‘You certainly don't go back to the doctor once you've been told, “I'll never understand women like you.”’ Seeking candidacy and structural competency in the dynamics of domestic abuse disclosure

Mhairi Mackenzie*, Maria Gannon, Nicky Stanley, Katie Cosgrove, Gene Feder

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)

1 Citation (Scopus)
35 Downloads (Pure)

Abstract

A reticence on the part of women to disclose domestic abuse to family doctors, allied to front-line responses that do not always reflect an understanding of the structure and dynamics of domestic abuse, hampers the provision of professional support. Using data from 20 qualitative interviews with women who have experienced domestic abuse, this paper explores their discourse about interacting with family doctors. It is the first study to explore first-hand accounts of these interactions through Dixon Woods’ lens of candidacy. It finds disclosure to be inherently dynamic as a process and expands the candidacy lens by considering the: (1) conflicting candidacies of victims and perpetrators; (2) diversionary disclosure tactics deployed by perpetrators; and, (3) the potential role of GPs in imagining candidacies from a structural perspective. By exploring the dynamics of disclosure through the concept of ‘structural competency’ it finds that in encounters with women who have experienced abuse GPs ineluctably communicate their views on the legitimacy of women’s claims for support; these in turn shape future candidacy and help-seeking. Greater GP awareness of the factors creating and sustaining abuse offers the potential for better care and reduced stigmatisation of abused women.
Original languageEnglish
Pages (from-to)1159-1174
Number of pages16
JournalSociology of Health and Illness
Volume41
Issue number6
Early online date18 Apr 2019
DOIs
Publication statusPublished - 1 Jul 2019

Keywords

  • candidacy
  • Doctor–patient interaction
  • domestic abuse
  • primary care
  • structural competency

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