Information & Resources

Find information and resources to help manage your pain.

Get Help & Support

Find the tools you need to
help you manage your pain.

Get Involved

Help make a real difference to people
in the UK living with chronic pain.

About Us

Find out about Pain Concern and how
we can help you.

Domestic Abuse and Chronic Pain Resources

Funded by a grant from the Women’s Fund for Scotland

In 2020, at the height of the Covid-19 pan­dem­ic, Pain Con­cern received a grant from the Wom­en’s Fund for Scot­land. With this fund­ing we cre­at­ed an extend­ed episode of our pod­cast, Air­ing Pain, on the top­ic of domes­tic vio­lence and chron­ic pain. We also pub­lished arti­cles writ­ten by domes­tic vio­lence sur­vivors and aca­d­e­mics in a spe­cial issue of our free online sup­ple­ment, Pain Press.

You can lis­ten to the pro­gramme and read all the arti­cles below.

The above fact sheet con­tains links to resources, stud­ies, guide­lines, research and char­i­ties for both health pro­fes­sion­als and those who are experiencing/have expe­ri­enced abuse.

Airing Pain 126. Domestic Violence and Chronic Pain

Spotlight on pain and domestic violence: there is more that we need to understand

by Dr Caroline Bradbury-Jones

I was delight­ed to take part in the recent Air­ing Pain pod­cast that explored the rela­tion­ship between domes­tic vio­lence and chron­ic pain. The pod­cast drew on a num­ber of per­spec­tives regard­ing the nature of pain, how it comes about, how it is expe­ri­enced and what can be done to tack­le the prob­lem. The invi­ta­tion to par­tic­i­pate was, in part, because my col­leagues and I have begun to inves­ti­gate this issue, specif­i­cal­ly the asso­ci­a­tion between domes­tic vio­lence and fibromyal­gia and chron­ic fatigue syn­drome. The pod­cast pro­vid­ed an oppor­tu­ni­ty for us to share our insights and, along­side the lived expe­ri­ences of a domes­tic vio­lence sur­vivor, give air­time to this com­plex problem. 

The pro­gramme explored the links between domes­tic vio­lence and chron­ic pain, illu­mi­nat­ing par­tic­u­lar­ly the human impacts. Since record­ing the inter­view, I have been reflect­ing on how far we have come with­in soci­ety in under­stand­ing the prob­lem of domes­tic vio­lence. I have asked myself crit­i­cal ques­tions regard­ing the many issues that remain poor­ly under­stood, and the ques­tions that remain unan­swered. I am a researcher, so the issues dis­cussed in this edi­to­r­i­al are through a research lens. 

I am going to begin by think­ing about how far we have come. It is only in the last decade or so that domes­tic vio­lence has crept from behind closed doors, out into the pub­lic domain. It is in this are­na that domes­tic vio­lence is dis­cussed far more wide­ly than it was a num­ber of years ago. It has made its way, as a top­ic, into con­tem­po­rary TV pro­grammes, soap operas and cov­er­age in news­pa­pers. Over­all, this release into pub­lic dis­course is a pos­i­tive move, because it pro­vides oppor­tu­ni­ty to air the issue and to chip away at ingrained stereo­types and myths about the prob­lem. It means that domes­tic vio­lence is an issue that is dis­cuss­able now; we can talk about it. This is impor­tant because it is such a sig­nif­i­cant prob­lem that is a scourge on soci­ety. Rates of domes­tic vio­lence are shock­ing­ly high. It is dif­fi­cult to present an accu­rate pic­ture of the extent of the prob­lem because it is large­ly under-report­ed, but it is like­ly that one-in-four, or even one-in-three, women in the UK have expe­ri­enced domes­tic vio­lence. It is impor­tant to acknowl­edge that men and boys expe­ri­ence domes­tic vio­lence, and so too those in same-sex rela­tion­ships, but vio­lence against women and girls, per­pe­trat­ed by males, is the most preva­lent form. 

