how battered women are perceived as incapable of making good decisions if it's believed that there are decisions she could make to stop the violence. It's not hard to imagine how battered women are perceived as overly dependent if it's believed that her dependency was a precondition of her victimization rather than an outcome of control. It's not hard to imagine how battered women are perceived as women who "play the victim" if it's believed that if we could just get her to stop thinking like a victim, she'd stop being one. It's not hard. It's just wrong. In fact, when I hear people describe battered women in this way, I wonder if we're talking about the same women. When we fail to experience battered women as resilient, courageous, resourceful, active in decision making and concerned about their safety, it's because "you can't see it until you believe it." We fail to see it because of our faulty presuppositions about the causes of domestic violence and the options available to victims.

The key to explaining or solving battered women's victimization will not be found within victims themselves. Rather than asking, "What is it about her that she stays?", we need to ask, "What is it about our communities, our systems, our society that allows men to perpetrate domestic violence and that keeps women trapped?"

If battering could be explained through the pathology of batterers or through the pathology of victims or through their independent or combined use of substances, then we might reasonably conclude that if and when these individuals begin to get sober and begin to practice true recovery, that batterers will stop battering and battered women will get themselves safe. But it just doesn't work that way.

It doesn't work because alcohol use/alcoholism doesn't cause battering. The belief that alcoholism causes domestic violence, however, is a notion widely held both in and outside of the substance abuse field, despite a lack of information to support it. Although research indicates that among men who drink heavily, there is a higher rate of domestic violence and a higher rate of perpetrating assaults resulting in serious physical injury than exists among non-substance using men, most domestic violence occurs completely outside the context of alcohol or other substance abuse. The majority of batterers aren't alcoholic and the majority of alcoholic men don't abuse their partners.

Even for batterers who do drink, there is little evidence to suggest a clear pattern relating the drinking to the abusive behavior. The majority (3/4) of physical assaults occur in the absence of alcohol use. Further, there is no evidence to suggest that alcohol use or dependence is linked to the other forms of coercive behaviors that are part of the pattern of domestic violence. Economic control, sexual violence and intimidation, for example, are often part of a batterer's ongoing pattern of abuse with little or no identifiable connection to his use of or dependence on alcohol.

The belief that alcoholism causes domestic violence is rooted in not only a lack of information about the nature of battering, but also from adherence to the "disinhibition theory". This theory suggests that the physiological effects of alcohol include a state of lowered inhibitions in which an individual can no longer control his behavior. Research conducted within the alcoholism field, however, has not produced any convincing evidence to support this view. Rather, the research has consistently indicated that connections between alcohol use and subsequent aggressive behavior are primarily mediated by the expectations that individuals attach to the drinking experience. When the cultural norms and expectations about male behavior permit and support aggressive behavior when under the influence of alcohol, men operating within that cultural context are more likely to display aggression when drinking than men in cultures whose norms and expectations do not tolerate that behavior.

In spite of this, there is a widespread bias to hold people who commit crimes while under the influence of alcohol or other drugs less accountable than those who commit crimes in a sober state. Batterers, who have not been held accountable for their abusive behavior in general, find themselves held to an even lesser standard of accountability for battering perpetrated when they are under the influence of alcohol. The alcohol provides a ready and socially acceptable excuse for the violence.

Men who batter blame the woman, blame the drink, and given the opportunity, they blame the weather. Beware the batterer who presents himself as a victim; and I've yet to meet one who doesn't present as the victim of his partner's shortcomings, failings or provocation. There is no excuse. No justification. No "I was drunk". No "I had a bad day". No "My father beat me." There's no room for collusion here. We need to be crystal clear about their responsibility for their choice to use violence.

Thinking that alcohol or substance abuse causes domestic violence also leads to thinking that treatment for the chemical dependency will stop the violence. But battered women consistently report that when their partners begin to get "sober" the violence not only doesn't stop but often gets worse. And even when the level of physical violence does abate or stop, they often report a corresponding increase in the other forms of control - the threats, isolation, emotional abuse, and economic abuse intensify. Treating a batterer's substance abuse problem without addressing the violence is unlikely to stop the violence; and may even increase the victim's danger.

Another misunderstanding comes from attempting to explain why domestic violence gets worse over time. The "progression" of violence is likened to the progression of the disease of addiction, inviting the use of an addictions model for responding to the problem of battering. Use of an addictions framework assumes that just as an addict experiences loss of control over the substance, there is a point at which a batterer can no longer control his violence.

