Gabby Petito and the Silent Epidemic of Intimate Partner Violence

— Provider and public intervention can help prevent similar situations

MedpageToday
Photos of Gabby Petito and other items arranged at a makeshift memorial to Gabby Petito

In September, a 22-year-old white woman named Gabby Petito was reported missing by her family. A few months earlier, she had set off in a camper van she renovated with her high school sweetheart, Brian Laundrie, to explore the wild spaces of the American West. She updated her Instagram as she went with smiling photos of herself and Laundrie, framed by canyons and lit by sunsets, and touched base with her family back east every few days.

Sometime during the last week of August, she went silent. The search for her and then for Laundrie captivated the nation and ignited an important discussion about why searches for white women garner disproportionate media attention and resources compared to the thousands of missing women of color and indigenous women. But less discussed was the thread in her narrative that drew in so many with its terrifying familiarity: the slow descent of what began as a seemingly happy road trip into abuse and intimate partner violence.

Intimate Partner Violence in the Petito Case

We don't have a final word on who killed Petito, but there are several facts we do know. We know that Laundrie showed up alone at his parents' home in Florida in Gabby's van on September 1. He refused to speak to authorities, and then disappeared himself. Meanwhile, on September 19, remains later identified as Petito's were found outside a campground where she and Laundrie had stayed. The cause of death was eventually declared: strangulation. After a weeks-long hunt for Laundrie, he was found dead in a nature preserve. There's a reason that police investigate husbands and boyfriends first when a woman is found murdered: nearly half of female homicide victims are killed by an intimate partner.

There is also no reported cause of death for Laundrie yet, but plenty of speculation that he ended his own life. Though murder-suicides are rare, they most often happen in the context of domestic violence. Seventy-two percent of murder-suicides involve an intimate partner, and as with most acts of intimate partner homicide, the perpetrators are overwhelmingly male and the victims overwhelmingly female (94%).

Petito and Laundrie's dream road trip didn't start out as a nightmare. Her Instagram posts show her and Laundrie posing together on beaches and under desert arches, smiling adoringly at each other. Family and high school friends, even in retrospect, didn't report concerns about Laundrie's potential for violence or any history of abusive behavior.

But somewhere between Florida and Wyoming, things took a dark turn. Following social media conventions, her Instagram account doesn't document the quotidian hardships of van life: rainy days, small spaces, tight budgets, minimal comforts. It's hard to get time or space away from a partner, and behind the sunny posts, the stresses seemed to wear on the two.

In mid-August, campers in Moab called 911 after seeing Laundrie slap Petito in an argument over a phone, lock her out of the van, then drive away. Bodycam footage of law enforcement pulling them over later shows a sobbing Petito blaming herself for the incident. She tells officers that Laundrie ran over the curb because she distracted him from driving, then attributes their fighting to her anxiety and obsessive-compulsive disorder. Officers put Laundrie up in a hotel for the night, and she asks how far she will need to go to pick him up the next morning because she doesn't feel comfortable driving the van alone (though it is registered in her name). Despite the account given by the 911 caller, police determine that Petito was the aggressor after hearing her take responsibility and seeing the scratches on Laundrie's face.

This wasn't the only time she had been rendered helpless in the face of his anger. A couple reported later that they had seen the pair at a restaurant in Jackson, Wyoming. Laundrie became aggressive with restaurant staff, yelling and storming in and out in an obviously enraged state while Petito cried on the sidewalk, appearing fearful and embarrassed.

It's easy to ask why victims of abuse don't get out of dangerous relationships sooner, especially after something tragic happens. But for many, there is good mixed in with the bad, and things get worse slowly enough that better times seem within reach. Victims may believe -- based on empty promises and even sincere attempts to change -- their partner will reform. And they often shoulder responsibility for the abuse, hoping that if they can just be better, it will subside. In her conversation with the police officers in Moab, Petito blamed her own shortcomings for the stress of their van life, their escalating arguments, and even for Laundrie's bad driving.

Responding to Intimate Partner Violence

Intimate partner violence is unfortunately common: one in four women and one in nine men will experience it in their lives. LGBTQ people, people with disabilities, those with lower socioeconomic status, and people of color are at an even higher risk. Many of us have witnessed incidents like those between Petito and Laundrie at the restaurant or campground. And like most bystanders, we probably brushed it off as a personal matter or worried that intervening could inflame the situation or bring us into harm's way.

The CDC and other organizations have endorsed bystander training for the lay public. This might include education about the frequency and signs of intimate partner violence and norms of healthy, non-violent relationships. It might also encourage people to intervene when they see signs of abuse. This approach can reduce relationship and sexual violence in communities where a significant number of people can receive the training, like college campuses.

As healthcare providers, we see patients in abusive and violent relationships, whether or not we recognize it. Victims are often hesitant to divulge their situation out of fear or shame, while others may not recognize their experience for what it is.

For this reason, the U.S. Preventive Services Task Force recommends screening all women of childbearing age -- a high-risk group -- for intimate partner violence. Screening should be done in a private, confidential setting. Focused questions about specific feelings or behaviors such as "Do you ever feel unsafe at home?" or "Does your partner ever yell at you or insult you?" or "Has your partner ever pushed or slapped you?" may elicit more concrete answers than asking generally if a patient is being abused.

If a patient screens positive for an abusive or violent relationship, it's important to respect their desires about how to proceed. Leaving may be financially complicated, it may affect child custody, and it may further inflame an already frightening situation. Those who screen positive should be referred to a multidisciplinary team that can provide counseling and other services. Providers should be aware of what resources are available in their area and should offer information in a confidential manner. Follow-up is critical, as circumstances may change, as may readiness to act.

For Petito, it's hard to know if any of this would have helped. Their tiny van home in the West trapped them together and isolated them from trusted support systems that might have realized something was wrong and stepped in. Even if Petito saw her relationship for the bad situation that it was, she may not have had the capacity to leave, in a vast and unpopulated area, in a van she wasn't comfortable driving. Or maybe she never considered leaving, not yet recognizing that her dream trip had changed direction to head down a road from which she would never return. But for others in a similar situation, intervention from providers or the public can be lifesaving.

Amy Barnhorst, MD, is the vice chair for Community Mental Health at the UC Davis Department of Psychiatry and the director of the BulletPoints Project, a state-funded effort to develop and disseminate a curriculum to teach healthcare providers across California how to counsel at-risk patients about firearms.