Domestic Violence and Traumatic Brain Injuries

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Since October is Domestic Violence Awareness Month, I thought this would be a perfect time to share with you a societal problem that has been largely ignored. Not only do war veterans, football players, and accident survivors sustain traumatic brain injuries, but women who are victims of domestic violence sustain TBIs too. Here’s the tragic truth: Close to five million women in the United States experience domestic-related assaults every year, and the injuries they suffer are mostly to the head, neck, and face. Men experience approximately three million domestic-related assaults each year. The CDC estimates that nearly one hundred sixty thousand TBI-related deaths, hospitalizations, and emergency room visits in the U.S. every year are a result of physical assaults. But the actual numbers are unknown. Why?

Many victims don’t report the abuse to family, friends, or the police because they worry others will not believe them. And victims are often dependent on their abusers, financial and physically. Also, a TBI can make it difficult to communicate clearly, preventing victims from reporting the abuse. The perpetrator may convince others that the victim shouldn’t be taken seriously because of her TBI-related cognitive problems, and victims may be unwilling to admit that they have a TBI out of fear of the fallout: losing custody of children for instance.

An obvious trauma does not have to occur for a TBI to exist. Women who suffer a blow to the head in a domestic violence incident may not lose consciousness, and, therefore, they may not seek medical attention. Symptoms may not be easily recognized and women are often misdiagnosed with a mental health illness. In an article from the Huffington Post, a woman who was interviewed about her experience subjected to a two-and-a-half year abusive relationship says, “When you are in a relationship with that much trauma and violence, you don’t know what’s physical or what’s emotional or mental.”

In a past study conducted by the American Psychological Association, trained staff surveyed one hundred sixty nine women who visited three different emergency rooms with injuries sustained over a period of seven to nine months. Of the forty-six women who answered all the survey questions, seventy-one assaults were reported. Thirty-five percent of the women were identified as possibly having sustained a mild traumatic brain injury.

Women with traumatic brain injuries caused by domestic violence have below average recoveries and are more likely to develop post-concussive syndrome. Researchers don’t know the reasons for this, but suspect it’s due to the nature of the injury to the head, that female hormones may affect recovery, or that female victims of domestic violence have sustained multiple injuries.

Overall, researchers found that sixty-seven percent of the women who participated in the survey exhibited symptoms of a TBI.

What is being done about this dire reality? Researchers have advocated for further exploration into the nature and consequences of domestic violence and TBIs. They are also proponents of early screening for TBIs, so women have access to treatment, thus preventing further injuries.

The New York State Office for the Prevention of Domestic Violence has made available to those likely to encounter victims of domestic violence a list of statistics, TBI symptoms, and questions to ask when assessing for abuse. Though the document is geared toward professionals, I encourage all of us to read it, to be better aware of the connection between domestic violence and TBIs.

 

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Social Media and Post-Traumatic Stress Disorder

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How often do you view social media sites? Two, three, five times a day? Do you have nightmares after viewing clips of school shootings or movie theatre bombings? Do you feel chronically uneasy, irritable, hyper-vigilant after watching unfettered displays of violence?

If this is the case, you might be suffering from post-traumatic stress disorder. Yes, viewing violent news events on social media can cause PTSD. In a recent study conducted by Dr. Ramsden, a researcher at the University of Bradford in the UK, 189 individuals completed questionnaires regarding personality and violent news events such as 9/11 and suicide bombings. They also participated in clinical assessments concerning PTSD and vicarious traumatization, a term typically assigned to those who repeatedly witness trauma such as therapists, rescue workers, crisis clinicians, police officers, and nurses.

Out of the 189 participants, nearly one quarter of them scored high on clinical assessments of PTSD, showing that they were significantly affected by watching violent news events on social media. The more individuals who viewed violent events, the greater they were affected. Extroverts were also found to be at greater risk for developing PTSD.

Now that I’ve added a layer of worry to your day, (sorry), how do we protect ourselves from unrestrained acts of violence? Though, in June of this year, the Supreme Court ruled in favor of protecting free speech on social media and the Internet, we, as viewers, possess a similar freedom of choice, namely the freedom to make choices that protect our emotional well being. We can choose to walk away from our computers, iPhones, iPads, e-readers, and tablets. The challenge I pose to you is this: Can you shift your eyes from the screen, even for a day, and onto something else like a walk in the woods, a fantasy novel, or a crossword puzzle?