But batterers don't lose control of their violence. How would "loss of control" account for the fact that batterers overwhelmingly target their punches and their kicks to their partners' torso - parts of the body that are covered by clothing?

How would "loss of control" account for the fact that men who batter have personal limits beyond which they won't go? Whether the line is drawn at a closed fist, the use of a weapon, or drawing blood, batterers, almost without exception, have their own personal limit at any given point in time.

How would loss of control account for the fact that batterers who appear to be "uncontrollably drunk and out of control with rage" in the midst of perpetrating some physical assaults retain the remarkable ability to "sober up" and regain their composure when the police show up at the door?

Batterers aren't out of control. Quite the contrary; they are consummate controllers. Violence escalates over time for other reasons. Batterers may need to increase their partner's sense of danger and fear in order to continue to maintain control and prevent her from seeking help or leaving. And since batterers experience few, if any, negative consequences, once a batterer perpetrates a particular level of violence with impunity, he may find it easier to cross that threshold in the future.

The bottom line is that batterers who are also alcohol or other drug addicted need to address both problems separately and concurrently. Recovery may be a process that involves more than simply "putting down the drink", but substance abuse treatment, AA, NA, aren't enough to effectively address the attitudes and beliefs that are at the root of batterers' behavior. They weren't designed to address them. That's a job that belongs to all of us.

Until we challenge the attitudes and beliefs that support men's right and entitlement to control the lives of women and children, until we impose consequences for men's choices to engage in intimate violence, until we actively reinforce 100% accountability upon batterers for their violence - unless we do that, we're going to have a heck of a time trying to get batterers to want to stop. As Ann Jones, the author of "Next time, she'll be dead", suggests: It's not enough to speak out against domestic violence in our communities, we need as a community to act as if we believe it. To act as if we believe it. We must actively participate in holding men who batter 100% accountable for their violent behavior.

Accountability for battering men is necessary in the interests of victim safety. But it's also necessary in the interests of battering men. For alcohol or drug addicted battering men, we can't even help them get sober unless we address the battering. A man can beat his wife and be successfully abstaining. But a man can't beat his wife and be successfully in what we call "recovery". Furthermore, battering is a relapse issue for substance using batterers. If there's a connection for a man between raising his fist and raising a glass, it's a relapse issue. Intervention for the violence has to be integrated into the treatment plan because continued violence poses a direct threat to his sobriety. You can't help him get sober unless you're willing to do what it takes to directly address his violence.

Dealing with both problems means, minimally, conducting routine upfront assessments for domestic violence as part of the intake process and integrating attendance at a batterers intervention program into the treatment plan. Not that a man's participation in a BIP is necessarily an indication that he has made the decision to stop battering. Those who work with men who batter are humbled daily when faced with the actual limitations of their efforts. BIPs are not a panacea. They do not and, I would argue, can not solve the problem of men's violence in isolation of other community wide efforts.

Here, in New York State, we advocate the development of batterers programs in the context of a community wide coordination strategy. My agency is in the process of adopting standards for BIPs that uphold some basic principles. One - the priority concern of a responsible BIP should be victim safety. Anyone working with batterers must have a direct linkage to domestic violence programs and thus to battered and formerly battered women as a way to continually assess the impact of their work on the safety of victims in the community.

Two - BIPs should provide education and accountability, not therapy. While many batterers may be insecure, may have suffered childhood trauma, may be angry or stressed out, these things no more explain their choice to be intimately violent than does alcohol or other drug use. Batterers with issues of insecurity, childhood trauma, or substance abuse deserve help and we should help them get it. But at the root of battering behavior is the set of beliefs that supports men's choice to control their partners. That ought be the sole target of interventions designed to stop battering.

Three, batterers intervention programs must operate in the context of a coordinated criminal justice systems response to ensure that if an individual man doesn't use the information and the tools he receives in a BIP to make the internal decision to stop his violence, then we have an external system of control that we can mobilize to best ensure the safety of victims.

We also have a responsibility to inform battered women about the limitations of substance abuse treatment alone to solve the violence as well as the limitations of treatment in combination with Batterers intervention. She needs to understand that her partner's participation in treatment and batterers intervention is not a guarantee for her safety. We should encourage her to plan for her safety in the event that her partner rejects the assistance he is getting to choose sobriety and to choose non-violence.

