INVISIBLE WOUNDS: PSYCHOLOGICAL EFFECTS OF GENDER-BASED VIOLENCE ON RURAL WOMEN IN KHYBER PAKHTUNKHWA, PAKISTAN

Abstract

This study explored the psychological effects of gender-based violence (GBV) on rural women in Khyber Pakhtunkhwa, Pakistan, with a focus on how socio-cultural and structural dynamics shaped survivors’ mental health experiences. Despite global commitments under Sustainable Development Goals (SDGs) 3 and 5 to ensure well-being and eliminate violence against women, GBV remained pervasive in rural Pakistan, with limited attention to its psychological consequences. A qualitative design was employed using purposive sampling to conduct 12 in-depth interviews (IDIs) with survivors, four focus group discussions (FGDs) with community women, and six key informant interviews (KIIs) with healthcare providers and social workers. Data were analyzed thematically using NVivo software. Findings revealed eight interrelated psychological effects of GBV: chronic fear and anxiety, internalized guilt and self-blame, depression and emotional numbness, social withdrawal, low self-esteem and loss of identity, intergenerational psychological impact, trauma and PTSD-like symptoms, and learned helplessness. Survivors reported persistent hypervigilance, emotional detachment, and diminished sense of self, while expressing concern over the transmission of fear and normalization of violence to their children. Key informants corroborated these patterns and highlighted the absence of trauma-informed mental health services in rural health systems. The findings underscored that GBV in rural Khyber Pakhtunkhwa functioned as both a mental health crisis and a public health challenge with intergenerational implications. This study concluded that addressing GBV required integrating culturally sensitive, trauma-informed psychosocial support into rural healthcare and GBV response frameworks, strengthening community-based referral pathways, and providing family-centered interventions to break cycles of violence. By documenting the psychological burden of GBV in a marginalized rural context, the study contributed evidence to inform Pakistan’s progress toward SDG 3 (Good Health and Well-Being) and SDG 5 (Gender Equality).