© British Association of Social Workers
Victims of Personal Violence: The Relevance of Symonds' Model of Psychological Response and Loss-Theory
Jonathan Shepherd is Consultant and Reader in Oral and Maxillofacial Surgery. University of Bristol Dental Hospital and the Bristol Royal Infirmary. He is the author of papers on surgical, criminologic, socio-economic and forensic aspects of inner-city violence—now the most frequent cause of serious facial injury in Britain.
Correspondence to Dr J. P. Shepherd, University Department of Oral Medicine, Surgery and Pathology, Bristol Dental School and Hospital, Lower Maudlin Street, Bristol BS12LY.
Summary
Response to personal violence is explored through a randomized case study of 40 injured victims who attended an inner-city Accident and Emergency Department. Accounts of the assaults were characterized by initial helplessness and bewilderment. Victims with no history of previous violence experienced the most marked symptoms of loss, whilst victims with a history of repeated violence were less affected. The latter group, whether ‘battered wives’ or habitual street-fighters, could not easily be fitted into the Symonds model of response to violence and telescoping or apparent absence of his classic stages were apparent. A typical ‘mourning’ process was evident in the former group, the duration of which was linked with levels of emotional support from partners and parents, and with chronic physical symptoms such as facial numbness and scarring. Behavioural changes were apparent in two-thirds of victims six months after assault, particularly the avoidance of locations of violence. At six months, resolution of distress was incomplete in one quarter of victims. Victim support agencies should seek to supplement and encourage support in the family setting, and also provide the emotional support which is lacking in Accident and Emergency Department waiting and treatment areas.
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