Themes of Healing and Posttraumatic Growth in Women Survivors’ Narratives of Intimate Partner Violence

Abstract

Research on the effects of intimate partner violence (IPV) on women demonstrates the significant physical, emotional, psychological, and spiritual consequences of this form of interpersonal trauma. It is well documented that experiencing IPV can have devastating consequences to women’s physical and mental health, overall well-being, and quality of life, as well as that of their children’s. However, a small, predominantly qualitative body of research exists on women’s experience of and capacity for healing from the effects of IPV, but more research is needed to advance theory and practice in this important area. This study applied secondary analysis to an existing data set to answer the question, “What are the themes of healing and posttraumatic growth in ten diverse women’s narratives of IPV?” Lengthy, detailed interview transcripts were rigorously subjected to inductive and deductive thematic analysis, which revealed three overarching themes, and six subthemes, of healing and posttraumatic growth in women’s narratives: Awareness and Insight (subthemes: Discerning the Self and Understanding Relationships), Renewal and Reconstruction (subthemes: [Re]building the Self and Redefining Relationships), and Transformation and Meaning (subthemes: New Perspectives and Finding Purpose Through Helping Others). Findings further revealed that women’s healing from the effects of IPV involves a multidimensional, personalized, nonlinear, and often transformative process that operates within themselves and through relationships. Practitioners working with women who have experienced IPV should consider survivors’ potential for healing and target appropriate intervention strategies. Additional qualitative and longitudinal research with diverse populations would deepen understanding of the dynamics, variables, and circumstances that impact healing and posttraumatic growth for women exposed to IPV.

Keywords

domestic violence cultural contexts mental health and violence intervention/treatment

Intimate partner violence (IPV) is defined as “behaviour within an intimate relationship that causes physical, sexual, or psychological harm, including acts of physical aggression, sexual coercion, psychological abuse, and controlling behaviours” (World Health Organization, 2010, p. 11). Although IPV is usually perpetrated by men against women, it can refer to violence between any current and former partners of any gender, in any type of intimate relationship (World Health Organization, 2010). IPV is the most common form of violence experienced by women (Devries, Mak, Garcia-Moreno, et al., 2013); worldwide, almost one third (30%) of ever-partnered women are estimated to have experienced IPV (World Health Organization, 2013).

To date, much of the literature on IPV has focused on the many serious negative consequences for women who have experienced this type of violence, but comparatively little research has been conducted on women’s healing from the effects thereof (Allen & Wozniak, 2010; Flasch, Murray, & Crowe, 2017). The potential long-term negative health and quality of life effects of IPV on women, including mental health symptoms such as depression, anxiety, suicidal ideation and attempts, and posttraumatic stress disorder, are well documented (Basile, Arias, Desai, & Thompson, 2004; Devries, Mak, Bacchus, et al., 2013; Dillon, Hussain, Loxton, & Rahman, 2013; Macy, Ferron, & Crosby, 2009). However, even in light of these major consequences, many women are able to engage in a process of healing from their experiences of IPV (Flasch et al., 2017). Some evidence suggests women may even experience growth as a result of their struggle to overcome such trauma (Cobb, Tedeschi, Calhoun, & Cann, 2006; M. E. Smith, 2003; Ulloa, Hammett, Guzman, & Hokoda, 2015; Valdez & Lilly, 2015), although research on posttraumatic growth (PTG) is still in its infancy. Thus, the purpose of this study was to conduct a secondary qualitative analysis (Heaton, 2008) to identify themes of healing in the narratives of 10 women who have experienced IPV and to explore what these themes suggest about the potential for PTG in the wake of such trauma.

Literature Review

Healing From IPV

Much of the literature focuses on the negative physical and psychological consequences of IPV (Allen & Wozniak, 2010; Flasch et al., 2017). However, there is a small, predominantly qualitative body of research that addresses women’s experience of and capacity for healing from IPV. This literature demonstrates that women’s healing from IPV involves physical, mental, and spiritual components (Allen & Wozniak, 2010; Farrell, 1996).

Some researchers identify specific phases that comprise women’s healing (Allen & Wozniak, 2010; Giles & Curreen, 2007; M. E. Smith, 2003; Wuest & Merritt-Gray, 2001), while others view it as an ongoing process and focus on the themes across survivors’ experiences (Davis & Taylor, 2006; Farrell, 1996; Flasch et al., 2017; Senter & Caldwell, 2002; Taylor, 2004). Multiple studies identify common elements in women’s healing, including reclaiming the self and identity (Allen & Wozniak, 2010; Davis & Taylor, 2006; Flasch et al., 2017; Senter & Caldwell, 2002; M. E. Smith, 2003; Taylor, 2004; Wuest & Merritt-Gray, 2001), increased self-awareness (Farrell, 1996; Senter & Caldwell, 2002; Wuest & Merritt-Gray, 2001), acknowledging the abuse (Farrell, 1996; Senter & Caldwell, 2002; Taylor, 2004), the importance of supportive relationships (Farrell, 1996; Flasch et al., 2017; Senter & Caldwell, 2002; M. E. Smith, 2003); forgiveness (Flasch et al., 2017; M. E. Smith, 2003; Taylor, 2004), and helping others (Flasch et al., 2017; Senter & Caldwell, 2002; M. E. Smith, 2003; Taylor, 2004).

PTG

Some studies on women’s healing from IPV suggest that there is an element of transformation in their healing processes (Senter & Caldwell, 2002; M. E. Smith, 2003). The notion that an individual can experience positive transformation following significant adversity is not new. Indeed, positive personal change occurring in the wake of suffering has been recognized for centuries in various religious, philosophical, and literary contexts (Calhoun & Tedeschi, 2014; Linley & Joseph, 2004; Saakvitne, Tennen, & Affleck, 1998). In the 20th century, existential scholars such as Frankl (1963) and Yalom (1980) discussed the idea of personal growth ensuing from great loss. In the 1990s, researchers in psychology pursued a more systematic understanding of this issue by using quantitative and qualitative tools to conduct empirical research into the phenomenon of PTG (Tedeschi & Calhoun, 1995, 1996), an area of inquiry that was propelled forward by the advent of positive psychology (Seligman & Csikszentmihalyi, 2000) and is now an established field of research (Calhoun & Tedeschi, 2014; Joseph & Linley, 2005, 2006; Joseph, Murphy, & Regel, 2012; Tedeschi & Calhoun, 2004).

Many terms have been used to describe the concept of growth in the aftermath of suffering; however, researchers and clinicians have generally adopted PTG (Tedeschi & Calhoun, 1995, 1996) as the most widely used term in this field (Joseph et al., 2012). Conceptual understanding of PTG continues to develop; however, researchers have accepted three broad domains of positive change related to PTG (Calhoun & Tedeschi, 2014; Joseph et al., 2012; Tedeschi & Calhoun, 1996, 2004). The first domain is the perception of self: people describe a change in their self-perception, accepting that they are more vulnerable than they realized while simultaneously discovering newfound strength, resilience, and wisdom. The second domain is relationships with others: people describe improved relationships, especially in the form of increased compassion for others and valuing existing bonds. The third domain is general life philosophy: people describe reevaluating their priorities and experiencing increased appreciation for life.

In addition to coining the term PTG, Tedeschi and Calhoun (1996, 2004; Calhoun & Tedeschi, 1998, 2001, 2014) contributed the most comprehensive theoretical model of growth to this field of study (Joseph & Linley, 2005, 2006). PTG refers to the positive psychological transformation that follows one’s struggle with significant loss, suffering, or trauma (Calhoun & Tedeschi, 1998; Tedeschi & Calhoun, 2004). They further described it as “a significant beneficial change in cognitive and emotional life beyond previous levels of adaptation, psychological functioning, or life awareness” (Tedeschi & Calhoun, 2003, p. 12). Their functional-descriptive theory posits that it is not the traumatic event that causes growth in an individual, but “the struggle with the new reality” following the trauma (Tedeschi & Calhoun, 2004, p. 5). This model features five domains of PTG: greater appreciation of life and changed sense of priorities; warmer, more intimate relationships with others; a greater sense of personal strength; recognition of new possibilities for one’s life; and spiritual development (Tedeschi & Calhoun, 2004).

