Physical Abuse, Sexual Abuse, or Rape

Topic Overview

Violence can happen to anyone. You are not to blame. No matter what you did, violence against you is never okay. Violent people usually have many problems that they find hard to deal with, and this can cause them to act out with violence.

Violent behavior can include rape, attempted rape, any forced sexual contact, and physical abuse. The act of violence may come from a stranger, acquaintance, or from a close friend or family member. Many victims of violence know their attacker.

Violent behavior can also hurt you emotionally. You may feel sad or frightened. Feelings of guilt may prevent you from getting help. But it is important for you to seek help and continue to get help for yourself as long as you need it. Talk to your local child or adult protective agency, the police, or a health professional, such as a doctor, nurse, or counselor. You can also call a local rape crisis center or a local mental health clinic. Any of these people can help you deal with your feelings, get medical treatment if needed, and take steps to stop the abuser.

Domestic violence

Domestic violence is different from an occasional argument—it is a pattern of abusive behavior that one person uses to control another person. Anger and arguments are normal parts of healthy relationships. However, anger that leads to threats or violence, such as hitting or hurting, is not normal or healthy. Physical, verbal, or sexual abuse is not an acceptable part of any relationship.

Domestic violence is very damaging, both physically and emotionally. The violent behavior often begins with verbal threats or relatively minor incidents, but over time it can involve physical harm. You are more likely to have a long-term health problem from the injuries and stress of living in a violent relationship.

Both men and women experience domestic violence (intimate partner violence). It is a common form of violent behavior and is a major problem in the United States. Each year an estimated 1.5 million women are physically or sexually abused by an intimate partner. Approximately 25% of women in the United States will experience partner violence at some time during their lives.

Call the National Domestic Violence Hotline (1-800-799-7233) for free, confidential counseling.

Children and violence

Child abuse and neglect (also called child maltreatment) includes any act that harms a child.

Children who are maltreated may suffer in many ways. Young children are at special risk. They may not grow properly, or they may have learning problems. They may feel bad about themselves and not trust other people. They may be scared or angry. Abuse that continues over a long time may cause more severe physical and emotional problems.

Children are not able to understand that abuse or neglect is not their fault. They may think that they did something wrong and deserve what happened. It is up to adults who care to protect them. If you know about or suspect child abuse or neglect, there are ways you can help.

• If you are a child or teen who is being abused, don't keep the secret. Tell someone who can make a difference—a trusted family member, teacher, counselor, or doctor. You do not deserve to be abused.
• If you think a child is being abused or neglected, call the police or local child protective services. If a child is in immediate danger or has been badly injured, call 911 or other emergency services.
  • Physical abuse includes hitting, kicking, shaking, pinching, and burning. It may leave bruises, cuts, or other marks and cause pain, broken bones, or internal injuries. It is often the easiest type of abuse to notice.
  • Emotional abuse is saying or doing things that make a child feel unloved, unwanted, unsafe, or worthless. It can range from yelling and threatening to ignoring the child and not giving love and support. It may not leave scars you can see, but the damage to a child is just as real.
  • Sexual abuse is any sexual contact between an adult and a child or between an older child and a younger child. Showing pornography to a child is a type of sexual abuse.
  • Neglect means that a child is not getting the shelter, schooling, clothing, medical care, or protection he or she needs. Child neglect is just as serious as child abuse and is even more common.

Violence causes more injury and death in children, teenagers, and young adults than infectious disease, cancer, or birth defects. Murder, suicide, and violent injury are the leading causes of death in children.

Elder abuse

Elder abuse refers to any of several forms of maltreatment of an older person by a caregiver, family member, spouse, or friend. It can include:

• Hitting, beating, pushing, shoving, shaking, slapping, kicking, pinching, and burning. The inappropriate use of medicines or physical restraints, force-feeding, and physical punishment of any kind also are examples of physical abuse.
• Forced sexual contact or sexual contact with a person who is not capable of giving consent. This includes unwanted touching and all types of sexual assault or battery, such as rape, sodomy, forced nudity, and sexually explicit photography.
• Emotional abuse, such as name-calling, insults, threats, intimidation, humiliation, and harassment.
• Neglect, such as failing to provide an older person with food, clothing, personal shelter, or other essentials, such as medical care or medicines or needed medical devices, such as dentures, a walker, or a commode.
• Abandonment or desertion of an older person by the person who is physically or legally responsible for providing care.
• Illegal or improper use of an older person's funds, property, or assets. This includes forging an older person's signature, stealing money or possessions, or tricking an older person into signing documents that transfer funds, property, or assets.

