While domestic violence was already an epidemic before COVID-19, the health crisis caused a tremendous spike in incidents of abuse last year. Increased isolation, social distancing, and shut downs made a difficult situation even worse. These conditions could be so easily manipulated by an abuser to prevent a victim from escaping the abuse, calling a domestic violence hotline or seeking help, talking with friends and family, or reporting the abuse.

Intimate partner violence (IPV) is extremely common, with estimates of nearly 1 in 3 women reporting violence from a partner. IPV is stigmatizing and can feel embarrassing, and it traverses all socioeconomic, ethnic, and political boundaries. Unfortunately, it is also true that the majority of injuries reported by women are to the neck and higher (Wu et al, 2010). Abusers will often hit their victims on the head to conceal bruises. An estimated 36% of domestic violence survivors have sustained injuries to the head, neck, or face. Women seeking medical attention for these injuries are 7.5 times more likely to be survivors of domestic violence than women with other bodily injuries. TBI may also be associated with sexual assault with or without the experience of domestic violence. Along with blows to the head, domestic violence victims often experience trauma-inducing, terrifying strangulation (most victims refer to it as “choking”), chokeholds, or attempted drowning – all which can affect the brain.

 

This next fact is critical: brain injuries from IPV are commonly invisible! What this means is that neither the women themselves nor the providers who are meant to help and/or treat them, typically recognize that a brain injury has occurred or recognize the importance of asking about the potential occurrence of a brain injury – especially from a partner. So my message to you is to ask. First, we should be asking if women feel safe at home, and if we identify a woman who we think has experienced IPV, we should consider the possibility that she has sustained an IPV-related brain injury either from a strong force to the brain (e.g., punch, kick), or a strangulation incident. The more brain injuries a woman had sustained from her partner, the more likely she’ll have trouble learning and remembering a list of words and performing a cognitive flexibility task, in addition to being more likely to develop depression, anxiety, worry and post-traumatic stress symptoms.

It is important to remember that there also exists an inclusive spectrum of people who may have TBI from domestic or other types of relationship-related violence. This spectrum includes but is not limited to: children and teens who are abused in the home; men and teens experiencing domestic or dating abuse; those who are LGBTQ+; women who are pregnant; and victims of human trafficking. It is imperative that providers “screen in” rather than “screen out” who may live with abuse or have a history of being abused. Any type of person may have a domestic violence head injury, and may need treatment and resources regardless of a past or recent experience with abuse.

We invite you to use the following resources to learn more about the interplay of TBI’s and IPV: TBI Trainer’s Guide Handout and TBI Trainer’s Guide.

Conclusion

The data makes clear that a range of cognitive and psychological issues that women have been reported in various situations have likely been misinterpreted as something other than the symptoms of a brain injury. This needs to change. Survivors may not readily share with providers that they experience or have experienced relationship violence, and if their TBIs are injuries related to this violence. We should be asking about times when women have lost consciousness, been dizzy, dazed, disoriented or confused, seen stars or spots, or suffered memory loss after anything their partner ever did to them. If the answer is ‘yes,’ she has likely sustained an IPV-related brain injury, and her care and intervention need to take this information into account. It is only in asking that we will identify this information and consequently be able to provide appropriate care to so many women who have sustained, and will sustain, IPV-related brain injuries.

Brain injury providers are in a unique position to make a meaningful difference for survivors of domestic violence by administering opportunities to heal. Assessing all patients or clients for domestic or dating violence may enhance medical assessments and diagnoses. Doors may open further, enabling a provider an opportunity to tailor a rehabilitative plan to the true nature of an injury and to make warm referrals for domestic violence services, and these additions to service provision can be profound for domestic violence survivors with TBI, their families, and the community.

 

“PERSONAL INJURY LEGAL SERVICES WITH A PERSONAL TOUCH.”

A Schmidt Salita Personal Injury Lawyer can come to your home, the hospital, or a discreet public setting chosen by you for your initial visit. The Schmidt Salita Law Team strives to provide personal injury legal services with a personal touch to help the victims of personal injury through a very difficult time in their lives.