Evidence on the relationship between psychological distress and PTG is mixed (Tedeschi & Calhoun, 2004). While some studies found higher levels of growth tend to be associated with lower levels of distress (Frazier, Conlon, & Glaser, 2001; Park, Cohen, & Murch, 1996), others found no consistent relationship between PTG and distress (Cordova, Cunningham, Carlson, & Andrykowski, 2001; Grubaugh & Resick, 2007; Powell, Rosner, Butollo, Tedeschi, & Calhoun, 2003), or demonstrated a significant association between intrusive thoughts (one of the symptoms of posttraumatic stress disorder) and PTG (Calhoun, Cann, Tedeschi, & McMillen, 2000). Cobb et al. (2006) found no association between depressive symptoms and PTG, contributing to the lack of consensus on the relationship between distress and PTG.

PTG and IPV

Most of the literature that examines PTG in women focuses on the aftermath of medical crises (e.g., breast cancer) and interpersonal traumas similar to IPV (e.g., physical and sexual assault and childhood sexual abuse; Linley & Joseph, 2004), although PTG has also been linked to IPV (Cobb et al., 2006; Ulloa et al., 2015; Valdez & Lilly, 2015). In an empirical review, Ulloa et al. (2015) showed that psychological growth is consistently found in women who have experienced IPV and that the three broad domains of change (i.e., perception of self, relationships with others, general life philosophy; Tedeschi & Calhoun, 1996) applied to growth in the aftermath of IPV.

The results of Cobb et al.’s (2006) study supported Tedeschi and Calhoun’s (1995) expectation that most growth occurs after the resolution of the trauma. However, researchers suggest caution when interpreting results with respect to the timing of PTG in relation to IPV (Cobb et al., 2006; Ulloa et al., 2015). Unlike other forms of trauma that are a single occurrence (e.g., natural disasters, accidents, single violent incident by a stranger), IPV is usually ongoing and involves repeated traumas and attempts to leave the traumatic situation (Landenburger, 1998; Ulloa et al., 2015). When a woman indicates she is still in an abusive relationship, she may have actually experienced growth during one of her periods away from her abusive partner (Cobb et al., 2006). In addition, women may continue to experience IPV after they leave the relationship (Renzetti, Edleson, & Bergen, 2011); therefore, when a woman indicates that she is out of the abusive relationship, she may experience some form of PTG while continuing to experience actual or threatened IPV (Cobb et al., 2006).

More recently, Valdez and Lilly (2015) extended previous research on PTG in women who experienced IPV by focusing on the relationship between PTG and changing world assumptions in a longitudinal study. They relied on Janoff-Bulman’s (1992, 2006) theory of world assumptions and model of PTG to guide their examination of the schema reconstruction process in women who experienced PTG following IPV. The sample was composed of 23 women who, after experiencing at least one physically violent incident with a partner in the 6 months prior to the beginning of the study, completed self-report questionnaires at two points, approximately 1 year apart. Results indicated that women who were not revictimized in the year following the initial assessment reported more positive world assumptions at Time 2. The majority of the participants (87%) reported PTG regardless of their revictimization status. The women who were able to positively reconstruct their schema of the world within the year, meaning perceiving the world as generally (though not always) controllable, predictable, and mostly good, perceived greater growth. This study suggests some of the mechanisms involved in PTG for women who have experienced IPV, though its small sample size limits the generalizability of its findings.

These studies provide some evidence that IPV survivors can experience healing and even PTG. However, additional study in this area is needed as research related to PTG following IPV lags behind research on PTG following other traumas (Cobb et al., 2006; Valdez & Lilly, 2015).

Method

Narrative thematic analysis (Braun & Clarke, 2006) was used to analyze existing interview data from the Healing Journey project, a larger longitudinal study that examined women’s experiences and impacts of IPV in the Canadian Prairie provinces with the aim to improve service provision (Hendrika, Hampton, & Bruyninx, 2012; Tutty, Radtke, & Nixon, 2009).

Data Source and Collection

During the Healing Journey project, 670 women, divided equally across the three Prairie provinces, completed detailed structured surveys at 6-month intervals in seven waves from 2005 to 2010 that focused on the impact of IPV on health, parenting, and general utilization of and satisfaction with services. Participants were recruited from service provider agencies, and were required to meet the following inclusion criteria: (a) having experience with IPV with the last incident occurring no earlier than January 2004; (b) not being in a crisis situation; (c) reporting a high interest and likelihood of staying in the study for the full three and a half years; and (d) not reporting or experiencing any serious or debilitating mental health issues at time of initial screening. Although women were recruited via a variety of service providing agencies, they were not required to be accessing services during the study interval.

Of this larger sample, and separate from the waves of structured survey interviews, approximately 110 women also self-selected to participate in open-ended narrative interviews that focused on their subjective, personal “journeys” with IPV. Conducted in English by interviewers trained on researching sensitive topics, each woman was asked a broad orienting question about her journey with IPV. The nature of the interviews allowed participants the freedom to express what was important to them, in their own words. Minimal probes were used to facilitate women’s story-telling and descriptions when necessary.

Specifically, the data for this study were de-identified verbatim transcribed interviews with 10 women who resided in a specific mid-sized prairie city. These 10 interviews were conducted in a residential nonprofit organization that provided services to women impacted by violence, including programming for women impacted by residential schools. The organization was structured to provide confidentiality, physical and emotional safety, and resources to participants, and had staff available to support any participants post-interview, if wanted or needed. The interviews were completed within 2 to 4 hours and transcripts ranged in length from 45 to 110 pages, providing abundant rich data for analysis. This study received ethical approval.

The 10 participants whose transcribed interview data were used were between 21 and 78 years of age. Six of the women identified their cultural background as Aboriginal, three identified their cultural background as European Canadian, and one identified her cultural background as a combination of European Canadian and Aboriginal. Eight of the women identified as heterosexual, one identified as lesbian, and one identified as bisexual. All of the women were mothers, with numbers of children ranging from one to five. The duration of the women’s abusive relationships ranged from 1.5 to 41 years. At the time of the interviews, two women identified as currently experiencing abuse, one woman was in a relationship with her previously abusive partner but was no longer experiencing abuse, and seven of the women were no longer in a relationship with their abusive partner.

Data Analysis

Secondary analysis

This study was a secondary analysis of existing, de-identified interview transcripts from the Healing Journey project. Secondary qualitative analysis involves using existing data to explore supplementary research questions (Heaton, 2008). It is a methodology that has gained momentum in research and scholarship since the mid-1990s (Heaton, 2008). A potential critique of secondary analysis (Heaton, 2008; Irwin, 2013; Szabo & Strang, 1997) is that the secondary researchers were not present for the collection of the data; however, it has also been suggested that secondary researchers’ “distance” from direct data collection can yield unique findings.

Thematic analysis

Though some researchers (Boyatzis, 1998; Ryan & Bernard, 2000) consider thematic analysis a tool to be used across various qualitative methods, others such as Braun and Clarke (2006) argue that thematic analysis is “a method in its own right” (p. 78). The current study aligns with Braun and Clarke’s position and adopts their six-phase approach to thematic analysis: (a) familiarizing yourself with your data, (b) generating initial codes, (c) searching for themes, (d) reviewing themes, (e) defining and naming themes, and (f) producing the report (Braun & Clarke, 2006).