If you are an older adult who is being abused, don't keep the secret. Tell someone who can make a difference—a trusted family member, teacher, counselor, doctor, or the police or the local adult protective services. You do not deserve to be abused.

Review the Emergencies and Check Your Symptoms sections to determine if and when you need to see a health professional.

Emergencies

Do you have any of the following symptoms that require emergency treatment? Call 911 or other emergency services immediately.

• You think you are in immediate physical danger.
• You or someone else has just been physically abused or raped.
• You have been physically hurt and do not have someone who can safely take you to emergency care.

Check Your Symptoms

If you answer yes to any of the following questions, click on the "Yes" in front of the question for information about how soon to see a health professional.

Review risk factors that may increase your chance of becoming a victim of violent behavior.

If you have:

• Been abused by your partner: Go to the topic Domestic Abuse.
• Problems with anger: Go to the topic Anger, Hostility, and Violent Behavior.

Yes

Has someone hurt you?

See significance of abuse if you need information to help you answer the question below.

Review risk factors that may increase your chance of becoming a victim of violent behavior.

Note:

In some situations, it may be better to call 911 or the police to get the help you need.

Call your health professional immediately if you answer "Yes" to the following question.

Yes

Do you have an injury from physical abuse?

If you have answered "No" to the above questions, go back to Check Your Symptoms and continue to answer the questions to evaluate your symptoms.

Yes

Has someone in your family been hurt?

See significance of abuse if you need information to help you answer the questions below.

Review risk factors that may increase your chance of becoming a victim of violent behavior.

Note:

In some situations, it may be better to call 911 or the police to get the help your family member needs.

Call your health professional immediately if you answer "Yes" to any of the following questions.

Yes

Does your child have an injury from physical abuse?

Yes

Does a family member have an injury from physical abuse?

If you have answered "No" to the above questions, go back to Check Your Symptoms and continue to answer the questions to evaluate your symptoms.

Yes

Have you been sexually abused or raped?

See significance of sexual abuse or rape if you need information to help you answer the questions below.

Review risk factors that may increase your chance of becoming a victim of violent behavior.

Note:

In some situations, it may be better to call 911 or the police to get the help you need.

Call your health professional immediately if you answer "Yes" to any of the following questions.

Yes

Have you been raped?

Yes

Have you been sexually abused?

If you have answered "No" to the above questions, go back to Check Your Symptoms and continue to answer the questions to evaluate your symptoms.

Yes

Has a family member or friend been sexually abused or raped?

See significance of sexual abuse or rape if you need information to help you answer the questions below.

Review risk factors that may increase your chance of becoming a victim of violent behavior.

Note:

In some situations, it may be better to call 911 or the police to get the help your family member or friend needs.

Call your health professional immediately if you answer "Yes" to any of the following questions.

Yes

Do you think or know your child has been sexually abused or raped?

Yes

Do you think or know that a family member has been sexually abused or raped?

Yes

Do you think or know that a friend has been sexually abused or raped?

If you have answered "No" to the above questions, go back to Check Your Symptoms and continue to answer the questions to evaluate your symptoms.

Other Symptoms to Watch For

Even if there is not a physical injury, it is important to find help if you think abuse or neglect has occurred. If you are concerned about:

• Domestic abuse (intimate partner violence): call the National Domestic Violence Hotline to help you find resources in your area. Call the hotline toll-free: 1-800-799-7233.
• Child abuse and neglect: Call a local social service or mental health department. Many social service agencies involved with child abuse investigation also offer services to parents who need help with anger and stress. Agencies are listed in the phone book, usually under your state's Department of Social Services, Protective Services, Social and Rehabilitative Services, or Children and Family Services.
• Elder abuse: Call the National Directory of Hotlines and Crisis Intervention Centers for a referral to services offered in your area: 1-800-999-9999 or TDD 1-800-999-9915.

