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After the 'Guffaw' -- The Serious Face of Visible Trauma

May 13, 2014 | Updated Jul 13, 2014

With my tongue in my cheek, I recently brought you the GHFH (pronounced "guffaw") diet. Most of you aptly recognized the intent as spoof and satire. And as advertised, the tale was brought to you with the prior approbation of its victim, my sister -- Elizabeth C. Katz, Ph.D., a clinical psychologist. She in fact had only one criticism for me when I read it to her before posting it here: "Stop, it hurts to laugh!"

But then again, some of you correctly noted that there really is nothing funny about trauma to the face and head. There was a tangential point to make about our societal idiocy when it comes to quick-fix-weight-loss-by-any-means, and I made it. But then what? What comes after the... "guffaw"?

There is, of course, a very serious face to visible trauma -- and that, too, is a tale worth telling. And here the shoe changes foot, for it is my sister who asked me for permission to publish, and I who gladly granted it.

Here, then, is the serious side of the story, in my sister's words.

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On April 29, 2014, my 19th wedding anniversary, my horse rapidly swung his head up into my face. It wasn't malicious -- another horse had trotted by us as I was walking him in from the field and he got excited. It was my poor judgment, luck, or both that I happened to be looking at him at the time. I suffered a laceration in my left eyelid, requiring stitches, a fracture at the base of my nose and a split lip. My appearance was variously equated to Donatello, the Teenage Mutant Ninja Turtle (because of the purple "mask" surrounding my eye and my swollen upper lip that came to a point -- very much like a turtle's) and to Robert De Niro at the end of Raging Bull. Needless to say... I looked really bad. One of the positive outcomes from that day was that my husband and I got to spend much more time together, albeit in the emergency room, than we otherwise would have -- it is an anniversary we will definitely remember.

Many years ago, when my kids, nieces and nephew would cry over some small injury, I told them that every scrape, bruise, and scar is a trophy -- they remind us of what we have done; they represent a life well-lived. One of my nieces reminded me of that upon seeing the photographs of my injuries on my Facebook page. True to that belief, I sported the bruises, cuts, and swelling as a badge of honor that said, "Look at me world, I am a serious bada--." Despite my husband's encouragement (mainly because he was concerned that I would scare small children), I chose not to cover my injuries. I was also concerned about what people would think if I were to try and hide them.

What I discovered was that, covered or not, people thought my husband had beaten me. They did not say as much but, with the exception of close friends and colleagues who knew what had happened, people either stared unabashedly or averted their gaze in apparent discomfort and embarrassment. You may think: Wait a minute, you looked horrible, right? Trust me, they thought I was a battered woman! So, how can I be so sure?

About three days after my accident, we went to a local street festival. I was wearing a cap to block my face from the sun because I could not wear sunblock. My husband and I were discussing the fact that it seemed as if people believed he had beaten me (based on all of the nasty looks he was getting and the embarrassed looks on people's faces when they looked at me). A woman walking by overheard our conversation and yelled back, "That is EXACTLY what I thought!"

This is not the first black eye I have gotten, though it definitely was the worst. The two most recent ones were also courtesy of my horse, though both were ultimately my fault -- I need to be much more mindful of where I put my face when tending to his feet. What amazed me was the fact that even some people I knew well, colleagues with experience in mental health, did not ask me what had happened -- their discomfort around me, attempts to ignore my injury and reluctance to ask what happened, embarrassed me. Because I had a black eye, I MUST be a victim of domestic violence (DV).

This represents a double standard: A man with a black eye is an athlete or, at worst, was in a fight -- a woman with a black eye is being beaten. While it is true that the majority of victims of DV are women, (and that 1.3 million women are victims of domestic assault each year), between 5 percent and 15 percent are, in fact, men.

Many years ago, as a pre-doctoral intern, I worked in a domestic violence and rape crisis center. I saw, first-hand, the devastating impact of ongoing abuse. In addition to experiencing severe psychological trauma, these women were socially isolated, had low self-esteem, felt guilty and ashamed, and, after years of abuse, felt as if they deserved what they got -- that they must have done something to bring it upon themselves.

Walking around with a face that looked like I had been punched by the Hulk (description courtesy of a colleague), and people's reactions to me made me reflect on what it must be like to be a victim of DV. Don't misunderstand me... the fact that I got to go home to a husband who loves me and who tended to my injuries rather than added to them made it impossible for me to really know what it is like. But I made a serious effort to empathize. Every time someone stared, or looked away quickly, or pretended they had not noticed, I felt marginalized and blamed -- I felt ashamed and guilty, as if I were worthless and deserving of being victimized. Notwithstanding the risks associated with trying to leave (approximately one-third of female homicide victims were killed by an intimate partner; women are at highest risk of serious violence when they attempt to leave an abusive partner), it is not surprising that domestic violence is severely underreported and that victims are unlikely to seek medical attention for their injuries.

So, what is the lesson in all of this? The first step in addressing a problem like DV is to face it, eyes up and head on. The next time you see a woman with a black eye do not automatically assume she is a victim of DV. The next time you see a man with a black eye, do not automatically assume he is not a victim of DV. Finally, do not allow your own discomfort or fear, that if you know the truth you are now responsible for doing something about it, to keep you from treating these individuals with respect. By pretending not to notice their injuries, by staring, or by looking away in embarrassment, you perpetuate the abuse they are already receiving at home. If it is someone you know, reach out, ask what happened and offer help, support and compassion. Perhaps by being more accepting, and less judgmental of DV victims, we can make headway in ensuring that it is reported more often and that victims (and perpetrators) receive the treatment they need and deserve.

Need help? In the U.S., call 1-800-799-SAFE (7233) for the National Domestic Violence Hotline.

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Elizabeth C. Katz, PhD is a Maryland Licensed Psychologist and is an Associate Professor of Psychology at Towson University. She directs the MA program in Psychology, Clinical Concentration.

She is greatly indebted to Beau, her retired thoroughbred racehorse, for helping her gain insight into the plight of victims of visible trauma.