1. Alcohol and family violence
Alcohol, Gambling and Family Violence Forum
for Local Government
22 March 2017
Ingrid Wilson, Research Fellow
Judith Lumley Centre , La Trobe University

2. Background Post-doctoral Research Fellow – La Trobe University
‘Tackling alcohol-related family violence – a multidisciplinary program to build strategies prevent and reduce domestic violence
Judith Lumley Centre (Prof Angela Taft)
Centre for Alcohol Policy Research (Prof Robin Room)
La Trobe Violence Against Women research Network (LaVAWN)
But firstly, let me start with some acknowledgements - my supervisors Professor Angela Taft - widely researched in the area of intimate partner violence and health care responses. And Dr Kate Graham from Canada who has conducted decades of research on gender, alcohol and violence.
And I also acknowledge sources of support.

3. Not all partner violence is alcohol-related
Alcohol is involved in a substantial proportion of partner violence
Involved in considerable proportion of IPV 60% Uganda – 35% Canada (Graham et al., 2011)

4. Alcohol-related family violence in Australia
Alcohol involved in between 23% and 65% of family violence incidents reported to police (Police data sources cited in FARE, 2015)
5 in 10 Australian women reported that alcohol or other drugs contributed to most recent incident of physical assault from a male (ANROWS, 2016 Additional analysis of ABS Personal Safety Survey, 2012)
Indigenous partner homicides 13 times more likely to involve alcohol than non-indigenous partner homicides (Dearden & Payne, 2009)
40% females experienced alcohol-related physical violence in intimate relationship compared with 11% of males
(AIHW, National Drug Strategy Household Survey)
A snapshot: data from different sources
– police stats (we know under report)
– Violence victimisation surveys
– Nationally representative drinking survey
Good consistent data is a problem
But shows alcohol is involved in considerable amount of IPV
50% of partner violence is alcohol-related; 73% physical assaults (Laslett et al., 2010)
Australian victimisation survey: 1 in 3 (35%) recent incidents were alcohol-related (Mouzos and Makkai, 2004)

5. Alcohol: a global risk factor for partner violence
Single country
studies: US
Brazil
Ukraine
Germany
New Zealand
Australia
Mongolia
Africa
India
Uganda
Women whose partners got drunk often, 6 times more likely to report partner violence
Multi-country studies
European Union
Prevalence of physical and/or sexual partner violence increases from 5% to 23% where partner gets drunk once or more times a month
(European Agency for Fundamental Human Rights, 2014)
Similarly studies across the global US studies - alcohol is involved in 25-50% of partner violence (Leonard, 2001)
Abramsky et al., 2011 – WHO Multi-country study of women’s health (11 countries HML income);
Hindin et al., 2008 – 10 low income countries;
Graham et al., 2011
Latin Americas
Uganda - Women whose partners got drunk often were 6 times more likely to report PIPV (95% CI: ) compared to those whose partners never drank alcohol.
Intersectionality - some groups more affected than others: lower socio-economic, indigenous, ethnic groups (Hispanic, black)
* Some groups more affected than others

6. Alcohol as a risk factor over the lifespan of intimate relationships – more critical in early relationships
(O’Leary & Woodin, 2005)
Adolescent, teen dating relationships (Niolon et al., 2015; Rothman et al., 2012)
College dating (Stappenbeck & Fromme, 2010)
Early marriage (Quigley & Leonard, 2000)
Pregnancy, postpartum and children (Helmuth et al., 2013; Salvi et al., 2014)
Established relationships - problem drinkers (Murphy & Ting, 2010; Wiseman, 1991)
O’Leary & Woodin, 2005 Cross-sectional analyses from nationally-representative samples demonstrate significant age-related trends in partner aggression and problem drinking. Both behaviors are most prevalent in the early to mid-twenties and increasingly less common thereafter.
Note Stappenbeck & Fromme - A longitudinal investigation of heavy drinking and physical dating violence – complex interaction of both genders drinking and violence. For men, heavy drinking and dating violence were concurrently associated during their freshman year (Year 1), whereas for women heavy drinking during their sophomore year (Year 2) predicted dating violence in their junior year (Year 3).
Salvi et al., study of pregnant women in tertiary hospital in India – with alcoholic husbands 4.65 times more likely to experience physical violence

7. “Alcohol may not cause partner violence but it seems to make things worse” (Graham et al., 2011)

8. Opportunities for intervention “The strong association between alcohol and intimate partner violence and sexual violence suggests that primary prevention interventions to reduce the harm caused by alcohol could potentially be effective.” (World Health Organization, 2010; p.53)

9. Living with a violent drinker – women’s experience
Fearing the “changed” man
Connecting drinking and violence over the relationship trajectory
Living the cycle of drinking and partner violence
Caveats – interviewed women who felt afraid when their partner drank. Aim to understand the experience.

