At the end of this chapter you will be able to do the following.

Define crisis

Define life stressor

Differentiate between the types of abuse

Differentiate normative and acute stressors

FAMILY FUNCTIONS AND DYSFUNCTIONS

Families are functional at some levels and simultaneously dysfunctional at others. No two families are exactly alike, and very few families experience blissful ideal family experiences. Family functions are the tasks and goals that support and sustain the family. Dysfunctions are failures in the family to accomplish these tasks and goals. Functions are intended; dysfunctions are typically unintended. For example, family members do not intend to establish poor communication patterns, invisible sexual boundaries (incest), or economic hardships. The basic family functions which are intended include economic cooperation, control of sexuality, socializing children, identity and social status, and social and emotional need fulfillment. Families that meet family members’ needs well are referred to as high resource families. Low resource families might meet some needs well and other needs poorly or not meet many of the needs. Resources can include an inherent resiliency, money, extended family, strong friend network, or strong religious community.

Family dysfunctions can be handed down from generation to generation, with few family members aware that something is wrong in the family system. A dysfunction is a breakdown or disruption in the family (the individuals or the family as a whole) which threatens its stability. Drug or alcohol abuse, pregnancy, or loss of a job are some common dysfunctions. A pregnancy can be planned or unplanned; in either case it is a dysfunction since it causes a disruption in the family.

FAMILY STRESSORS

There are a variety of crises events that families must deal with over the life course. A crisis is a dramatic emotional or circumstantial upheaval in a person’s or family’s life course.¹ The life course of the family refers to the culturally defined sequence of stages in human life, rather than to precise periods of years or to biological development and is measured in relation to their time together, presence of children, ages, and work experiences. In young families the adults tend to be in their 20s and 30s; they have young children, are establishing their careers and buying assets, and have less than a decade together. These families have many stressors that accompany the process of establishing their family. Normative stressors are expected life events and processes that bring stress by virtue of their nature. Having a baby, getting a new job, and buying a home are all normative stressors at this stage of the life course.

Many married couples experience a noticeable decline in marital satisfaction which accompanies the birth of their first child. Judith Wallerstein is quoted as having said, “Each couple must embrace the daunting roles of parents and absorb the impact of her majesty the baby’s dramatic entrance while protecting the couples’ own privacy.”² Many researchers have established a decline in marital satisfaction after the birth of a child, especially the first child. The better the couple are as friends, the less the impact the first child has on their marriage. To transition to the role of parents, it was found that couples who planned to have the baby and who work closely and in a mutually supportive manner make the best adjustments.2

Middle families are in their 30s to 50s, their children are teens or young adults, they are in mid-career, and are financially established with a home and cars. Middle families launch children into college, military, and jobs while maintaining steady earnings. They typically have some retirement investments and are paying off mortgages and other loans. As they age into their 50s they find that some of their married children return home for a short season because of marital or financial hardships. Parents begin to witness the death of their own parents and siblings and are much more aware of their pending move into the ranks of the elderly. These families have fewer normative stressors than younger families.

Elderly families have more freedoms from childrearing than the younger families have. They are 60 plus and are often grandparents, have their homes paid off, and are looking forward to retirement. Their grandchildren graduate college and become parents in their own right. They have experienced the passing of their grandparents, parents, aunts and uncles, and sometimes siblings. They also have begun to face the sober realities of their biological health declines. These families have far fewer normative stressors than younger families.

Acute stressors are typically unexpected, sudden, and demand tremendous resources to cope with them. Bankruptcies, illnesses, crime victimization, loss, and natural hazards are just a few of the acute stressors that could impact a family. Wallerstein and Blakesly (1995) also reported that happily married couples had “confronted and mastered the inevitable crises of life, maintaining the strength of the bond in the face of adversity.”

LIFE STRESSORS

In the 1970s, two psychiatrists named Thomas Holmes and Richard Rahe developed a scale that measured life stressors that could have impacted an individual or his or her family over the last three years.³ For families in the young family stage, getting married, having a baby, buying a home, or having a parent die ranked as the most stressful events. For middle and older families, having your spouse die, divorce or separating, moving, and getting married were among the most stressful events. In this paradigm one of these events can be coped with fairly well if the family members can gather enough resources to meet the challenge. Two or more acute stressors can pile up into your normative stressors and overwhelm you to the point of illness.

How families respond to stressors makes a huge difference in their quality of life. Researchers have established that stress can strengthen you or destroy you, depending on how you cope with stressors as individuals or families. When a series of normal and less significant stressors accumulate, it can have the same effect as a major acute stressor. If both happen together, stress can pile up. Stressor pile up occurs when stressful events accumulate in such a manner that resolution has not happened with existing stressors before new stressors are added. Stressor pile up can be detrimental if adequate resources are not obtained to meet the demands of the stressors.⁴ This generation of families does not share the same conservative financial tendencies as did the generation of our grandparents. In the U.S. many desire to have what they desire now, even if debt has to be incurred to get it. Now-time gratification (also called present time) is the individual perspective that seeks immediate satisfaction of their needs, wants, and desires. Delayed gratification is the ability to invest time and effort now in hopes of a payoff down the road. Delayed gratification is very common among college students who are willing to put in 4-6 years of higher education for the promise of a life-long career of better earnings and life experiences.

FAMILY VIOLENCE AND ABUSE

Family abuse is the physical, sexual, or emotional maltreatment or harm of another family member. Abuse is perpetrated by powerful people on less powerful people. You may have heard that there is a chain of abuse passed from parent to child to grandchild. Some estimates are that 1 in 3 sexually abused children grow up to be abusers. Many abuse survivors are meticulous about marrying non-abusers and about over-protecting their children from potential abusers.

CHILD ABUSE

Sexual abuse is one form of child abuse. The American Academy of Child and Adolescent Psychiatry reported that 80,000 cases of child sexual abuse are reported each year in the U.S. with many more cases unreported.⁵ Symptoms of sexual abuse in children include the following: avoiding or showing an unusual interest in things of a sexual nature, problems sleeping or having nightmares, signs of depression or becoming withdrawn from friends or family, seductive behavior, talking about their bodies as dirty, being concerned that there is something wrong with their genitals, refusing to go to school, delinquent behaviors, conduct problems, being secretive, being unusually aggressive, exhibiting suicidal behavior, and illustrating sexual molestation in drawings, games, or fantasies.

Recent U.S. data indicate that there were 3,300,000 alleged cases of child abuse and neglect in 2010.⁶ It was reported that 78% were neglected, eight percent suffered emotional abuse, nine percent suffered sexual abuse, and 18% suffered physical abuse. They also reported that girls (9.7 per 1,000 children) were slightly more abused than boys (8.7 per 1,000 children).

Figure 1 shows child abuse data from 2000 to 2007 for males, females and total. The number of substantiated cases declined between 2006 and 2007, but this drop still represents hundreds of thousands of cases. The actual number of cases may be two or three times that high since many cases go unreported. Figure 2 shows the specific types of abuse that have occurred. These, too, are declining, yet consistent, in their relationship to one another. Neglect cases are by far the most common with over ½ million each year. Medical neglect is the least common abuse. Other national studies of child abuse report similar findings.7

Figure 1. Numbers of U.S. Child Abuse Cases Substantiated, 2000-2007.8

Figure 2. Numbers of U.S. Child Abuse Cases Substantiated between 2000-2007.9

The U.S. now has a national Child Abuse and Neglect Data System (NCANDS) which is designed to gather more accurate data on child maltreatment.¹⁰ Figure 3 shows the numbers of child abuse victims by their ages. The highest numbers of abuse cases were found among the two- to five-year olds with rates declining as children age. One website reported that 12% of high school girls and five percent of high school boys had been sexually abused.¹¹

Over half of the reports of child maltreatment came from professionals (57%). This report stated that in 2007 about 1,760 children died, mostly from neglect. In 2010, an estimated 1,560 children died from maltreatment in the United States.¹² 

Figure 3. Numbers of U.S. Child Abuse Cases Substantiated, 2000-2007.¹³

SPOUSAL ABUSE

Abuse may also be perpetrated by adults against adults in families. When violence occurs between adult spouses or partners, it is often called intimate partner violence or IPV. The CDC provides a useful definition. “…intimate partner violence (IPV) is defined as actual or threatened physical, sexual, psychological, emotional, or stalking abuse by an intimate partner. An intimate partner can be a current or former spouse or non-marital partner, such as a boyfriend, girlfriend, or dating partner….”¹⁴ The guidelines from the CDC focus on frequency of physical, sexual, and emotional abuse.

The U.S. Bureau of Justice Statistics (BJS) tracks this type of crime. In 2007 there were 186,560 crimes perpetrated by spouses and 79,860 perpetrated by ex-spouses.¹⁵ These included 153,790 assaults by spouses and another 63,650 assaults by ex-spouses. These also included 20,670 rapes and sexual assaults by spouses and another 6,200 by ex-spouses. Quite disheartening was the report that almost 60% of victims did NOT report their crime to police. The BJS estimates for 2008 state that about 22% of murders in 2002 were family murders. Of the nearly 500,000 men and women in state prisons for a violent crime in 1997, 15% were there for a violent crime against a family member. Intimate partners were responsible for three percent of all violence against males and 23% of all violence against females in 2008. Family violence accounted for 11% of all reported and unreported violence between 1998 and 2002.¹⁶

Another BJS report for the year 2008 showed how many cases of family violence were perpetrated on males and females and who the perpetrator was (see Figure 4). Females were over five times more likely to be attacked by their intimate partner than were males. They were also about twice as likely to be attacked by a relative as males. Males were more likely to be attacked by a friend or acquaintance. The Rape Abuse and Incest National Network reported that three percent of men had been victims of attempted rape or rape in their lifetimes and about 1 in every 10 rape victims is male.¹⁷

Figure 4. Numbers of Violent Crimes against Males and Females, 2008.¹⁸

Figure 5 presents family maltreatment on a continuum of violence and control. In families, normal disagreements occur. These are typically not at the degree of violence or control that authorities would become involved. Many parents have spanked their children. A spanking can be a simple swat used rarely and with low levels of violence and control; this would not concern authorities. However some parents use spanking at high levels of violence and control. They may emotionally, physically, and or sexually abuse their children in the name of spanking. All abuse is emotional or has emotional underpinnings because in families we are emotionally connected to each other and we all filter experience through our emotions.

Figure 5. Family Maltreatment Considering Degree of Violence and Conflict.

The sexual assault, stalking, and homicide categories of maltreatment are typically considered to be between adults and other adults, but parents do injure children to the point of death. Family violence is common and mostly perpetrated by males on others, but males are also victims of family violence. Even though violent crime has been declining since 1994, males are far more likely to be victimized  than females (except in sexual violence). In less common circumstances, women perpetrate violence on men.¹⁹ There are networks of shelters for men abused by women and or by other men. The easiest way for a man to get help is to call 911.

Spousal/intimate partner abuse is particularly important to those who try to intervene in family violence. One study using a sample of 16,000 adults in the U.S. reported that 25% of women and 7.5% of men had been assaulted by their spouse, cohabiting partner, or date; these data yield estimates of over two million intimate partner assaults per year in the U.S.²⁰ Scientists at the CDC estimate that there were over $8 billion in medical costs for spousal violence in 1995 and eight million lost work days.²¹

Intimate partner violence used to be called domestic violence. It can be physical, emotional, sexual, threats of violence, or stalking. Stalking is when someone harasses or threatens another repeatedly; even knowing their pursuit is unwanted. Various studies indicate that intimate partner violence is more common among the poor, unemployed, younger parents, and substance abusing partners.²²

CDC’s goal is to prevent Intimate partner violence before it begins.²³

It is very important to understand how violence and abuse transpire in intimate relationships. A 2006 study identified the nature of control and violence between the two people involved. Four types of relationships emerged based on violence and control. The main person is violent. His or her controlling behavior and partner’s violent and controlling behavior determines what type the relationship is. The first type is when the individual is violent and controlling, but the partner is not; this is called intimate terrorism. The next type is called violent resistance; this is when the individual is violent but not controlling and the partner is the violent and controlling one. In situational couple violence, the individual is violent, but not controlling and the partner is neither violent nor controlling. In mutual violent control, the individual and the partner are both violent and controlling.²⁴

In the 1970s, new models emerged which helped professionals understand and intervene in abusive situations. These models focused on the cyclical nature of abuse.²⁵ That means abusers typically cycle in and out of violence with their intimate partners. For example, after the relationship becomes established abusers go through a stage of tension and frustration buildup. These times are filled with perceived offenses by the perpetrator who begins to define

him/herself as being victimized. Eventually the perpetrator attacks and releases this pent-up anger and hostility. Shortly thereafter, the perpetrator feels remorse and apologizes to the victim.

