The lived experiences of intimate partner violence in Iranian women staying with their abusive partners

Abstract

Background

Intimate partner violence (IPV) has severe physical and mental complications; however, some women stay in abusive relationships. There is little in-depth qualitative work on the experiences of IPV in Iranian women staying with their abusive partners. In this study, we aim to explore the lived experiences of IPV in Iranian women with a history of remaining in abusive relationships in order to help identify the factors related to their decision to stay with their abusive partners.

Methods

This is a qualitative study that was conducted in 2021–2022. Twelve married women living in Tehran city, who had a history of staying with their abusive partners for at least two years were sampled purposefully (after reaching data saturation) and interviewed. The content analysis was conducted using Colaizzi’s seven-step method.

Results

The results led to the extraction of five themes including psychological factors (psychological entrapment, depression, fear of loneliness, conflicting feelings, PTSD, fear of life-threatening danger, low self-esteem, learned helplessness), relational factors (repeat of violence, return of violence, emotional divorce, presence of children), family-related factors (parents as role model, bad relationship with parents, escape from family, lack of family support), socioeconomic factors (social stigma, social isolation, lack of proper mental health services, financial dependence, inefficient criminal justice system, lack of support from governmental organizations), and attitudinal factors (justifying violence, faking happiness, lack of awareness, shame, hope for change).

Conclusion

Different psychological, relational, family-related, socioeconomic, and attitudinal factors affect Iranian women’s decision to stay with their abusive partners. Policymakers and decision-makers in Iran should focus on empowering these women, especially those who are the victims of IPV, and consider ways to develop policies that support them in all areas.

Introduction

Intimate partner violence (IPV) is an important health concern worldwide. The World Health Organization defines IPV as “behaviour by an intimate partner or ex-partner that causes physical, sexual or psychological harm, including physical aggression, sexual coercion, psychological abuse, and controlling behaviours” [1]. The prevalence of lifetime IPV ranges from 20% in the Western Pacific, 22% in high-income countries and Europe and 25% in the American countries to 33% in the African countries, 31% in the Eastern Mediterranean Region, and 33% in the South-East Asia [1]. According to the World Bank data, more than 1 in 4 women (26%) aged ≥ 15 years have suffered IPV at least once [2]. In Iran, a systematic review study in 2016 estimated the prevalence of domestic violence against women as 66%. Geographical classification revealed that the prevalence varied from 59% in the center to 75% in the west of Iran [3]. A study in 2019 showed that 98.8% of housekeeper women living in Qom, a religious city in the center of Iran, were exposed to at least one type of IPV (verbal, psychological, physical, financial, and sexual) [4]. Another study reported that the annual prevalence of psychological, physical and sexual violence against women of reproductive age in southeast of Iran were 60.9%, 34.7%, and 37.7%, respectively [5]. Although IPV is highly prevalent, few reports exist on its occurrence. Most victimized women choose not to disclose IPV and consider it as a private affair and keep it as a secret [6]; they has a belief that disclosing violence is a sign of disloyalty and have a fear of retaliation by the abusive partner [7].

IPV has severe physical and mental health consequences for women such as depression, post-traumatic stress disorder (PTSD), substance abuse, suicide ideation, and cardiovascular, gynecological, digestive problems [8,9,10,11]; however, some women often remain in abusive relationships despite being at risk of these consequences. The reasons can be due to financial, social, emotional, cultural, and legal factors [12]. Leaving can be both practically and emotionally difficult for them and they may have a feeling of being trapped [13]. IPV can lead to job instability, homelessness, and social isolation in women [14, 15]. Female victims may have hope that their abusive partner will change their behavior [16]. Having children can also be a barrier to leaving since women may have fear of losing custody [17] or because they are concerned about the wellbeing of their children [18]. Depression and low self-esteem can also reduce the chance of leaving [19]. Furthermore, women from traditional less-developed or developing countries such as Iran (with beliefs against divorce and separation) choose to stay with their abusive partners to avoid bringing shame on their families or ostracization [20], or because their relationships met their other important needs, including the desire for respect and dignity [21].

