Breaking the silence – violence as a cause of brain injury

In our latest blog Emma bravely shares her brain injury story.  Emma’s brain injury occurred 13 years ago due to a kick to the head when she was 12 years old resulting from ongoing domestic abuse. Emma now volunteers as a helpline counsellor and works to shape health policy to try to support other young people experiencing domestic abuse get the support they need.

How did your brain injury happen?

I was 12 years old and growing up in a difficult home environment with parents who regularly argued, with rows that sometimes culminated in physical violence directed at my mum or us, children. My brother was acting out at school and at home, modelling some of the violent behaviours and mood swings he saw in my father. One afternoon, after school, he lashed out at me and I sustained a kick to the temple side of my head. The force was quite significant and caused a headache. When my parents arrived home I told them what had happened, but they dismissed it as normal sibling rivalry, and I went to bed. Over the course of that night and the next morning, I developed an increasingly severe headache and started vomiting. I cried non-stop from the pain and slipped in and out of sleep. I pleaded with my parents to take me to the hospital but they thought I was being dramatic, and didn't want to explain the situation to anyone. They encouraged me to sleep it off until I became really hazy and unable to stay awake or walk straight. That was when I was rushed into hospital and diagnosed with an acute subdural haematoma. A subdural heamatoma occurs when a vein ruptures between the skull and the surface of the brain. When that happens, blood collects into that small space, causing increased pressure and pushes the brain out of shape, injuring it. This condition mostly results from severe trauma, or a sudden jolting action. Children are particularly vulnerable, as their brains have more space within the skull to be knocked about.

How did you feel when you found out about your brain injury?

At the time, I blacked out and didn't know what was going on. But when I came to and realised the seriousness of what had happened to me, and saw the scans of the bleeding in my brain, I was shocked, scared and upset. Over time, I felt resentful that my parents had not taken my symptoms seriously, and that it took almost 24 hours for me to receive medical attention. I was also frightened that it would happen again at home, as it was kept a secret.

In the early days is there anything you wished the doctors had done differently?

I owe an enormous debt of gratitude to the medical staff in charge of my care. They were fantastic at getting me properly assessed, diagnosed and treated.
I feel that they weren't comfortable addressing the elephant in the room, which was domestic violence. My case was complicated by the fact that it was sibling abuse, so I think they weren't sure how to react."
I wished that those in charge of my care had made family assessments and counselling a mandatory part of my discharge and recovery, as this was not a normal family dynamic. I wish that they had talked to me and my siblings more about what life was like at home. I also wished that the hospital had informed my school or requested a secondary guardian to support my care and monitor the situation, so that I didn't have to keep it a secret, continue to feel afraid, or have to feel guilty or naughty for having been hurt.

Life since the brain injury

In the months following my TBI, I remember struggling to concentrate at school, and suffering from unusual mood swings. I would frequently be reprimanded for 'day dreaming'. I stopped playing sports or doing extracurricular activities, my grades dropped significantly, and I became socially withdrawn and anxious. My parents put me on Ritalin and told people that I had Attention Deficit Disorder. Since then, I have been remarkably fortunate to have recovered the way I have. My speech is normal, my learning and memory has recovered, and I am proud to say that I recently graduated with a master's degree. Emotional recovery has been somewhat slower though, and I have benefitted from trauma counselling and anti-depressants. On a day to day basis, I do still struggle to concentrate, and I find mental calculations such as adding and subtracting particularly challenging. For the rest of my life, I also can’t play contact sports, and have to be cautious about knocking my head again. On the whole, I feel as though I have made a full recovery, although people remark that I am very accident prone and clumsy, or scatter-brained, so I don't always know whether that's my TBI talking, or just my personality! Either way, Zumba is a no go!

Changing the world for the better

In the years since, I became a volunteer in various children's hospitals working in front line roles with families, and I now volunteer weekly as a helpline counsellor for children suffering from abuse. I feel passionately about early adversity and health, and am really happy to now work in the charity sector in health policy. It took me almost seventeen years to disclose my situation at home, mostly because I feared other people’s reactions, or lack thereof.  Today, I am quite open about my brain injury, when appropriate, as I feel that it is important to talk about and recognise the signs of child abuse, and to destigmatise the subject. I think when witnessing someone's disclosure, it helps to actively listen, and sensitively probe, rather than sidestep an important issue which so many children sadly continue to lose their lives to. 

My advice to others after brain injury

If, like me, you or a loved has also suffered a brain injury, I would say focus on building and praising the remarkable resilience of brain injury survivors. There's so much left to be proud of, once the emphasis is shifted from what has been lost."
And, if there's anything I've learned, it's that the pain and the trauma of the loss never really goes away, but that my relationship with it keeps changing.

Domestic abuse is everyone’s responsibility

It is important for all professionals working with children and young people to be aware of their responsibility to protect the children they are working with. Any concerns about a child must be reported to the correct people and every organisation will have clear safeguarding policies and procedures which staff should have read thoroughly and have a clear understanding of. Everyone has a responsibility to keep children and young people safe so if you are concerned about a child the NSPCC has a helpline you can call 0808 800 5000. If you are a child experiencing domestic abuse or have any other worries you can contact Childline on 0800 1111 a free, confidential advice and support service whatever your worry, whenever you need help.
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