Aim: To know the contribution of the Reflective Group to the confrontation of conjugal violence. Method: A study carried out with 11 participants from a reflexive group for men in criminal prosecution for conjugal violence linked to the Specialized Nucleus of Attention to Man in the city of Belém, Pará, Brazil. The data were collected through the focal group, in the months of June and July, and submitted to the thematic content analysis technique. Results: Men understand the relevance of the Reflective Group to the confrontation of conjugal violence as it clarifies the forms of expression of conjugal violence; sensitizes the disrespectful and criminal nature of their conduct and encourages dialogue as a mediator of conflicts. Discussion: In revealing the contributions of the Reflexive Group, the study indicates that this represents a strategy that favors more harmonic conjugal relations.
Descriptors: Violence against women; Masculinity; Family conflict.
Marital violence consists of a public health problem with serious repercussions on the health of the whole family and society and must therefore be prevented and dealt with. Considering the social construction of gender, which regulates and naturalizes masculine power over the feminine, the challenge to overcome this reality is through the transformation in men's way of thinking and acting in order to build harmonious conjugal relationships.
It is estimated that around 40 thousand Brazilians seek the Unified Health System (Sistema Único de Saúde – SUS) for treatments resulting from violence, representing an annual cost of more than five million Reais for this sector(1). The United States also had an estimated annual expenditure of $ 5.8 billion with the health sector due to violence(2). However, it is known that expenditures related to the experience of violence go beyond the health field, and the expenses with other sectors must be added, since people inserted in the context of violation of rights present demands that require intersectoral care of a service network that also involve areas such as the social, police, legal, education, among others(3).
It is important to mention that this sum does not represent the actual expenditure on care due to violence, since only the cases represented in police stations are measured and, in the case of health damage, more serious situations, such as those that generate hospitalizations. In the domestic context, this reality is aggravated, above all due to the invisibility of the abuses committed by people who, a priori, should watch over the protection and security of the family. Studies carried out in Ecuador and Brazil suggest that, for the most part, the victims tend to silence the violence suffered by several factors, among them: fear, disrepute as to the effectiveness of the laws, hope for the change in the behavior of the partner, and financial and/or emotional dependence(1,4).
In the specific case of conjugal violence, masking is accentuated by the naturalized and private character with which it is perceived socially: as a problem that concerns only the couple. This social understanding was also revealed in a study carried out in Ecuador, which makes clear that marital problems are intimate, and should not be discussed publicly, nor with the intervention of third parties(4).
Considering the 'invisibility' of the phenomenon, one can infer the lack of knowledge about the burden of conjugal violence, either because there are no reliable records of the cases or their implications on the other members of the family, such as the children and the companion.
Nevertheless, authors from different parts of the world corroborate that boys and girls experiencing marital violence tend to present psychological problems, impacting on depression, misconduct, drug use, difficulty concentrating, and low school performance, as well as the tendency to reproduce these actions in their future marital relations(1,5).
The implications for male health should be added to the harm of marital violence against women and children. Considering its inter-relational character, it is believed that this experience also has repercussions on the health of the men, although the productions do not lead to such object.
Although indirectly, Brazilian research revealed that the experience of pre-trial detention due to conjugal violence triggered male illness, expressed by mental impairment, such as sadness, low self-esteem, apathy and depression; and physical damage, such as gastric changes, changes in sleep pattern, headache, tachycardia and hypertension(6).
Beyond magnitude, one must consider the complexity of the phenomenon, with roots in the macho and phallocentric culture that legitimizes and naturalizes marital violence. This is because women are perceived socially as passive, being attributed characteristics such as subservience and fragility, while men receive more active attributes, such as strength, courage and aggressiveness(3,7). Considering that such roles and attributes are taught to men as well as to women, it is urgent to create spaces that enable the deconstruction of gender stereotypes and masculine reflection about their actions, which also points to a greater awareness and responsibility for their actions.
In Brazil, Law 11.340, known as the Maria da Penha Law, recommends the creation of education and rehabilitation centers for perpetrators of violence, as well as the participation of men in recovery and re-education programs based on reflexive, educational and pedagogical activities(8).
