This is particularly true of persons without adequate access to mental health care, as appears to be the case with Cassandra's family. "People with depression and anxiety disorders often self-medicate by drinking, which can make things worse" (Depression and anxiety facts, treatment and prevention, 2013, UHC)
However, epigenetics, or how genes can be 'turned on' or 'turned off' in the environment must also be taken into account. "Changes in gene expression in brain reward regions are thought to contribute to the pathogenesis and persistence of drug addiction" (Renthal & Nestler 2008)
Investigators in one study found that all of the twenty-five emotional abuse subjects that were studied had three sequelae of "battered woman's syndrome" six months after leaving their partners, 'including trauma symptoms, low self-esteem, and a paradoxical attachment to the former partner," while another study revealed that the victims of even severe intimate partner violence reported psychological humiliation as their worst battering experience (Frieden pp). A report from the American Psychological Association Task Force on Violence and the Family cites the power differences between men and women as an important factor in understanding the psychology of abuse (Walker pp)
Thus, the woman become perpetually fearful of the man and feels helpless to improve her situation (Orr pp). According to Susan Ditter, a forensic psychiatry fellow at the University of Virginia, "people who are emotionally and physically abused by their intimate partners develop more mental illness and substance abuse problems than those who are only physically abused" (Frieden pp)
The battered woman syndrome is much more recognized today than it was ten years ago, resulting in several different agencies available to assist and protect women, such as social service departments, battered women's shelters, and counseling services' hotlines that can provide both emergency services and long-term help (Battered pp). The three phases involve verbal abuse, then physical abuse, then comes contrition on the part of the batterer, and then the cycle begins all over again (Orr pp)
Basically when a woman (a wife or girlfriend) is beaten and battered over and over for years, the courts have accepted that the woman has a right to retaliate in self-defense. The courts have become "increasingly receptive to expert testimony concerning the [battered woman's] syndrome"; and if the woman can establish that she has been subjected to "the cyclical patterns of physical and psychological abuse," she should therefore have strong justification for taking what self-defense measures that are available to her (Cipparone, 1987)