Upon hearing the term “domestic violence”, what first comes to most people’s minds is physical abuse. In fact, until MA Bill H.4744 added coercive control in September 2024, Massachusetts’ legal definition of domestic violence focused exclusively on physical abuse and physical sexual assault. By contrast, domestic violence advocates commonly define it as “a pattern of coercive control that one individual intermittently exerts over another”. Physical abuse is one method abusers use to assert power and control, along with verbal and psychological abuse, technological abuse, financial abuse, spiritual abuse, and other tactics. While physical abuse is perhaps the easiest form of abuse to understand and identify, there are some behaviors in this category that are less obvious. This post will explore the complexities of physical abuse and its multitude of short and long-term effects.
Defining Physical Abuse
Physical abuse is when a perpetrator intentionally uses physical force or violence to cause harm, create fear, or to control another person. This can run the gamut from injurious and/or nonconsensual bodily contact with the victim, to employing weapons or other objects to harm or threaten the victim, to using their physical presence to intimidate the victim. While sexual abuse can be perpetrated verbally, technologically, etc., it frequently involves physically abusive actions. Physical abuse commonly escalates in severity and frequency over time. The most dangerous times for victims are when they are pregnant and when attempting to leave the abuser.
Easily Identifiable Physical Abuse Behaviors
Most people can recognize and name a host of physically abusive behaviors off the top of their heads. Violent, rough, forceful actions perpetrators implement against their victims’ bodies by employing their hands, feet, or an object/weapon. The most apparent of these cause direct injury, pain, restriction, and/or trauma. Examples include hitting, punching, slapping, pushing, shoving, kicking, shaking, pinching, scratching, hair-pulling, burning, biting, cutting, whipping, and spitting. Abusers may use handheld or thrown weapons such as knives, guns, bats, or any other object they can wield (like a phone, shoe, book, plate, rock, etc.) to inflict harm.
Strangulation and suffocation are also common tactics of physical abuse that can be extremely damaging and lethal within seconds or not for days to weeks after an incident due to delayed complications. Check out DVSN’s March 2025 blog post, “Strangulation: Detailing Dangers & Demystifying Misconceptions” for in depth information on the differences between strangulation, suffocation, and choking and their widely misunderstood and often invisible impacts. Another frequently utilized physical behavior is restraint, whether abusers pin their victim against a surface, grab and/or hold their clothes/body to prevent them from moving/leaving or to force them to move/go somewhere, or bind their limbs together or to a chair/stationary object. Touching any part of a victim without consent and forcing or manipulating them into any sexual act is both physical and sexual abuse.
Less Obvious Physical Abuse Behaviors
While many physical abuse tactics are clear and noticeable, others are less obvious or overlap with other types of abuse (verbal, psychological, financial, etc.) while still having decidedly physical acts and/or impacts. Restraint via the abuser’s body or some sort of binding is more clearly physical abuse, for example, while restraint by locking the victim in a room, in the house, or out of the house, or removing their access to a phone, vehicle, or other transportation may also be considered physical abuse as these things impact the victim’s physical movement, physical wellbeing, and/or opportunity to seek assistance with physical difficulties. Abusers may control the victim’s physical environment by doing things to make them uncomfortable, such as opening windows or doors in inclement weather, preventing them from using blankets or pillows while sleeping, or not letting them be alone with family, friends, healthcare providers, or support services. The perpetrator’s physical presence alone can cause fear or prevent the victim from seeking assistance. Perpetrators may also use their physical presence to intimidate by invading victims’ personal space, looming or leaning over them, displaying or keeping a weapon within reach, raising a hand toward them, shaking a fist at them, making insulting or offensive gestures, and other uses of their body that do not involve direct touching but imply their violent capability.
Similarly, abusers may use non-corporeal violence and threats against the victim or people, animals, or possessions they care about. This can involve throwing an object near a victim to scare/threaten them, punching a wall, kicking a door, breaking a window, and damaging or destroying the victim’s valuable or sentimental belongings or important documents to demonstrate their power. Threats of harm against the victim, children, pets, other loved ones, or loved one’s possessions can be considered verbal, psychological, or physical abuse, while actual injury to others in order to control the primary victim is more straightforwardly physical. Abusers may also threaten to (or even actually) harm or kill themselves in order to manipulate their victims into doing what they want. Vehicles are a common tool perpetrators use to create fear and physically endanger victims by doing things like preventing victims from wearing a seatbelt; driving recklessly with victims in the car; interfering with victims’ driving (such as by grabbing the steering wheel or covering the victim’s eyes while the vehicle is moving); transporting victims to unfamiliar places and abandoning them there; or damaging vehicles to prevent victims from leaving, accessing support, going to work, to force them to spend money in repairs, or to prove their power by breaking a valuable possession. These are all examples of physical actions that do not directly physically harm the victim but are abusive. They are often intended to convey that abusers are capable of similar violence against the victim or that they know the best ways to make the victim suffer without laying a finger on them, confirming their power over them.