Although prevalence and causal factors of domestic violence against women have been reported quantitatively, and the reasons for remaining in abusive relationships have been discussed in previous studies conducted in different countries, there is little in-depth qualitative study on the experiences of IPV in women staying with their abusive partners. On the other hand, understanding what reasons IPV victims give to decide to stay in abusive relationships may help counselors and professionals adequately support victims and empower them to become free from violence [22]. To our knowledge, there is no qualitative study on Iranian women’s experiences of IPV endurance. Considering this gap, this novel qualitative study aimed to explore the lived experiences of IPV in Iranian women with a history of staying in abusive relationships to gain deeper understanding of their feelings and perceptions. By this approach, the results can help identify the factors that have a role in Iranian women’s decision to stay with their abusive partner.

Methods

This is a qualitative study that was conducted in 2021–2022. Participants were married women in Tehran, Iran, who had a history of staying with their abusive partners for at least two years. Considering the sensitivity of the topic and the difficulty in identifying abused women, three Iranian women activists (living abroad, having high number of followers in Instagram, and high activity in the related field) volunteered to help us with finding samples. They posted a story on Instagram and invited abused women living in Iran. Sampling was done purposefully from among volunteers. Sixteen women met the inclusion criteria (willingness to share their lived experiences, living in Tehran, having cognitive literacy [diagnosed by asking the questions about their other lived experiences and how they reflect them or by assessing how they give feedback to the told stories about IPV], being married, divorced, or separated, suffering from IPV according to self-report, and living with abusive partners for at least two years). The sample size was determined 12 after reaching data saturation.

To collect data, in-depth semi-structured interviews with 7 open-ended questions were used. Before the interviews, informed consent was obtained from the participants. They were informed of the sensitive nature of the interview content and given the freedom to leave the study at any stage of the interview. We also ensured the confidentiality of their information. Face-to-face interviews were conducted in a clinic in Tehran (except for one participant, which was conducted by video calling on WhatsApp due to commuting problems). The interview started with questions surveying demographic characteristics (age, occupation, educational level, duration of marriage, number of children). The next questions included: 1- What does “living with an abusive partner” mean to you? 2- What is your perception of IPV tolerance? 3- Tell us about your experiences as a woman exposed to IPV, 4- How staying with your abusive partner affected your daily life? 5- How do you feel about staying with your abusive partner? 6- What opportunities did you miss due to staying with your abusive partner? 7- How staying with your abusive partner affected your other relationships? At the end of interview, a cash gift card was provided to the women as compensation for their commute to the clinic for interview.

The content analysis was conducted using Colaizzi’s seven-step method [23]. In the first step, the interview transcripts were read and reread for familiarization with the data and obtain a general send of the whole content. In the second step, key statements that pertain to the phenomenon (the statements made by a participant that are directly related to her experience of the phenomenon) were identified. We attached a number to the participant to preserve anonymity. In the third step, formulated meanings were extracted from the key statements. In the fourth step, the formulated meanings were read carefully and divided into clusters based on the term similarity. In the fifth step, to develop exhaustive description of the phenomenon, clusters of themes and sub-themes were created. Two authors prepared the themes. In case of disagreement, the dispute was resolved by the third author. In the sixth step, a description of fundamental structure of the phenomenon was generated after a rigorous analysis and removal of extraneous information. In the final step, the findings were shared with the participants to ask if they agree with the results and if they have any additional comments. They all were agreed.

To assess the trustworthiness of the data, Lincoln and Guba’s four criteria were used, which included credibility, achieved through extended involvement, persistent observation, and triangulation; transferability, achieved through comprehensive and detailed explanations; dependability, achieved through rigorous documentation and the creation of an audit trail; and confirmability, achieved through peer debriefing, member checking, and reflexive journaling.

