The security footage leaked Monday told an ugly truth we had already imagined: Former Baltimore Ravens running back Ray Rice struck his then-fiancé, Janay, so hard that she fell unconscious onto an elevator floor.

When TMZ aired the previously unseen clip of the February assault at an Atlantic City casino, it sparked outrage — and judgment. The NFL suspended Rice indefinitely and the Ravens cut him from the team. Across the Internet, Rice was cast as a sociopath, and Janay as a victim who made a grave mistake for marrying the man who viciously hit her.

Women like her enable women beaters!So sad! RT @nycjim: Ray Rice’s wife vows to “show the world what real love is!” http://t.co/3SCQV2yFDX — Sevgi Akarcesme (@sevgistanbul) September 9, 2014

Ray Rice actually not making a effort to persuade her not to put that out there when he knows his wrong doing shows me he's a sociopath — BReaking BEard (@CWellion) September 9, 2014

The footage also spawned two Twitter hashtags documenting why domestic violence victims had either stayed with or left their abusers. These confessions were cathartic, describing experiences the public doesn't regularly hear and demonstrating the complexity of living in abusive relationships.

I stayed because I was halfway across the country, isolated from my friends and family. And there was no one to help me. #WhyIStayed — Beverly Gooden (@bevtgooden) September 8, 2014

#WhyILeft B/C I didn't want my kids growing up thinking that violence was normal in relationships. — Sil Lai Abrams (@Sil_Lai) September 8, 2014

Yet, most voices never considered one of the most taboo questions regarding domestic violence: How do we effectively treat batterers so that fewer women experience the horrors of abuse?

Research shows that domestic violence can be a behavior observed and learned early in childhood, much like substance abuse. One major study of more than 17,000 adults found that 13% had witnessed the violent treatment of their mother as children. Surely, many of those individuals vowed as a result to never strike a loved one, and still others simply weren't able to keep that promise. The question is: Could they have benefited from effective treatment to halt the intergenerational cycle of violence?

We often avoid that question by collectively focusing on a different narrative, one that views perpetrators as unequivocally beyond helping, and considers the women (and men) who try to salvage their relationships and families as not yet ready to accept that truth.

Janay Rice seemed to protest this in an Instagram post published Tuesday morning in which she castigated the media for forcing her to relive a moment she and her husband "regret" everyday. She also tried to redefine the public's perception of her marriage. "Just know we will continue to grow & show the world what real love is!" she wrote.

Some observers were shocked by that sentiment, logically concerned Janay Rice would be subject only to further physical and psychological abuse over time. This is a reasonable assumption — countless women have remained with their abusers only to lose their lives, or children or loved ones after violence turns deadly.

Jacquelyn Campbell, a professor and researcher at the Johns Hopkins University School of Nursing who has interviewed thousands of domestic violence survivors, told Mashable abusive behavior is a pattern likely to repeat itself without treatment or intervention.

Yet, we commonly dismiss the possibility that some of the men who commit these heinous acts might actually be capable of reformation. Instead, they are typecast uniformly as sociopaths or psychopaths driven by hatred of women. Campbell said, however, that research indicates such men account for a minority of offenders.

To even acknowledge such a restorative approach first appears to undermine hard-fought victories won by advocates who forced American institutions to take domestic violence seriously. Campbell is clear that she makes no apology for abusers. But there is a lingering, real concern: Even if a woman leaves her tormentor, without substantive and effective treatment, he is likely to victimize the next woman who takes her place.

"I really do feel this is a teachable moment for the public to not only understand a little more about how domestic violence happens and how serious it is, and how there is no excuse for that kind of behavior, and how there should be very clear sanctions, but sanctions are not enough." Campbell said. "When someone is abusive toward another person — violent toward a loved one — there are deep and complex reasons for that. That’s not to excuse anyone. But ... this kind of human behavior needs some real strategic intervention specifically for domestic violence."

Ray Rice is reportedly undergoing counseling as part of a pre-trial intervention program, but a spokesperson for the Atlantic County Prosecutor's Office could not provide Mashable with additional details regarding the nature of his treatment, nor that of similar interventions for domestic violence offenders. ESPN reported that Rice was required to participate in anger management counseling.

There are several challenges in obtaining effective treatment, Campbell said. First, if an abuser is truly sociopathic or psychopathic, sending him to a batterer's group or standard therapy is unlikely to make a difference. Second, those who might benefit from treatment are — like Rice — often mandated by courts to receive anger management counseling, which has not been shown to reduce subsequent acts of domestic violence. Finally, the available treatments that do work are not as effective as researchers would like.

Central among these is the batterers' intervention group. These small gatherings are not therapy, but rather a series of facilitator-led discussions in which men are challenged to rethink their use of control and authority in a relationship.

In a 2004 paper, Julia Babcock, an associate professor of psychology at the University of Houston, analyzed the success of different interventions, including the batterer's group, and found they had a minimal impact in reducing violence over a sustained period of time.

This doesn't mean that all abusers are intrinsically malevolent and cannot be treated, Babcock told Mashable. In fact, she has noted that for as many as 50% of couples, abuse is not necessarily the result of psychosis or a similar condition, but rather violence that erupts when an argument escalates rapidly and the partners remain locked in heated conflict. Babcock is careful to stress that while this insight into behavior is valuable, it could never justify an abuser's actions.

One key to effective treatment for an abuser — even for someone who delivered as vicious a blow as Ray Rice did — may lie in a controversial approach Babcock used to resolve discord amongst couples in which the male partner had been previously violent. In 2011, she published a study in which some of the men were taught how to better listen to their female partners.

A core problem of abusive behavior, Babcock and her co-authors wrote, is that aggressive men not only mirror negative emotions like sadness or anger during an argument, but they respond with "contempt, belligerence or defensiveness," and invalidate a partner's concerns. By marginalizing a woman's deeply held feelings, and responding with physical force, these men create a destructive pattern of violence.

Yet, tackling this dynamic through couples therapy is a contentious approach; the practice has been characterized as placing blame on the victim for her "role" in the argument. Some states have even forbidden the use of couples therapy for domestic violence offenses, according to Babcock. While her study did not measure whether the training reduced future incidents of violence, male participants did demonstrate more positive and less aggressive behavior.

Babcock said the strategy, which would be used in conjunction with legal punishment, needs further testing and wouldn't work for everyone, particularly not for men whose behavior is rooted in a personality disorder as well as feelings of neediness or jealousy. Still, she worries about the characterization of all abusers as evil.

"That scares people away from even trying to fix the problem," she said. "We say, 'They’re all psychopathic. Lock them up and throw away the key.' Not every man who has beaten his wife deserves to be treated this way."

This is not a popular viewpoint, and Babcock, who emphasizes that we must hold abusers legally accountable for their actions, has been mocked by peers for her unconventional perspective. But she wonders, "Why are we spending our lives doing this research if we think these guys are a lost cause?"

Jacquelyn Campbell believes it is possible for some abusers who are appropriately punished and treated to learn non-violent behavior patterns. "For [Ray Rice], I hope that he’s getting some sort of counseling that will address the complex wellspring of this behavior, because otherwise it will happen again, unfortunately," she said.

She also believes it's possible that a former abuser could forge, with his partner, a relationship in which violence wasn't used as a weapon.

"Ninety percent of the women I have interviewed have said, 'I love him, I want to make this work ... and I just want the hitting to end,'" Campbell said, noting that women stay with abusers for myriad, complicated reasons.

"As a domestic violence advocate and researcher, I want that too. I want us to figure out a way to have the hitting and psychological abuse end."

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