Traumatic Brain Injury (TBI) is a hidden disability. Most individuals who have it appear to be like anyone else. However, TBI can impact on memory, emotions and other cognitive functions. Often the person with TBI is interpreted to be “uncooperative” or “non compliant with the program.” It is a potentially large issue for domestic violence victims because emergency room studies show a strong correlation between facial assault and intimate partner violence. The Family Violence Protection Fund reported that intimate partner assault tended to focus on the upper part of the head where there is greater danger for vision and hearing loss or TBI.

Brent Simonds [pictured above with another wheelchair user] is a social worker who has been a team member both at Freedom House, BFL’s domestic violence shelter and at BFL’s Non-Residential Domestic Violence Program Secret Garden. Below, he shares his experience with Traumatic Brain Injury. Brent just left BFL to pursue a PhD in social work in Ohio.

Survivor’s Story

Miss B. came to the Secret Garden as a referral from Barrier Free Justice, a collaborative project involving Barrier Free Living, the Kings County District Attorney’s Office, and South Brooklyn Legal Services. Miss B. was diagnosed with Schizophrenia. Her husband for 20 years had been severely physically and emotionally abusing her. It was through my work with her that I developed certain tools to help determine if a client may have TBI, though not have awareness of the injury.

Working with Miss B., I first noticed a pattern: she repeatedly mentioned that her memory was bad. I asked if she had ever been hit in the head and she described twice that she was struck very hard in the head during domestic violence disputes. Considering the possibility of TBI, the next important question I asked was if she had ever blacked out. She recalled blacking out twice. One such blackout occurred when her head was struck repeatedly against the brick façade of her building. She also reported severe migraine headaches.

I wrote a letter of advocacy to her primary care physician as well as her mental health provider stating the symptoms, suggesting it may be TBI. I asked that they follow up with necessary medical tests. Due to the length of time that had passed between the injury and her work with me at Secret Garden, it has thus far been difficult to determine decisively her diagnosis (still ongoing).

I was able to help Miss B. identify and manage her symptoms, which to me were presenting as symptoms of TBI. She now carries a calendar to help her with memory and is being treated appropriately for her migraines.

One thing I learned through working with Miss B. is that in domestic violence situations, it may not be just the product of being struck in the head once; it can be the result of a series of injuries over time, which can make it difficult for a person to realize they have TBI symptoms. They may have, over time, learned to adjust to symptoms rather than dealing with them.

Some tips to identify the potential for TBI.

1. Ask if they have ever been struck in the head.

2. Ask if they have ever blacked out as a result of being struck in the head.

3. Ask if they have issues with memory.

4. Ask if they experience sudden personality changes and/or do friends or relatives notice personality changes.

5. Ask if they suffer migraines.

Resources:

Facial Plastic Surgery (Journal Article). Maxillofacial Injuries and Violence Against Women. Feb., 2009.

Alabama Head Injury Foundation, Traumatic brain injury and domestic violence facts.

Brain Injury Association of Virginia, Tip card on traumatic brain injury and domestic violence.

CDC, National Center for Injury Prevention and Control, Victimization of persons with traumatic brain injury or other disabilities: A fact sheet for professionals.

Corrigan, J.D., Wolfe, M., Mysiw, J., Jackson, R.D. & Bogner, J.A. Early identification of mild traumatic brain injury in female victims of domestic violence. American Journal of Obstetrics and Gynecology, 188, S71 – S76