Results

Characteristics of participants

Table 1 presents the sociodemographic characteristics of 12 married women participated in this study (6 were still living with their abusive partners, 3 were divorced, one was separated and living in her father’s house, 2 were on the verge of divorce). As can be seen, the age of participants ranged from 24 to 55 years (Mean = 35.8 years) and their marriage duration ranged from 2 to 34 years. Most of them had an academic degree (n = 11) with no children (n = 7), and were housekeeper (n = 8). Most of the women had experienced emotional abuse (n = 12) and coercive control (n = 10) from their partners. The frequencies of physical and sexual abuses were lower (n = 4 and 2, respectively).

Table 1 Sociodemographic characteristics and the IPV types for each participant

Identified themes

We extracted five main themes and 27 thematic clusters contributed to lived experiences of Iranian women staying with their abusive partners. The themes included psychological, relational, family-related, community, and attitudinal factors. Tables 2, 3, 4, 5 and 6 show how we constructed thematic clusters and aggregated them to establish these five main themes.

Table 2 Constructing the theme clusters of psychological factors

Table 3 Constructing the theme clusters of relational factors

Table 4 Constructing the theme clusters of family-related factors

Table 5 Constructing the theme clusters of socioeconomic factors

Table 6 Constructing the theme clusters of attitudinal factors

Discussion

The purpose of this novel qualitative study was to survey the lived experiences of female victims of IPV in Iran who were staying with their abusive partners. We identified five main themes of (1) psychological factors (with sub-themes of psychological entrapment, depression, fear of loneliness, conflicting feelings, PTSD, fear of life-threatening danger, low self-esteem, and learned helplessness), (2) relational factors (with sub-themes of repeat of violence, return of violence, emotional divorce, and presence of children), (3) Family-related factors (with sub-themes of parents as role model, bad relationship with parents, escape from family, lack of family support), (4) Socioeconomic factors (with sub-themes of social stigma, social isolation, lack of proper mental health services, financial dependence, inefficient criminal justice system, and lack of support from governmental organizations), and (5) attitudinal factors (with sub-themes of justifying violence, faking happiness, lack of awareness, shame, and hope for change).

Psychological factors

The results of the interviews showed that the psychological state of the female victims had an impact on their experience of enduring IPV. Beating and humiliation by the abusive partner cause PTSD decreased self-esteem, and depression in women, which can make them unable to think correctly and make timely decisions. The participants reported that when they wanted a divorce, their abusive partners threatened them mentally or physically. This fear of life-threatening danger led to staying with their partners. Many women reported a sense of “entrapment” in their relationships. They gave up their educational, occupational and social needs and made sacrifices and much effort. They were worried that if they divorced, they would lose everything they had already invested in the relationship. As a result, they tried to prove that their choice was not wrong or to make sure that their efforts were not wasted. Women with emotional entrapment would exert effort to improve their relationships and thus commit to abusive relationships [24]. Some women tried many times to change the situation, but the failure of their efforts led them to despair and “learned helplessness”, a term coined by Seligman to describe the expectation that outcomes are uncontrollable [25]. IPV can undermine women’s priorities and lead to feelings of learned helplessness, posing a barrier to leaving [26]. A person experiencing learned helplessness is powerless to change the situation, which causes the acceptance of violence. Moreover, some women stated that they had a fear of loneliness that prevented them from leaving. In their father’s houses, they had no warm and loving relationship with their parents and other family members. Therefore, when the abusive partner shows some love to the woman, it leads to the formation of a belief that he is the only person who cares about her. As a result, she is very afraid of leaving and being alone.

