Families in Psychiatry

Helping patients bring an end to domestic violence


As healers trained to address some of the psychosocial issues facing our patients, we need to understand various forms of domestic violence – and what we can do to stop it. One form, honor killings, remains pervasive across the globe.

In a sample of 856 ninth-grade students from 14 schools in Amman, Jordan, for example, about 40% of boys and 20% of girls believed that killing a daughter, sister, or wife who had dishonored the family was justified (Aggress Behav. 2013 Sep-Oct;39[5]:405-17). The schools were representative of students from different religions, socioeconomic statuses, and upbringings. The proportions are broadly in line with the religious affiliation of Jordanians, with 92% of the population identifying themselves as Muslims, 6% as Christians, and 2% as affiliated with other religions.1 However, researchers found that support for honor killings was more widespread among adolescents from poorer and more traditional family backgrounds.

Dr. Alison Heru

Dr. Alison Heru

Those findings are in accord with those from studies on related topics such as wife beating, which also is more prevalent among the less educated and traditional groups of Middle Eastern societies. However, neither religion nor the intensity of religious beliefs was a significant predictor of attitudes toward honor crimes. This supports the theory that honor killings do not depend on a specific religious background; rather, they depend upon patriarchy, family honor, and the preservation of female virginity as prominent values. Jordan is considered modern by Middle Eastern standards, so the high proportion of young people with supportive attitudes about honor killing is concerning.

What are honor killings?

According to Sally Elakkary, MD, and her colleagues, honor killings are “violence implicated against a female for the deviancy of her activities from the traditional cultural norms.”2 The perpetrators in these crimes are usually male relatives but may be other family members, including women. Males also can be victims of honor crimes. For example, a male can become a victim if he is the female’s lover in an extramarital relationship or if he is homosexual.

Most honor killings are reported from countries in the Maghreb region of North Africa; the Middle East (Palestine, Lebanon, Syria, Jordan, and Turkey); and Western and Central Asia (Iraq, Pakistan, Afghanistan, and India). However, honor killings also occur in countries with strong minorities from those origins. A report3 published in 2000 by the United Nations Population Fund estimated that 5,000 honor killings were carried out worldwide per year, with the largest absolute numbers reported for Pakistan and India (about 1,000 cases per year in each country).

Until the 1960s in the United States, penal codes in some states, such as Georgia, New Mexico, Texas, and Utah, justified a husband killing his wife’s lover. In those states, the law was formulated to protect the male’s honor. Honor killings are culture-based practices that are supported indirectly by that country’s legal system. In a recent New York Times op-ed4 piece, Bina Shah stated that “upending misogynistic tribal codes is the real key to finally ending the most egregious gender crime.” The Pakistan Parliament recently stiffened the punishment for honor killings. The new anti–honor killing law mandates a minimum lifetime jail sentence for perpetrators and closes a legal loophole that allowed an honor killer to walk free if the family of the victim forgave him.

However, in rural areas, a Pakistani woman accused of violating family or tribal honor can be sentenced to death by an informal village court or a gathering of tribal elders. Women have been killed by stoning, shooting, or being buried alive. Sometimes, the woman’s relatives condemn her to death without a trial. Women are killed for reasons such as wanting to marry of their own choice, divorcing abusive husbands, or speaking to a man or boy outside the family; “in one case, four young girls who were filmed dancing in a rain shower were executed by their cousin for immorality,” Ms. Shah said.

Range of behaviors

Abusive behavior can take many forms, including:

• Isolating a person from her friends and family.

• Depriving her of basic needs.

• Monitoring her time.

• Monitoring her use of online communication tools or spyware.

• Taking control over aspects of her everyday life, such as where she can go, whom she can see, what she can wear, and when she can sleep.

• Depriving her of access to support services, such as specialist support or medical services.

• Repeatedly putting her down, such as telling her that she is worthless.

• Enforcing rules and activities that humiliate, degrade, or dehumanize the victim.

• Forcing the victim to take part in criminal activity such as shoplifting, and neglecting or abusing children to encourage self-blame and prevent disclosure to authorities.

• Abusing finances, including controlling resources so that the person is allowed only a punitive allowance.

• Threatening to hurt or kill her.

• Threatening a child.

• Threatening to reveal or publish private information (for example, threatening to “out” someone).

• Assaulting the person.

• Causing criminal damage (such as destruction of household goods).

• Engaging in rape.

• Preventing a person from having access to transportation or from working.


Next Article: