Domestic Abuse or Violence

Domestic abuse or intimate partner violence (IPV) is a pattern of behaviour — physical, sexual, emotional, psychological, financial, or technological — used by one partner to gain or maintain power and control over another. It affects approximately 1 in 3 women and 1 in 8 men in Canada and produces substantial mental and physical health consequences.

Overview

Domestic abuse — also called intimate partner violence (IPV), domestic violence, or family violence — is a pattern of behaviour used by one partner to gain or maintain power and control over another. It includes physical violence, sexual violence, emotional and psychological abuse, financial abuse, technological abuse, spiritual or religious abuse, and stalking. The behaviour is typically not a single incident but a pattern that escalates over time.

Domestic abuse is not a DSM-5-TR diagnosis. The DSM-5-TR addresses related clinical contexts through PTSD when criteria are met, depression and anxiety disorders that frequently follow IPV, and Z-codes including “Spouse or Partner Violence, Physical” (T74.11), “Spouse or Partner Violence, Sexual” (T74.21), “Spouse or Partner Abuse, Psychological” (T74.31), and “Spouse or Partner Neglect” (T74.01).

Population data: approximately 1 in 3 Canadian women and 1 in 8 Canadian men experience intimate partner violence in their lifetime. Rates are substantially higher in Indigenous women, women with disabilities, LGBTQ+ individuals, and women in transition shelters. IPV is the most common cause of injury to women in Canada and accounts for approximately 25% of all violent crime reported to police.

The “Power and Control Wheel” (Domestic Abuse Intervention Programs, Duluth) provides a comprehensive framework for understanding the patterns of behaviour in IPV: using intimidation, emotional abuse, isolation, minimizing/denying/blaming, using children, using male privilege (in heterosexual contexts), economic abuse, coercion and threats — surrounded by physical and sexual violence. The framework recognizes that physical violence operates within a broader pattern of coercive control.

Mental-health consequences of IPV are substantial: elevated rates of PTSD (~50% of IPV survivors meet criteria), major depressive disorder, anxiety disorders, substance use disorders, suicide risk, complex PTSD, and chronic physical-health consequences. The mental-health impact often persists long after the relationship ends.

Treatment is highly effective for IPV-related mental-health consequences, but requires specific safety considerations. Trauma-focused therapy, safety planning, connection to community resources (shelters, legal advocacy, financial support), and addressing comorbid conditions all support recovery. Recovery is the typical outcome with appropriate support, though it often takes substantial time.

Signs and symptoms

Acute injuries from physical violence — Bruises, fractures, head injuries, internal injuries — often in patterns suggestive of abuse (multiple injuries at different stages of healing, defensive injuries, locations consistent with assault).
PTSD symptoms — Intrusion (memories, flashbacks, nightmares), avoidance, negative cognition/mood, hyperarousal — common consequence of sustained IPV.
Depression — Persistent low mood, hopelessness, anhedonia, suicidal ideation — both consequence of abuse and risk factor for staying in or returning to abusive relationship.
Anxiety and panic — Persistent anxiety, panic attacks, hypervigilance, sleep disturbance — chronic stress responses to dangerous environment.
Substance use — Increased alcohol, cannabis, prescription medication, or other substance use as coping; substance use disorders frequently develop.
Eating disorder symptoms — Restrictive eating, binge eating, purging — sometimes related to body-control attempts in context of having little other control.
Self-harm and suicidal ideation — Substantially elevated risk; IPV is associated with substantial proportion of female suicide attempts and completions.
Chronic physical-health consequences — Chronic pain, gastrointestinal issues, cardiovascular consequences, autoimmune conditions, sexual and reproductive health impacts.
Difficulty leaving — Trauma-bond dynamics, financial dependence, child custody fears, immigration status concerns, fear of escalation, lack of housing alternatives — many practical and psychological barriers to leaving. Leaving is the most dangerous time for victims of physical violence.
Lasting impact post-separation — Mental-health consequences often persist after the relationship ends; ongoing court proceedings, custody, and stalking can continue the impact.