When I first began to research the top­ic a num­ber of years ago, domes­tic vio­lence was very much a mar­gin­alised sub­ject. Researchers need 

fund­ing to sup­port the research they seek to under­take, but that becomes a real prob­lem when fund­ing agen­cies fail to see it as a pri­or­i­ty. While it is well-recog­nised that domes­tic vio­lence can, and does, have cat­a­stroph­ic impacts on lives, both in terms of health and social costs, it can be remark­ably tricky to secure fund­ing to inves­ti­gate the prob­lem. My obser­va­tion that domes­tic vio­lence has shift­ed from the mar­gins to the main­stream as regards soci­etal dis­course and aware­ness, is sure­ly indica­tive of a pos­i­tive move? I believe this to be the case. Fun­ders are now invit­ing appli­ca­tions specif­i­cal­ly about domes­tic vio­lence, and to that end, progress has been made. I think though, that some sub­jects are still at the periph­ery and war­rant far greater atten­tion. The rela­tion­ship between domes­tic vio­lence and pain is at the fore­front of my mind here, and this leads me to the crit­i­cal reflec­tions about what we still need to understand. 

I have been in the priv­i­leged posi­tion as a researcher on the top­ic of domes­tic vio­lence, to inter­view many sur­vivors. Real life sto­ries of vio­lence and abuse are pow­er­ful and dis­tress­ing. They leave an endur­ing print on one’s mem­o­ry. The real­i­ty of liv­ing with coer­cion, con­trol, gas light­ing and abuse in its myr­i­ad forms is a dif­fi­cult real­i­ty to hear. Yet it is one that I have lis­tened to over the years and from which, I hope, I have learned.  One thing that I have heard – repeat­ed­ly – is the sto­ry of pain. Domes­tic vio­lence sur­vivors talk of pain a great deal. For some (a minor­i­ty) the pain aris­es as a result of phys­i­cal injuries sus­tained as a con­se­quence of domes­tic vio­lence. For most though, the ori­gins of the pain are not phys­i­cal­ly root­ed, but tied up with com­plex biopsy­choso­cial rela­tion­ships that are not eas­i­ly tracked, nor artic­u­lat­ed. We know from large cohort stud­ies, such as the one men­tioned in the open­ing para­graph, that fibromyal­gia and chron­ic fatigue syn­drome are more com­mon in women with domes­tic vio­lence expe­ri­ence, than those with­out. Fur­ther stud­ies are required to explore this rela­tion­ship more ful­ly, includ­ing, for exam­ple, the risk fac­tors or how some groups may be dis­pro­por­tion­ate­ly affect­ed. What we need more than ever, though, are stud­ies that focus on the lived expe­ri­ence of pain and domes­tic vio­lence. We need stud­ies that get right to the heart of the prob­lem, from which we can under­stand not only what it is like but what can be done to bet­ter sup­port sur­vivors. Air­ing PainPain Press and an emerg­ing body of research may be indica­tive of the con­tem­po­rary spot­light on domes­tic vio­lence, but media and soci­etal dis­cours­es peak and wane. It is impor­tant there­fore to seize the oppor­tu­ni­ty now, so that we can shed far greater light on the prob­lem of pain and how it is lived, in the con­text of domes­tic violence.

Dr Car­o­line Brad­bury-Jones is a reg­is­tered nurse, mid­wife and health vis­i­tor. She is Pro­fes­sor of Gen­der Based Vio­lence and Health at the Uni­ver­si­ty of Birmingham

Back to top

Have you ever wondered why victims stay in abusive relationships?

by Kath Twigg

The answer is com­plex, and the phe­nom­e­non which caus­es vic­tims to become trapped not wide­ly under­stood:  it’s called ‘trau­mat­ic bond­ing’. In tox­ic and abu­sive rela­tion­ships the vic­tim becomes weak­ened and los­es per­spec­tive; instead of tak­ing pro­tec­tive mea­sures and walk­ing away, they look to the abuser for the solu­tion to their suf­fer­ing. They may try end­less­ly to per­suade the abuser to become, once again, the lov­ing per­son they thought they had met; against clear evi­dence to the con­trary, they per­sist in the irra­tional belief that things will turn out OK. The most trag­ic con­se­quence is the loss of self-regard and self-pro­tec­tion, sac­ri­ficed first to the desires and then to the dom­i­nance of another. 

This is no tem­po­rary blip or aber­ra­tion; often orig­i­nat­ing in past trau­ma, it is a deep seat­ed and entrenched psy­cho­log­i­cal process which can defy log­ic and cloud rea­son­ing. The slight­est indi­ca­tion that things may change can cause hope and expec­ta­tion to re-sur­face, and dan­gers which are all too clear to out­siders are ratio­nalised away. 

