Brainwashing and battering fatigue. Psychological abuse in domestic violence.

Intimate partner violence occurs often in the United States; it involves an interrelated combination of physical, sexual, and psychological abuse, usually directed against women. The psychological aspect deserves special attention because victims who lose their independence, self-esteem, and dignity tend to remain in abusive situations. The abuse is perpetrated by a domestic partner to maintain power and control in the relationship. To assert control, the abuser uses "brainwashing tactics" similar to those used on prisoners of war, hostages, or members of a cult. Common features of brainwashing include isolation, humiliation, accusation, and unpredictable attacks. The abusive environment produces real and anticipated fear, which contributes to the battered woman's belief that her situation is hopeless and that she must depend on her abuser. She develops coping strategies to deal with her oppressive environment, but eventually exhibits symptoms of "battering fatigue," similar to the battle fatigue of soldiers in combat who, like battered women, live in fear of being killed or severely injured. Recognizing the state of mind of these women can help us understand why it is difficult for them to flee their traumatic environment and why they may resort to suicide or homicide. For healthcare providers to screen and treat their patients adequately, it is imperative that they appreciate the complex and devastating psychological aspects of domestic violence.

Textbooks and software used to teach behavioral science and clinical psychiatry to medical students.

The authors discuss the results of a questionnaire sent to medical schools to assess textbooks and computer software used in teaching behavioral science and clinical psychiatry. Attributes concerning presentation, theoretical viewpoints, and topics covered were rated by 75 respondents. Certain texts emerged as frequently used. Although the books rated will become outdated, consumers can use the assessment attributes from the questionnaire to examine forthcoming texts. Authors considering new books or revisions may want to know why certain books are popular and to address areas identified as weak in existing textbooks. The software market needs entrees.

Incest and physician responsibility.

This paper examines the epidemiologic, psychologic, and clinical aspects of incest, and emphasizes the need for action by physicians. The apparent increase in the incidence of this emotionally damaging experience makes it essential for the physician to understand the dynamics of incest, individually and in the family, so as to be prepared to meet the needs of the patient and the community. This paper stresses the responsibility of the physician in the intervention of the immediate trauma and in the prevention of its continuation or recurrence. Ways in which the physician, because of his close contact with the family, may fill this role are discussed.