Causes and risk factors

IPV occurs across all demographic groups but has identifiable risk factors:

Perpetrator factors: personality features (antisocial, narcissistic), substance use, history of being abused as child, learned patterns from family of origin, hostile masculinity beliefs, controlling personality features.

Victim vulnerability factors: younger age (highest IPV rates ages 15-25), pregnancy (substantial elevation in IPV during pregnancy), separation/divorce process (highest danger period), pre-existing mental illness, immigrant status with limited support, disability, LGBTQ+ status (with limited support).

Relational factors: early relationship onset of jealousy, control, isolation; rapid escalation of relationship; pattern of cycles of tension building, acute battering, contrition.

Contextual factors: social isolation, financial pressure, family modelling of IPV, cultural norms supporting male dominance, gun availability, alcohol availability.

Specific high-risk contexts: separation/divorce, partner pregnancy, partner threatening to leave, escalating control patterns, prior strangulation (substantially elevates homicide risk), prior firearm threats.

Indigenous women face substantially elevated risk: approximately 3x higher IPV rates than non-Indigenous women; Missing and Murdered Indigenous Women and Girls (MMIWG) crisis reflects compounded structural factors.

Comorbidity: mental-health consequences (PTSD, depression, anxiety, substance use) are the rule rather than the exception in IPV survivors.

Typical treatments

Effective treatment for IPV survivors requires specific approaches:

Safety planning: first-priority intervention for anyone in active or recent IPV. Includes risk assessment, escape planning, document gathering, financial planning, child safety planning, communication safety. Specialized IPV advocates trained in safety planning.

Trauma-focused therapies for survivors:

Cognitive Processing Therapy (CPT) — strong evidence.
Prolonged Exposure (PE).
EMDR.
Trauma-Focused CBT.
Phase-oriented treatment for complex trauma when extended IPV history is present.

Specific IPV-focused therapy programs: HOPES (Helping Older Adults Heal), HOPE (Helping Older Adults Heal — IPV adaptation), Survivor-Therapy.

Group therapy: IPV survivor groups provide validation, normalization, and connection. Often combined with safety planning and resource navigation.

Pharmacotherapy: SSRIs for comorbid depression, anxiety, PTSD; prazosin for trauma-related nightmares; cautious use of benzodiazepines given dependence risk.

Treatment of comorbid conditions: substance use disorders, eating disorders, chronic pain.

Couples therapy is generally CONTRAINDICATED in active IPV. Couples therapy can be used by abusers to manipulate the therapy process and amplify harm. Individual therapy is appropriate for both partners; couples work is appropriate (if at all) only after sustained period without violence and demonstrated change in perpetrator.

Children’s mental-health support: children exposed to IPV (witnessing, hearing, being aware of) experience substantial mental-health consequences; child trauma-focused treatment is appropriate.

Community resources: shelters, legal advocacy, financial support, immigration assistance, housing assistance — all integral to comprehensive support.

Coordinated community response: integration of healthcare, mental health, legal, child welfare, housing, and advocacy services produces the best outcomes.

For perpetrators: specialized batterer intervention programs (BIPs) provide structured intervention; outcomes are modest and best when programs are court-mandated and sustained over substantial time.

When to seek help

If you are in immediate danger now, contact emergency services: dial 911.

Professional support is indicated when:

You are experiencing or have experienced any form of intimate partner violence — physical, sexual, emotional, psychological, financial, or technological.
You are afraid of your partner, walking on eggshells, or modifying your behaviour to avoid their reactions.
You are considering leaving an abusive relationship and need safety planning support.
You have left an abusive relationship and are dealing with the lasting impact.
You are experiencing PTSD, depression, anxiety, substance use, or suicidal thoughts.
Your children are exposed to IPV and you are concerned about their wellbeing.
You have left and are facing ongoing court proceedings, custody disputes, or stalking.

