No Visible Bruises: What We Don’t Know About Domestic Violence Can Kill Us

I just finished No Visible Bruises and found a lot that was valuable in it. I have worked with child survivors of domestic abuse and have one relative who fled an abusive marriage and another who was killed by a family member. The degree to which Snyder embeds herself with police officers, counselors, and others addressing this complicated and devastating problem is admirable. The story of the Cleveland police officer, in particular, is very moving.However, there were two major omissions. The first is the absence of religion as a confounding factor. The Southern Baptist Convention is in turmoil over the churches’ response, or lack thereof, to domestic violence. This is an issue not just for Baptists, but for all faiths that promote men’s superiority and women’s submission. Snyder does not address the role of religion and religious organizations, not as an exacerbating factor nor as an avenue for victims to get help.The second is the omission of middle/upper class abuse among her cases. A shelter worker I spoke to told me that wealthier women have a much harder time getting help - they are often economically dependent, they fear no one would believe their successful husband was doing this, and they are often more isolated within their community. This omission weakens the book considerably, as readers who are middle/upper class might (continue to) view domestic violence as a problem of “those” people. Of course it is not, but a reader of Snyder’s book would not come away with that impression.Snyder makes a valuable contribution to our understanding of domestic violence as progressive and pervasive. However, the narrowness of her focus makes the book less informative than it might have been.