Sometimes there is a phase of calm that lasts until the perpetrator recycles back into the tension and frustration build up stage again, repeating the violent cycle over and over.²⁶ Why some women and men stay with their abuser is difficult to explain, but is a major component of successful efforts to intervene. Some have learned that this is part of an intimate relationship-to suffer and forgive. Others stay because they see no economic possibilities if they did leave. Others stay to minimize the relationship break up and the impact the harm of that breakup may cause to their children. Communities have responded to this ongoing problem in multiple ways and at multiple levels. Coordinated efforts have been designed to get police, medical personnel, courts, and other social agencies working in the same direction for the best outcomes. The most common model used today to intervene in domestic violence is called the Duluth Model.

The Duluth Model came in the 1980s from Duluth, Minnesota where an experiment was attempted that united 11 community agencies to reduce violence against women.²⁷ This model claims that it is the community that controls abusers (not the spouse), that there are differing types of abuse and each must be responded to in appropriate ways, that socio-economic and historical factors of persons involved must be considered, and that intervention must include perpetrators and victims.²⁸

Critics of the Duluth model point out the absence of counseling and therapeutic efforts. Other critics argue that it is the court and legal avenues that ultimately protect the victims. Intervention models often include Duluth and cognitive behavioral therapy plus community intervention strategies. One study found that when considering the most common intervention models, there was really no strong indication that one might be better than the other.²⁹ One website is designed to encourage abused people to leave the relationship.³⁰

ELDER ABUSE

There is also a concern about the large numbers of elderly abused by younger family members. Family elder abuse is the maltreatment of older family members in emotional, sexual, physical, financial, neglect, and other ways, especially where trust was expected and violated.³¹ Cooper and others (2008) estimated that 1 in 4 elderly persons may be at risk for abuse in Western Nations.³²

The American Association of Retired Persons (AARP) estimates that $2.6 billion dollars is lost each year from younger persons abusing the finances of the elderly.³³ The National Center on Elder Abuse reports that care facilities also work diligently to prevent sexual, emotional, physical, and other forms of abuse by employees and family members. This Center estimates about two million elderly who’ve been abused, even though it admits that there is no uniform system in place to track the abuses.³⁴

1. http://dictionary.reference.com/browse/crisis
2. The Good Marriage By Wallerstein, J. S. & Blakeslee, S. 1995, Houghton Mifflin: NY
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4. Holmes, T.H. and Rahe, R.H.: The social readjustments rating scales, Journal of Psychosomatic Research, 11:213-218, 1967, also see another approach from Brown, G.W. and Harris, T.O.: Social origins of depression: A study of psychiatric disorder in women. London: Tavistock, 1978
5. search Hill and McCubbin’s ABCX Models
6. retrieved 23 April, 2010 from Child Sexual Abuse, “Facts for Families,” No. 9 (5/08) http://www.aacap.org/galleries/FactsForFamilies/09_child_sexual_abuse.pdf
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8. see U.S. Department of Health and Human Services, Administration on Children Youth and Families. Child Maltreatment 2007 [Washington, DC: U.S. Government Printing Office, 2009] available at: http://www.childwelfare.gov.2.Finkelhor, Ormrod, H, Turner, H, Hamby, S. The Victimization of Children and Youth: A Comprehensive National Survey. Child Maltreatment 2005; 10:5-25.3.Theodore, AD, Chang, JJ, Runyan, DK, Hunter, WM, Bangdewala, SI, Agans,R. Epidemiologic Features of the Physical and Sexual Maltreatment of Children in the Carolinas. Pediatrics 2005; 115: e330-e337
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29. Walker, Lenore E. (1979) The Battered Woman. New York: Harper and Row
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31. see http://www.theduluthmodel.org
32. Retrieved 18 April, 2013 from The Duluth Model home page at
33. http://www.theduluthmodel.org/about/index.html
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36. http://helpguide.org/mental/elder_abuse_physical_emotional_sexual_neglect.htm
37. Cooper C, Selwood A, Livingston G (March 2008). “The prevalence of elder abuse and neglect: a systematic review”. Age Ageing 37 (2): 151-60. doi:10.1093/ageing/afm194. PMID 18349012. http://ageing.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=18349012
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41. http://www.ncea.aoa.gov/about/index.aspx