I know first-hand of the ter­ri­ble impris­on­ment of trau­mat­ic bond­ing, because it hap­pened to me. I spent my days as a senior man­ag­er in the crim­i­nal jus­tice field, where I was deal­ing with the impact of vio­lence and abuse dai­ly. I knew well that most vic­tims had suf­fered at the hands of a per­pe­tra­tor who was in a rela­tion­ship with them. Despite this knowl­edge and expe­ri­ence I lived in a rela­tion­ship char­ac­terised by coer­cive con­trol, threat­en­ing behav­iour and inci­dents of vio­lence. I was iso­lat­ed and depressed, try­ing des­per­ate­ly to main­tain an out­ward veneer of respectabil­i­ty whilst return­ing dai­ly to a sit­u­a­tion which many would have aban­doned long before. 

It’s hard to leave your home and every­thing you’ve worked for; it’s even hard­er to admit to the world that yet anoth­er of your rela­tion­ships has failed. These things, com­bined with the habit­u­al behav­iour I had acquired from many years of try­ing to mend rela­tion­ships which were beyond repair, ensured that I stayed for far too long, when all I real­ly need­ed to do was walk out through the door and ask for sup­port. Even when I found the courage to break away I near­ly didn’t make it, due to dis­tort­ed think­ing which re-sur­faced and caused me to believe that I could return to my tox­ic rela­tion­ship and it could all be put right. 

When oth­er peo­ple began to notice what was hap­pen­ing to me, I began to recog­nise that I had lost the per­son I used to be; the vibrant, pas­sion­ate and prin­ci­pled per­son who knew what she believed in and want­ed in life had dis­ap­peared. I start­ed to grieve for this per­son, to realise that I had lost myself and sac­ri­ficed all that was impor­tant to me on the altar of a rela­tion­ship that could nev­er work. All my ener­gy had been spent try­ing to regain what was only an illu­sion of hap­pi­ness and secu­ri­ty. Through the kind­ness of oth­ers, I was remind­ed of what healthy rela­tion­ships felt like. At times the poignan­cy was too much to bear.

and phys­i­cal health dete­ri­o­rat­ed, I was in con­stant pain, I devel­oped low­ered immu­ni­ty and often dragged myself to work, sup­press­ing my dis­tress and attempt­ing to project an image of a capa­ble and con­fi­dent pro­fes­sion­al to the world. The strain of doing this for so long even­tu­al­ly caught up with me. I began to be late for appoint­ments and couldn’t con­cen­trate or deal with sim­ple every­day tasks. I took a sev­er­ance pack­age and walked away from the long-term career I loved. When my rela­tion­ship final­ly end­ed I believed I could sim­ply put all the pain behind me and start again; I was wrong. The road to recov­ery has been long and hard and, at one point, almost cost me my life when I suc­cumbed to bac­te­r­i­al menin­gi­tis, which I put down to years of fail­ing to pause and take care of myself. The answer is not to push for­ward relent­less­ly, as I often did; doing so is part of the pat­tern of behav­iour which per­pet­u­ates abuse. It’s impor­tant to stop, acknowl­edge what you have expe­ri­enced and do what­ev­er feels right to help you to heal. I only learned this after many years of pain, when it was almost too late. 

There is no quick fix, or panacea. Enlight­en­ment comes grad­u­al­ly, through find­ing your true self, treat­ing that self as a pre­cious child and recog­nis­ing that you deserve kind­ness and com­pas­sion as much as any­one else. Love shouldn’t hurt.  There is no still point at which every­thing falls into place, there will always be chal­lenges and it is best to take time for this heal­ing to hap­pen, but with the right sup­port, and by always act­ing accord­ing to your cher­ished val­ues and beliefs, things will improve. 

Thank­ful­ly, I’m now free and many years away from these expe­ri­ences. I’m also in a hap­py and bal­anced rela­tion­ship with a beloved old friend, which came into my life when I stopped try­ing to make things hap­pen and expend­ing all my ener­gy in the wrong direc­tion. Writ­ing my sto­ry proved a pow­er­ful ther­a­peu­tic process. I‘m now a social work lec­tur­er and could have writ­ten an aca­d­e­m­ic book on trau­mat­ic bond­ing, but I found that writ­ing more freely allowed me to work through my thoughts, feel­ings and expe­ri­ences. As I wrote, the pat­tern of my life emerged on the paper, and the mirac­u­lous events which set me free organ­ised them­selves into a sto­ry which seems to touch those who read it in a way that aca­d­e­m­ic analy­sis nev­er could. I found myself describ­ing and pro­cess­ing deep emo­tions at the same time, sub­con­scious­ly heal­ing the pat­terns which had so blight­ed my life and rein­forc­ing the things I had achieved.  I final­ly knew who I was and was proud of myself. 

