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Book Review   |    
More Than Victims: Battered Women, the Syndrome Society, and the Law
Margaret Jensvold, M.D.
Psychiatric Services 1998; doi:
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by Donald Alexander Downs; Chicago, University of Chicago Press, 1996, 309 pages, $27.50

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As a psychiatrist dealing with forensic issues and evaluating and treating victims and perpetrators, I have long been curious about psychiatric diagnoses that are not official DSM categories but are accepted within the courts and legal system. "Battered woman syndrome" is an exemplary case in point. This syndrome was proposed as a subtype of posttraumatic stress disorder early in the deliberations about DSM-III, but was not included in that or subsequent DSMs. In recent years several states have passed laws mandating the acceptance of this diagnosis for use within their state courts and legal systems.

Whether mandated by legislation or not, courts have accepted the use of the diagnosis and the attendant expert testimony. The niggling suspicion that labeling persons who have defended themselves against battering as having "battered woman syndrome" might lead to unintended negative consequences is hard to fend off. I, like many others, have wondered about the ramifications of this psychiatric diagnosis for the law, for psychiatry, and for victims and perpetrators.

For anyone considering these issues, Donald Alexander Downs' book, More Than Victims: Battered Women, the Syndrome Society, and the Law, is a must-read. It is an eloquent and elucidating book. With sharp clarity, Downs cuts through much murky territory and gets to the quick: that it is very important to be sensitive to the needs and experiences of persons who experience battering, but that relying on syndromal reasoning in defending women who defend themselves against battering has negative consequences. Furthermore, better legal arguments are available.

Negative consequences of the syndrome argument are many, including consequences for the battered woman herself. For example, after relying on a diminished-capacity argument, which is what syndromal arguments are, the woman may then be denied custody of children on the same basis. "Battered woman syndrome" itself creates new stereotypes that not all battered women fit. Women who do not fit the syndrome perfectly may be found not to have been battered or not to be believable. The syndromal reasoning requires battered women to experience learned helplessness, which definitely does not characterize all women who are battered. The syndromal reasoning also does not acknowledge the increased attentiveness of many women to their batterer's patterns and behaviors, which many women who are battered do have.

Battered woman syndrome also has negative consequences for the law. Downs makes a strong argument that having different law for different subgroups of persons, such as those who were or were not battered, is inferior to having universal law that is applied sensitively, taking into consideration the facts and history of the particular situation.

Part of the beauty of the book is that better legal arguments are persuasively proposed. The bulk of the book describes in detail the history, ramifications, and pros and cons of the syndrome, particularly from legal and political science perspectives (Downs is a professor of political science), and to a lesser extent from mental health and philosophical perspectives. In the final chapter, Downs and Evan Gerstmann make specific recommendations for how to improve the law. For example, they propose changes in jury instructions that would acknowledge certain of the realities of persons who are battered while still applying the law uniformly in terms of reason, citizenship, and so on.

The one potential weakness of the book is that occasionally the author's erudite style of presentation may interfere with easy grasp of his points. But overall, the clarity of logic, combined with compassion and recommendations for better ways of handling these complex issues, makes this book a joy to read. It is an important contribution to the field. Psychiatrists, forensic and otherwise, will find the book to be valuable reading for understanding a society in which syndromal arguments are increasingly being used for excusing otherwise criminal behaviors.

Dr. Jensvold is director of the Institute for Research on Women's Health in Washington, D.C., and is in the private practice of psychiatry.

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