Concerns about victim safety also arise in the context of service provision to chemically dependent battered women. Although the vast majority of battered women are not alcohol or other drug-involved, those who are confront a system that often attempts to solve the violence problem through the recovery process. Often, intakes to treatment programs do not include an assessment for adult domestic violence. Even when domestic violence is identified, it is often assumed that chemical dependency treatment must occur before the client can begin to address or make decisions about her victimization.

One of the concerns with the "sobriety first" approach is that it doesn't consider the increased risk of violence that a woman's recovery may precipitate. Batterers are typically very resistant to their partners' attempts to seek help of any kind, including substance abuse treatment. In response, they may sabotage the recovery process, and may respond with intensified violence, as I mentioned earlier. Many chemically dependent battered women leave treatment in response to the increased danger or are otherwise unable to comply with treatment demands because of the obstacles constructed by their partners. Many battered women are terminated from treatment because of the counselor's inability to see the role her victimization plays, instead taking her failure to comply with the treatment plan as evidence that she is "non-compliant", "resistant", not serious about getting sober. Even if a battered woman is able to complete a treatment program, being revictimized puts her at extremely high risk of relapse. So, not only may a battered woman's recovery precipitate increased violence, but continued violence may also precipitate relapse. Substance abuse recovery strategies that don't integrate safety planning are almost destined to fail.

Some battered women who participate in substance abuse treatment and are able to comply with the treatment plan often want to focus on the multiplicity of problems that are directly related to immediate and long-term safety, i.e. - legal protection, housing, medical problems, child care, child custody, lack of job skills, unemployment, etc. Here, too, treatment professionals sometimes misunderstand battered women's desire to focus on these issues as "resistance to treatment" or as a defense to avoid dealing with the addiction. But there's a big difference between survival strategies and safety needs on the one hand and resistance to treatment on the other. Successfully engaging and treating battered women with alcohol and other drug problems may rely upon our ability to discover that difference and to integrate their concrete safety needs into their treatment plan. That may mean being willing to let go of some of the rules that have governed addictions treatment for a long time. It's time we recognized and accepted that no one way works for everyone. It's long past time for us to listen to the women who are saying that it's not working for them and to offer them the help that they deserve.

Let me give you an example of how a little flexibility can go a long way. I ran into a substance abuse counselor recently who had attended a training I conducted last spring. The counselor, Ellen, is a very bright, very perceptive, very knowledgeable counselor who had been working almost exclusively with women for some ten years. She told me that she had a woman in treatment who had disclosed she was battered and was linked with domestic violence services but was still living with her partner. One week, the woman came in for her appointment and reported to Ellen that she had had a "slip". In the middle of an argument with her partner, he grabbed her by the hair, held her head back, forcing her mouth open and took an open beer and poured it down her throat. He was yelling stuff like, "You think you're so high and mighty, better than the rest of us 'cause you're all clean and sober. Well, you're just the same bitch you always were." He held the bottle up and told her to drink it. Drink it or "you might not live to regret it."

Ellen told me that her standard response would have been to tell her client, "Look. You and only you are responsible for your sobriety. You should have put on your walking shoes and gotten the hell out of there instead of taking that drink." But then she said she heard this nagging voice in the back of her head. She said, "I think it was your voice, Theresa." This nagging voice telling her to try a different tack. And she did. She said to her client, "Whoa. We've got a serious problem here. The danger your partner puts you in is interfering with your ability to stay sober. We need to figure out a way to make sure that never happens again. How can we keep you safe so we can keep you on the path to recovery?" Ellen said that she was used to losing a lot of clients like this woman, but that this woman was still in treatment and doing well.

You've heard the saying - "There's no such thing as a resistant client. Just resistant counselors?" The notion that battered women are particularly resistant clients is a myth. We've just been trying to sell them the wrong bill of goods, a bill of goods that has failed to make their safety a priority.

There is a second concern with applying the "sobriety first" approach to interventions with battered women. Many battered women report that they started to use substances as a way to cope with the physical and emotional pain of the abuse, and most typically after other attempts to seek help failed. Frequently, these women report that they had sought help repeatedly from the traditional social service and legal systems but received inadequate or negative responses. In fact, many chemically dependent battered women are addicted to sedatives, tranquilizers, stimulants and hypnotics, drugs which were prescribed by the health care providers from whom they sought help. The "help" they got came in pill form, a pill which alleviated their symptoms but also often communicated a powerful message, a message that "there is something wrong with me".