Other studies have also reported the psychological consequences of IPV on women in Iran [27,28,29,30] or other countries [7, 9,10,11, 19, 31]. Baloushah et al., in a qualitative study on the lived experiences of Palestinian women suffering from IPV, produced a theme related to psychological violence threatening the self-esteem of women [7]. Loke et al. investigated the lived experiences of female victims of IPV in Hong Kong. In their study, women were also ambivalent about staying in an abusive relationship and experienced low self-esteem and depression. The women also had negative experiences in help-seeking [19]. Heron et al. examined reasons for staying in abusive relationships in an ethnically diverse sample of female domestic violence victims from the UK. Nearly all women in their study mentioned that they stayed in an abusive relationship due to feeling trapped; they had invested too much, making it difficult for them to just leave. Also, some women demonstrated learned helplessness as a reason for staying [22]. McKinley and Liddell assessed the barriers to American women’s ability to leave violent relationships. They reported that IPV could undermine women’s priorities and lead to feelings of learned helplessness, posing a barrier to leaving [26]. These findings can be consistent with our results.

Relational factors

The second emerged theme was the “relational factors” which explained a part of the lived experiences of IPV in Iranian women. A relationship that seemed perfect for them at the beginning was involved in a cycle of violence (where the abuser’s behaviour can change drastically from one day to the next), return of violence (as a self-protection strategy), and emotional divorce (which can reduce the relationship level). Some abused women reported that they defended themselves by nonphysical or physical means. Although these self-defense mechanisms help the victim survive mentally, they can worsen the violence. Women reported that there was emotional distance between them and their husbands, without good communication and sexual relationships. To avoid legal divorce, couples may continue to cohabitate and live together, especially in countries like Iran, where women who are dissatisfied with their marriage prefer not to divorce legally due to socio-cultural pressures [32]. Emotional divorce can increase disputes and infidelity and is associated with alexithymia [33]; people with alexithymia often use negative coping strategies such as suppression and are less likely to use reappraisal strategies [34]. Some women also reported that they tolerated the abuse because of their children, to protect or support them. They perceived that it was better for their children to have both a mother and a father in the same home. They also had a fear of losing custody. Abusive partners often use manipulation, threats, and intimidation related to taking children in custody battles as tactics to control women [26].

Our results in this section are consistent with the results of other studies [12, 16, 17, 22, 26, 35]. These studies also reported the factor of children as a reason for staying in an abusive relationship. In Downs et al. study in the USA, women were also found to have developed numerous self-protection strategies by nonphysical and/or physical means during the incidence of IPV [36].

Family-related factors

The third theme was “family-related factors”. Most of the women perceived their relationships with their parents as “bad”. They did not feel loved by their parents or family members and grew up in a home that did not respond to, validate, or encourage their emotions enough. Some even experienced childhood abuse by their fathers (physical or emotional). Therefore, women perceived marriage as a way to escape from their own families. It should be noted that, due to the cultural conditions, young girls in Iran cannot become independent from their families and live alone, even if they are financially independent. In fact, they are forced to live with their parents. Many of them think that they will have more freedom if they get married. Therefore, many of them stay in abusive relationships because of the fear of losing their independence and freedom. In addition, the absence of good relationships between parents and the way women’s own mothers tolerated their abusive fathers created a pattern that continued to their own relationships and was considered normative. Therefore, the quality of relationship with own family can explain a part of women’s experiences of enduring IPV. Furthermore, women reported a lack of support from their own families due to violating the norm of keeping abuse private, bringing shame to them by getting divorced, or their low financial ability. Divorce and moving back into the parents’ house require their support and that of other family members. If they do not support, women, especially those without income, will hesitate to leave. Our results in this section are consistent with the results of studies by Estrellado and Moh in the Philippines [12], Sichimba et al. in Zambia [16], McKinley and Liddell in the USA [26], and Bhandari and Hughes and Abdul Azeez et al. in India [37, 38].

Socioeconomic factors

Another extracted theme was “socioeconomic factors”. The participants indicated the effects of social stigma surrounding divorce which exist in patriarchal societies such as Iran, and the social, economic and support problems after divorce, which caused them to be hesitant to leave. The stigma of divorce can change these women into worthless creatures who do not deserve a desirable and appropriate marriage [39]. Social isolation and financial dependence were also reported to be effective. The abusive partners gradually reduced the women’s presence at work and school and kept them away from social and economic support sources, including coworkers, friends, and family. Social isolation along with the lack of financial support can create a false dependence of the victim on the abuser, and foster feelings of despair, inefficiency, and powerlessness which act as barrier to leaving. Social support, mainly from family and friends, can cause feelings of empowerment in women; lack of this support can put their emotional health in jeopardy [40].