The first intervention program in this field began in Boston, in the United States in 1977, developed by the Counseling and Education to Stop Domestic Violence (EMERGE), based on the initiative of a group of academic men as a strategy for coping with the phenomenon of conjugal violence(9). Since 1980, these interventions have been articulated to the judicial system, as well as spreading to European, Nordic and Latin American countries, arriving in Brazil in 1990(9). In Brazil, many of the activities of attending to the man living in violence are also developed in partnership with the judicial sector, and it is predominantly the initiative of university research groups. It is should be highlighted 19 institutions with methodologies of reflective groups of men authors of violence in ten Brazilian federal units: The States of Santa Catarina, Paraná, São Paulo, Rio de Janeiro, Espirito Santo, Minas Gerais, Mato Grosso, the Federal District, Acre(9) and Bahia, the latter under the initiative of the Group of Studies on Health and Quality of Life (Grupo Vid@) of the Federal University of Bahia(6).
These spaces promote discussions anchored in gender inequality and in the masculinity referential, aiming at changes in the perception and behavior of men in family and marital relations(9).
Based on the assumption that these spaces favor a change in male behavior towards a life free of violence, the following question arises: How does RG contribute to the confrontation of conjugal violence? The objective is to know the contribution of the RG to the confrontation of conjugal violence.
This is a descriptive study, using a qualitative approach, carried out with 11 participants from a reflective group for men in criminal prosecution for marital violence. These men were under the supervision of the Specialized Nucleus of Assistance to Man (Núcleo Especializado de Atendimento ao Homem – NEAH) in the city of Belém, Pará, Brazil. Linked to public advocacy, this service aims to ensure the right of defense to men denounced for violence against women in domestic and family matters.
Providing assistance since January 2011, NEAH has the purpose of enforcing article 35, Section V of Law No. 11.340/06, which provides the education and rehabilitation of the aggressor. This has come about through the development of RG, led by social workers, psychologists, pedagogues, and public defenders. Each reflexive group occurs in the period of six months, with weekly meetings lasting 2 hours.
Referring to conjugal violence, topics such as gender social roles, hegemonic masculinity, family relations, expressions of violence, precipitating and intensifying elements of violence, and peaceful resolution of conflicts are discussed. Since the RG is a judicial measure that integrates the criminal process, the participation of men is mandatory, and these must fulfill the workload established by the judge of the Court for Domestic and Family Violence against Women. This sometimes directs the essential themes, in which there can be no absence, even if they are paid up to two faults. Three faults are allowed in the condition of restoration of the theme in the meeting of the next cycle. Above this number, the whole process must be restarted.
The approach with men occurred through the authorization of NEAH coordination and monitoring of the entire process of a particular RG. After the end of the cycle of meetings, the participants were invited to participate in the study, having been clarified on: the purpose of the study; the right to participate or not, and to withdraw at any time; the anonymity and confidentiality of their information, the employees being identified by means of alphanumeric coding (H1, H2, ... H11), using the letter H, followed by numerals; and other ethical precepts of Resolution No. 466/12 of the National Health Council (CNS). Considering that there was no refusal to collaborate with the study, all RG participants signed the Informed Consent Form.
It should be noted that only after the approval of the Research Ethics Committee (CEP, acronym in Portuguese) of the Federal University of Pará (UFPA), under opinion number 1,091,031, data collection was started. This occurred in the months of June and July 2015, using the technique of the focal group, with three focal points. Initially, information was collected on sociodemographic aspects (age, religion, race/color, schooling, and family income) for characterization purposes. Subsequently, the focus group was initiated by two observers, who assisted in the group's conduction and recorded impressions on the participants and also by a conductor, responsible for mediating the whole process, encouraging the employees' speech from the following guiding question: For you, how does RG help prevent violence in your marital relationship?
Each focalization, which lasted an average one and a half hours, was recorded and transcribed. All the material was systematized based on the analysis of thematic content, which guided the organization of the contents of the messages obtained in the text, allowing the emergence of categories. Thus, after the floating reading, the exploitation of the material and the categorization of the data, three categories emerged: "Clarifying about the forms of expression of conjugal violence", "Raising awareness of the disrespectful and criminal character of their conduct" and "Encouraging dialogue as a mediator of conflict".
Researchers were between 21 and 57 years of age. They were mostly brown, identified as Catholics, and had low schooling and family income of up to two monthly minimum wages. The contributions pointed out by men to face marital violence were revealed, according to categories, namely:
Clarifying on the forms of expression of conjugal violence
The speeches reveal that the research collaborators understood that violence was expressed only in physical forms. After participating in the RG, there was clarification regarding the other manifestations of violence in conjugality.