Thematic analysis allows for the identification of themes within the data to occur either inductively or deductively (Braun & Clarke, 2006) or by using a hybrid process of both approaches (Fereday & Muir-Cochrane, 2006). A hybrid deductive–inductive approach was appropriate for the purpose of this study. As a starting point, an initial deductive approach was used to code for three broad categories that aligned with the three general domains of growth identified by Calhoun and Tedeschi (2014): positive changes/aspects of self, relationships with others, and life philosophy. Once the data were reduced into these three broad categories, the switch was made to an inductive approach to generate a greater number of more specific data-driven codes, followed by searches for themes from these codes (Boyatzis, 1998).

The trustworthiness of the analysis was established by satisfying criteria (i.e., credibility, transferability, dependability, and confirmability) that correspond with the study’s underlying constructivist paradigm (Lincoln & Guba, 1985; Morrow, 2005). These criteria were fulfilled in several ways: through the use of an audit trail generated by the first author who analyzed the data, which ensured the transparency of the analytic process; through the use of verbatim excerpts to guide and support the data analysis; through the use of discussion and debriefing among the authors of the analytic process and results; and through the first authors’ practice of reflexivity (Morrow, 2005).

Narrative Themes

Three major themes of healing were identified in the women’s narratives of IPV: Awareness and Insight, Renewal and Reconstruction, and Transformation and Meaning. Each of these themes was comprised of two subthemes that demonstrate how the theme operated both within the participants’ interior selves and through their relationships.

Awareness and Insight

Regardless of their relationship status, all participants displayed an awareness and understanding of themselves, their romantic and nonromantic relationships, and their experiences of abuse in their narratives. They expressed insight into who they are, how their experiences with IPV have impacted their identity and sense of self, and the role of their relationships in their stories of abuse and healing. As such, two subthemes, Discerning the Self and Understanding Relationships, work in concert to form the theme Awareness and Insight. Some participants demonstrated the theme Awareness and Insight by looking back on themselves and their experiences from a place of hindsight and understanding. Other participants, especially those who continued to experience various aspects of IPV at the time of the interview, displayed awareness that was anchored in the present as they spoke of their understanding of themselves and their relationships in the context of their current situation.

Discerning the self

The subtheme Discerning the Self illustrates the women’s willingness to explore and share their understanding of and insight into themselves, their strengths and personal struggles, and the context surrounding their abusive relationships. The participants also displayed efforts to deepen and share their understanding of how their experiences in their families of origin and with IPV have shaped and impacted them, as well as their understanding of how they coped with IPV. Several women articulated how their childhood experiences and the messages they learned as children affected their sense of self and therefore their choice of romantic partner. One participant, for example, made a direct link between the lessons she learned as a child and what she brought into her romantic relationships:

You might not make the other person happy by what you believe or by what you think, but that’s a stand I have to take, but I was never taught that. I was taught as a child you’re quiet, you do what your husband tells you . . . You don’t talk about stuff outside the home. You just put up with that. Which is no way to live . . . I took that into my relationships.

Participants also displayed an awareness of how their personal circumstances at the beginning of their abusive relationship elicited a vulnerability in them that contributed to starting or continuing the relationship. A participant explained,

I met him at a really low time in my life and I think the biggest thing was I was lonely . . . Being a single mom and what it took just to survive, and it was kind of nice at first . . . the first time I met [him], my gut feeling wasn’t good . . . I justified myself right into it.

Many of the women demonstrated a strong recognition of how their sense of self was eroded throughout their experiences of IPV, and how they have been physically, emotionally, and psychologically affected by the abuse inflicted on them by their romantic partners. For example, a participant displayed her insight into how her entire world revolved around her husband’s needs, leaving little room to learn about herself:

I didn’t know how to act, I didn’t know how to react, I didn’t know how to do anything because when we would go someplace I would just watch him to make sure he had everything that he wanted . . . I knew his body language, his face expression . . . and so I didn’t have to be responsible for myself at all.

Participants who were aware of how their experiences of IPV affected their sense of self experienced a compartmentalizing effect on their identity. One participant, for example, articulated an understanding of the symbolic function of her decorative mask collection:

Now I know [it was] because I wear so many faces sometimes . . . I was trying to hide everything from everybody . . . This was the face I wore in my house and then I wore a different one out the door.

This participant’s self-awareness and insight into the meaning behind her mask collection, however, suggests a new sense of wholeness in her identity.

Several participants expressed an awareness of the coping strategies they used while living with abuse in their relationships. For example, some demonstrated their understanding of the significance of exercising self-agency and control over the aspects of their lives, however quotidian, where this was possible. Participants also displayed an awareness of their use of coping strategies such as talking about their problems and their feelings with friends and counselors, participating in cultural and spiritual rituals (e.g., going to a sweat lodge, attending church), and finding comfort in their faith in a higher power.

Understanding relationships

The participants demonstrated awareness and insight into their abusive partners’ behavior and the dynamics of abuse in their romantic relationships, as well as the roles of their relationships with family, friends, and community in their experiences of abuse and in their healing journeys.

Throughout their narratives, participants demonstrated their awareness and insight by expressing their understanding of their partners’ behavior in their abusive romantic relationships. Several participants expressed a strong awareness of how control played a role in their relationships. Looking back on their relationships, they described how their partners initially assumed control over their lives under the guise of caring about them. For example, their partners would express not wanting them to overexert themselves or seemed worried about their safety. However, as time passed, many participants came to realize that their partners maintained their control by harming or threatening to harm them or their children. Not only did participants demonstrate their understanding of their partners’ need for control, they also developed awareness of how their partners maintained control when they were being abusive. Several women previously believed that their partners “lost control” when they were abusive toward them, just as their partners had insisted. However, some came to understand that their partners had, in fact, maintained total control during abusive episodes. One participant explained,

I always thought that he lost control, that’s why he would hit me, but he was in total control . . . I always thought that I made him lose control but I learned in counselling that he was in total control . . . And that was a hard thing for me to come to terms with.

Some participant narratives also demonstrated the theme of Awareness and Insight through their understanding of how their families impacted their journey of abuse and healing. One participant, for example, expressed her understanding of the damaging intergenerational impact of the residential school system on her family, linking her parents’ residential school experiences to subsequent violence in her family of origin and, later, in her romantic relationships. Though this woman’s story was one of violence and abuse, it was also one of personal insight into her family’s history and dynamics and the role these have played in her personal journey.

Many participants also shared their understanding of how their children were affected by witnessing IPV. Several spoke of the importance of their relationships with their children in their lives and some understood these relationships to be significant in their healing.

Renewal and Reconstruction

Many of the women described their renewal and reconstruction of themselves, their lives, and their relationships in their narratives. Several described experiencing changes in how they view themselves, in their ability to be assertive and set boundaries, in their comfort being on their own, in their sense of their personal power, in their physical and mental health and lifestyles, and in their relationships with their children, families, and new romantic partners. This second major theme, Renewal and Reconstruction, is composed of two subthemes, (Re)building the Self and Redefining Relationships.

(Re)building the self

This subtheme demonstrates the changes many of the participants experienced within themselves as they (re)built themselves following IPV. With few exceptions, the women discussed changes in their sense of self and identity, their feelings of empowerment, or their health and lifestyles. Some of the participants spoke about these changes explicitly in terms of rebuilding the self they “lost” when they were experiencing IPV. Others spoke about their personal changes in a manner that seemed to indicate they were building themselves up in ways that were totally new to them, rather than restoring their previous self. Notably, nine of the 10 participants experienced some form of childhood abuse, but not all of these participants discussed the impact of these experiences on themselves; therefore, the nature of a participant’s sense of self and identity pre-IPV could not be surmised unless she explicitly discussed this or her perception of the changes in herself. Thus, it was not always possible to determine whether such changes indicated that the participant was rebuilding or, in fact, building these aspects of her self. Consequently, the term (re)building is used to denote the change in self where this nuance is unclear.