Whether the relief they get comes from a pill, a glass, a needle, or a pipe, battered women often report that use of the substance helps to reduce their feelings of fear. Think of the "magic" in that drug. Fear can be an incredibly paralyzing emotion and battered women live in constant fear. If, as a battered woman, a drug can minimize my fear and help me manage and get by day to day, to get the kids off to school and keep the house and cook the dinners, that's "magic". These are the women who may be particularly resistant to fully engaging in a recovery process until they have some other way of mediating their fear, until they have achieved some level of genuine safety. The traditional treatment approach that says "until you are willing to put down the drink, I can't help you", poses a particular double bind for these women because, for them, giving up the drink means giving up some safety.

Now, think about it. If she's not willing to give up the drink and we're not willing to work with her until she does, we're at a serious impasse. And frankly, I think her reasons for hanging onto the drink or drug are way better than our reasons for hanging onto the notion that it has to be "sobriety first". With the exception of some women who are so debilitated by their addiction that they truly can't engage with us in any constructive way, it's a myth - a big lie - that women have to be sober in order to work on their safety.

Battered women who are active in an addiction do lots and lots of things every day to help keep themselves safe. Many of them are quite capable of filing for orders of protection and using those orders effectively. Many are quite capable of attending battered women's support groups and beginning to break down isolation, get information and build a support system. If they can manage to abstain long enough, they're even capable of residing in an emergency shelter and satisfying their immediate safety needs.

I'm not suggesting that we engage addicted battered women in safety planning and simply ignore the addiction. But if we're willing to start where she is and where she is is interested in focusing on her safety, then trust me, sooner or later her addiction is going to get in the way of her safety plans. And that's where we come in, stage left, and seize the opportunity to help her explore how her addiction is directly interfering with her safety plans, a process which may help to increase her motivation to get treatment for her addiction.

I worked with a woman who showed up high for her court date for an order of protection. Another woman who called the police on a violation of an order of protection, but when they arrived and discovered her drunk, refused to arrest her partner. A woman who missed her custody hearing because she was passed out. I worked with all these women. They hung onto their respective drugs of choice for dear life. But they wanted domestic violence services and we gave it to them even though they were completely unwilling to give up the drug. But, you know, over time, with our help, they began to experience increased safety and began to see, with a little help from us, how their safety goals were compromised because of their addiction - and they began to loosen their grip on the drug. Not all of the chemically dependent women I worked with got sober, but a lot more of them did.

Everybody always asks what you deal with first, the domestic violence or the chemical dependency. I don't think there's a good answer for that. Mostly because I think that safety and sobriety are joined at the hip. We can't help women get sober unless we also help them get safe. We can't help women get safe unless we help them get sober. Some women say that they had to get sober before they could do anything else.

Others say that they needed to work on their safety related concerns before they would even consider giving up their drug of choice. There isn't a particular chronology on which to base our interventions other than what the woman in front of us tells us she is ready and able to do. The challenge is to be willing and able to fashion our interventions based on her individual needs.

So, starting with safety can further the goal of sobriety and vice verse. But only if we are well-equipped to attend to both problems. Only if we incorporate safety planning into our treatment planning and support for recovery into our safety interventions. Not by coercing women to do things they're not ready to do. But by continually being a source of information about the connection between safety and sobriety and working to help her figure out what's in her own best interests.

There are additional considerations regarding the impact of traditional treatment approaches on battered women's safety. Couples or family sessions tops that list and it is frequently requested by battered women because it's the one kind of help that their partner may agree to participate in. He tells her, "Okay, I'll get help. But you're coming with me," which, in effect, makes his change contingent upon her willingness to share responsibility for that change.

The premise of couples counseling is that both parties are a part of the problem and therefore both need to be part of the solution. It's precisely why batterers often agree to this kind of help. But domestic violence isn't a "relationship" issue. A batterer's violence is completely independent of his partner's likability, desirability, behavior or inadequacies. The message in couples counseling is that the victim is at least partly responsible for her partner's violence. And both the battered woman and the batterer get that message, reinforcing the batterer's externalization of blame on his partner, colluding with his desire to avoid accepting full responsibility for his behavior and contributing to a woman's internalization of blame.

In addition to clouding the issue of who is responsible for the violence, couples counseling places the battered woman in an impossible bind. Though she is expected to be open about her feelings, air her grievances, and report her husbands' violence, to do any of these things places her at very high risk for retaliation. Battered women commonly report that couples counseling sessions were followed by threats, intimidation and physical assaults. In response, battered women often begin to communicate their feelings and concerns in an indirect way, which then gets misinterpreted by couples counselors as noncompliance or noncooperation.

Coercion and violence create an imbalance of power between the batterer and victim that precludes the safe or effective use of mediation, couples or family sessions - whether the violence is the problem being addressed or not. The use of partners as collaterals or their participation in planned interventions are also practices common within the substance abuse treatment system, practices that put battered women at risk.

Treating domestic violence as a "family systems" problem is at best, based on faulty premises and subsequently ineffective. At worst, it is dangerous and life-threatening. Whatever the therapeutic benefit these interventions have for families not experiencing domestic violence, the collective voice of battered women who have had the misfortune to look to couples counseling for solutions and have suffered the consequences of that decision directly at the hands of their partners - their collective voice should be sufficient reason to refrain from engaging battered women in couples counseling, marriage counseling, mediation, collateral information gathering and planned interventions.

We also need to rethink the conventional wisdom of interventions for the partners of addicted battering men. The treatment system's intervention with female partners of alcoholics often includes recommendations to attend Al-Anon - an organization whose principles and practices have helped tens of thousands of people trying to cope with a loved one's addiction - but which, for battered women, encourage changes that may not enhance their safety. In Al-Anon, there is encouragement and support for members to get self- focused and practice emotional detachment from the substance abuser. Members are encouraged to stop "enabling" the addicted person, to stop doing things that protect him from the consequences of his addiction. While this may be a useful goal for family members of alcoholics who aren't living in coercion and fear, for battered women, such changes often put them at greater risk for violence.

Many battered women are very attuned to their partners' moods as a way to attempt to assess current danger. They may focus on their partners' needs and cover up for them as part of their survival strategy. Battered women's behaviors are not symptomatic of some underlying "dysfunction", but are instead the life-saving skills necessary to protect them and their children from future harm. These behaviors are also what, in the alcoholism field, are interpreted as "co-dependency". When we encourage a battered woman to give up these behaviors, to get "self-focused" and "detached" and to stop "enabling", we are, in essence, encouraging her to give up the very things that are helping her and her children be most safe.

Battered women do not have the same freedom to stop "enabling" their partners as do family members of substance abusers who are not living in coercion and fear. Such changes in battered women's behavior will almost certainly result in an escalation of violence. Battered women cannot "take their power back" from their partners by defining their boundaries and setting limits on behavior because they didn't give their power up in the first instance. Their power to negotiate was taken from them through their partners' use of coercion and violence.

Battered women whose partners are chemically dependent should be provided accurate and complete information about available resources so that they can make informed decisions and set realistic expectations about the potential benefits of these different sources of help. It is critical that they understand the purposes of Al-Anon and co-dependency groups and the limitations of these forums as sources of accurate information regarding safety-related concerns. They should also be advised of the availability of domestic violence programs and encouraged to connect with these services for assistance.

Improving responses to battered women who are also affected by alcohol and/or other drug problems requires honest and ongoing dialogue between the fields and increased coordination of services. This cooperation is sometimes hindered by the differences between the fields, i.e., use of the socio-political model vs. the medical model, individual intervention vs. a family systems approach. Think about our languages. One says, "empowerment" and the other says "I am powerless over". One says to women, "you are not responsible" and the other says "make a searching and fearless moral inventory and make amends". One says "safety first" and the other says "sobriety first". One says "you are a survivor; your behaviors are normal for someone who is reacting to coercion and fear". The other says "you are co-dependent". One says "you are not sick; society is sick" and the other says "you are sick; you have a disease". If you think it confuses us, imagine the effect on women involved in both domestic violence services and recovery services.

Some of these language differences are frequently misinterpreted and misunderstood, and can perhaps be resolved through increased knowledge and clarification of their meanings. But in other cases the disparate languages reflect analyses which are qualitatively different. These are, after all, different problems. And these differences, if not acknowledged and reconciled, can and do get in the way of cooperation between our fields.

Meeting the needs of battered women who are affected by substance abuse requires an open and effective working relationship between the substance abuse and domestic violence communities. It is our mutual responsibility to ensure that our respective responses promote victim safety, offender accountability, and recovery from addictions. It's our mutual responsibility to better help women affected by both problems to get both safe and sober.

I applaud the organizing agencies for planning this conference and all of you for your participation and I'm truly pleased to be here among you. I applaud you for taking the time out of busy and demanding schedules to come here and by your presence to demonstrate your concern about domestic violence and about substance abuse in your community. But the real challenge lies ahead of us. It's just not enough to say it, to think it and to feel it. The real challenge and the challenge that is before us all, is to act as if we believe it.

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