10. Living the cycle of drinking and intimate partner violence
GETTING DRUNK
Baiting, blaming
Looking for a fight
Verbal abuse
STARTING
DRINKING
Sociable, fun, high
“life of the party”
CRAVING*
Build up
Restlessness
SOBER
Remorse
Denial
Silence
HUNGOVER*
Bad-tempered
Uncommunicative
DRUNK
Incapacitated
Passed out
INTOXICATED
“flip” “switch”
“crazy aggressive”
“in your face”
Physical abuse
threats
SAFE
UNSAFE
WORST
* Partners with more serious drinking problems
Recognising patterns
“Once he started drinking on a Friday night then Mr Happy would ... Mr Bouncy would come out again. But Mr Happy started turning into Mr Sarcastic and Mr Making Personal Remarks and ... and then being threatening and then, you know, hurting.” (Kath, 50 years)
So this is explaining the episode of drinking/violence

11. SAFE UNSAFE ANTICIPATING ABUSE SAFE WORST UNSAFE
Developing safety strategies
Preventing
Predicting
Responding
Protecting
Re-integrating
Pretending normality
Questioning her reality
SAFE
Protecting
Avoiding
Removing
SOBER
Remorse
Denial
Silence
Stopping his drinking
Preventing
Minimising triggers
Planning ahead
Disrupting routines
UNSAFE
HUNGOVER*
Bad-tempered
Uncommunicative
CRAVING*
Build up
Restlessness
ANTICIPATING ABUSE
Checking on his welfare
Returning home
Being the carer
SAFE
Remaining vigilant
Recognising signs
Seeing it coming
Treading carefully
Predicting
DRUNK
Incapacitated
Passed out
STARTING
DRINKING
Sociable, fun, high
“life of the party”
“when he was drunk I would just try not to argue with him because I knew that it would never end well if I argued. The only - the way I stopped it was if I just shut up.” (Linda, 42 years)
INTOXICATED
“flip” “switch”
“crazy aggressive”
“in your face”
Physical abuse
threats
Avoiding/removing
De-escalating
Protecting
Locking down
Seeking help
Responding
Fighting back
Reacting
Defending self
GETTING DRUNK
Baiting, blaming
Looking for a fight
Verbal abuse
WORST
UNSAFE
Tactical compliance
Avoiding arguments
Being compliant
Disengaging
So this is explaining the episode of drinking/violence

12. Connecting drinking and violence over the relationship trajectory

13. (dis)missing early warning signs
“I think at the start… when he’s around another group of, like, another six boys who were drinking just as heavily, you don’t flag it… and it’s always out to have a good time…” (Simone, 28 years)
“I didn’t see it as a problem because I just thought that was normal… We’d go out together and there’d be perhaps a group of us, and then the girls would go home and the boys would just continue on, and often he’d get home at 5am or even midday the next day… it didn’t really concern me because I knew he wasn’t cheating…” (Belinda, 35 years)
Red flags – excessive drinking; excessive anger;
Normalised drinking; defining normal drinking; conforming to relationship rules;

14. Realising problems and identifying patterns (experiencing the cycle)
“I think a few months into the marriage… I started noticing he had alcohol issues … And initially he never was abusive when he was drinking — he’ll just drink, pass out, go to sleep… but eventually I started getting frustrated, and I started questioning why, and that’s when he started becoming a little bit more abusive…” (Sarita, 28 years)
Others – drinking/aggression context-based
Others – particular scenario giving rise to jealousy.
Impact of drinking came to be felt – financially, emotionally. Questioning his drinking often a catalyst for abuse; several women the drinking and violence escalated after children.

15. ‘Fixing’ his drinking to stop the abuse
Private actions: pouring out alcohol, creating home as a dry zone, limiting drinking occasions, informal control
Help seeking: GPs, mental health, relationship counsellors, drug and alcohol
Women question selves first. In face of denial of problems; women were blamed

16. Managing daily life around the drinking and abuse
Maintaining normality
Managing safety
Keeping it hidden
Distancing
“Once the alcohol kicked in then you’ve only got a small window… where you could talk to him about things where he wouldn’t get defensive… (Fran, 46 years)

17. Caring as dangerous work
“Whenever I used to go over, I used to hide my handbag… I’d always make sure I had my keys on me, I was very strategic because you never knew when something might shift. I was very mindful of my safety and I always kept a couple of metres away.”
(Geraldine, 48 years)

18. Leaving … and ongoing impact
Waiting for the day
“Five years now on, and I’m still waiting for the moment when he will become drunk and angry … we are the damaged goods (laughs)” (Carla, 43 years, speaking of her new relationship)
Resetting normal
De-sensitising around alcohol
Negotiating non-violence in new relationships
Enduring impact
“I get sort of a trauma reaction if people were drinking too much around me so I don’t tend to socialise much in that area.” (Anne-Marie, 45 years)

19. The culture of men’s drinking
“You’re never going to stop people drinking because it’s freely available. They’re never going to say, ‘You can’t come into this pub because you physically assaulted your wife.’ That’s never going to happen (laughs). Because those men in there, half of them probably do it too, and it’s their culture. It’s normal. It’s just normal to drink and look the other way.”
(Linda, 42 years)

20. Conclusions and Implications for Local Government
Key message: Partner alcohol use may not cause violence but it disempowers women in their lives – “the mere threat to go drinking acquires the power that a raised stick would have.” (Room, 1980)
Liquor Control Reform
B. Municipal Health Plans
Connect alcohol strategies with PVAW strategies = reducing the potency of a known and modifiable risk factor
Reflect gendered nature of drinking AND family violence
Change norms that promote excessive drinking AND disrespectful attitudes towards women

21. Twitter @ingridmwilson
Thank you
Wilson IM, Graham K, & Taft A. (2014). Alcohol interventions, alcohol policy and intimate partner violence: a systematic review. BMC Public Health, 14(1), 881. doi: /
Wilson IM, Graham K, & Taft A. (2017). Living the cycle of drinking and violence: A qualitative study of women's experience of alcohol-related intimate partner violence. Drug and Alcohol Review, 36(1); doi: /dar.12405
Graham K, Wilson I, Taft A. (2017). The broader context of preventing alcohol-related intimate partner violence. Drug and Alcohol Review, 36(1) doi: /dar
Twitter @ingridmwilson