The majority of the participants revealed in their narratives how they (re)built themselves and experienced changes in their sense of self following IPV by developing their identity and gaining personal strength. Several discussed their process of learning more about themselves, and the positive outcomes of developing their sense of self. One participant described how she “lost [herself]” during the years of abuse she experienced with her ex-husband but that since leaving him, she has “come leaps and bounds from being the doormat to . . . trying to be [her] own self again.” She described the return to self: “You do lose who you are, and its kind of a big shining light when you come back to it, though.”

Some of the participants’ narratives illustrated how they have (re)built themselves, not only through a renewed and reconstructed sense of self and identity, but also through a change in their sense of their own power. One participant spoke of how developing her sense of her own power aided by the support she received from members of her community. She found that various community services helped her to stand up for herself when her ex-husband tried to hurt and intimidate her:

I got thinking, if I was seven feet tall with a whole bunch of muscles I could just pick him up by the front of his shirt and hold him against the wall and say, “How do you feel?” Shake him a little. Let him know I’m serious. And there came a day when I had support from the police and those counsellors and my minister that I said, “you know, for the first time in my life I am seven feet tall. Take your hands off me.” And that’s where you don’t have to be mean to have a bit of power.

Redefining relationships

As part of the Renewal and Reconstruction theme, the Redefining Relationships subtheme is illustrated through participants’ changes in their relationships with others. Participant narratives demonstrated improved relationships with new romantic partners and with their children, family, friends, and community. When the participants discussed their experiences of abuse, many revealed the challenges they faced with adopting the values and lifestyles of their partners to the exclusion of their own, not being able to say “no” to their partners or family members, and taking on their partner’s and family’s problems as their own. In their narratives, participants articulated that they were creating and sustaining new limits with others that worked well for them and improved relationships with loved ones.

Contrary to being in an abusive relationship where she was “so scared to even talk,” one participant described feeling like she can relax and be herself in her new marriage, appreciating that her husband “takes care of all [my] little quirks” resulting from her experience with IPV, such as her need for increased security measures at home.

The participants’ improved nonromantic relationships also illustrated the Renewal and Reconstruction theme. They described a renewed interest in and ability to hang out with friends and to join community and church groups, as well as more careful discernment about which friends they would allow in their lives. Participants also spoke of redefining what motherhood meant to them, choosing to break the cycle of violence some of them had experienced in their childhood homes. One participant explained,

My mom was abused, I saw that, and we were abused, and that was no good. And, once I started yelling at my kids and then realized . . . I’m turning into my mother. [So] we try to discuss things in our house, and we have a wall where we put [up things] about respecting each other, not freaking out, sit down and talk, we put different things. Everyone worked on the wall together . . . When the kids get upset I tell them [to do] deep breathing, let’s do some deep breathing together.

Transformation and Meaning

The third theme, Transformation and Meaning, illustrates how, though the women have experienced trauma and pain in their experiences with IPV, some of the participants transformed in their perspectives on life and in their roles with others as they found meaning in these experiences. Here, meaning is conceptualized as significance, referring to the participants’ construction of value and purpose in life from their experiences of IPV (Janoff-Bulman & Yopyk, 2004). This theme is divided into two subthemes that illustrate the women’s transformation: New Perspectives and Finding Purpose Through Helping Others.

New perspectives

The subtheme New Perspectives demonstrates the participants’ personal thriving in the form of a transformation in their perspective on life. The participants’ narratives clearly illustrated the significant negative toll that their experiences of IPV had on them. However, some of their narratives also illustrated feelings of happiness and pride in their accomplishments in the years following their experiences of abuse. Participants described “feeling great” and “enjoying life” at the time of their interviews. These women transformed their perspective as they created lives of contentment, peace, and happiness in the years after they left their abusive relationships. Some also spoke of forgiving their abusive partners and experiencing gratitude in the face of their challenges which have made them into who they are today. They also demonstrated their transformation through a change in perspective about their future, in that they now have hope. Interestingly, the participants who spoke of hope for the future often did so through their hopes for their children. Some of the women discussed how they drew hope and strength from their children and their pursuit to provide them with better lives. For example, when talking about her hopes for the future, one participant envisioned,

Healthy, smart, intelligent kids off to college . . . writing my books, doing more painting and drawing . . . and spending more time with the kids and making it quality time . . . so being more of who I want to be, not what everyone else expects me to be . . . I think that’s very positive . . . I never would have said that three years ago.

Finding purpose through helping others

The second subtheme of Transformation and Meaning demonstrates how some participants found meaning and purpose in their experiences and lives through helping other women who have experienced IPV. Many of the participants described supporting women who were experiencing IPV either formally (through organizations) or informally (through friendships). One participant explained her reasoning for reaching out to other women: “If I keep it to myself, I feel nobody gets better. If I can share, one person gets helped or the next generation gets helped.”

In addition, some of the women expressed that their desire to participate in the interviews stemmed from wanting to offer support and help to other women who are experiencing IPV. One participant explained, “I hope [doing the interview] could help people, like, that’s why I like to talk about it. I know it hurts and it brings up some bad feelings but . . . I just hope it helps people.” During the interviews, along with sharing their own stories, participants were given the opportunity to share what they would want to tell other women who are experiencing IPV. One woman wanted to dispel the idea that victims of abuse are alone in their suffering and declared: “It’s not true! And, if you can, have the courage and the strength . . . to reach out, somewhere, somehow to someone, and just say, ‘help, please.’” Another woman commented on the value of learning about themselves and gaining inner strength:

Get life swimming lessons . . . The stronger you are and the better you take care of yourself, the better chance you have of swimming out of there . . . Build yourself up young! Educate yourself, make yourself a better person, have an independent lifestyle.

The participants consistently offered words of encouragement to other victims of abuse, thereby transforming themselves, even if only momentarily, into advocates for other women.

Discussion

Thematic findings are discussed with reference to the extant literature and practical implications and future research directions are identified.

Awareness and Insight

The theme Awareness and Insight illustrates the participants’ discernment of themselves, their insight into how their experiences of abuse impacted their sense of self, and their understanding of the role of their relationships in their stories of IPV. This theme was identified in all of the participant narratives. This may be expected as the participants in this study were recruited through service providers such as shelters and counseling centers, and self-selected into both the overall project and the interviews. These women, therefore, had already sought external formal supports related to IPV, and identified themselves as people who were interested in talking about their experiences. They may have gained awareness and insight through counseling support and other healing approaches, and may be among those who are naturally predisposed to engaging in self-reflection.

The women expressed a common sentiment of feeling that they “lost” themselves when they were experiencing IPV; some indicated that they did not have a sense of who they were separate from their abusive partners. As most of the women were no longer experiencing IPV at the time of the interview, many demonstrated a retrospective understanding and insightfulness as they reflected on the impact of abuse on their sense of self from a place of safety. These women spoke with insight about their previous loss of self and their survival and coping abilities, which suggests they had moved into a new place of awareness through a process of healing. Senter and Caldwell (2002) note a similar finding in their research: The participants in their study were only able to engage in self-discovery and the development of self-awareness after they stopped experiencing abuse, as most of their energy when in the relationship went toward survival. Wuest and Merritt-Gray (2001) also report a similar finding that, once the woman no longer felt at risk, she experiences “relative stability [that] allows her time and energy for purposeful reflecting on the past” (p. 83). However, the present study’s findings differ from Senter and Caldwell’s (2002) and Wuest and Merritt-Gray’s (2001) in that this theme was evident in all of the women’s narratives, regardless of the status of their abusive relationship. Some form of awareness and insight, either related to the self, their past and present experiences of abuse, or the role of their relationships was accessible to all of the women in their healing process, including the two women who were experiencing IPV at the time of the interview. However, this awareness and insight may have resulted from a time when the women were not in an abusive relationship.

