Trigger warning (TW): This post may be a difficult read for domestic abuse survivors. The report referenced in the post was difficult for me to process. The post could also be triggering to those with medical anxiety, acquired brain injury and other traumas. Please make sure you are in a good place before you read this, or ask a trusted person to read on your behalf.
New report highlights lack of awareness of brain injuries in domestic abuse survivors
A worrying new report from The Disabilities Trust finds that survivors of domestic abuse, who may have sustained a brain injury, are not getting support for the often hidden impacts of their injury. The study illustrates the need for domestic abuse practitioners to be trained to recognise the symptoms and causes of invisible brain injury.
(TW) The study reveals that survivors ‘often’ report symptoms or causes of brain injury, including blows to the head, face or neck (56%), being thrown against the wall or floor (56%), and ‘sometimes’ having their teeth knocked out (66%) or loss of consciousness (66%).
Despite how prevalent these injuries are in domestic abuse survivors, 81% of the practitioners who responded to the study reported no previous training in brain injuries. And 62% said they felt mostly unprepared to identify the signs and symptoms, meaning that these life changing injuries could go unnoticed and untreated in victims of abuse.
Furthermore only 10% of practitioners had heard of or used the Brain Injury Screening Index. Professionals providing front line care to domestic abuse survivors can learn about BISI or register for access here.
What does this mean for domestic abuse survivors?
The lack of training and awareness can lead to misdiagnosis of domestic abuse survivors or symptoms being missed altogether. Misdiagnosis means that survivors are missing vital care and rehabilitation that they need to understand their condition and recover.
“Far too many people with a brain injury remain invisible. I welcome this further research from The Disabilities Trust which shines a light on the limited awareness of the link between domestic abuse and brain injuries.” says Chris Bryant MP, Chair of the APPG on Brain Injury “It is critical that we ensure that providers of domestic abuse services receive the right training in order to ensure survivors are afforded the proper neurorehabilitation they need, so they can understand the condition they are living with and recover to as fulfilling life as possible.”
A previous 2016-2018 study by The Disability Trust called “Making the Link” first drew public attention to the effects of undiagnosed brain injuries in domestic abuse victims. The study screened female prisoners at HMP/YOI Drake hall for brain injuries and provided 1:1 support through a Brain Injury Linkworker. It highlighted that women with undiagnosed brain injuries are more likely to:
- Be seen as avoidant or irresponsible for frequently missing appointments
- Repeatedly do and say the same things over and over again
- Say they will do something but not get around to it
Domestic abuse survivors with undiagnosed brain injuries might be labelled as “difficult”. The effects of the brain injury might be mistaken for mental health conditions (which could also be present, the two aren’t mutually exclusive), being non-compliant with treatment or even as a personality trait.
How can domestic abuse lead to brain injury?
(TW) There are many different causes of acquired brain injury. Many domestic abuse survivors have been physically assaulted by the perpetrator(s), often resulting in trauma or injury to the head. Unfortunately many survivors have been subject to strangulation and lack of oxygen is also a leading cause of brain injury.
What are the symptoms of acquired brain injury?
Brain injuries can affect people in different ways. As you’ll see from the list of symptoms below, a lot of the symptoms cross over with other conditions that are common in domestic abuse survivors (such as PTSD). Diagnosis of mental health conditions with similar symptoms (which may also be present) could result in a brain injury being missed.
Physical symptoms of Acquired Brain Injury
- Weakness, shaking and stiffness
- Loss of co-ordination and poor balance
- Tiredness and changes in sleeping pattern
- Seizures
- Headaches
- Changes to senses (vision, smell, touch)
- Heightened sensitivity to pain
- Persistent headaches
- Sensitivity to light
- Extreme mental fatigue
- Extreme physical fatigue
Cognitive symptoms of Acquired Brain Injury
- Memory problems and forgetfulness
- Lack of concentration
- Poor attention span
- Confusion
- Difficulty with planning and organisation
- Communication difficulties
- Feeling disoriented
- Difficulty making decisions or understanding abstract concepts
Emotional symptoms of Acquired Brain Injury
- Changes in personality
- Mood swings
- Feeling irritable or on edge
- Reduced tolerance to stress
- Flattened or heightened emotional reactions
- Sluggishness
- Impatience
- Depression
- Anxiety
If you have experienced domestic abuse, including loss of consciousness, injury to the head, lack of oxygen or another trauma that you think may have led to a head injury, please speak to your GP about your concerns. The brain injury association, Headway, have information and resources on their website.
How is brain injury diagnosed?
The correct diagnosis and treatment is imperative to assess the location and extent of the injury, as well as to minimise further damage. The severity and effect of brain damage can be determined by a brain scan (such as a CT scan or MRI), neurological exams and psychological assessment.
Treatment will depend on the type of brain injury and extent of the injury, but almost all patients will benefit from rehabilitation to assist in long term recovery.
My thoughts on the findings of this report
The report deeply affected me emotionally because of my history with domestic abuse and the ongoing symptoms I experience day to day.
(TW) I was subject to physical violence at the hands of my abuser, which included trauma to the head and strangulation. Naively, I always thought that brain injuries would be immediately debilitating and dangerous, and had never heard of acquired brain injuries that could have potentially long-lasting effects.
I frequently experience many of the symptoms listed above, but as I said there is a crossover with PTSD (and I have a PTSD diagnosis). But because of how many of these I experience, I’ve come to realise that it’s worth asking my GP to refer me for assessment. And it’s just so difficult to even accept the possibility that I could be living with even more effects of the abuse that I wasn’t even aware of up until now.
This is raw right now and I feel very confused. I don’t really want to even think about the possibility of further health complications (I’m only just coming to terms with the formal PTSD diagnosis). But at the same time I also know that I deserve to have the proper care/treatment and just want to give myself the best chance, so it’s at least worth asking about.
The effects of domestic abuse are ongoing for survivors. They last far longer than the abuse itself and affect us long into the future. If you’re reading this as a domestic abuse survivor, please know that you are not alone. We walk together and, although it’s hard, we deserve recovery, peace and happiness.
Here is an open letter to abuse survivors about your relationship with yourself.
You might also be interested in reading 9 financial obstacles facing domestic abuse survivors.
Stay safe and well, gang.
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Incredible read, so informative and SUCH a important conversation to have. I’m proud of you, for sharing and for being so open. Sharing your experience is the bravest thing you can do.
Xxx
Ah, thank you so much Rachael – it’s been really scary tbh!!