Moreover, some women reported negative experiences when seeking help from psychologists and governmental organizations. In this regard, lack of proper mental health services, lack of adequate social support from governmental organizations and inefficient criminal laws were identified to have a role in female victims’ decision to stay in an abusive relationship. Lack of legal protection for women, not having the right to divorce and custody, giving legitimacy to patriarchy and men’s violence in the family, lack of sympathy of family courts with female victims, police officers’ lack of training on how to properly behave with IPV victims, lack of specific and appropriate protocol in police departments to protect the safety of IPV victims, and existence of strict and inflexible laws can make Iranian women hesitate to leave an abusive relationship. In addition, lack of compulsion for premarital counseling and low quality of the provided services, lack of information of mental health providers about the risks of IPV, high cost of counseling sessions, and unprofessional behavior of counselors and psychologists are among the factors that can make female victims of IPV in Iran hesitate to use mental health services, and lower their ability to be hopeful about the future and lead to acceptance of violence.

Other studies also indicated the factors of societal pressure and cultural norms [12, 16, 22, 37, 38]. In Heron et al.’s study, most British women reported that their partners socially isolated them, and this made it difficult for them to leave, and they felt that they had no choice but to stay. Also, half of the women in their study stated that they were economically dependent on their partners which contributed to staying in their abusive relationship, since they were unable to provide for themselves or their children and had no money to leave [22]. McKinley and Liddell and Smye et al. reported the factors of societal/family pressures, restricting relationships, and fear of biased police and child welfare systems as barriers to leaving violent relationships in American and Canadian women [26, 41]. McKinley and Liddell also indicated the role of ineffectual law enforcement and criminal justice response [26]. In a review study, Ghaffarihosseini et al. also concluded that there are no laws against domestic violence in Iran, despite all the damage it costs. All the efforts have come to an unlegislated bill which has been reduced to a financial penalty [42]. In the studies by Oyewuwo-Gassikia in Africa and Notko et al. in Finland, the type and quality of the support received from formal and informal sources of help were also identified as a relevant factor [43, 44]. Notko et al. conducted interviews with social and health care professionals and the police concerning domestic violence. Their results indicate that successful interprofessional collaboration requires comprehensive knowledge and education on domestic violence as a phenomenon, on the tasks and the duties of different professionals, as well as tolerance and flexibility in their joint efforts [44]. In Loke et al.’s study in Hong Kong, abused women also reported that financial insecurity was the crucial reason for staying in their abusive relationships. They also had negative experiences when seeking help from police and doctors. They said that police belittled their feelings and recommended that they compromise and reconcile with their partners. Doctors were not concerned about their feelings and could not help solve their domestic problems. Social workers did not offer realistic solutions [19].

Attitudinal factors

The final theme was “attitudinal factors”. Some women denied violence or tried to justify it, thinking that the abuse is “normal” and other women also have same problems. This justification hinders the recognition of the abuse as a problem. Some women even blamed themselves for their partners’ violent behaviors, which can exonerate the perpetrator of abuse. These situations may bring negative effects on the health of the couples, contributing to a violence cycle perpetuation [45]. Since most cycles of IPV has a “honeymoon” phase where the abusive partner feels sorry for the abuse and acts loving and apologetic, abused women had hope that the abusive man would change his behavior. In some cases, even though the relationship between couples was deteriorating and women were being abused by their partners, they pretended to be happy and faked a perfect life on Instagram or showed it to their acquaintances and relatives. For this reason, in order not to ruin this image, they inevitably stayed in an abusive relationship. This pretense for many years can hide their tense relationship from others and make the victim unable to convince others (especially family) to support her divorce and separation. Also, some women tolerated their abusive partners due to feeling shame or embarrassment about disclosing their situation, especially to their parents or relatives. When the victim’s attitude towards leaving includes concepts such as disgrace, shame, and incompetency, she can hardly leave this relationship. Some women also did not know the occurrence of violence, caused many of them to be unaware of subjection to IPV for years and were enduring the violence due to ignorance.