The title of Rachel Louise Snyder’s eye-opening, powerful, page-turner of a book, No Visible Bruises, refers specifically to strangulation. Some sixty percent of domestic violence (DV) victims are strangled at some point during an abusive relationship (p. 65). Turns out that only some 15% of the victims in one study had injuries visible enough to photograph for the police report (p. 66). Most strangulation injuries are internal – hence, the title.Since 2012 when I completed the 40-hour training in Understanding Domestic Violence (DV) at the community organization ApnaGhar, several important innovations have occurred. Snyder presents the reader with these, including the distinctions of (1) a Fatality Review Board for Domestic Violence; (2) initiatives to provide treatment for the abusers; (3) the Danger Assessment (which leads back to the role of strangulation).Lack of oxygen to the brain can cause micro-strokes, vision and hearing problems, seizures, ringing ears, memory loss, headaches, blacking out, traumatic brain injury (TBI) (p. 69). As the victim in near death due to strangulation – but so far there would only be red marks around the neck – the nerves in the brain stem lose control over sphincter muscles. So the urination and defecation were not mere signs of fear. They were evidence that the victim was near death (p. 67).Such victims may have poor recall of the event. They may not even be aware that they lost consciousness. The victim is not being difficult or drunk in being incoherent. The victim is fighting the consequences of a life-threatening event and may not know it at the moment.Even medical professionals may overlook the signs of serious injury by strangulation unless they are altered to the circumstance of the visit to the emergency room. Fact: DV victims are not routinely screened for strangulation or brain injury in the emergency room. They are discharged without CT scans or MRIs. The assaults and injuries are not formalized and abusers are prosecuted under lesser charges, say, misdemeanors rather than felonies.“What researchers have learned from combat soldiers and football players and car accident victims is only now making its way into the domestic violence community: that the poor recall, the recanting, the changing details, along with other markers, like anxiety, hypervigilance, and headaches, can all be signs of TBI” (p. 70).Now the ultimate confronting fact: Strangulation often is the next to last abuse by a perpetrator before a homicide. The correlation is strong, very strong. Strangulation is a much more significant marker than, say, a punch or kick that the abuser will escalate to lethal violence. Strangulation dramatically increases the chances of domestic violence homicide (p. 66).This leads directly to an important innovation in the struggle against DV, the Danger Assessment. Jacquelyn Campbell has quantified the Danger Assessment, which is especially effective when combined with a timeline of incident. In addition, to strangulation high risk factors in any combination that portend a potential homicide include: gun ownership, substance abuse, extreme jealousy, threats to kill, forced sex, isolation from friends and family, a child from a different biological parent in the home, an abuser’s threat of suicide or violence during pregnancy, threats to children, destruction of property, and a victim’s attempt to leave anytime within the prior year. Chronic unemployment was the sole economic factor (p. 65). None of these cause DV; but they make a bad situation worse – much worse – and add to the risk of a fatal outcome.You can see where this is going. First responders, police, medical professionals, family, friends need to ask the tough questions – perform the assessment and have a safety plan ready to implement to get the potential victim out of immediate danger. Hence, the need for Snyder’s important book and its hard-hitting writing and reporting to be better known at all levels of the community.Snyder reports on a second important innovation in the struggle against DV: the Fatality Review Board (FRB) for DV Homicide. Air travel has become significantly safer thanks to the Federal Aviation Administration commitment to investigate independently every airplane crash. The idea is to find out what sequence of things went wrong without finger pointing. No blame, no shame. The idea is to perform an evidence-based assessment of all aspects of the system – human, administrative, mechanical, procedural.In a breakdown big enough to cause loss of life, multiple errors, anomalies, and exceptions are likely to have occurred in the system. Rarely is there is single cause of a disaster big enough to cause loss of life. “If systems were more efficient, people less siloed in their offices and tasks, maybe we could reduce the intimate partner homicide rate in the same way the NTSB [National Transportation Safety Board] had made aviation so much safer” (p. 85). The Fatality Review Board is born.For example, the authorities knew the perpetrator. They had visited the home multiple times. The abuser was released from detention without notifying the potential victim. An order of protection was denied due to a paperwork error, or, if granted, the police could not read the raggedy document that the woman was required to have on her person at all times. The prosecutor was unaware of a parallel complaint by the victim’s mother because it was filed in the same docket and dismissed when the victim recanted in the hope of placating the abuser and saving her own life.For example, multiple touch points occur at which victims and perpetrators interact with social services, healthcare facilities, community organizations, the veteran’s administration, law enforcement, and the clergy. The FRB is tasked with determining how the fatal outcome could have been avoided.Chase down all the accidental judgments, missed cues, and blind spots. Talk to everyone able to talk. Gather all the data. Someone knew something, had actionable information that was not acted upon. Formulate recommendations to avoid repeating the mistakes.That means building formal lines of permissioned communication between administrative siloes. For example, there as a restraining order against the abuser but it was in another state and the local authorities did not know about it.In the age of the Internet there needs to be a central clearing database that preserves such data. Or, for instance, the shooter had no criminal record, but the victim had expressed fear for her life to the local pastor at church based on his statements. Who can he (or she) call? Who can intervene with a safety plan?No one single factor can be singled out as causing the fatality; instead a series of relatively small mistakes, missed opportunities, and failed communications. The FRB looks for points where system actors could have intervened and didn’t or could have intervened differently (p. 86). Today more than forty states now have fatality review teams. Though the violence continues, this is progress.Snyder makes an important contribution in clarifying why the victim does not run leave the abuser and the abusive relationship. Why does she return to the abuser, or recant her testimony in the police report, frustrating the attempt of the prosecution to get a conviction?Though every situation is unique, Snyder builds a compelling narrative that often the victim is trying to save her own life. The system works much slower than a determined abuser, and the victim knows it. In short, the abuser knows how to work the system; and all-too-often the victim cannot rely on the system to protect her when she most needs protection. In addition, her judgment may be impaired due to being called every name in the book and slapped, punched, or strangled.As the abuser senses he is losing power and the victim is getting ready to leave, the risk of violence to regain control escalates. The abuser is strangling her, escalating to deadly violence, and yet he is charged with a misdemeanor. He will be out on $500 bail in 24 hours – buying a gun and gasoline to burn down the house after killing her and the children. In fear for her life, the victim is makes up a story about love to try to placate the abuser – she is recanting to try to buy time – while she accumulates enough cash or school credits to escape and have a life. The victim recants her narrative in the police report and says she loves him because she wants to live.A third major strong point of Snyder’s work is her report on interventions available for abusers. Incarcerating an abuser to protect the community is necessary. But that does not mean the abuser does not need treatment. He does. Absent treatment, jail just makes the abuser worse. The entire middle section of the book is devoted to the dynamics of perpetrator treatment.At another level I found Snyder’s deep insight to be an extension of Simone de Beauvoir’s assertion circa 1959 that woman is not a mere womb. The enlightened man adds to de Beauvoir’s statement (which is not quoted by Snyder): man is not mere testosterone. In both cases, biology is important, but biology is not destiny. I repeat: biology is not destiny. Some men have not been properly socialized and need to get in touch with and transform their inner uncivilized cave man.The recovery programs in jails on which Snyder reports sound rather like “boot camp” to me. The emphasis is on “tough love.” This is a function of the close association, if not identification, of masculinity with violence.In some communities, violence is how masculinity gets expressed. This extends from “big boys don’t cry” and if he hits you, hit him back all the way to a misogynistic gangster mentality that uses devaluing language to describe woman as basically existing for the sadistic sexual satisfaction of men. It may also be common (and justified!?) in a military context. As near as I can figure – and this is an oversimplification – the treatment groups are given lessons in cognitive or dialectical behavioral therapy: skills in emotional regulation, distress tolerance, self-soothing, and interpersonal negotiations.On a personal note, when I started reading this book, I knew it was not for the faint of heart. I said to myself: “Ouch! This is like the ‘ketchup scene’ in Shakespeare’s Hamlet.” At the end of Hamlet, the entire family gets killed. To deal with something as disturbing (and hope inspiring) as Snyder’s book, I had to go to Shakespeare.Indeed Hamlet begins with domestic violence. Hamlet’s uncle kills his own brother, Hamlet’s father, to seize the throne by marrying Hamlet’s mother. The latter is not technically DV, but a boundary violation. (This is the original Game of Thrones if there ever was one.) In turn, Hamlet perpetuates verbal and emotional abuse, whether fake insanity or genuine narcissistic rage, against his fiancé, Ophelia. Hurt people, hurt people. Sensitive soul that Ophelia is, she commits suicide. Ophelia’s brother then seeks revenge. Hamlet kills her brother as the brother simultaneously kills Hamlet with a rapier tipped with a deadly poison. The mother drinks the poisoned goblet, intended for Hamlet, and the uncle is run through by Hamlet – also with the poisoned rapier. The point?Horatio’s provides a summary at the backend of Hamlet which also forms a review of Snyder’s work: “So shall you hear – Of carnal, bloody, and unnatural acts – Of accidental judgments, casual slaughters, – Of deaths put on by cunning and forced cause, – And, in this upshot, purposes mistook, – Fall’n on the inventor’s heads. All this can I truly deliver.” Just so.All too often the events seemed to me to unfold like a Greek tragedy – or in this case a Shakespearian one. You already know the outcome. The suspense is enormous. You want to jump up on the stage and shout, “Don’t open the door – therein lies perdition!” But everything the actors do to try to avoid the tragic outcome seems to advance the action step-by-step in the direction of its fulfillment.Snyder provides a compelling narrative – and actionable interventions – of how to interrupt the seeming inevitability and create the possibility of survival and even, dare one hope, flourishing.

