Traumatic Brain Injury As a Result of Domestic Violence and Its Influence on Communication

December 2013/Second Year of College

 

Abstract

The aim of this research proposal was to examine the relationship between communication theories such as The Coordinated Management of Meaning (CMM) and Constructivism, along with associated executive functions that include constructing goals, plans, and actions resulting as a consequence of Traumatic Brain Injury (TBI), especially as it pertains to victims and survivors of domestic violence (DV). Communication theory as it relates to DV/TBI can present a unique series of challenges for persons affected by DV/TBI and the communication disorders that often follow. There was vast research on the topic of communication deficits that present in the form of autism and other mental health diagnoses. However, the topics of DV/TBI and interpersonal communication have never previously been combined. Because the way people communicate is often more important than the content of what they say, I investigated the challenges that TBI and DV pose to the interpersonal communication setting. My results showed that the theories associated with communication in non- DV/TBI persons have an impact on the way communication is navigated in forming relationships and creating and developing communication among DV/TBI persons. From here on out, DV will precede TBI, due to the fact that TBI is often directly caused by DV. Persons that have experienced DV will be referred to as “survivors” and persons with TBI will be “TBI-sufferers.”

 

Traumatic Brain Injury As a Result of Domestic Violence and Its Influence on Communication

Introduction

Traumatic Brain Injury (TBI) results from four different injuries, which are namely contusions: direct impact causes bruising; compression: the brain is forced against the skull as a result of direct impact; rotational injuries: the brain rotates within the skull, tearing veins; and pressure build-up due to hemorrhaging: hemorrhaging happens when an artery in the brain bursts and causes localized bleeding in surrounding tissues (Bryon, 2010). Currently, The Commonwealth of Pennsylvania estimates that 245,621 people are living with TBI (Brain Injury Association, n.d). While motor vehicle traffic accounts for 20 percent of all TBI-related incidents, a whopping 74 percent of TBI-related incidents can be attributed to falls, assaults, and unknown occurrences—many of which are predicted to have occurred as a result of domestic violence (DV) (Why, n.d.). Despite the staggering significance of that number, one in four women will be victims of DV in their lifetimes, with an estimated 36 percent of those women sustaining injuries to the head, neck, or face (Wilson, 2009). The frontal and temporal lobes receive the brunt of the cognitive function loss: Common symptoms include loss of concentration, self-monitoring, organization, speaking expressively, awareness of abilities and limitations, personality, mental flexibility, inhibition of behavior, emotions, problem solving, planning and goal-making. Furthermore, an increase can be seen in impulsivity, risk-taking, self-focus, and intolerance (Brain Injury Association, n.d). Because all of these things can be worsened when communication is introduced into the setting, it isn’t surprising that many DV/TBI-sufferers are incapable of tasks related to job-searches and paying rent. They also have difficulty in forming relationships through the interpersonal communication setting, which is where many of the communication theories come into play. I will examine the following relevant communication theories as they relate to DV/TBI, as well as additional factors of communication deficits: The Coordinated Management of Meaning (CMM) and Constructivism theories.

The Coordinated Management of Meaning (CMM)

The coordinated management of meaning (CMM), “starts with the assertion that persons-in-conversation co-constrcut their own social realities and are simultaneously shaped by the worlds they create” (Griffin, 2010). Barnett Pearce (The Fielding Graduate University) and Vernon Cronen (University of Massachusetts) assert that communication is a collective process through which events and objects of our social world are created. Part of the evolution behind this theory developed in order to provide parents, therapists, social workers, teachers, and advocates construct a more supportive social environment. In terms of DV/TBI, the theory allows for bystanders to show more understanding for communication deficits that would otherwise harm an interpersonal communication or relationship setting. In order to create these bonds of union, Pearce and Cronen assert that “the mood and manner that persons-in-conversation adopt play a large role in the social construction process” (Griffin, 2010). This is critical to understanding the communication process for someone with DV/TBI. Instead of the non-DV/TBI person engaging in a destructive or damaging process of communication in response to communication errors made by the DV/TBI participant, the non- DV/TBI listener can adopt that the “logic of meaning and action” shouldn’t overshadow the communication encounter. With this in mind, “they are equipped to intervene, breaking the destructive cycle and creating an opportunity for better patterns of communication to emerge” (Griffin, 2010). An example of this in the DV/TBI setting could be a simple interaction between a landlord and his tenant. A Toronto study of homeless men and women found that 58% of men and 42% of women were found to have a history with TBI (Braininjury, n.d.). This statistic could easily be related to the type of communication taking place in a landlord/tenant setting. If the landlord is asserting that the DV/TBI -affected tenant has not paid rent, Pearce and Cronen display that the landlord has two options for engaging with the tenant. He could either engage in an argument where he is asserting logical force, “the sense of obligation a person feels to respond in a given way to what someone else has just said or done,” leading to a back-and-forth he said/she said debate (Griffin, 2010). Or, the landlord could make allowances for the fact that his DV/TBI -affected tenant is not remembering whether or not she has paid rent, and is acting defensively and lacks inhibition of behavior and character because she doesn’t have a sensor for violations that may be taking place during the interaction. Then, reflexively, Pearce and Cronen maintain, “the actions of persons-in-conversation are reflexively reproduced as the interaction continues” (Griffin, 2010). In this way, as the discussion continues, the understanding given on the part of the landlord could serve to reorient the DV/TBI -affected tenant, causing the situation to modify itself without conflict, just as their research found in Asperger-sufferers (Griffin, 2010). As a result, persons-in-conversations actually come to co-construct their own social realities. For some, this could mean a “world” of difference—It could be the difference between shelter and homelessness.

