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Outside the cyclone of abuse, there is a social structure steeling the actions of abusers, and this is abundantly clear in the ways ableism informs abuse. Say you have a life-threatening heart condition that worsens if your heart rate goes too high, and your rage-a-holic partner can inflict severe physical harm through prolonged yelling. Over two years, you go from being semi-bedbound to totally bedbound from her verbal abuse, yet you cannot get a restraining order because she never slapped or punched you. You tell an advocate that your partner did inflict bodily harm, in ways you might never recover from, but the advocate fixates on the heroic ways your partner helped you out after your last hospital stay. You talk about Munchausen Syndrome By Proxy and how your partner loved the attention, and ask if any courts in this state allow phone access, but you may as well be explaining shortness of breath to an unmindful marathoner. The advocate finally concedes “emotional abuse” is “very real.” The battered women’s shelter is “working on” making one room disability accessible, but it’s “not a funding priority.” Your phone therapist says, “Well, you do have a degenerative condition—are you sure she made you sicker?” Meanwhile, you can’t get up for a glass of water, and a simple phone call leaves you exhausted. You finally contact your abuser because you need someone to pick up a prescription. She stops at the drugstore and rekindles the abuse cycle. It’s not about flowers and chocolate: it’s about meds that keep you alive.

Intimate Partner Violence organizations have begun to address these realities of disability, but they rarely do more than cite statistical horrors (people with disabilities are at least twice as likely to be abused) and impose a template that doesn’t fit. Disability is treated as a sidebar, not something with dramatically different risks and needs. Many IPV organizations are in fact performing acts of neglect and exclusion that mimic those of abusers, by denying access (not providing materials in Braille, not installing wheelchair ramps or enforcing strict fragrance free policies) that effectively shut disabled victims out and keep them locked in violence. Afraid to confront their own ableism, these organizations rationalize the ways that disabled people are denied help, using a tired social argument that it’s “too hard” to treat people with disabilities as equals.

In a culture that denigrates human vulnerability and provides nothing but a shoddy caregiving net, people with disabilities often rely on their abusers for food, bathing, toileting, transportation, and other survival needs. Leaving can be imminently life-threatening because victims might lose sustaining care, and replacing this can be next to impossible unless there are non-abusive family members willing to provide it. Many caregivers—not just partners—have intimate access to the lives of people with disabilities. If IPV organizations don’t understand the pressing need for transitional hands-on care, a disabled person will not be able to leave. Most IPV literature attributes this literal dependency to an erroneous psychological belief system instead of addressing cruel social projections that people with disabilities are needy for having fluid physical realities. If the only alternative to an abusive caregiver is an institution or a life where she is peeing into a bedpan with nobody to empty it, a disabled victim may be weighing one bad option against another. Are four sterile walls better than an abuser who offers affection, money, or other perks? Not necessarily.

For every Stockholm Syndrome, there are highly detailed acts of physical deprivation and torture that hold a person captive. When someone has a disability, these acts are easy to inflict: they may just be a matter of hiding someone’s painkillers, or sabotaging his TTY phone, or—more insidiously—becoming an indispensable aid so that he can’t function without the provided care. Disabled victims can’t always just get up and go—an idea rooted in the assumption that all people are unencumbered by physical restrictions. Whereas a safety plan for an able-bodied person may involve words like run, walk, call, or drive, these action verbs may not be possible for a quadriplegic, a heart failure patient, someone with a brainstem injury, or someone with cognitive impairment.

IPV crimes against people with disabilities are typically handled administratively through social service organizations, not the criminal justice system. This belies a disturbing social philosophy: our society does not really view abuse of the disabled as a crime. Although many states have mandatory reporting laws for abuse against people with disabilities, and social service personnel are legally mandated to report such abuse, few IPV organizations are familiar with these laws. Plus the court system is ridiculously inaccessible. Several years ago, a woman contacted me about the fact that she was being dragged down hallways by her hair and thrown against walls by a partner. I tried to convince her to get a restraining order, but this was immeasurably hard for her due to her anxiety disorder and extreme agoraphobia. She was quite disabled, but it didn’t matter as far as the courts were concerned. They would not do anything to accommodate her disability. I asked an attorney friend of mine what it would take for the courts to accommodate a homebound person. My friend laughed and said, “Oh, they won’t come to you unless you get a doctor’s letter saying you’re going to die within weeks.”

Later, I tried to get my own restraining order against a partner who was terrorizing me. Bedridden and homebound, I could not even make the calls to advocates, who kept refusing to talk to my Personal Care Attendant on my behalf—probably because they assumed she was my abuser, and they couldn’t imagine a disability hindering someone’s ability to make phone calls. They told my PCA there was no way I could get a restraining order without going to the courthouse unless an attorney filed a special motion on my behalf (not only can I not travel, but I can’t go into facilities that aren’t fragrance and chemical free). It took my PCA about fifty calls (she estimates) to find an attorney who would do this. The attorney said time was of the essence as weeks had passed since my last contact with the abuser, and then she stopped returning our calls. I gave up in a state of complete despondency. I was hovering on the edge of death and couldn’t even fight for appropriate medical care, let alone coordinate the changing of my locks or action against my partner. My helplessness wasn’t learned: it was literal. Even lifting a phone receiver or talking into it required more strength than I generally had.

The West Virginia Coalition Against Domestic Violence reports that disabled victims are more likely to be blamed for their abuse, because they are perceived as difficult to be around or care for, and “caregiver stress” is considered a legitimate excuse for bad behavior. These social myths are no different from abuser jargon that habitually accuses the victim of provoking the abuse. Because of the subtleties involved in abusing a disabled partner, people with disabilities might not identify themselves as abused, and rarely get support from a society that already perceives abusers as self-sacrificing for dating crips. It is common for batterers to “target punch” their victims to avoid getting caught. With an able-bodied victim, this might mean hitting her torso where bruises will not show. With a blind partner, this could mean putting obstacles in her path so she will trip and fall. With a frail partner who is too neurologically impaired to express consent, this could mean using body weight to hold her down during sex even while she tries to resist by stiffening her body and pushing weakly with her forearms, then forcing the sex in a way that physically harms her.

Advocates working with disabled victims of IPV must redefine the list of what constitutes IPV, tailoring it to an individual’s disabilities just as the abuser has probably done. Abusers will sometimes use the minimum amount of force to maintain power and control, and this minimum amount of force used on a disabled victim—though it may cause substantial injury—might not fit neatly into legal definitions of abuse. Coercion and threats to a disabled partner could involve threatening to withdraw basic support, an act that can be more dangerous to a person with a disability than a violent beating. Intimidation tactics might include harming or mistreating a service animal. Economic abuse might include embezzling funds from a disabled partner who can’t fill out a deposit slip, or giving her lavish gifts of adaptive equipment the state won’t pay for to encourage her dependence. Physical abuse might consist of rough handling when transferring someone out of a wheelchair, or over-medicating. Sexual abuse might include forced abortion, inappropriate touching during bathing or dressing, or put downs about a disabled person’s sexuality. Neglect can include withholding care, medication, or life-sustaining attention. Denying the person’s feelings might include attributing injuries to the disability itself (“You’re just touch-sensitive! That didn’t hurt”). Many forms of abuse against people with disabilities—particularly those against some of the most vulnerable groups, such as the developmentally disabled—involve discrediting a person’s own voice when she tries to convey her experience.

Activists have to think about the creative ways that abusers are maniacal and get away with it. Abusers sail through life, therapy, and the court systems with a “not as bad as that guy” philosophy. Their rationalizations are endless, and they can often pass off controlling behaviors toward a disabled partner as “concern.” If they can convince themselves or others that looking through a partner’s garbage, monitoring his phone calls and mileage, and insisting to know what he does every waking hour is not abuse, they will. For a disabled person confined mostly to a home or bed, such acts of control can be a replication of the inherent suffering the disability might already create. Most people will believe the abuser’s pleas that she was simply trying to protect the (ungrateful) disabled victim.

At every juncture, society is complicit in the abuse of disabled victims. For example, an abuser will isolate a victim of IPV. If that victim is wheelchair-bound, and very few venues in town are wheelchair-accessible, the abuser is not the only one isolating her: society has shut her out by relinquishing responsibility for accommodation. When she comes forward with her abuse, her peers might side with the abuser because they are, through inaction, supporting a similar agenda. When the abuser talks about all he has done for his victim—as abusers are prone to do—and the list includes bathing her, driving her to medical appointments, and hand-dispensing medication, people might view him as a hero. This reflects the deep threads of ableism in our culture, which believes that basic, hands-on care for most disabled people is exceptional, and should not be socially mandated.

People often believe that disability empowerment means taking a “just like me” attitude that presumes a disabled person wouldn’t want exceptional treatment—even if that treatment is fragrance free accommodation or a sign language interpreter or, more subtly, acknowledgement of someone’s physical vulnerability. The differences in human vulnerability can be huge, especially when talking about IPV dynamics that involve power and control. To sidestep this fact pretty much denies the entire reality of people with disabilities and reinforces a mentality that only wheelchair athletes and feel-good- super-crips should be recognized. Understanding the intricate differences in power and ability enables activists to calibrate their definitions of abuse. While the abuser of an able-bodied person might dramatically bar her exit by pushing furniture in front of escape routes and pulling phone cords out of the walls, the abuser of a bedridden individual can inflict the same level of terrorism by simply charging into a bedroom and screaming when she can’t get up and leave. These acts are equivalent and should be treated as such. It can be incredibly invalidating for a disabled abuse victim to hear, “I would just leave if someone treated me that way!” Or even, “I would just ask the abuser to leave.” Asking an abuser to leave is often not an option for someone with a disability: she might need him to take care of her after he battered her. And who is going to explain to the hospital staff the medical needs relating to her rare congenital condition?

Ironically, what endears a batterer to a disabled victim is often his investment in her vulnerability, which most of society insults, ignores, and doesn’t respond to in an empowering way. All abusers are dependent on keeping their victims vulnerable—a fact that transcends disability. This attunement to the power imbalance can give abusers a sixth sense about what a disabled person needs, and how to give or withdraw it for the purpose of control. This is no small thing when other able-bodied people just stand by and don’t offer help. Few people know the intricate ergonomics of a disabled person’s life, even though her ability to function or very survival depends upon these things. What puts the “I” in Intimate Partner Violence is often this: abusers may see intimately into a complex reality that most people do not notice or care about. For example, I tried to explain to my family for years why I needed someone to be on call 24 hours a day due to my erratic medical emergencies, my need for someone to bring me food and water while I was lying down unable to move, and my need for someone to nurse me during my many unpredictable crashes after having a chemical exposure or exerting myself. They offered inconsistent bursts of help and care—a week here and a few days there. They assumed that someone out there would fill in the gaps between these weeks and days. But I had nobody to do it, nobody but an abuser carefully tuned in to my vulnerabilities. While others in my life would try to create a cheerful mood and bring me take-out food, my abuser would dig in to the gritty realities of my disability, draping a blanket over my legs before I even said I was cold and bringing me a glass with a straw so I could drink lying down. These were the acts of kindness woven into the abuse, but without them I wouldn’t have survived. This isn’t to excuse the abuser’s heinous behavior, but to point out that until people are given the resources to live healthy, functional lives, they will be easy prey no matter how many Model Mugging techniques they know.