The name-calling was common in our marital relationship, but I did not understand that it was a form of violence. [...]I learned from the group of men that violence against women is not just about beating (H5). (Data collected in 2015)
Before, I thought violence was just beating. In the reflective group, I discovered that there are several types of violence: psychological, emotional, and others (H2). (Data collected in 2015)
Raising awareness of the disrespectful and criminal nature of their conduct
The RG experience enabled men to reflect on the behavior in the marital relationship and to perceive them as disrespectful, violent and punishable.
We were always arguing because of jealousy. She assaulted me physically and I retaliated. I thought that this kind of behavior was normal in the marital relationship. After the group, I realized that such behavior is disrespectful and that men and women must denounce, since, according to the Maria da Penha Law, they are liable to punishment (H3). (Data collected in 2015)
I didn't realize that what I did was violence or that I was violating her rights. Today I know that this type of behavior is a crime, it hurts the rights of women and must be denounced (H1). (Data collected in 2015)
Encouraging dialogue as a conflict mediator
In RG, men realize that the absence of conversations in the conjugal relationship is a precipitating element of violence and awaken to the importance of dialogue in order to avoid such phenomenon.
In my conjugal relationship there was no dialogue, so the situations of violence were constant. Now I understand that the couple should understand each other: listening and talking, rather than using violence (H6). (Data collected in 2015)
There were no moments of conversation between us; because of that, the fighting was commonplace. The group showed me that, within a conjugal relationship, there must be dialogue to avoid fights (H8). (Data collected in 2015)
The experience of participating in the RG allowed men a better understanding in terms of the forms of expression of violence, often associated only with physical aggression. Corroborating, studies conducted in Brazil and Uganda(5,10) show that punches, kicks, burns, strangulations and injuries with a knife or firearm are the most perceived forms of violence. When analyzing the reports of occurrences registered in a women's police station, it was also verified that almost all the records were due to physical aggression(10).
In Ethiopia and South Africa, men also have limited understanding of the manifestations of marital violence, many of the expressions being invisibilized(7,11). In Brazil, Law 11.340, known as Maria da Penha, has been contributing to the transformation of this reality. In evaluating the Brazilian denunciations made before and after this legal device, it is evident that in 2005, the complaints referred only to the expressions: physical (55%), psychological (36%) and sexual (9%)(12). However, after the law, which typifies forms of violence, the registered manifestations are increased: physical (47.3%), psychological (44.9%), sexual (4.4%), patrimonial (2.5% ) and moral (0,9%)(10).
Although physical aggression is both prevalent at both times, the percentages suggest a greater perception about the other manifestations after the implementation of the law. Although in much lower percentage, the registration of these expressions confers visibility to the phenomenon, and its investigation should be encouraged in the opportunity of contact with women. This should occur both in the police sphere, as well as in the health, education, social, and legal scenario.
Regarding the influence of the RG on the marital relationship, the study indicates that men recognize that their conduct towards their partners is disrespectful and criminal and therefore punishable by law. Studies in countries in Europe and North America corroborate the importance of RGs for the accountability of men to violence perpetrated against their female partners(13,14).
It is important to emphasize that the male speech portrays the interrelationship of violence, since it also reveals the aggression practiced by women. It is necessary to warn that denunciation is a right granted to both and, therefore, represents an attitude that can and should be taken equally by men who perceive themselves in a situation of violence. However, this is still sporadic action, which is related to the social construction of gender(1). This is because men feel ashamed to make public that they suffer violence from a woman, a situation that is understood as humiliation(15). In the United States, studies reveal advances in this matter, because when Americans feel violated in their rights, they denounce their partners(2).
In Brazil, while men go to the common police stations, women look for the specialized police stations to present what happened. Currently, there are 372 Specialized Attendance Offices for Women (Delegacias Especializadas de Atendimento à Mulher – DEAMs) in Brazil, in order to serve women victims of violence(16). This represents one of the greatest achievements of the women's movement. The first DEAM was created in 1985(16).
Until then, the women were attended to in the common police stations, where they faced difficulties to carry out the representation of the violence experienced by the hands of their companions. In these places, male police officers were not very sympathetic to complaints about "couple" conflicts, and common attitudes were: refusal to listen, judgment of their actions and devaluation of their speeches and their context of life. However, research with women treated at the DEAMs warns that respectful care does not depend on the employee's sex.
