The abuse might not occur regularly. Not all victims of domestic violence present in an ED with physical marks of abuse. Some may not have abrasions or fractures, but have injuries or pain much harder to detect. Emotional abuse and degradation are more difficult to pinpoint. Words and threats of violence leave invisible wounds at first, then fulminate into depression, helplessness, and low self-esteem.
Sexual abuse is more overt in forced, unwilling sexual acts, which often go unreported.
Abusers use violence because it works to keep their loved ones under control. The perpetrators, sometimes church-going community leaders, are often not violent toward anyone but the people they love. For them, it is an issue of power and control over another person. Issues of Power and Control Abusers may control partners through finances by allowing victims no means to leave or to secure credit for a separate future. An abuser may refuse to allow the partner to work or attend school, complaining that the family will suffer from the woman's absence.