Other less obvious physical abuse tactics can affect victims’ health or wellbeing without the more straightforward bruises, wounds, lacerations, or broken bones that often result from the easily identifiable behaviors mentioned in the previous section. Abusers may forbid or physically prevent victims from eating, sleeping, taking prescribed medications, or accessing medical treatment. They may force victims to use drugs or alcohol, to take too much/unnecessary prescribed medication or other poisonous/harmful substance, or they may take away/damage their assistive devices, such as wheelchairs, walkers, glasses, hearing aids, etc. Manipulating or forcing victims to do things they find too strenuous (such as intense workouts or long hikes), blocking them from calling 911 or utilizing other emergency responses, and preventing payment of victims’ medical bills or insurance premiums can also cause indirect physical harm.
Physical Abuse Stats
Physical abuse is very common. The CDC’s 2016/2017 National Intimate Partner and Sexual Violence Survey (NISVS) found that 47.3% of women and 44.2% of men in the United States reported any contact sexual violence, physical violence, and/or stalking victimization by an intimate partner at some point in their lifetime. That’s almost half the population. Narrowing that to physical violence alone, 42% of women and 42.3% of men reported experiencing any physical violence by an intimate partner in their lifetime. Both women and men reported this most commonly took the form of being slapped, pushed, or shoved (39% for both) and severe physical violence, including being hit with a fist or something hard (32% of women, 24.6% of men). Significant numbers of women also reported being slammed against something (24.4%), having hair pulled (17.7%), being choked or suffocated (16.2%), and being beaten (15.2%). 12.2% of men reported being kicked. Victims often begin experiencing physical abuse at a very young age. 72.3% of female victims and 62.1% of male victims reported that they were first victimized before age 25, with 27.1% of females and 21.4% of males first victimized before age 18. Across all types of violence, the majority of both female and male victims reported experiencing violence from one perpetrator (NISVS). Women average 6.9 and men 4.4 physical assaults by the same partner in a year (HealthyPlace).
Identifying Physical Abuse
Because it often leaves visible wounds, physical abuse is the form of domestic violence that is easiest for victims’ family, friends, and health care providers to notice and recognize. That is not to say that it is easy to identify. It’s estimated that only 34% of people injured by physical abuse receive medical care for those injuries (NCADV). Many victims also attempt to hide injuries and/or lie about how they got them, perhaps due to shame or to protect themselves from further harm if their abuser finds out. One study found that 23% of women presented in the emergency room 6 to 10 times before physical abuse was diagnosed and a further 20% sought medical attention on 11 occasions before a diagnosis of abuse finally was made. No matter how seemingly apparent, signs are easy to miss, ignore, or attribute to other causes. Many don’t think to, or find it too uncomfortable to, ask about it if they do spot potential signs of abuse.
Of course, many effects of physical abuse can also have other causes, but there are some things to look out for. Frequent injuries or injuries in multiple stages of healing may result from physical abuse, as may patterns of bruises or bruises/injuries reflecting the shape of an object (such as a belt buckle or rope) or a body part (such as a bite mark or handprint). Other potential signs of abuse include flinching at loud noises or touch, being overly vigilant of surroundings, showing fear or unease around a particular person, and not being able to recall or having unlikely or no explanations for how injuries occurred. (Healthline) A 2020 study by the Radiological Society of North America found that up to one-third of adult women who sustain a non-displaced fracture to the ulna bone of the forearm may be victims of intimate partner violence, as this particular injury often occurs when people hold up their hands to protect their faces from being struck. These are some of the most common signs but do not definitively indicate physical abuse.
Short-Term Effects of Physical Abuse
Physical abuse can have many effects on victims. The NISVS found that 87% of female victims and 60% of male victims reported at least one intimate partner violence-related impact. In the shorter term, injuries are the most common impact, affecting 74.6% of females and 47.7% of males, with 29.3% of females and 25.5% of males reporting seeking medical care for their injuries. The most frequent forms of injury reported were mental or emotional harm (60.1% of females, 25.5% of males), minor bruises or scratches (54.9% of females, 34.9% of males), and cuts, major bruises, or black eyes (33.3% of females, 14.5% of males). Beyond bodily injury, physical abuse can have a huge impact on victims’ mental and emotional health. PTSD symptoms are nearly as common as physical wounds, with 71.3% of females and 32.9% of males reporting experiencing them.
Other significant impacts for females are fear (60.2%) and concern for safety (63.3%). Quite a few respondents also noted the need for help from law enforcement (38.6% of females, 12.4% of males), legal services (25.5% of females, 13.2% of males), and that they missed at least one day of work due to the abuse (26.9% of females, 12.9% of males). Many victims of physical abuse deal with fear, anxiety, shock, disbelief, sadness, anger, helplessness, and hypervigilance. They may have trouble sleeping and/or nightmares. (Healthline) Many of these impacts have ripple effects to a variety of aspects of victims’ lives. They can compound each other and worsen over time to potentially develop into persistent and more severe consequences.
Long-Term Effects of Physical Abuse
Whether or not they continue to experience physical abuse, the consequences to victims’ physical health, mental health, social and emotional health, and overall lifestyle can persist for years, decades, or the rest of their lives.
Physical Health
Statistically, victims of intimate partner and sexual violence make more visits to health providers over their lifetimes, have more hospital stays, have hospital stays of longer duration, and are at greater risk of a wide range of physical, mental, reproductive, and other health consequences than those who have not experienced abuse. Some of these conditions may result directly from physical injuries, others from unhealthy behaviors adopted to cope with abuse (such as smoking or substance abuse), and some from the harmful effects of chronic stress due to experiencing violence. (NISVS) Prevalence of chronic pain, frequent headaches, asthma, irritable bowel syndrome and other gastrointestinal problems, serious hearing and vision impairment, arthritis, involuntary shaking, sexual disfunction, fertility issues, HIV/AIDS, impaired immunity, cardiovascular conditions, and metabolic, hematologic, respiratory, and inflammatory diseases are all higher among those who experienced physical abuse compared with those who did not. Dehydration and/or malnutrition can be caused by physical abuse, particularly in situations of elder abuse when the abuser is a caregiver. (NISVS, DomesticShelters, Healthline, Lancet)
Difficultly sleeping is another very common impact of physical abuse (NISVS). Whether it is a byproduct of other abusive behaviors or is a tactic employed by abusers in and of itself, sleep deprivation can cause or exacerbate a number of health issues and has a cumulative effect. Even short-term sleep deprivation has been linked to an increased risk of Alzheimer’s disease and cancer, particularly breast and colorectal cancer. (DomesticShelters) Some long-term effects of sleep deprivation include weakened immune system, weight gain, poor balance and coordination, and increased risk of high blood pressure, diabetes, and heart disease. Poor sleep can also increase memory issues, such as an inability to remember new information, and trouble thinking and concentrating, including problem-solving. (Healthline)
Mental Health
It may be instinctual to only consider the physical effects of physical abuse, but the psychological impact of physical abuse can be just as devastating as the physical harm, and perhaps longer lasting. Incidents of physical abuse are typically extremely traumatic for victims, who often experience post-traumatic stress disorder (PTSD). This may take the form of flashbacks, nightmares, and severe anxiety. General anxiety disorders, panic attacks, and hypervigilance are also quite common mental health impacts of physical abuse, along with depression and thoughts of self-harm or suicide ideation. Victims may engage in self-harm as a coping mechanism for the trauma of the violence they experience. Eating disorders such as bulimia and anorexia, addictions, and substance abuse are also common coping mechanisms for victims of physical abuse. Some victims have challenges with concentration and memory, and even psychosomatic symptoms, which are physical ailments arising from psychological distress. Mental health issues can be extremely challenging to experience and to improve, and often affect other areas of life. (Healthline, MHCI, DomesticShelters)
Social & Emotional Health
