Our brains can be injured by both physical and psychological abuse
- By Amanda Kippert
A domestic violence survivor calls the police after her abusive partner is violent. It isn’t the first time. He’s been doing this for years. Sometimes his abuse is psychological and sometimes it’s physical. She’s been hit, slapped and strangled before. This time, he shoved her so hard that her head collided with the wall. For a moment, she saw stars. Her ears were ringing.
Police arrive and ask for the details. How did the fight start? What room were you in? What did he say? What did you do in response? Suddenly, it’s difficult to recall all of the details. They ask again. Her answers change slightly.
She’s lying. She can’t even keep her story straight, the abuser tells police. The police take a report, but she can tell they’re skeptical. When the court date arrives, the details she gives the judge vary slightly again. She tries to remember, but her memories are fuzzy. The abuser is not charged and she’s left feeling like no one believes her. She even begins to doubt herself—did that really happen? Why can’t I remember everything?
It’s a story that plays out with survivors of domestic violence time and time again—a repeated cycle of abuse by a partner, whether physical or nonphysical, results in trauma and affects the brain to such a degree that memories of that abuse become fragmented, like blurry photos or books with pages missing. Survivors are certain something bad has happened, but when asked for exact specifics and timelines, their memories seem to have lost those details. It’s not only frustrating to the survivor, but it’s also an easy way for abusers, the court system and anyone else who may hear about the abuse to discredit the survivor.
So why does this happen? There are two explanations—one is chemical and one more physical.
Chemical: Our Bodies Can Freeze in High-Danger Situations
Edie Zusman, MD, is a trauma-trained neurosurgeon and director of the Spine Program and TBI/Concussion Research at the Piedmont Neuroscience Center in Oakland, Calif. The sympathetic nervous system, she explains, takes over when we’re in danger. It’s the part of the nervous system responsible for our fight, flight or freeze responses.
In fight and flight, our heartbeat will increase to deliver oxygen to other parts of the body—useful if we need to fight or run. Our pupils enlarge to let in more light so our vision is better. Our livers activate glucose energy stores that can be used quickly if needed. Our brains tell our adrenal glands to produce epinephrine, otherwise known as adrenaline. Our bodies are ready for a fight.
Unless, of course, we freeze. A measure of protection from our bodies, the freeze option, explains Zusman, is hardly ever our choice. It can feel like limbs that weigh a thousand pounds, holding one’s breath, hiding from an attack or simply standing still, unsure what to do next.
Adds Zusman, “The hormones secreted at that time can decrease the active retention of memory during that period. If someone’s in a situation of overwhelming stress, they won’t be able to move or fight during the freeze response and will also have a loss of some or all of the memories of that time.”
Physical: Traumatic Brain Injuries Can Erase Memories
Regardless of which response your sympathetic nervous system goes with, your brain’s ability to hold onto memories of that trauma is most often affected by a traumatic brain injury, or TBI. Concussions are among the most common type of TBI which can occur when a survivor is hit or slapped, pushed down, hit with an object, strangled or suffocated.
In one particular study of domestic violence survivors who came into an emergency shelter, it was found 80 percent had sustained a brain injury, reports Zusman. A third reported being strangled while approximately two-thirds said they were either slapped, thrown down, kicked or shook by an abuser, and some reported more than one.
“These folks were the majority. They were not in freeze. They were trying to get away,” says Zusman. As a result of the TBI, many reported memory loss, known as retrograde amnesia, which is why these individuals can’t clearly remember the sequence of events that led to that injury.
Among her patients, Zusman found no difference between brain injuries from sports and brain injuries from domestic violence. Yet the treatment of the two groups in many medical facilities across the country is what stands in stark comparison.
“Right now in healthcare, if a man comes into a hospital with dark glasses on and reports a sports injury, he’s diagnosed with photophobia, a hallmark of a concussion,” she says. Photophobia is a sensitivity to bright lights that occurs in an estimated 43 percent of individuals who sustain concussions.
“If a woman comes in in dark glasses and was abused, we say she’s wearing the dark glasses because she’s embarrassed by the black eye and bruises. We’re diagnosing the man with a medical concussion and the woman with an emotional condition,” says the doctor.
While concussions in sports are often treated with brain rest—or avoiding any situation that could result in another concussion before the first is healed, which can lead to compound and sometimes lifelong effects—domestic violence victims are not often prescribed the same.
“We have an opportunity to use sports guidelines and apply them to the 20 million people in the U.S. living with violence in their homes,” Zusman says.
To kick off that change, Zusman and her team have begun working in conjunction with police departments to train officers on evaluating survivors for brain injuries before they interrogate them about what happened. The police report may be incomplete due to amnesia caused by the brain injury.
“If they’re actively concussed, their report isn’t valid,” says Zusaman. “Neurosurgeons have come together in support of screening for brain injury like we do for sports as part of every evaluation of abuse. It [a survivor’s report] needs to be understood in the context of a concussion.”
What Should You Do if You Suspect a Concussion or Other TBI?
If you think you may have sustained a concussion or other brain injury after domestic violence or other trauma, there are three steps Zusman recommends taking immediately.
- Make sure you are somewhere safe until you heal from that injury. Another brain injury that occurs before the first one heals will compound and could possibly have irreversible effects.
- Get immediate medical care for injuries to the head and neck, confusion, neck swelling or difficulty breathing.
- Take a two-minute concussion screening at SafeLivingSpace.org.
- Follow up with your doctor. “Victims who have experienced violence need to be advocates for themselves and go to their doctors, primary or OBGYN. Say, ‘I took the concussion screen and it looks like I may have had a brain injury,’ and a doctor should be able to help guide them on the medical journey.” Adds Zusman, “They’re likely not going to screen for concussion unless that person asks.”
Reminder: Brain Injury can be invisible with no outward signs. Even if you feel generally OK after being physically assaulted—your head doesn’t hurt or you didn’t lose consciousness while being strangled or suffocated—it’s still vitally important to take the steps above.
Content retrieved from: https://www.domesticshelters.org/articles/health/fragmented-memories-how-trauma-can-cause-memory-loss.