The Darkness of Traumatic Brain Injuries: Not Just for Football Anymore

Headaches. Dizziness. Memory loss. Confusion. Irritability. Depression. Aggression.sadness-woman-looking-down

When imagining the people that experience these symptoms, who comes to mind? Based on current events, and potentially life experiences, you’d likely say football players. That was certainly the first group that came to my mind, as I played in college and am an avid fan well aware of the troubling information uncovered connecting the sad stories of many retired NFL players diagnosed with CTE resulting from brain injuries suffered during their playing days. You might also include boxers and/or soldiers in your answer. And all of those answers are correct.  Experts are finally taking note that, for each group, such symptoms may not appear right away but likely are the result of trauma from repeated blows to the head. But the experts’ findings are also true for another group largely forgotten in this discussion and left in the dark.

For many of us, myself included, we would not think to include domestic violence victims in the list of those suffering from the symptoms listed above. Shockingly, though, estimates are that roughly 25% of women have experienced severe physical assaults at the hands of a partner during their life and that at least 60% of survivors suffer from traumatic brain injuries (TBIs). Such injuries can result immediately from one blow or develop over time as a result of repeated abuse. Ramifications of abuse often include – as with football players, boxers, and soldiers –memory loss, irritability, depression, confusion, debilitating headaches, and chronic traumatic encephalopathy (also referred to as CTE).  According to Hirsch Handmaker, a radiologist working with the Sojourner Center BRAIN (Brain Recovery And Inter-professional Neuroscience) Program, up to 20 million women each year experience TBIs as a result of domestic violence. Such numbers, for me, led to serious reevaluation of my own priorities (especially as a man) in being so acutely aware of the plight of athletes as a result of TBIs while simultaneously so in the dark regarding the overwhelming impact of such injuries on victims of domestic violence.

 

Thankfully, the suffering experienced by athletes and soldiers as a result of TBIs is finally receiving the attention it deserves. Ample evidence is being developed linking violent TBIs to the list of long-term problems above. And for the aforementioned athletes and soldiers, such evidence brings hope. Hope that testing and treatment can begin earlier. Hope that educating others about the signs and symptoms of brain injuries will allow them to advocate on behalf of the injured during the critical moments after the injury, in which advocating for themselves is extremely difficult, if not impossible. Hope that knowledge of the impact of the violence they’ve experienced in the past can lead to treatment which can help minimize the damage in the future. Hope that the light shed on the issues they face can help them understand the changes they’ve experienced.

But for victims of domestic violence, the light currently does not shine so brightly and the resultant hope is nowhere near as real. The link between domestic violence and TBI is rarely discussed and infrequently considered during treatment for injuries suffered at the hands of domestic abusers. Health care providers rarely screen for TBIs when a victim presents at the hospital, victims oftentimes cannot remember or will not report exactly what happened to cause their injuries or the extent of previous brain injuries, police officers are not adequately trained to search the scene of a domestic assault for signs of strangulation or brain damage (e.g., victims experiencing TBIs may not have been physically hit in the head, but may have been strangled and deprived of air to the point of urination before death), and the party with the most knowledge of the injuries sustained over the course of the abuse, the abuser himself, is unlikely to assist medical professionals in properly diagnosing and treating the patient.

Consequently, many women are left to struggle with severely debilitating TBIs without any explanation as to their root cause or treatment for them.  And I am left thinking that I have likely interacted with some of the estimated 20 million women suffering from a TBI, failed to recognize the connections to domestic violence those women have suffered, and discounted their behavior as something less severe than it truly is. And while I frequently engage in discussions with friends about the problem TBIs pose for football players, I have never once talked about the potential TBI injuries so many women in this country and around the world experience due to domestic violence. Such injuries oftentimes lead to difficulties in the workplace, which can lead to poor job performance, trouble relating to coworkers, financial problems, and potentially homelessness. At times, women may even be unable to engage in coherent conversation with those in positions of authority, friends, family, or even their own children. The effects of undiagnosed, untreated TBIs can also be used against women in custody battles as evidence of unrelated mental illness and can make it more difficult for women to be successful in court cases against their abusers.

Although traumatic brain injuries in domestic violence victims are not yet adequately understood or considered during the treatment and rehabilitation process, efforts are being made to shine light on this dangerous condition. For instance, an emergency room screening tool called HELPPS has been created to help identify domestic violence victims with potential TBIs even though such injuries have historically not been considered. Additionally, the Sojourner Center and its BRAIN Program are working to increase data on the prevalence and impact of TBIs as a result of domestic violence in an effort to better arm domestic violence advocates, first responders, and treatment providers in the fight to minimize the impact of such injuries on the lives of survivors.

But these efforts must be supported and built upon in order to shine a bright enough light on this issue and create an environment in which the link between domestic violence and traumatic brain injury is brought to the forefront of societal consciousness and adequately considered. And domestic violence must be eliminated in order to prevent millions of additional women from suffering TBIs.

The efforts of organizations like Global Rights for Women and others that facilitate coordinated community responses to domestic violence in communities around the world are of critical importance. Such efforts result in the sharing of information between all relevant community parties (like law enforcement, prosecutors, advocates, and health care providers) in order to better assist victims of domestic violence and thereby help turn up the lights on the critical issue of survivors’ TBIs. By challenging ourselves to become just as aware of, and just as concerned about, the impact of TBIs on domestic violence victims as we are with respect to their impact on football players, boxers, and soldiers, we render ourselves capable of also helping move our world ever closer to a point where TBIs will become increasingly less frequent and significantly less damaging.

 

Noah Lauricella, an attorney at Goldenberg Law, is a volunteer contributing writer for Global Rights for Women.