Renewal and Reconstruction

The second major theme of Renewal and Reconstruction related to changes in the participants’ sense of self and relationships. Similar themes related to (re)building the self (Davis & Taylor, 2006; Farrell, 1996; Flasch et al., 2017; Humbert, Bess, & Mowery, 2013; M. E. Smith, 2003; Wuest & Merritt-Gray, 2001; Young, 2007) and redefining relationships (Anderson, Renner, & Danis, 2012; Davis & Taylor, 2006; Flasch et al., 2017; Humbert et al., 2013; Senter & Caldwell, 2002; M. E. Smith, 2003; Ulloa et al., 2015; Wuest & Merritt-Gray, 2001; Young, 2007) are commonly represented in the literature on women’s healing from IPV.

In her qualitative study of women’s recovery from IPV, M. E. Smith (2003) found that healing involved the participants’ rediscovery of their identity that was lost during the abusive experience. Similarly, Humbert et al. (2013) identify the theme Expansion of Self which illustrates changes within the women and “a discovery of who they were becoming as individuals” (p. 259) as they overcame IPV. In addition, Flasch et al. (2017) report a common theme in their participants’ responses centered on regaining and recreating one’s identity following experiences of IPV. These previous findings support the present study’s Renewal and Reconstruction theme that showed that many of the women who were interviewed described a “return to self” and efforts to rebuild their sense of self after they left their abusive relationship.

The Renewal and Reconstruction theme in the current study also illustrates the women’s healing from IPV through changes in their romantic and nonromantic relationships, a finding in accord with previous research (Anderson et al., 2012; Davis & Taylor, 2006; Flasch et al., 2017; Humbert et al., 2013; Senter & Caldwell, 2002; M. E. Smith, 2003; Ulloa et al., 2015; Wuest & Merritt-Gray, 2001; Young, 2007). An established consequence of being in an abusive relationship is isolation from friends, family, and community (Sanderson, 2008). It follows, then, that part of the healing process for women recovering from IPV would involve an improvement in these relationships, as demonstrated in the Redefining Relationships subtheme in the present study and similar notions in the literature (Anderson et al., 2012; Davis & Taylor, 2006; Flasch et al., 2017; Humbert et al., 2013; Senter & Caldwell, 2002; M. E. Smith, 2003; Ulloa et al., 2015; Wuest & Merritt-Gray, 2001).

In addition, the changes in the women’s sense of self and in their relationships that are evident in the Renewal and Reconstruction theme also support previous research on women’s growth following IPV (Anderson et al., 2012; Cobb et al., 2006; Ulloa et al., 2015). Two major domains of growth are changes in the perception of self, especially in the form of newfound strength, and changes in relationships with others in the form of increased intimacy and connection (Tedeschi & Calhoun, 2004). These domains have been found to apply to women’s growth in the aftermath of IPV (Anderson et al., 2012; Cobb et al., 2006; Ulloa et al., 2015).

Transformation and Meaning

The theme Transformation and Meaning demonstrated the women’s transformed perspectives on themselves and their lives. Consistent with previous research on women’s healing and recovery from IPV (Farrell, 1996; Flasch et al., 2017; Senter & Caldwell, 2002; M. E. Smith, 2003; Taylor, 2004; Wuest & Merritt-Gray, 2001), the happiness and contentment, pride, forgiveness, gratitude, and hope the participants demonstrated in their narratives point to their healing process. This theme also illustrated that helping other women who have experienced IPV fostered healing for many of the participants by helping them find meaning in their experiences of abuse and a sense of purpose in their life. These results are highly consistent with previous research on women’s healing from IPV (Flasch et al., 2017; Giles & Curreen, 2007; Humbert et al., 2013; Senter & Caldwell, 2002; M. E. Smith, 2003; Taylor, 2004; Ulloa et al., 2015).

The changes in the women’s perspectives on life and the meaning they derived from helping others that are reflected in the theme Transformation and Meaning also support research on women’s growth following IPV (Cabral, 2010; M. E. Smith, 2003; Taylor, 2004). Another major domain of growth is a changed philosophy that centers primarily on a greater appreciation for life and a greater sense of purpose (Tedeschi & Calhoun, 2004). Tedeschi and Calhoun (2004) proposed that the growth that occurs following trauma is a result of the process of making meaning out of the traumatic experience. The transformation in perspectives on life and meaning illustrated in the women’s narratives are consistent with previous research on women’s growth in the aftermath of IPV (Cabral, 2010; Taylor, 2004).

Healing as a Multidimensional, Personalized Process

The three major themes explored in this study reinforced that women’s healing from IPV is a multidimensional, personalized process (Allen & Wozniak, 2010; Farrell, 1996; Flasch et al., 2017) that involves physical, psychological, social, cultural, and philosophical aspects of their experience.

As supported by Flasch et al. (2017), the women’s healing processes took place over the long-term and included accounts of a range of personal and social stressors. This finding differs from M. E. Smith (2003), who suggests that psychological distress and healing cannot coexist in women’s experiences of recovery from IPV. However, Tedeschi and Calhoun’s (2004) view that “growth experiences do not put an end to distress in trauma survivors” (p. 13) further supports the present findings that the women’s healing processes, including their potential growth, did not preclude experiences of distress. Indeed, while most of the women either implicitly or explicitly expressed an overarching sense of forward movement in their healing journey, many recounted cycling through feelings of loneliness, fear, sadness, uncertainty, and discouragement along with feelings of connection, courage, happiness, confidence, and hope. This points to the complexity of the women’s experiences and supports previous research that reveals women’s IPV-related healing is a nonlinear, process-oriented journey (Davis & Taylor, 2006; Farrell, 1996; Flasch et al., 2017) rather than a sequence of phases that culminate in a definitive point of arrival (Allen & Wozniak, 2010; Giles & Curreen, 2007; M. E. Smith, 2003; Wuest & Merritt-Gray, 2001).

The women’s healing journeys in the current study were varied and personalized. Though their narratives shared common themes, each healing journeys was unique. For example, the women displayed some commonalities in demonstrating their self-awareness or an understanding of how they coped with IPV, or changes in themselves and their relationships, or the meaning they found in their experiences of helping others; however, what each woman understood or how each woman coped with IPV or which changes each woman experienced was unique to her and her situation. For example, three participants talked about their faith in God as an element in their personal healing journey, while two participants referenced their use of sweat lodges in their efforts to cope with their experiences of IPV. These women’s references to their spirituality and cultural traditions point to the personalized nature of the women’s healing journeys.

Furthermore, at the time of the interviews the participants were in varying states of relationship with their abusers, ranging from divorced/separated for several years with little to no contact, to more recently separated with periodic contact that is sometimes abusive, to currently in an actively abusive relationship. In addition to their unique personal qualities and external supports, their differing levels of contact with their abusive partners and the length of time that had passed since their last experience of abuse necessarily personalized each woman’s healing journey. Regardless of their relationship status, however, at least some themes of healing were identified in all of the women’s narratives, a finding supported by previous research indicating healing from IPV can begin while the woman is still in the abusive relationship (Cobb et al., 2006; Farrell, 1996; M. E. Smith, 2003; Wuest & Merritt-Gray, 2001).

Though some themes of healing were identified in all of the women’s narratives regardless of their relationship status, the voices of the women experiencing IPV at the time of the interview were better represented in the Awareness and Insight theme than in the Renewal and Reconstruction and Transformation and Meaning themes. This suggests that looking inward to try to understand oneself and one’s personal history and context, as well as looking outward to try to understand the dynamics of one’s abusive relationship, were the most accessible processes in the women’s healing regardless of their relationship status. This also suggests concrete changes that underpin the Renewal and Reconstruction and Transformation and Meaning themes (those linked to the domains of PTG), were more accessible to women further removed from their experiences of abuse. This finding is consistent with previous research on women’s growth following IPV (Cabral, 2010; Cobb et al., 2006; Ulloa et al., 2015; Young, 2007) that indicates growth, when it occurs, is commonly in the aftermath of the abusive relationship.