Sichimba et al. [16] also reported the role of hope for change in Zambian women’s decisions to stay. Abdul Azeez et al. [38] indicated the factors of hope and normalization of violence in Indian context. In Loke et al.’s study [19], abused women in Hong Kong also reported that they were ashamed to reveal their situation and talk about the violence in their family. In Heron et al.’s study, British women stated that they felt they were to blame for the abuse and this contributed to their decision to stay with their abusers [22]. Pokharel et al. in review study reported that self-blame and normalization of violence were factors influenced the silencing of women experiencing IPV [35]. In Razera and Falcke’ study in Argentina, couples explained their reasons to stay together based on the love that initially united them, and the practicality of coexistence. Although couples openly mentioned episodes of violence, they found it difficult to recognize them; thus, they normalized the abuse and its consequences [45]. These findings are consistent with the results of this study.

Conclusion

By exploring the lived experiences of Iranian women suffered from IPV and had a history of staying in abusive relationships, we identified five themes of psychological, relational, family-related, socioeconomic, and attitudinal factors. Most of abused women in Iran feel psychological entrapment, depression, PTSD, and learned helplessness; have fear of loneliness and life-threatening danger from her partner; and suffer from conflicting feelings and low self-esteem (psychological factors), thereby depriving them of the possibility of making an appropriate decisions. They use self-defense measures and/or emotional separation as tactics to tolerate the IPV. Some have to stay with their abusive partner because of their children (relational factors). Bad relationship with parents, history of escape from the family, history of IPV experience in parents, and lack of family support are other barriers to leaving (family-related factors). Social stigma, social isolation, lack of proper mental health services, financial dependence, inefficient criminal justice system, and lack of support from governmental organizations (socioeconomic factors) also force them to stay in an abusive relationship. They have to rely on themselves to leave, and if they have no economic and social conditions, it is better for them to endure the violence. To cope with the situation, some of them pretend to be happy and fake a perfect life on social media, and some deny violence or try to justify it, thinking that the abuse is normal. Some of them are even unaware of the occurrence of violence. The abused women feel shame or embarrassment about disclosing their situation, especially to their parents or relatives, and have hope that their abusive partner will change his behavior (attitudinal factors).

Having the knowledge of the experiences of women staying in abusive relationships may help in providing each victim the help they need to become free from violence, for example, by providing financial support for those with financial dependence on their abusive partner, counseling for those with mental problems or negative coping, and motivational interventions for those feeling entrapment. The findings indicate the need for experts involved in designing policies to have a thorough understanding of the realities that Iranian women living in violence face and how this understanding can be integrated into programs for enhancing their wellbeing. This study has implications for policy and psychosocial interventions to bring progressive changes in the lives of Iranian women experiencing IPV. Policymakers and decision-makers in Iran should focus on empowering women, especially those who are victims of IPV, and consider ways to develop policies that support them in all areas.

This was the first qualitative study in Iran that explored the lived experiences of women who had decided to stay with their abusive partner (for at least two years). However, there were some limitations to this study. This study had a small sample size of 12 due to the non-cooperation of the Welfare Organization, the Justice Organization, and the centers supporting the victims of domestic violence in Iran. In this regard, we asked three women activists to help us with finding participants. Also, the samples were recruited from one city in Iran. Therefore, the results cannot be generalized to the broader population of IPV victims in Iran or other countries. Moreover, some interviewed women were divorced or separated, but their reasons for leaving were not surveyed. Future studies are recommended to investigate the reasons for leaving in Iranian women suffered from IPV.