Constructivism

In constructivism, it is clear that Jesse Delia (University of Illinois) believes that some people are better at communication than others. “People with a large set of interpersonal constructs have better social perception skills than those whose set of mental templates is relatively small” (Griffin, 2010). In the DV/TBI context, persons suffering from DV/TBI have a smaller set of mental templates, due to damage that incurred in the initial injury. Delia claims that people who are more cognitively capable and complex in perception taking of others have an advantage over others who cannot, similar to DV/TBI -sufferers. When there is a person who is more inclined to perception taking, these fortunate few are able to better create person-centered messages that are more effective forms of communication. Person-centered messages refer to “messages which reflect an awareness of and adaptation to subjective, affective, and relational aspects of the communication contexts” (Griffin, 2010). Interestingly enough, scholars who study communication define the capacity to create person-centered messages, with skills like self-monitoring, sensitivity, and audience awareness at the foreground—all of which are decreased and sometimes destroyed by a DV/TBI -sustained injury. Along with this, persons who are effective at creating person-centered messages are often successful in creating goals, plans, and actions that encourage social-communication (Griffin, 2010). If someone is suffering from DV/TBI and cannot commit to any of these influences or factors of communication, they are less likely to succeed in an interpersonal setting. Many times this plays a significant role in leaving an abusive situation. Person-centered messages are responsible for social support, relationship maintenance, and organization effectiveness. If a survivor of DV is also suffering from TBI, reaching out to others can be nearly impossible. The kind of social support messages they have come to know (low support messages that dismiss feelings and are invalidating) would be reflected to others, which could lead to a destruction of personal relationships outside of the abusive home setting (PCADV, n.d.). To complicate things further, relationship maintenance cannot be carried out effectively if the DV/TBI sufferer is not able to detect cues that the relationship requires maintenance like ego-support and conflict resolution. This could lead to the dissolution of friendships and further isolation from support. Because abuse is a cycle, the abuse (and subsequent trauma) would continue to fester and be perpetuated. Additionally, organizational effectiveness is almost directly linked to corporate success, so this inability to gauge conversation cues and create person-centered messages could easily lead to a loss of job and income for the victim, even long after the abuse has ceased and the TBI remains (PCADV, n.d.).

Rationale

If I were able to conduct research with TBI-sufferers with DV past or present, I believe that I would find that there is not only correlation but causation between conflict and error in the communication setting among DV/TBI persons and non- DV/TBI persons. A lot of the above research was grounded in communication theory as it pertained to communication deficit disorders (like Autism) that often mirror the symptoms of TBI. There seems to be a myriad of sources available for the study, seeing that TBI has often been studied in conjunction with DV. However, I would like to conduct research of my own in a safe, advocacy-centered location in order to better understand how the addition of DV into the TBI/communication brings additional complexity. There are many other theories that I would be interested in studying and researching as they pertain to DV, such as The Expectancy Violations Theory and Cognitive Dissonance. These could be explored not only as they pertain to the survivor of DV but to the abuser as well: They are often purposeful tactics employed by abusers in order to mask and re-shape the realities of the victims. When this layer is added to the many communication challenges that TBI-sufferers face, the situation is further convoluted for the survivor. It would be extremely interesting to include this information in my observations and research about DV/TBI.

 

References

Brain Injury Association of America. n.d. Facts about traumatic brain injury. About brain injury.             Retrieved from http://www.biausa.org/aboutbi.htm.

Braininjury.com. (n.d.). Traumatic brain injury common among homeless. Latest Medical Research. Retrieved from http://www.braininjury.com/research.html.

Bryon, Deborah. (2010). Domestic aggression and traumatic brain injury. Retrieved from http://www.4therapy.com/life-topics/family- relationships/domestic-violence/domestic-     aggression-and-traumatic-brain-injury- 25

Griffin, Em. (2008). A first look at communication theory. New York, NY: McGraw-Hill.

Pennsylvania Coalition Against Domestic Violence. (n.d.). Traumatic brain injury as a result of     domestic violence: information, screening, and model practices. Retrieved from PCADV     website. Module posted to http://www.pcadv.org

The Why Files: The Science Behind The News. (n.d.). Pie Chart (CDC 2006). Retrieved from      http://whyfiles.org/2010/traumatic-brain-injury

Wilson, Sharon. R. (2009). Traumatic brain injury and intimate partner violence in Connie             Mitchell’s Intimate partner violence: A Health based Perspective. 187. Oxford University Press, Inc., New York: NY.

 

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