SOCIAL JUSTICE BEGINS AT HOME: EMOTIONAL VIOLENCE IS A GLOBAL HEALTH ISSUE Veronica Pastor

The issue of emotional violence is increasingly being recognized as having an impact on health and development. Before discussing the effects of emotional violence on the lives of its victims and its impact on society at large, it would be useful to have a consistent agreed-upon definition. So far, however, this task has proved elusive. This is because emotional violence has important subjective elements, i.e., what constitutes emotional violence can vary across cultures, social classes and even from individual to individual. So, what is generally understood as emotional violence and why is it a legal issue of global concern? Emotional violence exists in all cultures and all levels of society. It has been depicted in classic movies, such as George Cukors 1944 Gaslight.i Today, the notion of emotional violence is widely understood to encompass elements of abuse of power, such as intimidation, humiliation, threat of physical injury,ii that exceeds the capacity of a reasonable person in the circumstances of the victim to tolerate without emotional injury. Emotional violence is predicated on a power differential between perpetrator and victim. Although victims and perpetrators of abuse can be men or women, the gender-based power differential that exists in all societies makes emotional violence into a womens issue treated as part of a larger problem of violence against women.iii The first person to point out emotional abuse as a widespread mental issue (and therefore a public health problem) was French psychiatrist Marie-France Hirigoyen. In her 1996 book, Stalking the Soul Emotional Abuse and the Erosion of 1

Identity, Dr Hirigoyen states that the purpose of emotional abuse is the virtual murder of the victims soul.iv Emotional abuse is often but not always - accompanied by physical abuse that can, in extreme cases, culminate in murder. While physical abuse is easy to discern the fist in the face, the kick in the groin other elements of abuse can be hard to pinpoint. They often include intellectual abuse (just because you are a schoolteacher you think you are smarter than any of us), sexual abuse (coerced sex or pregnancy), economic abuse in the form of threats to withdraw economic support, spiritual abuse (it is Gods will that you submit to me) and, increasingly cyberabuse.v There is clear evidence that emotional violence is transmitted intergenerationally as children learn behavior patterns form their parents.vi The principal risk factors for being a victim of emotional violence include (1) being female, (2) being young, (3) parents with disharmonious relationship, (4) pregnancy, and within this category, complications in pregnancy, (5) low education, drug and alcohol use, lack of financial independence, and (6) being unmarried.vii Although emotional violence cuts across cultures and social classes, it is important to make a distinction between the experience in the developing and developed world. In the developing world, emotional violence is more pervasive at the societal level (in addition to the private sphere) and more accepted as a normal part of life. In the developed world, with its emphasis on individual dignity and rights, it is more likely to be a private individual issue and perceived by others as wrong or immoral. The concept of emotional violence is perceived as related to legal concepts of bullying and hate crimes that are incorporated into the legislation

of most Western countries. However, the health consequences are consistent across cultures. They include depression, difficulty working or performing daily activities, pain, psychosomatic pain and therefore increased consumption of pain killers, loss of memory and difficulty concentrating, difficulty sleeping, sexually transmitted diseases and unwanted pregnancy, and loss of self-esteem sometimes leading to suicidal thoughtsviii that are sometimes acted upon.ix At the international level, there is a legal basis for tackling the problem of emotional violence against women. The United Nations has called violence against women in general [p]erhaps the most pervasive human rights violation that we know today,x and has many programs committed to fighting it. Moreover, under Art. 2 of its constitution, the World Health Organization is charged with foster[ing] activities in the field of mental health, especially those affecting harmony of human relations and assist[ing] in developing an informed public opinion. As a result, the WHO has identified addressing gender-based violence, as key to achieving the Millennium Development goals, and specifically includes emotional violence in its definition of violence against women.xi The fight against gender-based violence, including emotional violence, promotes MDGs 1 and 2 (eradicating extreme poverty and hunger, achieving universal primary education) by facilitating the access of women to education and remunerated work free from intimidation and fear. MDGs 3 and 4 (promoting gender equality and empowering women, reducing child mortality and improving maternal care) are also tied to freedom from emotional violence, as few things are more disempowering than intimidation and fear. Moreover, it has been demonstrated that the health of the mother including her

emotional health correlates positively with infant health. In addition, freedom from emotional violence will also promote MDG 4 (fight against infectious disease) by giving women more control over their sexual activity (crucial for AIDS) and access to education about prophylaxis for all infectious diseases. Emotional violence has been definitively identified as an issue of global concern, and is increasingly being mentioned in domestic and international legal instruments as a scourge to be fought,xii yet there is no agreed-upon definition and no completely reliable epidemiological data.xiii Even in the United States, emotional violence has been described but not defined.xiv Current descriptions center around the actions of the perpetrator rather than focusing more precisely on the effect on the victim. This legal lacuna is somewhat surprising, as there is legal precedent for definition and punishment of purely non-physical conduct in the form of the old tort of intentional infliction of emotional distress. Only one country, Dr Hirigoyens France, has created a legal definition of emotional violence that is victim-effect centered and put its weight behind enforcement of its international and domestic human rights commitments by criminalizing emotional violence in intimate relationships. Loi No. 2010-769 of 9 July 2010 defined emotional violence as repeated acts that can include words or other actions, degradation of life conditions, that bring about alteration of physical or mental health. Persons convicted of this crime face fines of up to 75,000 Euro, stays in prison of up to 5 years, and wearing of a monitoring bracelet. Perhaps the French law and its associated public education campaign will act as a model for effective action in the rest of the world after enough time has passed to gauge their effectiveness. In any

