Choosing to Abuse: Mental Illness and Substance Abuse



Stages of Healthy Gay Relationships

Intro To Domestic Violence

Introduction to Gay Male Domestic Violence

Treatment Of Domestic Violence

Treatment Of Domestic Violence

DV Links


Domestic Violence in Gay Couples
History of Abuse

Power Differences




Gender Roles

Mental Illness

Mental illness has been generally linked to domestic violence, but there is no "Abusive Personality Disorder" because the types of mental illness seen with domestic abuse are varied, and not all people with the same diagnosis abuse. Some have tied personality "issues" such as fears of abandonment, extreme jealousy, and impulse control problems to domestic violence, while others have focused on diagnosable disorders such as Borderline Personality Disorder, a Depressive Disorder, and even Post-Traumatic Stress Disorder (Riggs et al, 2000). Disorders that have received considerable attention include substance abuse and dependence.

Leonard (1985) found that 44% of alcohol men presenting for treatment had been violent with their spouses, compared to a similar estimate in a control sample of non-alcoholic men of 15%. Murphy and O'Farrell (1994) found higher numbers in their samples, with 66% of alcoholics reporting relationship violence compared to 20% of a control sample. Some studies have found that 25% of the specific incidents of abuse are tied to alcohol consumption (Kantor and Straus, 1987). Others have obtained higher estimates of an association between alcohol use and a specific incident of violence (46%), but similar estimates (23%) for intoxication and a specific incident of violence (Pernanen, 1991).

Farley (1996) found that 47% of gay male abusers reported alcoholism in their family of origin. Further, 40% admitted to substance abuse themselves, and of the non-users, 73% of male abusers admitted to other additions and compulsions. This is consistent with other estimates (see for example Cruz and Peralta, 2001), but contrasts greatly with prevalence estimates from Narrow and colleagues (2002) indicating that 11.5% of adults have some problems with alcohol, while 7.6% would meet criteria for an alcohol abuse or dependence disorder.

Some early studies (Shaefer et al, 1987) reported that gays were at three times the risk of straights for developing alcoholism. Again, some might argue that being gay causes alcoholism, for example, drawing on the stereotype that there is a reliance on gay bars as the main area for gay socialization. However, studies have not supported this (e.g. Kus, 1989); heavy drinkers tend to drink heavily in bars, as well as at home, and most people in bars do not drink to alcoholic levels.

Another possibility is that alcoholism stems from internalized homophobia and a negative gay identity (Kus, 1989). Alcohol and other drugs also function as disinhibitors, allowing one to act on urges and impulses that otherwise would be repressed by negative social messages, and ignore shaming self-statements taught to them for a while. They could help men who are uncomfortable with their identity to have intimate relationships, and attribute any negative reaction from others to "being drunk" or "out of control just that once." For men who do not need to deny their sexual orientation, given the absence of exposure to socially presented models of male intimacy, alcohol and drug use may still be the only way they learned to engage with other males, overcome shame and self-doubt, and feel connected and desired (Guss, 2000).

Substance use has also been studied in victims of abuse, some of who explain that substances became a way to cope with the abuse. For some, substance abuse became a problem after the abuse began; for others, substance use was a problem before the abuse began, and the violence led to relapse (Cruz and Peralta, 2001).

Thus, in so far as substance use is linked to domestic violence (see for example, Schilt et al., 1990), negative social messages and shame placed on gays and lesbians by churches, politicians, teachers, and other public figures could lead to greater use of alcohol and other substances in some gay men. This, in turn, could lead to greater levels of domestic violence due to the loss of inhibition and good judgment, as well as the lack of adaptive coping skills associated with substance use.

Of note, some argue that there is a neurological underpinning to abusive and violent people. In other words, brain abnormalities, problems in frontal lobe functioning, head trauma... could all lead an abuser to become more prone to violent behavior. While this is undoubtedly a useful area to explore, biophysiological and neurological explanations are beyond the scope of this paper.