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It is rare for women to kill their abusers, but when they do, it is probably not planned. It is often a self-defence response or a way to protect their children. Few cases involve premeditated retaliation.
Dr. Ryan Hall highlighted what forensic mental health professionals need to know about the perpetrators and victims of intimate partner violence (IPV), whether male or female. It was all part of his presentation during the International Forensic Psychiatry Lecture Series. (You can watch a recording of his March 6, 2025, lecture online.) As is always the case in forensics, the fact pattern of each case is often unique, and the following statements should be seen as general information.
AI-generated image, Google Gemini
The Abuse
Abuse can be physical, sexual, psychological and emotional — including deprivation, neglect, or verbal — or stalking. About half of stalking cases involve a current or former romantic partner. Abuse tends to get progressively worse, increasingly frequent, and life threatening.
Unlike the American Medical Association’s guidance for child or elder abuse, clinicians should not report IPV to the police. Not only are victims competent adults, but calling the police may cause them to instinctively protect their abusive partner and set up a distorted relationship dynamic, such as Stockholm syndrome.
“Maybe a lot like substance abuse, you want to start the discussion. How do we go from pre-contemplative to contemplative to action stage, and getting out of a bad relationship?” Dr. Hall said.
He also suggested clinicians not suggest couples therapy right away, even if the victim has called police.
“You want six months of individual therapy or counselling for both partners separately. See that certain benchmarks or guides are being met, like going to anger management, having put in enough actual behaviour to justify moving on to the couple section, because otherwise you’re just setting up for more frequent episodes of violence and potential escalation of the problems, not the resolution of it.”
The Perpetrator
Perpetrators of IPV can be jealous, paranoid, physically and emotionally controlling, impulsive, and often have low self-esteem, anger, and depression. They depend on their partner for love, support, intimacy, and problem-solving, and often make promises they do not keep.
The Johnson Typology of Violence considers two types of IPV: situational violence and coercive control.
Situational violence is used in specific conflicts and is not part of a larger control agenda. It is part of an escalating pattern of conflict that gets out of hand with one or both partners using physical aggression. It is the most common pattern seen in couples’ therapy.
Coercive controlling involves domination in all aspects of a partner’s life, with violence as the main tactic. Other tactics include isolation, blaming for the situation, accusations of cheating, name-calling, explicit threats, and implication of complicity.
Men are more likely to use severe violence, like strangling or beating. Women are more likely to slap, kick, bite, punch, throw something (like an ashtray or TV remote), or hit with something (like a broom or wrench).
The Victim
Victims of IPV typically have low self-esteem, believe they cannot make it on their own, feel powerless and hopeless, and may use alcohol or drugs. They often distrust other people and feel guilty about the abuse. Many have depression, with bipolar disorder, anxiety, and post-traumatic stress disorder also being common.
They may stay out of fear of more abuse or not being believed. They may stay for economic or religious reasons.
Not being believed is a real concern, even in the criminal justice system. Victims can be seen as having done something to anger the perpetrator. Traditional gender roles suggest that mothers must protect their children, so they could be seen as being complicit if a child is also being abused.
Strong female judges may have negative views of female victims who appear passive or weak. In 2016, a Florida judge was publicly reprimanded for belittling an IPV victim.
Clinicians need to know that victims of IPV seek medical attention eight times more often than people who are not abused. However, 92% of victims do not voluntarily report abuse to medical staff. Women who are abused expect their doctors to start discussions about abuse, and they will usually respond if they are asked in direct, empathetic, and nonjudgmental ways.
Nearly 60% of female IPV victims reported using some form of mild violence against their male partners, with 55% using some form of severe violence.
Domestic Homicide
Roughly one in two female murder victims and one in 13 male murder victims are killed by their intimate partners. About 70% of female domestic homicides happen after the victim leaves the perpetrator, often in the first three days.
When women do attack their abusers, they are usually younger than 30 years old and have an older common-law partner.
Many fights start or end in the kitchen, so about half of these women impulsively use a knife as a conveniently available weapon.
Written by Virginia St-Denis and approved by Dr. Ryan Hall.