A perhaps less visible area where physical abuse can also have a profound and lasting impact is on victims’ social and emotional wellbeing. Being hurt by someone who is supposed to care about them can cause victims to have difficulty trusting others, which hinders them forming close bonds and maintaining healthy relationships, be they familial, social, romantic, or occupational. They may struggle with low self-esteem and find it difficult to set boundaries and communicate their emotions and needs effectively. This can lead to relationship strain, social withdrawal, and isolation, be it self-imposed or due to others not understanding and avoiding them. All of these can inhibit success in school, work, and other areas of life, not to mention contribute to the development or prolongation of some of the physical and mental health concerns above and an increased vulnerability to revictimization in a new abusive relationship or situation. (MHCI, Healthline)
Lifestyle & Activity Limitation
Whether or not they also struggle with social and emotional health, the effects of physical abuse can significantly impact other areas of victims’ lifestyles and activities. On the level of kinetics, some injuries can leave victims with difficulty or inability to perform aspects of daily life they previously could, such as doing errands alone, climbing stairs, walking, bathing, or dressing themselves. From a cognitive perspective, victims of physical abuse have a higher prevalence of concentration and memory challenges and often struggle with making decisions. (NISVS, Healthline) Some experience dissociation, the feeling of being “checked out” or detached from their surroundings and/or experiences, which can lead to difficulty completing even basic tasks on a day-to-day basis (DomesticShelters). Consequences of physical abuse may necessitate significant changes to victims’ lifestyles, causing them to need help from others or to stop doing some things altogether, potentially impacting job performance, financial security, housing, and overall wellbeing and quality of life.
Increasing Safety
The longer victims continue to experience physical abuse, the greater most of these physical, mental, social, emotional, and lifestyle impacts are likely to be. While every situation and every person is different, there are some things many victims can do to increase their safety and minimize severe and lasting effects. Talking to a trusted friend, family member, service provider, community leader, or domestic violence advocate can help victims feel supported and less alone and provide them with information and resources to assist them with making choices for their future. Safety planning can be incredibly helpful in the short and long term. Check out DVSN’s 2-part September/October 2022 blog post, “Safety Planning: Reducing Risk & Exploring Options” and “Safety Planning: Different Circumstances & Special Considerations”, for more details on what safety planning is and suggestions and considerations for creating one.
For those experiencing physical abuse, a safety plan might include determining or establishing a “safe room” to go to if abusers become violent. A “safe room” may be one that does not have many objects abusers can use against victims, has a window where passersby could see the violence occurring to deter abusers, is closest to where a neighbor could hear the violence and call for help, and is not near stairs or areas of the home children are likely to be. Other safety plan suggestions include keeping their phone charged and on their person, hiding a spare vehicle key where it is easily accessible but not known to the abuser, parking a vehicle facing the road for quicker escape, or leaving the building through the back door or other path that makes it most difficult for abusers to follow. If leaving or deescalating the situation is impossible, victims may be able to minimize harm by hiding behind large furniture or items of value that the abuser would not want to damage. Getting into a corner or against a wall, pulling knees to the chest, tucking head down, and using arms to cover the neck can help protect vital organs from kicks, punches, weapons, etc. (Hotline)
Domestic violence agencies like DVSN can assist victims with the details of their safety plan and implementing aspects of it. They can also help with other measures to increase safety and/or leave an abusive situation, such as obtaining a restraining order, finding safe housing for the victim and their children and/or pets, and navigating the legalities and potential complications of pressing charges against an abuser, divorce, or custody. There are many resources and caring, trained, and informed people out there to help victims prevent further abuse, begin to heal from the multitude of effects they may be experiencing, and to rebuild their lives.
Resources:
- DVSN – call our toll-free & confidential Help Line at 888-399-6111 to speak with an Advocate, or find general domestic violence information, hotlines, counseling & support group information, legal & immigration assistance, shelters & housing resources, and financial, food, clothing, medication, and transportation aid at DVSN.org/Resources
- National Domestic Violence Hotline – call, chat, or text with an advocate 24/7 by calling 800-799-7233 or texting “START” to 88788, use their step-by-step safety planning tool here
- MA Safelink – call the hotline at 877-785-2020 for safety planning assistance, resources, referrals
- Non-Emergency Text Line – those who feel unsafe calling or prefer not to call can text with a victim witness advocate from the Middlesex District Attorney’s Office for resources and information Monday-Friday 8:30am-5pm at 781-281-4066
- DomesticShelters.org – search by zip code to find a domestic violence shelter, plus find comprehensive information about shelters & abuse
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