If you are concerned that a family member, friend, or coworker has a problem with violent behavior: Go to the topic Anger, Hostility, and Violent Behavior.

If a visit to a health professional is not needed immediately, see the Home Treatment section for self-care information.

Home Treatment

If you feel threatened, you must have a plan for dealing with a threatening situation. If a family member or someone else has threatened to harm you or your child, seek help:

• If you need immediate help, call 911 .
• Call the National Sexual Assault Hotline toll-free (1-800-656-4673) or the National Domestic Violence Hotline (1-800-799-7233) for free, confidential counseling.
• Tell someone: the police, a trusted friend, a spiritual advisor, or a health professional. If the incident occurred at work, contact your human resources department for help.
• Find local resources that can help in a crisis. Your local YMCA, police department, mental health clinic, or hospital has information on shelters and safe homes.
• Be alert to warning signs, such as threats or drunkenness, so that you can avoid a dangerous situation. If you cannot predict when violence may occur, have an exit plan for use in an emergency.
• If you have been raped:
  • Call the police immediately.
  • Remember the rape was not the your fault.
  • Find a safe environment—anywhere away from the attacker.
  • Preserve evidence of the attack—do not change clothes, eat, drink, smoke, bathe, brush teeth, or clean up in any way. Write down all the details about the attack and the attacker.
  • Get medical attention. Even with no physical injuries, it is important to determine the risk of sexually transmitted diseases (STDs) and pregnancy. To preserve evidence, ask the hospital to do a rape kit exam. If you think you may have been drugged, ask that a urine sample be taken.
  • Call the local or national rape crisis hotline for support, information, and advice. A counselor can help you through the process.
• If a child tells you he or she has been abused, stay calm. Tell the child that you believe him or her and that you will do your best to keep him or her safe. Report the abuse to the local police or child protective services agency.

If you are no longer living with a violent person, contact the police to obtain a restraining order if your abuser continues to pursue you and act violently toward you.

If you know someone who may be a victim of violent behavior

Here are some things you can do to help a friend or family member.

• Let your friend know you are willing to listen whenever she or he wants to talk. Don't confront your friend if she or he is not ready to talk. Encourage your friend to talk with her or his health professional, human resources manager, and supervisor to see what resources might be available.
• Tell your friend that the abuse is not her or his fault and that no one deserves to be abused. Remind your friend that violence is against the law and that help is available. Be understanding if she or he is unable to leave. She or he knows the situation best and when it is safest to leave.
• If your friend has children, gently point out that you are concerned that the violence is affecting them. Many people do not understand that their children are being harmed until someone else talks about this concern.
• Encourage and help your friend develop a safety plan. This plan will help keep your friend and her or his children safe during a violent incident, when preparing to leave, and after leaving.

The most important step is to help your friend contact local domestic violence groups. There are programs across the country that provide options for safety, legal support, support, and needed information and services. To find the nearest program:

• Call the National Domestic Violence Hotline at 1-800-799-7233.
• Call the National Center for Victims of Crime at 1-800-FYI-CALL (1-800-394-2255).
• See the National Coalition Against Domestic Violence's Web site at http://www.ncadv.org/resources/state.htm.

The most dangerous time for your friend may be when she or he is leaving the abusive relationship, so any advice about leaving must be informed and practical.

If you have been a victim of abuse and continue to have problems related to the abuse, you may have post-traumatic stress disorder (PTSD). For more information, see the topic Post-Traumatic Stress Disorder.

Symptoms to Watch For During Home Treatment

If violence occurs again, use the Emergencies and Check Your Symptoms sections to determine if and when you need to see your doctor.

Prevention

Violence is learned behavior, so it is especially important to help your children learn that violence is not a healthy way to resolve conflict. Living in a violent environment increases your child's chances of developing behavior problems, depression, anxiety, post-traumatic stress disorder, poor school achievement, and lowered expectations for the future. People who are maltreated as children are more likely to abuse others. If you were ever abused, it is very important to get treatment so you don't pass the cycle of abuse on to your children.

Keep yourself safe from violence.