Free 24-hour Canadian IPV crisis support:

1-866-863-0511 — Assaulted Women’s Helpline (Ontario; multilingual; 24/7).
ShelterSafe.ca — Canada-wide directory of domestic violence shelters with map and contact information.
1-800-799-7233 — National Domestic Violence Hotline (also serves Canadian callers; 24/7).
1-888-340-1234 — VictimLink BC (24/7, multilingual).
1-844-762-8483 — SOS violence conjugale (Quebec, 24/7).
1-855-242-3310 — Hope for Wellness Helpline (Indigenous-led, 24/7).
1-800-668-6868 — Kids Help Phone (under 20).
9-8-8 — Suicide Crisis Helpline (24/7).
211 — local social services.

If you are in a same-sex relationship: most shelters and IPV services serve LGBTQ+ survivors. The 519 (Toronto, 416-355-9100) and provincial LGBTQ+ specific services provide additional resources.

If you are an immigrant or refugee: many shelters have multilingual services and immigration-aware support. Settlement.org and provincial settlement services can help navigate legal status concerns.

Frequently asked questions

When is the most dangerous time in IPV?

The period during and immediately after leaving is the most dangerous time for IPV survivors of physical violence. Approximately 75% of intimate partner homicides occur during separation. Safety planning before leaving substantially reduces risk; specialized IPV advocates can support this planning.

Why is it hard to leave?

Multiple factors: financial dependence (particularly with shared assets, debts, or children); housing insecurity; immigration status; fear of escalation or homicide; concerns about children (custody, witnessing transition); trauma-bond dynamics; isolation from support; cultural or religious factors; love or attachment that coexists with the abuse. Leaving is often a process not a single decision.

Can my partner change?

In a small subset of cases, with intensive specialized intervention (typically court-mandated batterer intervention programs sustained over years), some perpetrators show meaningful change. Most do not change without significant external pressure. Decisions about staying or leaving should not be based on hopes for change without sustained evidence over time.

Should I tell my doctor about IPV?

Healthcare providers are increasingly trained to support IPV disclosure. Most provinces have specific IPV protocols. Disclosure is your decision; many survivors find it helpful, particularly if mental-health and physical-health consequences are present. Mandatory reporting in Canada applies primarily to children — not to adult IPV survivors.

What if my partner finds out I'm in therapy?

Therapy is confidential and not disclosed to partners. Many survivors begin therapy without their partner's knowledge. Therapists trained in IPV are skilled at supporting this safely. If safety is a concern, this can be discussed openly at the start of therapy.

How long does recovery take?

Recovery from IPV is typically multi-year, particularly when violence was sustained or severe. Mental-health consequences often persist after the relationship ends, particularly if court proceedings, custody, or ongoing safety concerns continue. Recovery is the typical outcome with sustained support; many survivors achieve substantial post-traumatic growth.

References

Statistics Canada. (2023). Family Violence in Canada: A Statistical Profile.
World Health Organization. (2021). Violence against women prevalence estimates.
American Psychiatric Association. (2022). Diagnostic and Statistical Manual of Mental Disorders (5th ed., text rev.). APA.
Stark, E. (2007). Coercive Control: How Men Entrap Women in Personal Life. Oxford University Press.
Herman, J. L. (1992). Trauma and Recovery: The Aftermath of Violence. Basic Books.

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ShiftGrit Psychology & Counselling is professionally regulated, certified, and recognized by leading psychology and mental-health organizations across Alberta and Canada. These associations reflect our commitment to ethical practice, clinical standards, and evidence-informed therapy through Identity-Level Therapy and Reconditioning.

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The ShiftGrit Clinical Editorial Team combines the insight of registered psychologists, provisional psychologists, and trained writers to create accessible, evidence-informed therapy resources. All content is clinically reviewed by a Registered Psychologist.