The se­cret toll of spousal abuse

Los Angeles Times - - OPINION - By Maria E. Garay-Ser­ratos

In re­cent years, med­i­cal science has un­cov­ered the high risk and dev­as­tat­ing ef­fects of trau­matic brain in­jury, or TBI, among U.S. com­bat sol­diers and ath­letes, es­pe­cially football and hockey play­ers. What if a vastly greater pop­u­la­tion were also suf­fer­ing these ef­fects: women and chil­dren liv­ing with the con­se­quences of do­mes­tic vi­o­lence?

For as long as I can re­mem­ber, my mother took aspirin ev­ery day, com­plain­ing of un­bear­able headaches. Some­times she locked her­self in the bed­room with the lights off, ask­ing me to take my sib­lings out­side be­cause she couldn’t tol­er­ate the noise. As she got older, her naps grew longer and her sen­si­tiv­ity to light and noise in­ten­si­fied. By her 50s, her mem­ory had be­gun to fail.

On the day she fi­nally asked me to take her away from my fa­ther, I found her in a worse state than I had ever seen her. She could barely stand. She was crawl­ing from room to room while my fa­ther ig­nored her.

Her doc­tors asked the same ques­tion again and again: “What type of head trauma has your mother had?” I al­ways an­swered the same way: “Over 40 years of se­vere, on­go­ing trauma.” They fo­cused on treat­ing her phys­i­cal symp­toms. They ig­nored her history of vi­o­lent abuse by my fa­ther.

My mother never played a vi­o­lent sport or fought in a war. But the as­saults she en­dured on her head and body were at least as acute as those ex­pe­ri­enced by ath­letes and sol­diers, and the ef­fects were the same. When all the tests were fin­ished, the neu­rol­o­gist told us my mother was suf­fer­ing from mod­er­ate to se­vere Alzheimer’s dis­ease. The head trauma had been so great and so con­sis­tent that there was lit­tle they could do.

My mother died in June from the de­bil­i­tat­ing ef­fects of her abuse. She was re­ceiv­ing hos­pice care — bedrid­den, un­able to speak or rec­og­nize her chil­dren.

There are few em­pir­i­cal stud­ies on the preva­lence of TBI among women and chil­dren af­fected by do­mes­tic vi­o­lence. But ev­i­dence so far strongly in­di­cates a silent epi­demic, with ma­jor public health ram­i­fi­ca­tions.

A 2001 study found that 67% of women seek­ing emer­gency med­i­cal sup­port for in­juries stem­ming from do­mes­tic vi­o­lence had symp­toms re­lated to TBI, and 30% re­ported loss of con­scious­ness.

A 2002 sur­vey of three do­mes­tic vi­o­lence shel­ters found that 92% of the women had been hit on the head by their part­ners. Ap­ply­ing that fig­ure na­tion­ally, the size of the po­ten­tially af­fected pop­u­la­tion would be as­ton­ish­ingly high: about 20 mil­lion women ex­posed to the risk of TBI each year, and, given the doc­u­mented as­so­ci­a­tion be­tween part­ner abuse and child abuse, mil­lions more chil­dren.

Do­mes­tic vi­o­lence shel­ters do not gen­er­ally screen clients for TBI, and staff mem­bers are not trained to ad­dress it if en­coun­tered. As a re­sult, they can in­ad­ver­tently make mat­ters worse for those who have sus­tained TBI by re­quir­ing par­tic­i­pants to join in phys­i­cally de­mand­ing pro­gram ac­tiv­i­ties im­me­di­ately af­ter they ar­rive.

There is am­ple anec­do­tal ev­i­dence of the con­nec­tion be­tween do­mes­tic vi­o­lence and TBI in sto­ries like my mother’s, but we must dig deeper. We must ac­cu­mu­late data, de­velop screen­ing pro­to­cols and ap­pro­pri­ate treat­ment pro­grams, and spread aware­ness to our na­tion’s shel­ters and do­mes­tic vi­o­lence fa­cil­i­ties. We must treat do­mes­tic vi­o­lence like the emer­gency that it is, one that im­pairs the abil­ity of those af­fected to fully par­tic­i­pate in the work­force, in ed­u­ca­tion and in their com­mu­ni­ties.

To­day, I grieve my mother’s pass­ing, too soon and far from peace­ful. But I am inspired by the thought that with a full reck­on­ing of the re­la­tion­ship be­tween trau­matic brain in­jury and do­mes­tic vi­o­lence, another fam­ily may avoid such a fate.

Maria E. Garay-Ser­ratos

is chief ex­ec­u­tive of­fi­cer of So­journer Cen­ter, a do­mes­tic vi­o­lence shel­ter in Phoenix. In June, the cen­ter launched the BRAIN Pro­gram for re­search and treat­ment of trau­matic brain in­jury in women and chil­dren liv­ing with do­mes­tic vi­o­lence.

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