• Be alert to warning signs, such as threats or drunkenness, so that you can avoid a dangerous situation. If you cannot predict when violence may occur, have an exit plan for use in an emergency.
• Learn how to recognize signs of violent behavior in your teenager.
• If you are no longer living with a violent person, contact the police to obtain a restraining order if your abuser continues to pursue you and act violently toward you.

Reduce your chance for sexual abuse.

• When you go to a party, go with a group of friends. Arrive together, watch out for each other, and leave together.
• Do not leave your beverage unattended or accept a drink from an open container.
• Be aware of your surroundings at all times.
• Do not allow yourself to be alone with someone you do not know or trust. Do not get a ride from someone you do not know.
• Think about how intimate you want to be in a relationship and clearly state your limits.

Reduce the chance of your child being sexually abused.

• Teach your children that it is against the "rules" for adults to act in a sexual way with children. Use examples.
• Teach your children that it is okay to say no and it is okay to leave the situation if they are uncomfortable.
• Teach your children that their bodies are their own and that it is okay if they do not want a hug or other contact that might make them uncomfortable.
• Speak to your children about using the proper names for their body parts. Informed children are better able to talk to you about someone acting in a sexual way with them.

Prevent violence in your home.

• Learn nonviolent ways to resolve conflicts. Arguing is fine, even healthy, as long as it does not turn violent. For more information on anger control, see the topic Anger, Hostility, and Violent Behavior.
• Give your children consistent love and attention.
• Teach your children that violence is not a solution. Settle arguments without yelling or hitting. Do not use physical discipline, such as spanking, pinching, ear pulling, jabbing, shoving, or choking. If you need help controlling your children, consider taking a course in parenting skills.
• Limit your child's exposure to TV, movies, and video games to no more than 1 to 2 hours per day.
  • Participate in healthy alternatives, such as sports, interactive play, and reading, with your child.
  • Watch television with your children to discuss or limit violent content.
  • Use a "V-chip" to filter broadcast programming.
  • Do not glamorize weapon carrying or use firearms in play.
• Prevent violence with firearms and other weapons. Do not provide your children or teenagers with unsupervised access to guns or other dangerous weapons.
  • Do not keep loaded firearms in your home.
  • If you must keep firearms in your home, unload them and lock them up. Lock ammunition in a separate place.
  • Do not keep firearms in a home where there is someone who has a drug or alcohol problem, is prone to violent behavior, or has threatened suicide.
  • Make sure that no one in your home will have access to firearms or other weapons unless they know how to use them safely.

Preparing For Your Appointment

To prepare for your appointment, see the topic Making the Most of Your Appointment

If you have made an appointment with your health professional, you may be able to get the most from your visit by being prepared to answer the following questions:

• Have you been hit, slapped, kicked, or otherwise physically hurt by someone?
• Has anyone forced you to have sexual activities?
• Have you ever been emotionally or physically abused by your partner or someone important to you?
• How long have you felt threatened by the violent behavior of someone else?
• Are you the victim of angry outbursts or violent actions?
• Do another person's violent outbursts occur at regularly spaced time periods?
• Has the abuse increased recently?
• What kind of injuries has the abuse caused?
• Does the abuser control most or all your activities every day?
• What triggers the abuser's violent behavior?
• Has the abuser threatened violence against your children? Is he or she violent toward your children?
• Has the abuser hurt a pet or destroyed things that belong to you?
• Is the person who harmed you using any illegal drugs or alcohol?
• Does the person who harmed you have access to guns or other violent weapons?
• Does your family have a history of violent behavior?
• Has anyone in your family ever been diagnosed with depression or a mental illness, such as bipolar disorder, schizophrenia, or personality disorder?
• Do you have any risk factors that increase your chance of becoming a victim of violent behavior?

Other Places To Get Help

Organization

Related Information

• Alcohol Abuse and Dependence
• Alcohol and Drug Problems
• Anger, Hostility, and Violent Behavior
• Anxiety
• Bullying
• Child Abuse and Neglect
• Domestic Abuse
• Domestic Violence
• Feeling Depressed
• Post-Traumatic Stress Disorder
• Suicidal Thoughts or Threats