This is a well organized, passionate, and well written book reframing intimate violence and femicide for the era of #Metoo. It retakes the narrative, with startling and illuminating results. Snyder's genius and courage lies having the guts NOT to adopt the traditional journalistic frame of either "What a tragedy, too bad nothing can be done!" or "Why do THOSE women go back to their batterers?"Instead of blaming the victim or focusing on their perceived inadequacies, she has the guts, nuance and complexity to frame it like this: "Why do our systems (legal, media, practical, psychological, social, cultural) provide so little protection and support to women who want to leave batterers and don't want to be beaten up or assassinated by men who say they love them? What can WE (the larger society) do to change this?She shifts the responsibility from the victim to the larger systems in which they are entangled, and often inadvertently victimized by. She's not afraid of a feminist analysis of male privilege and its role in the thinking and emotions of batterers and the failure of larger systems to treat this issue as seriously as, say, gun violence in high schools. This is not a depressing book, at least not to me, because she explores solutions, such as intervention programs for batterers, and other changes in law and policy that are doing good. I also ended up, oddly enough, with more compassion for batterers -- when you look at this from the whole systems perspective, you see their backgrounds are also marked frequently with emotional or physical abandonment, witnessing domestic violence as children or being beaten themselves,, and alcoholic or addicted parents. Very inspiring book Hope it helps catalyze a movement. Sometimes the changes needed are as simple as giving a woman the money to get the locks changed, or not bailing the guy out immediately.

No Visible Bruises is an amazing ten year journey through some of the most terrifying and emotional scenes of everyday life when you're living a life that every day holds the potential for deadly violence.The book sets out to dispell a lot of myths about domestic violence such as, 'She would just leave if it was that bad;' 'I would know the signs of abuse from the outside;' 'there's no way to change the men who abuse;' 'If she keeps going back to him nothing can help her;' and, 'Just get her to a shelter and the issue is solved.' With an uncompromising grasp of facts and figures and a genuine desire to understand and communicate the perspectives of all those involved, Rachel Louise Snyder sets each myth in its context and shows how it's never that simple.This book is a wellspring of voices that reach out and close the gap between the dry distance of statistics and the real life experiences of the people they represent and leave the reader with a thorough understanding of where we are as individuals and as a society when it comes to domestic violence and, most importantly, what we can do in the future to change things for the better.

I‘m exhausted after reading this heartbreaking account on domestic violence and yet I can only say READ IT please. Snyder has written a book that explains the dynamics of abuse, the misconceptions about why victims stay, the root causes of violence (psychological and physical) and how it can be tackled before it’s too late!It's an urgently important book that is fully comprehensive and informative, presenting case studies that highlight all sides involved - victim, abuser, law enforcement, shelter management, rehabilitation programmes and how to help the victims back into safety. It also crucially highlights the importance in recognizing the importance of well supported and educated active bystanders. I urge everyone to read it!

This book is so well written and researched, and the subject matter is so important. We need to be talking about these issues and we need to give the victims a voice. I was completely moved by the stories of the families affected by domestic violence and I found the information on perpetrator programmes extremely insightful. Thank you for this book.

Obvious ideas in the book which you may already know

Quick delivery and perfect quality. Can’t wait to read such an important book