PTSD, TBI or Domestic Violence
Another serious issue facing many veterans and military families is the problem of violence. This problem we have experienced within our own family first hand as well have seen it quite often within other military families as well. How do you distinquish between PTSD, TBI or Domestic Violence for our returning veterans, troops and their families?
It seems that almost once a week when we pick up the newspaper there is an article discussing an incident in which a family member has been seriously injured or killed by someone who had promised to love and honor. Sometimes the offender serves in the Army, Air Force, Navy, Marines, or perhaps it is a civilian with military ties serving in the U.S. National Guard or Reserves. The correlation of PTSD and TBI symptoms with "domestic violence" are obvious.
Wives tell us of waking up and finding their husband's hands around their throat, others speak of being kicked while their husband slept and having terrible bruises on their thighs. Wives or girlfriends unfamiliar with PTSD may naturally be frightened by this behavior and call the police expecting, and hoping to receive help. Instead, their horror is increased by police who insist on arresting the man despite their pleas that he just needs help. Often peace officers are left with no options but to make an arrest. Because of his condition, or if he has been drinking, the man (or woman) may make the situation worse by becoming aggressive and belligerent with police, particularly if they are experiencing a flashback.
Some common disabilities associated with TBI include problems with cognition (thinking, memory, and reasoning), sensory processing (sight, hearing, touch, taste, and smell), communication (expression and understanding), and behavior or mental health (depression, anxiety, personality changes, aggression, acting out, and social inappropriateness).
Combat veterans suffering from TBI often have post traumatic stress disorder (PTSD) as well. Clearly, within an intimate relationship TBI is going to have many of the characteristics of abusive and violent behavior and when a person becomes frightened by the erratic behavior, the seizures, or other symptoms, and dials 911 for help the DV police are going to arrest the soldier or veteran. Often slurred speech, socially inappropriate behavior, and aggression will all be used against him in jail and in court where, typically, he will be denied essential medications or proper treatment.
Sorting it out Domestic Abuse is defined by DoD as follows: Domestic abuse is (1) domestic violence or (2) a pattern of behavior resulting in emotional/psychological abuse,economic control, and/or interference with personal liberty when such violence or abuse is directed towards a person of the opposite sex who is: (a) A current or former spouse; (b) A person with whom the abuser shares a child in common; or (c) A current or former intimate partner whom the abuser shares or has shared a common domicile. Posttraumatic Stress Disorder is an anxiety disorder that can occur after you have been through a traumatic event. A traumatic event is something horrible and frightening that you see or that happens to you. During the time of event, you think that your life or others’ lives are in danger. You may feel afraid or feel that you have no control over what is happening. A symptom of PTSD can be an Impairment of intimate or social relationships often expressed as irrational and inexplicable anger and rage.
Traumatic Brain Injury (TBI) occurs if the head is hit or violently shaken (such as from a blast or explosion), a “concussion” or “closed head injury” can result. Concussion is seldom life threatening, so doctors often use the term mild when the person is only dazed or confused or loses consciousness for a short time. However concussion can result in serious symptoms. People who survive multiple concussions may have more serious problems. People who have had a concussion may say that they are fine even though their behavior or personality has changed.
The easiest way to make distinctions about the assaultive conduct of an offender and whether military or trauma related PTSD or TBI is a consideration is to:
1. Determine if the conduct is new.
If the pattern of behavior is brand new, never occurred before the injury or the exposure to combat or other traumatic event, then possibly it is not classic domestic violence, but behavior that won’t be changed without treating an underlying condition. However, just because it never happened before, it may still be domestic violence….determining the attitudes and beliefs of the offender can lead to a different conclusion even when new behavior.
2. Determine if there have been any other incidents where violence was used.
A person suffering from PTSD or brain injury is not discriminating on whom the violence is directed and won’t be able to decide only to use violence when at home or with family members. He or she will most likely have other instances of violent conduct directed at those outside of the family. One of the cases at Fort Campbell involved a soldier who had assaulted members of his family, but then also assaulted a gas station attendant when he saw the cost of filling his tank. After interviewing all family members, neighbors and co-workers it was possible to feel confident that there had been no history of violent conduct prior to deployment and that his use of violence was not instrumental in attempting to have power over others, but was a result of his injuries.
3. Consider what other factors are present that require specific attention.
Whether the individual is a batterer or suffering the effects of brain injury or PTSD, he may also be using alcohol or drugs. He may require treatment for drug or alcohol addiction or modification of medication he is currently prescribed as part of any intervention strategy.
4. Look for avoidance behaviors.
Those suffering from PTSD will try to avoid situations or experiences that pull them back in reliving the original trauma. If something reminds the sufferer of the original event, then those vulnerable feelings associated with the original trauma can return.
5. Determine if the behavior is becoming more pronounced.
Those who seek to achieve and maintain power and control over others escalate the behavior when challenged. The progression of the use of tactics is predictable and linear for most batterers. Finally, enough can not be said about getting treatment and therapy for yourself as well as the whole family to prevent any violence from esculating and resulting in serious injuries. Knowing when to get help is the key and if you see yourself in any of this please reach out , there is hope and you are not alone.