Evan Stark and Anne Flitcraft, best known for their research about battered women who seek help in medical emergency rooms, explored the question of traumatization in a larger context in their book Women at Risk (Thousand Oaks, CA: Sage, 1996). Stark and Flitcraft questioned whether the severe psychological symptoms caused by post–traumatic stress disorder are a result of violence. They believe that the damage is done by the coercive control exercised by the abuser and that the damage may be compounded when law enforcement, health, and social service institutions ignore a woman's attempts to get help; traditional mental health treatment contributes to the coercion by assigning mutual responsibility or defining the issue in terms of the victim's behavioral problems, including her apparent helplessness. Stark and Flitcraft point out that often women's attempts to leave are undervalued because of the pervasiveness of the "learned helplessness" theory. The view of an abused woman as a passive victim is often easier for therapists, doctors, police officers and others to sympathize with than the view of the abused woman as a sometimes aggressive woman with a history of persistent (but failed) attempts to seek help.
In "Affect, Verbal Content and Psychophysiology in the Arguments of Couples with a Violent Husband" (Journal of Consulting and Clinical Psychology, vol. 62, no. 5, 1994), Neil S. Jacobson, a pioneering researcher in the area of marital violence, also questioned the view of the abused woman as a helpless and submissive victim. He theorized that a woman's intense anger, combined with fear and sadness, may be a part of her apparent helplessness. According to him, these women are hostile to their husbands and are by no means beaten into submission, but because of the physical abuse they are also afraid. Jacobson believes there is an intense need for more services and public policies to meet the needs of battered women.