event, the right time has come for the global community to move the issue of emotional violence to the front of the development and public health agendas.

The emotional abuse of an upper-class woman by her husband in order to gain access to her fortune shown in that motion picture has made the word gaslighting in psychiatry synonym with a certain type of emotional abuse consisting of convincing the victim the he or she is losing their mind by altering the reality around them in order to convince him or her that he or she has committed/not committed certain acts when the opposite is true. Or physical injury itself, as it is rare that physical injury is inflicted without some degree of accompanying intimidation and humiliation of the victim.
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In fact, the number one risk factor for being a victim of emotional violence remains being female.

According to Dr Hirigoyen, destruction of the will and personality of the victim occurs in phases. In the first taking hold phase, the abuser gains control of the victim, often by appearing helpful and friendly. The second phase, destroying any initiative by the victim, is followed by a third phase of denying meaningful contact to the victim. Latent ill-will and hostility follow, escalating to overt hostility. The cycle is then perpetuated by moving down to the children.
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Cyberabuse can take many forms, from hacking into a persons email to impersonating them on social sites in order to discredit them or cause them harm up to cyberrape. There are at least 2 forms of cyberrape: in one, a participant in a chat room is raped by other participants. (see, e.g., http://www.terry.uga.edu/~dawndba/4500CyberRape.html (last visited Nov. 30 2010), in another, video clips of an actual rape are sent to victims as a form of intimidation http://www.asafeworldforwomen.org/in-the-news/412-digitised-dishonour-cyber-rape-inpakistan-.html (last visited Nov. 30, 2010)
v

Violence against Women Facts and Figures, http://www.unifem.org/attachments/gender_issues/violence_against_women/facts_figures_violenc e_against_women_2007.pdf (last visited Nov. 30, 2010)
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Being unmarried as opposed to being unmated. By and large the most likely perpetrator of emotional violence is ones intimate partner, but partners in irregular situations appear to be more at risk than spouses. See e.g., Marianne Flury, Elisabeth Nyberg, Anita Riecher-Roessler, Domestic Violence Against Women: Definitions, Epidemiology, Risk Factors and Consequences, http://www.smw.ch/index.php?id=smw-2010-13099 (last visited Nov. 30 2010)
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See, e.g. Mieko Yoshihama, Julie Horrocks and Saori Kamano, The Role of Emotional Abuse in Intimate Partner Violence and Health Among Women in Yokohama, Japan, http://ajph.aphapublications.org/cgi/content/full/99/4/647
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See Burning Desperation, http://video.nytimes.com/video/2010/11/07/world/1248069290784/burningdesperation.html?emc=eta1; Alissa Rubin, For Afghan Wives, a Desperate, Fiery Way Out, New York Times, November 8 2010, http://www.nytimes.com/2010/11/08/world/asia/08burn.html?emc=eta1
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Violence against Women Facts and Figures, http://www.unifem.org/attachments/gender_issues/violence_against_women/facts_figures_violenc e_against_women_2007.pdf (last visited Nov. 30, 2010)
x

Addressing violence against women and achieving the Millenium Development Goals, World Health Organization WHO/FHC/GWH/05.1 (2005) http://www.who.int/gender/documents/women_MDGs_report/en/index13.html
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See, e.g. the UN Declaration on the Elimination of Violence Against Women, http://www.un.org/documents/ga/res/48/a48r104.htm; International Violence Against Women Act of 2010 , HR 4594
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For example, The Lancet mentions the prevalence of emotional violence as ranging between 9% to 70%. Emotional abuse: a neglected dimension of partner violence. www.thelancet.com vol 376 September 11, 2010
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For example, Psychological/emotional violence involves trauma to the victim caused by acts, threats of acts, or coercive tactics. Psychological/emotional abuse can include, but is not limited to, humiliating the victim, controlling what the victim can and cannot do, withholding information from the victim, deliberately doing something to make the victim feel diminished or embarrassed, isolating the victim from friends and family, and denying the victim access to money or other basic resources (CDC, 2007). United States Department of Health and Human Services. Centers for Disease Control and Prevention. Intimate partner violence: Overview. Retrieved on June 28, 2007, from: http://www.cdc.gov/ncipc/factsheets/ipvoverview.htm.
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