 

 

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Residue of Trauma

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“I dream about blood.” That’s how Erin Maynard, Acting President and CEO of PTSD Survivors of America, begins her tragic story, “I Killed a Man and I Want to Die.” In 2008, she unintentionally drove over and killed a pedestrian on the Long Island Expressway. Maynard was heading home from her job as an editorial aide when she felt a “thump” below her car. That “thump” changed her life. That “thump” reverberates throughout her story. Maynard tells it to us straight, bares her soul on the page with stunning courage. Her story is so powerful, and dense, with the residue of trauma – post-traumatic stress disorder, post-traumatic growth, survivor guilt, forgiveness, and identity – that it must be shared. It must be shared so that others can better understand life after trauma.

To learn how Maynard picked up the shards of her shattered life, I encourage you to read her full story in The Spectrum.

Click here for Erin Maynard’s full bio. 

Do you have a personal traumatic story to share? If so, how has it changed you? What can we learn from your experience?

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Eye Movement Desensitization Reprocessing: In Need of a Computer Geek

How exactly does EMDR work? Francis Shapiro, who discovered the treatment, explains it through the theory of the “Adaptive Information Processing Model.” The theory sounds metaphysical, but it’s not. The assumption is that all individuals have an information processing system, which takes our experiences and stores them in a section of our memories that is easily accessible. These experiences are connected to particular images, emotions, sensations, and beliefs.

Think of a computer. If you’re like me, you might have several folders filled with documents dotting your desktop, because you need the information to be readily available – at the click of the mouse. One of those folders might hold information that reminds you of something that evokes negative feelings. For instance, a folder has photos of your deceased parents. Every time you turn on the computer, you see the folder, and images of your parents fighting in front of you when you were a child return. You hear them screaming at one another, one of them saying, “I wish I never had children.” Each time you drag the folder into another one, so you won’t see it, the folder bounces back onto the desktop. Your computer is malfunctioning, so you need to take it to a computer geek.

Of course, we are not computers; we are human beings. Yet, our brains are very much like computers. In PTSD, the trauma – the negative images, emotions, and thoughts – are stuck in the easily accessible part of the brain. The processing system in our brains is working ineffectively, so each time something triggers memories of the trauma, like a car backfiring, you exhibit PTSD symptoms, such as panic. EMDR helps transfer the trauma and related images from your brain’s desktop into the part of the brain, or folder, that effectively processes the event.

When I speak to others about EMDR, they shirk from me, as if suspicious – maybe I’m looking to recruit them into a cult. But EMDR is not a cult at all, I promise.

 

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Eye Movement Desensitization Reprocessing: Taming the Inflammation

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Eye Movement Desensitization Reprocessing, or EMDR, was first discovered in 1987 by Psychologist Francis Shapiro.  One day, she felt anxious by negative thoughts, so went for a walk in the woods. Sure, you might say, sounds like a great way to shed some stress – walk it off. But as she moved her eyes from right to left, taking in nature’s greens, yellows, and browns, she noticed that her level of anxiety decreased. She tried a similar eye movement process with her clients, and it worked. They, too, experienced a reduction in anxiety. That’s how EMDR was born. Initially used to treat individuals with PTSD and other anxiety disorders, it is now used to treat other conditions like depression, schizophrenia and eating disorders.

When you cut your finger, cells race to the site and clump together to stop the bleeding. Your body’s nutrients then heal the wound. If it continues to get irritated, it will become inflamed and may open up again. Once the source of irritation is removed, the wound can finally heal. PTSD symptoms are like festering wounds; the goal of EMDR is to remove what is blocking those wounds from healing.

Here’s how EMDR works: The client recalls a vivid image from the trauma experienced, such as a lying on the pavement after being hit by a car while thinking about a negative belief about the self, such as “I’m going to die.” The client notes the visceral sensations and emotions she is experiencing like a tight chest, shortness of breath and increased fear. She then thinks of a positive image like taking a warm bath, then a thought: “I’m safe.” Following this, the client conjures the negative thoughts and images while undergoing 15-20 seconds of bilateral stimulation: lateral eye movements, where the client follows the back and forth movement of the therapist’s fingers. Even though lateral eye movements are the most common form of stimulation, other stimuli may be just as effective, such as tapping or tones. The therapist who treated me used walkie-talkie like devices that vibrated beneath the backs of my thighs.

The same bilateral stimulation is then used while the client focuses on the positive images and thoughts. Over time, these will become embedded in the client’s memory, blocking the negative images and thoughts – the wounds. Eventually, PTSD symptoms will lessen when exposed to sounds, smells, or sights reminiscent of a trauma or threat.

EMDR is different from exposure therapy, which involves prolonged exposure to a stimulus that triggers thoughts, emotions, and sensations about the traumatic event. Some therapists believe that prolonged exposure is necessary to produce effective treatment outcomes. But others believe that this type of therapy will cause fearful memories to outweigh the joyful ones in people who have experienced extreme trauma, then encounter a particularly stressful situation in the future.

http://www.emdr.com

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