Through shar­ing my sto­ry I have come to realise that there is much hid­den abuse amongst peo­ple such as myself. Peo­ple who often feel a sense of fail­ure and iso­la­tion, believe that they should be able to cope and there­fore feel ashamed to dis­close their suf­fer­ing and ask for help. If this is you, by under­stand­ing the ori­gin of your life pat­terns, remem­ber­ing the self that was lost along the way and know­ing what kind of rela­tion­ships you deserve, you can make safer choic­es and find a hap­pi­er life.

Kath Twigg is a senior lec­tur­er in social work, train­er, men­tor and writer; her book, The Hall of Mir­rors, How to Change Life Pat­terns and Avoid Tox­ic Rela­tion­ships, is reviewed by Paul Evans below

Back to top

One Scottish domestic abuse survivor’s experience of pain

by Jennifer Bowey

I recent­ly spoke to a Scot­tish domes­tic abuse sur­vivor who wish­es to remain anony­mous, we’ve called her Alex. The fol­low­ing is an account of Alex’s expe­ri­ence of abuse in ear­ly life, which result­ed in health prob­lems and chron­ic pain that have per­sist­ed into her adult life. 

Alex details both emo­tion­al and phys­i­cal abuse per­pe­trat­ed by her bio­log­i­cal father. The abuse was direct­ed towards both her and her moth­er, which Alex reg­u­lar­ly bore wit­ness to. She recounts suf­fer­ing from anx­i­ety, sick­ness and pain as a result of these experiences:

‘I realised what I feel isn’t uni­ver­sal­ly felt when I began reflect­ing on the inci­dent and work­ing through things in ther­a­py now that I’m an adult. 

I feel anx­i­ety to the point of phys­i­cal pain in my chest, it aches like the way hunger makes your stom­ach ache, and I believe this is due to hav­ing to ‘walk on eggshells’ at such a young age.  After look­ing into this fur­ther with a ther­a­pist, I began to notice more spe­cif­ic things that also cause me pain. For exam­ple, I always thought that my head/hair was very sen­si­tive and hav­ing oth­ers brush my hair when I was young used to send me into fren­zies and make me phys­i­cal­ly sick.’

Alex elab­o­rates upon expe­ri­enc­ing acute scalp pain when­ev­er some­body touch­es her head or her hair. This has not only caused her severe per­son­al dis­tress, but has posed prob­lems when hav­ing rou­tine haircuts: 

‘I always expe­ri­ence pain when I vis­it hair salons, to the point where I’ve had to ask them to stop. I despise peo­ple touch­ing my head and feel 

hap­py wear­ing a hat. I always chalked this down to an indi­vid­ual quirk, some­thing too triv­ial or sil­ly to talk about. But in real­i­ty, it’s not.’ 

Hav­ing dis­cussed her pain with a ther­a­pist in adult­hood, Alex dis­cov­ered that an adverse child­hood expe­ri­ence of phys­i­cal abuse was the root cause of these intense feel­ings of pain: 

‘When I was about sev­en my dad became very dis­pleased at the mess of my room and pro­ceed­ed to pin me down (his knees on my arms) and run the hoover noz­zle over my skull for some time, threat­en­ing to get rid of it. I thought it was going to pull my hair out, I real­ly believed that. I remem­ber scream­ing in pain and I then froze com­plete­ly in shock. It was so painful, it ached for so long after and my mum had to sit and de-tan­gle my hair, which ached also. 

So, I often feel the sen­sa­tion of my hair being ripped out, when I’m fact it’s just the salon work­er gen­tly remov­ing knots. This was one inci­dent on one occa­sion and I feel it as if it’s hap­pen­ing to this day, abuse doesn’t just hurt at the time – it hurts long after too.’ 

In our Air­ing Pain pro­gramme on domes­tic vio­lence and chron­ic pain, Clin­i­cal Psy­chol­o­gist Dr Kate Gillan dis­cuss­es how abuse can cause height­ened sen­si­tiv­i­ty to pain. She explains how sur­vivors of trau­ma and abuse often devel­op a hyper­sen­si­tive ner­vous sys­tem, which exists in a per­sis­tent state of ampli­fied pain. They may expe­ri­ence pain even when some­body is only touch­ing them light­ly. The brain does not pro­duce an appro­pri­ate, mild response to nor­mal touch, but a height­ened pain response.