Limitations

A limitation of this study and secondary analysis in general is that data were collected by other interviewers (Heaton, 2008; Irwin, 2013; Szabo & Strang, 1997). Generally, one advantage of choosing interviews as the method of data collection is that they happen in real-time, allowing the researcher and participant to enter into a dialogue and the researcher to follow up on significant issues that emerge through the process (J. A. Smith, 2004). Though there can be a dialogic quality to a researcher’s dynamic engagement with textual data (Tesch, 1987), in this case the primary dialogue was between the participants and other interviewers. As such, the analysis did not allow for additional data to come from further probing or clarifying questions regarding the participants’ understanding of their healing experiences. On the contrary, “distance” from the direct data collection process (Szabo & Strang, 1997) provided an opportunity to “shed analytical or critical light” on the interview data (Irwin, 2013, p. 298) through the exploration of the nuances of healing or PTG in the women’s accounts of IPV.

Implications for Practice

It is important for practitioners working with women who have experienced IPV to understand the complexity of responses to experiences of abuse. Clinicians should understand the dynamics of IPV and the resulting serious effects on survivors’ physical, mental, emotional, and spiritual well-being. Practitioners should also understand survivors’ potential for healing to provide a comprehensive approach to treatment and target appropriate intervention strategies that best support their clients (Flasch et al., 2017; Ulloa et al., 2015). While several of the women in this study discussed the transformation they experienced through their experience of IPV, it is important to make the distinction that none of the women were “better off” for having experienced IPV. As Anderson et al. (2012) cautioned, “professionals must be careful not to minimize victimization and its often devastating consequences” (p. 1295). Indeed, practitioners should recognize that when women experience positive outcomes, they are a consequence of their efforts to overcome the trauma of IPV, not a result of the trauma itself (Tedeschi & Calhoun, 2003, 2004). Professionals working with women who have experienced IPV should integrate both negative and positive outcomes and consider the role of PTG in their clients’ healing journeys (Sanderson, 2008) and the merits of strength-based interventions (Song & Shih, 2010).

In addition, the therapeutic relationship offers an opportunity for corrective relational connection. This is especially important for survivors of IPV, who commonly experience social isolation while in the abusive relationship (Sanderson, 2008). By adopting a caring, empathic, nonjudgmental stance, the therapist creates a safe environment in which the survivor can work toward reconnecting with the self through a connection with another. The relational-cultural model of development and therapy (Jordan, 2003; Jordan, Kaplan, Miller, Stiver, & Surrey, 1991), in which relationships are considered to be women’s primary source of healing and growth, calls for a therapeutic relationship that focuses on helping the client move from isolation, immobilization, and disempowerment toward connections that foster growth (Jordan, 2003). This also involves helping the client develop relational resilience, which is the ability to find and use relational resources in her life (Jordan, 2003). The significance of this type of resilience can be seen in the results of the present study, which demonstrate the primacy of relationships in the three themes of healing that were identified in the women’s narratives. Along with the results of the present study, the relational-cultural model also suggests that women thrive when they participate in promoting others’ healing (Jordan, 2003). As such, group therapy and support groups with other women who have experienced IPV can provide powerful opportunities for women to learn about and experience their relational selves within a safe context.

Finally, the majority of the participants identified as Aboriginal. The increased risk of these women experiencing IPV, which has been linked to the damaging effects of colonization (Bopp, Bopp, & Lane, 2003; Brownridge, 2003, 2008; Scrim, 2010; Truth and Reconciliation Commission of Canada, 2015), has practical implications. First, it points to the need for practitioners to consider the historical and cultural context of Aboriginal clients’ experiences and healing in their provision of “effective, ethical, and culturally appropriate interventions” (McCormick, 1998, p. 282). Second, it indicates the importance of prevention and intervention community supports for Aboriginal women. Not-for-profit organizations play a role in the provision and coordination of these services for Aboriginal women experiencing IPV. For example, the Native Women’s Association of Canada (NWAC) created You Are Not Alone: A Toolkit for Aboriginal Women Escaping Domestic Violence (NWAC, 2015), which provides Aboriginal women with information, strategies, and community safety planning resources to help them exit violent relationships. In the United States, the organization Mending the Sacred Hoop addresses violence against Native American women and works to end it by providing training to Tribal and Native communities related to responding to this form of crime, advocacy and systems responses, understanding and awareness, engaging men in the work to end violence against women, and coordinating community responses that provide for women’s safety and uphold offender accountability.

Considerations for Future Research

To date, most research on IPV has focused on the negative impacts of this trauma on women (Allen & Wozniak, 2010; Flasch et al., 2017), including an emerging body of work centered on the negative consequences of IPV for women across diverse racial/cultural, socioeconomic, and sexual orientation backgrounds (Sokoloff & Dupont, 2005). Despite some development in the understanding of women’s healing from IPV, this continues to be an area of research in need of development. Studies on PTG following IPV are especially sparse, particularly those using qualitative methodologies. The research that does exist on healing or growth from IPV seems to be concentrated on Caucasian or African American female survivors of abusive heterosexual relationships in the United States (Anderson et al., 2012; Cobb et al., 2006; Flasch et al., 2017; Senter & Caldwell, 2002; M. E. Smith, 2003; Taylor, 2004; Valdez & Lilly, 2015), though there are some studies on women’s healing from IPV from Canada (Wuest & Merritt-Gray, 2001), Australia (Davis & Taylor, 2006), New Zealand (Giles & Curreen, 2007), and Taiwan (Song & Shih, 2010). Future research on healing from IPV should be extended to more diverse populations (e.g., immigrant women, same-sex relationships, male survivors of IPV, etc.). Longitudinal studies would deepen understanding of the dynamics, variables, and circumstances that impact healing and PTG over time.

A particular consideration for Canadian researchers is to explore Canadian Aboriginal women’s experiences of healing from IPV. While IPV in Aboriginal communities shares many features with IPV in non-Aboriginal communities, the former has also been linked to the damaging effects of colonization, including the residential school system, and ongoing systemic oppression (Bopp et al., 2003; Brownridge, 2003, 2008; Scrim, 2010; Truth and Reconciliation Commission of Canada, 2015). It is understood that Aboriginal women are more likely to experience IPV than non-Aboriginal women because of this link (Brownridge, 2003, 2008), yet a search of the literature revealed zero studies on Aboriginal women’s healing from IPV. This suggests that concentrating on Aboriginal women’s experiences of IPV, their healing from this form of abuse, and possible interventions would be a significant contribution to the IPV literature. An ethical exploration of Aboriginal women’s healing from IPV should be grounded in the researcher’s competency to understand the historical, cultural, and systemic factors related to both violence and healing in Aboriginal communities, and the participants’ consent to engage in culturally focused research.

Finally, recognizing women’s remarkable capacity to heal from IPV is important, but so is acknowledging that no one should ever have to experience such abuse. While the women’s narratives demonstrate that there is a transformative quality to their healing, the burden of altering the landscape of IPV should not lie with them. Along with offenders’ personal responsibility to change their behavior, there is a continued need for individuals, families, and communities of researchers, service providers, and policy makers to better understand, interrupt, and reform the underlying personal, familial, and systemic mechanisms that engender IPV. The practice and policy implications that emerge from these findings argue for continued services that are strengths rather than deficit-based; stronger public awareness campaigns; services that continue past the immediacy of exiting from an abuse environment; and policies that support the strengthening of relationships with friends, family, and community. It is recommended that any policies include supporting culturally engaged services to meet the needs of Aboriginal women who are dealing with the impacts of residential schools and colonization, as well as those in immigrant and newcomer communities.

Footnotes

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Funding for the Healing Journey: A longitudinal study of women who have been abused by intimate partners project was provided by the Social Sciences and Humanities Research Council of Canada—Community/University Research Alliance (Principle Investigator, Dr. J. E. Ursel; University of Manitoba), Prairieaction Foundation, Alberta Centre for Child, Family and Community Research, and Alberta Heritage Foundation for Medical Research.