It is important to consider that, despite the fact that the professional context of the DEAMs consists mainly of women, they, as well as men, have been socialized under the same references that naturalize gender inequalities and conjugal violence, so that quality assistance is related to the world view of people. It is argued, therefore, that prejudiced and/or discriminatory care is not inherent to one sex or another, nor is it characteristic of police or health care, according to a study carried out with women who visited the network in search of coping with conjugal violence(17).
It is believed that the public knowledge of the Maria da Penha Law will make it possible to transform the social belief of conjugal violence as an intimate problem for the perception of criminal conduct, which will contribute to assure the denouncer a respectful and efficient assistance.
It should be emphasized that, after the representation of the fact, it can be deployed in: Emergency Protective Measure (eg, restriction of approaching the victim, setting minimum distance, prohibition of attendance, restriction or suspension of visits to minor children) and Criminal Action and, in the case of conviction, the offender may be punished with an alternative penalty or imprisonment(8).
The creation of laws to combat marital violence is also observed in other countries, such as Indonesia, where the public policy known as zero tolerance policy (ZTP) on violence against women provides support to women in situations of violence in specialized units and promotes police, psychological and legal assistance. After the creation of this instrument, there was a significant reduction in the cases of marital violence(18). This policy, as well as Maria da Penha, besides criminalizing and punishing perpetrators of violence, advocates the importance of spaces for re-education for purposes in peaceful relations.
Regarding strategies for the peaceful resolution of conjugal conflicts, men spoke of the need for dialogue in their relations with their partners, defending RG as an important tool for building violence free relationships. A Brazilian research on the tactics of resolving marital conflicts, with 104 couples, corroborates that the negotiation strategies are primordial for the experience of a harmonic relationship(15).
In countries such as Australia, England and the United States of America, in groups of men not only dialogue is encouraged, but also: negotiating strategies for the peaceful resolution of conflicts, based on the perspective of mutual gain; and the intersubjective component of putting oneself in the other's place(13,19,20). In 19 countries in Europe, methods for conflict resolution are also within the scope of reflexive groups, which address issues that instigate the practice of respect and non-violence in marital relationships(14).
The study shows the relevance of RG for coping with marital violence, as it provides men with the opportunity to recognize the various forms of expression of this aggravation and to perceive their disrespectful and criminal behavior. It is also in this space that they awaken to the need to exercise dialogue as a strategy for the peaceful resolution of conflicts.
These RG contributions favor masculine reflection on their conjugal daily life, making it possible to envisage ways of building more harmonious relationships. They can also support the targeting of interventions with men in order to enable social deconstruction of gender inequality and encourage mutual respect.
Faced with the complexity and magnitude of this phenomenon, these spaces represent an important method of transforming masculinity models capable of freeing men from stereotypes destined to the roles of executioners and, consequently, extinguishing the dualistic conception of victim versus aggressor.
Considering the interface of the thematic with the fields of health, education, social, and legal-police, integrated actions become imperative to prevent and face violence in interpersonal relations, as it is a problem that compromises the country's economy. In this process, nurses are essential characters, since in the health field they can early identify families with conflicting relationships for which RGs should be prioritized; in the school context, it is recommended to stimulate symmetrical relationships between girls and boys from childhood and to guide them so that they do not allow themselves to be violated; and to explore the other spaces to develop educational interventions.
All authors participated in the phases of this publication in one or more of the following steps, in according to the recommendations of the International Committee of Medical Journal Editors (ICMJE, 2013): (a) substantial involvement in the planning or preparation of the manuscript or in the collection, analysis or interpretation of data; (b) preparation of the manuscript or conducting critical revision of intellectual content; (c) approval of the version submitted of this manuscript. All authors declare for the appropriate purposes that the responsibilities related to all aspects of the manuscript submitted to OBJN are yours. They ensure that issues related to the accuracy or integrity of any part of the article were properly investigated and resolved. Therefore, they exempt the OBJN of any participation whatsoever in any imbroglios concerning the content under consideration. All authors declare that they have no conflict of interest of financial or personal nature concerning this manuscript which may influence the writing and/or interpretation of the findings. This statement has been digitally signed by all authors as recommended by the ICMJE, whose model is available in http://www.objnursing.uff.br/normas/DUDE_eng_13-06-2013.pdf
Received: 05/10/2017 Revised: 09/03/2018 Approved: 09/18/2018