Jen­nifer Bowey is Project Co-ordi­na­tor with Pain Con­cern. She has writ­ten this case study in col­lab­o­ra­tion with a Scot­tish domes­tic abuse sur­vivor who wish­es to remain anony­mous. Our thanks go to our sur­vivor for shar­ing their story.

Back to top

Review of The Hall of Mirrors: How to Change Life Patterns and Avoid Toxic Relationships by Kath Twigg

by Paul Evans

A new edi­tion of Air­ing Pain for the New Year (2021) explores, as one con­trib­u­tor describes it, the ‘per­fect storm’ in which Covid-19, domes­tic vio­lence, social iso­la­tion and chron­ic pain con­verge with poten­tial­ly dev­as­tat­ing con­se­quences.

Research by the Uni­ver­si­ty of Birm­ing­ham showed that UK domes­tic abuse vic­tims are three times more like­ly to devel­op severe men­tal ill­ness­es, and a fol­low-up study by the Uni­ver­si­ties of Birm­ing­ham and War­wick found that women who have expe­ri­enced domes­tic abuse are almost twice as like­ly to devel­op fibromyal­gia and chron­ic fatigue syn­drome (CFS) than those who have not. 

In mak­ing this pro­gramme, I spoke to lead­ing researchers, clin­i­cal psy­chol­o­gists in the fields of chron­ic pain and domes­tic vio­lence relat­ed trau­ma, and health­care pro­fes­sion­als work­ing with sur­vivors.

How­ev­er, it is the tes­ti­mo­ny of a sur­vivor of two abu­sive mar­riages, Kath Twigg, which real­ly opens the lid on how per­sis­tent phys­i­cal and men­tal, coer­cive abuse, will destroy mind, body and soul.

In her book, The Hall of Mir­rors: How to Change Life Pat­terns and Avoid Tox­ic Rela­tion­ships, she tells her sto­ry and, with the ben­e­fit of expe­ri­ence, offers strate­gies for oth­er vic­tims of domes­tic abuse, be they men or women, to take back con­trol of their lives.

How­ev­er, to treat it pure­ly as a self-help book as the title might sug­gest, is to do it a great dis­ser­vice. It is a well writ­ten, easy to read, and com­pelling auto­bi­o­graph­i­cal account of her dev­as­tat­ing jour­ney through two mar­riages to men who abused her both phys­i­cal­ly and mentally.

It is not a ‘rant’ about the fail­ings of two abu­sive men (the read­er must make her or his own judge­ment on that), but an account of how years of coer­cive abuse altered the mind­set of this pro­fes­sion­al, intel­li­gent woman 

to put up with the abuse and abuser for years, ignor­ing the warn­ings and well-mean­ing advice of friends:

He would only have to hit me once and I’d be gone. Why ever do you stay?

I lost count of the num­ber of times she uses the word ‘ashamed’:

I was too ashamed to con­fide in friends or fam­i­ly, not wish­ing to be seen as a fail­ure or a bur­den. I tried to pre­tend that all was well, a process made eas­i­er by isolation.’

I told no-one about the vio­lent inci­dent … for many years I had felt ashamed of my failed rela­tion­ships.’

So, who should read this book?
A self-help book? Yes, there are short ‘exer­cis­es’ at the end which are sim­ple ques­tions vic­tims, be they women or men, might ask them­selves to gain greater self-aware­ness of how the abuse is affect­ing the way they are deal­ing with it, and there­fore how to address it.
But it’s more than just a self-help book. It is for friends, fam­i­ly, care pro­fes­sion­als, col­leagues, in-fact, every­one in the social cir­cle of the abused to gain insight and under­stand­ing of the psy­cho­log­i­cal dam­age wrought by domes­tic abuse, and there­fore to know how best to sup­port the vic­tim through a tox­ic rela­tion­ship.
I found it easy and com­pelling to read, albeit out of my com­fort zone because it made me think about rela­tion­ships in my own social cir­cle.
The Hall of Mir­rors: How to Change Life Pat­terns and Avoid Tox­ic Rela­tion­ships by Kath Twigg is avail­able from Ama­zon as a Kin­dle down­load or paper­back.  Details from

Paul Evans is the pro­duc­er of Air­ing Pain.

Back to top