Author Biographies

Cassandra D’Amore, MEd, is a counselor with Prairie Spirit School Division, Saskatchewan. She completed master of education in school and counseling psychology at the University of Saskatchewan, focusing her research on women’s healing from the trauma of intimate partner violence.

Stephanie L. Martin, PhD, RDPsych, is an associate professor and graduate chair in the Department of Educational Psychology & Special Education, University of Saskatchewan. She teaches the theory and practice of counseling and psychotherapy, ethics, qualitative research methodology. Her research interests include healing from the trauma of violence and abuse, professional development and well-being, and women’s mental health.

Karen Wood, PhD, RSW, is an adjunct professor in the Department of Sociology at the University of Saskatchewan, a registered social worker, and a community-based health researcher and practitioner with a particular interest in addressing issues related to intimate partner and family violence.

Carolyn Brooks, PhD, is an associate professor in the Department of Sociology at the University of Saskatchewan. She teaches in the areas of criminology and social control and conducts research on intimate partner violence, First Nations youth resilience, and Aboriginal women’s health.

References

Allen

K. N.

Wozniak

D. F.

(2010). The language of healing: Women’s voices in healing and recovering from domestic violence. Social Work in Mental Health, 9, 37-55.

Anderson

K. M.

Renner

L. M.

Danis

F. S.

(2012). Recovery: Resilience and growth in the aftermath of domestic violence. Violence Against Women, 18, 1279-1299.

Basile

K. C.

Arias

Desai

Thompson

M. P.

(2004). The differential association of intimate partner physical, sexual, psychological, and stalking violence and posttraumatic stress symptoms in a nationally representative sample of women. Journal of Traumatic Stress, 17, 413-421.

Bopp

Lane

Jr. (2003). Aboriginal domestic violence in Canada. Aboriginal Healing Foundation. Retrieved from http://www.ahf.ca/downloads/domestic-violence.pdf

Boyatzis

R. E.

(1998). Transforming qualitative analysis information: Thematic analysis and code development. Thousand Oaks, CA: SAGE.

Braun

Clarke

(2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3, 77-101.

Brownridge

D. A.

(2003). Male partner violence against Aboriginal women in Canada: An empirical analysis. Journal of Interpersonal Violence, 18, 65-83.

Brownridge

D. A.

(2008). Understanding the elevated risk of partner violence against Aboriginal women: A comparison of two nationally representative surveys of Canada. Journal of Family Violence, 23, 353-367.

Cabral

C. M.

(2010). Psychological functioning following violence: An examination of posttraumatic growth, distress, and hope among interpersonal violence survivors (Doctoral dissertation). Available from ProQuest Dissertations and Theses Global database. (Order No. 869312610)

10.

Calhoun

L. G.

Cann

Tedeschi

R. G.

McMillen

(2000). A correlational test of the relationship between posttraumatic growth, religion, and cognitive processing. Journal of Traumatic Stress, 13, 521-527.

11.

Calhoun

L. G.

Tedeschi

R. G.

(1998). Posttraumatic growth: Future directions. In Tedeschi

R. G.

Park

C. L.

Calhoun

L. G.

(Eds.), Posttraumatic growth: Positive change in the aftermath of crisis (pp. 215-238). Mahwah, NJ: Lawrence Erlbaum.

12.

Calhoun

L. G.

Tedeschi

R. G.

(2001). Posttraumatic growth: The positive lessons of loss. In Neimeyer

R. A.

(Ed.), Meaning reconstruction and the experience of loss (pp. 157-172). Washington, DC: American Psychological Association.

13.

Calhoun

L. G.

Tedeschi

R. G.

(2014). The foundations of posttraumatic growth: An expanded framework. In Calhoun

L. G.

Tedeschi

R. G.

(Eds.), Handbook of posttraumatic growth: Research and practice (pp. 3-23). Mahwah, NJ: Lawrence Erlbaum.

14.

Cobb

A. R.

Tedeschi

R. G.

Calhoun

L. G.

Cann

(2006). Correlates of posttraumatic growth in survivors of intimate partner violence. Journal of Traumatic Stress, 19, 895-903.

15.

Cordova

M. J.

Cunningham

L. L.

Carlson

C. R.

Andrykowski

(2001). Posttraumatic growth following breast cancer: A controlled comparison study. Health Psychology, 20, 176-185.

16.

Davis

Taylor

(2006). Stories of resistance and healing in the process of leaving abusive relationships. Contemporary Nurse, 21, 199-208.

17.

Devries

K. M.

Mak

J. Y.

Bacchus

L. J.

Child

J. C.

Falder

Petzold

. . . Watts

C. H.

(2013). Intimate partner violence and incident depressive symptoms and suicide attempts: A systematic review of longitudinal studies. PLoS Medicine, 10(5), e1001439.

18.

Devries

K. M.

Mak

J. Y.

Garcia-Moreno

Petzold

Child

J. C.

Falder

. . . Pallitto

(2013). The global prevalence of intimate partner violence against women. Science, 340, 1527-1528.

19.

Dillon

Hussain

Loxton

Rahman

(2013). Mental and physical health and intimate partner violence against women: A review of the literature. International Journal of Family Medicine, 2013, Article 313909.

20.

Farrell

M. L.

(1996). Healing: A qualitative study of women recovering from abusive relationships with men. Perspectives in Psychiatric Care, 32(3), 23-32.

21.

Fereday

Muir-Cochrane

(2006). Demonstrating rigor using thematic analysis: A hybrid approach of inductive and deductive coding and theme development. International Journal of Qualitative Methods, 5(1), 80-92.

22.

Flasch

Murray

C. E.

Crowe

(2017). Overcoming abuse: A phenomenological investigation of the journey to recovery from past intimate partner violence. Journal of Interpersonal Violence, 32, 3373-3401.

23.

Frankl

(1963). Man’s search for meaning: An introduction to logotherapy. New York, NY: Pocket Books.

24.

Frazier

Conlon

Glaser

(2001). Positive and negative life changes following sexual assault. Journal of Consulting and Clinical Psychology, 69, 1048-1055.

25.

Giles

Curreen

(2007). Phases of growth for abused New Zealand women: A comparison with other studies. Affilia: Journal of Women & Social Work, 22, 371-384.

26.

Grubaugh

A. L.

Resick

P. A.

(2007). Posttraumatic growth in treatment-seeking female assault victims. Psychiatric Quarterly, 78, 145-155.

27.

Heaton

(2008). Secondary analysis of qualitative data: An overview. Historical Social Research/historische Sozialforschung, 33(3), 33-45.

28.

Hendrika

Hampton

Bruyninx

(2012, October). Summary of healing journey presentations/analyses conducted in Saskatchewan. Presented at RESOLVE Research Day, Regina, Saskatchewan, Canada.

29.

Humbert

T. K.

Bess

J. L.

Mowery

A. M.

(2013). Exploring women’s perspectives of overcoming intimate partner violence: A phenomenological study. Occupational Therapy in Mental Health, 29, 246-265.

30.

Irwin

(2013). Qualitative secondary data analysis: Ethics, epistemology and context. Progress in Development Studies, 13, 295-306.

31.

Janoff-Bulman

(1992). Shattered assumptions. New York, NY: The Free Press.

32.

Janoff-Bulman

(2006). Schema-change perspectives on posttraumatic growth. In Calhoun

L. G.

Tedeschi

R. G.

(Eds.), Handbook of posttraumatic growth: Research and practice (pp. 81-99). Mahwah, NJ: Lawrence Erlbaum.

33.

Janoff-Bulman

Yopyk

D. J.

(2004). Random outcomes and valued commitments. In Greenberg

Koole

S. L.

Pyszczynski

(Eds.), Handbook of experimental existential psychology (pp. 122-138). New York, NY: Guilford Press.

34.

Jordan

J. V.

(2003). Relational-cultural therapy. In Kopala

Keitel

M. A.

(Eds.), Handbook of counseling women (pp. 22-30). Thousand Oaks, CA: SAGE.

35.

Jordan

J. V.

Kaplan

A. G.

Miller

J. B.

Stiver

I. P.

Surrey

J. L.

(1991). Women’s growth in connection: Writings from the stone center. New York, NY: Guilford Press.

36.

Joseph

Linley

(2005). Positive adjustment to threatening events: An Organismic Valuing theory of growth through adversity. Review of General Psychology, 9, 262-280.

37.

Joseph

Linley

(2006). Growth following adversity: Theoretical perspectives and implications for clinical practice. Clinical Psychology Review, 26, 1041-1053.

38.

Joseph

Murphy

Regel

(2012). An affective-cognitive processing model of post-traumatic growth. Clinical Psychology & Psychotherapy, 19, 316-325.

39.

Landenburger

K. M.

(1998). Exploration of women’s identity: Clinical approaches with abused women. In Campbell

J. C.

(Ed.), Empowering survivors of abuse (pp. 61-69). Thousand Oaks, CA: SAGE.

40.

Lincoln

Y. S.

Guba

E. G.

(1985). Naturalistic inquiry. Beverly Hills, CA: SAGE.

41.

Linley

P. A.

Joseph

(2004). Positive change following trauma and adversity: A review. Journal of Traumatic Stress, 17, 11-21.

42.

Macy

R. J.

Ferron

Crosby

(2009). Partner violence and survivors’ chronic health problems: Informing social work practice. Social Work, 54(1), 29-43.

43.

McCormick

R. M.

(1998). Ethical considerations in First Nations counselling and research. Canadian Journal of Counselling, 32, 284-297.

44.

Morrow

S. L.

(2005). Quality and trustworthiness in qualitative research in counseling psychology. Journal of Counseling Psychology, 52, 250-260.

45.

Native Women’s Association of Canada. (2015). You are not alone: A toolkit for aboriginal women escaping domestic violence. Retrieved from http://www.nwac.ca/policy-areas/violence-prevention-and-safety/you-are-not-alone/

46.

Park

C. L.

Cohen

L. H.

Murch

(1996). Assessment and prediction of stress-related growth. Journal of Personality, 64, 71-105.

47.

Powell

Rosner

Butollo

Tedeschi

R. G.

Calhoun

L. G.

(2003). Posttraumatic growth after war: A study with former refugees and displaced people in Sarajevo. Journal of Clinical Psychology, 59, 71-83.

48.

Renzetti

C. M.

Edleson

J. L.

Bergen

R. K.

(2011). Sourcebook on violence against women (2nd ed.). Thousand Oaks, CA: SAGE.

49.

Ryan

G. W.

Bernard

H. R.

(2000). Data management and analysis methods. In Denzin

N. K.

Lincoln

Y. S.

(Eds.), Handbook of qualitative research (2nd ed., pp. 769-802). Thousand Oaks, CA: SAGE.

50.

Saakvitne

K. W.

Tennen

Affleck

(1998). Exploring thriving in the context of clinical trauma theory: Constructivist self development theory. Journal of Social Issues, 54, 279-299.

51.

Sanderson

(2008). Counselling survivors of domestic abuse. London, England: Jessica Kingsley.

52.

Scrim

(2010). Aboriginal victimization in Canada: A summary of the literature (Victims of Crime Research Digest No. 3). Department of Justice, Government of Canada. Retrieved from http://www.justice.gc.ca/eng/rp-pr/cj-jp/victim/rd3-rr3/toc-tdm.html

53.

Seligman

M. E. P.

Csikszentmihalyi

(2000). Positive psychology: An introduction. American Psychologist, 55, 5-14.

54.

Senter

K. E.

Caldwell

(2002). Spirituality and the maintenance of change: A phenomenological study of women who leave abusive relationships. Contemporary Family Therapy: An International Journal, 24, 543-564.

55.

Smith

J. A.

(2004). Reflecting on the development of interpretative phenomenological analysis and its contribution to qualitative research in psychology. Qualitative Research in Psychology, 1, 39-54.

56.

Smith

M. E.

(2003). Recovery from intimate partner violence: A difficult journey. Issues in Mental Health Nursing, 24, 543-573.

57.

Sokoloff

N. J.

Dupont

(2005). Domestic violence at the intersections of race, class, and gender: Challenges and contributions to understanding violence against marginalized women in diverse communities. Violence Against Women, 11, 38-64.

58.

Song

Shih

(2010). Recovery from partner abuse: The application of the strengths perspective. International Journal of Social Welfare, 19, 23-32.

59.

Szabo

Strang

V. R.

(1997). Secondary analysis of qualitative data. Advances in Nursing Science, 20(2), 66-74.

60.

Taylor

J. Y.

(2004). Moving from surviving to thriving: African American women recovering from intimate male partner abuse. Research and Theory for Nursing Practice: An International Journal, 18(1), 35-50.

61.

Tedeschi

R. G.

Calhoun

L. G.

(1995). Trauma and transformation: Growing in the aftermath of suffering. Thousand Oaks, CA: SAGE.

62.

Tedeschi

R. G.

Calhoun

L. G.

(1996). The posttraumatic growth inventory: Measuring the positive legacy of trauma. Journal of Traumatic Stress, 9, 455-471.

63.

Tedeschi

R. G.

Calhoun

L. G.

(2003). Routes to post-traumatic growth through cognitive processing. In Paton

Violanti

J. M.

Smith

L. M.

(Eds.), Promoting capabilities to manage post-traumatic stress: Perspectives on resilience (pp. 12-26). Springfield, IL: Charles C. Thomas.

64.

Tedeschi

R. G.

Calhoun

L. G.

(2004). Posttraumatic growth: Conceptual foundations and empirical evidence. Psychological Inquiry, 15, 1-18.

65.

Tesch

(1987). Emerging themes: The researcher’s experience. Phenomenology and Pedagogy, 5, 230-241.

66.

Truth and Reconciliation Commission of Canada. (2015). Canada’s residential schools: The legacy (TRC Report Vol. 5). Retrieved from http://www.myrobust.com/websites/trcinstitution/File/Reports/Volume_5_Legacy_English_Web.pdf

67.

Tutty

Radtke

H. L.

Nixon

K. L.

(2009). The Healing Journey: A longitudinal study of mothers affected by intimate partner violence, perceptions of their children’s well-being and family-related service utilization. Retrieved from http://www2.uregina.ca/resolve/assets/pdf/TuttyReport.pdf

68.

Ulloa

E. C.

Hammett

J. F.

Guzman

M. L.

Hokoda

(2015). Psychological growth in relation to intimate partner violence: A review. Aggression and Violent Behavior, 25, 88-94.

69.

Valdez

C. E.

Lilly

M. M.

(2015). Posttraumatic growth in survivors of intimate partner violence: An assumptive world process. Journal of Interpersonal Violence, 30, 215-231.

70.

World Health Organization. (2010). Preventing intimate partner and sexual violence against women: Taking action and generating evidence. Retrieved from http://whqlibdoc.who.int/publications/2010/9789241564007_eng.pdf

71.

World Health Organization. (2013). Global and regional estimates of violence against women: Prevalence and health effects of intimate partner violence and non-partner sexual violence. Retrieved from http://apps.who.int/iris/bitstream/10665/85239/1/9789241564625_eng.pdf?ua=1

72.

Wuest

Merritt-Gray

(2001). Beyond survival: Reclaiming self after leaving an abusive male partner. Canadian Journal of Nursing Research, 32(4), 79-94.

73.

Yalom

I. D.

(1980). Existential psychotherapy. New York, NY: Basic Books.

74.

Young

M. D.

(2007). Finding meaning in the aftermath of trauma: Resilience and posttraumatic growth in female survivors of intimate partner violence (Doctoral dissertation). Available from ProQuest Dissertations and Theses Global database. (Order No. 3258728)