Challenging behaviours after a brain injury can easily lead to domestic violence within a family.
It is possible that people with a brain injury may develop behaviours that lead to domestic violence. Many of us were raised to believe that we should stand by our family members no matter what. This stance is put to the test when threatened or actual violence occurs. Choosing to ignore the behaviour can mean your family member does not get constructive feedback on the negative behaviour, which can lead to a cycle of violence.
One of the most aggravating things that a family can experience is that the person with acquired brain injury can be the picture of politeness when speaking to the rehabilitation nurse or a visitor. Once you see that they can act appropriately, it is more difficult to accept abusive behaviour at home on a regular basis. There are different explanations for this, which may not make challenging behaviour or aggression easier to tolerate, but they do provide a framework for understanding.
Reasons for Violent Behaviour
We all tend to let our hair down with family, as opposed to strangers or acquaintances. Of course, after a brain injury a person’s interpretation of letting hair down may be well beyond what most would consider acceptable, particularly if their self-awareness has been affected. They may justify their violence by saying that others provoked them, not realising that the brain injury has increased their sensitivity to stress and decreased their ability to handle it.
The frontal lobe is often damaged in brain injury. This area of the brain is involved in reasoning, problem solving and controlling our more basic instincts such as anger. An individual who has sustained a brain injury has often lost these skills and therefore may have trouble controlling anger and violent outbursts. In many cases brain injured individuals often lose some of their social judgement capabilities and are not effectively able to reason out the appropriateness of either their own behaviour or the behaviour they expect from others.
Overall, a family’s patience can be quite worn after months of care of this individual. What makes matters worse is that the brain injured person may have little insight into their impact on the family.
The following are some examples of abuse a family may encounter:
- An adolescent spits in his mother’s face when he is not allowed to drive the car
- Grandfather screams constantly at his niece he adored prior to his accident
- The husband constantly accuses his wife of having an affair
- A husband hits his wife the moment she doesn’t agree with him on an issue.
Management Techniques
Do not allow a pattern of family abuse to become established in your home. You will need to make some allowances for changes brought on by a brain injury but continued abuse and violence is not acceptable. When the person still retains self-awareness, they will need to relearn communications skills, anger management, relaxation techniques to manage their anger and tendency to violence. Your Brain Injury Association should be able to provide or refer you to suitable support in this area.
Unfortunately there will be cases where a lack of self-awareness means that an individual cannot relearn these skills. In these cases, it is necessary to develop a behaviour management program to minimise or prevent violent outbursts. Tips on how to develop a program are available at www.biaq.com.au in another fact sheet called Challenging Behaviours.
When your loved one lacks self-awareness, don’t continually bring up reminders of the violent behaviour. This will only serve to upset them and will not be conducive to change.
There should be ‘family rules’ of which the person is aware prior to coming home. If anger or violence could be issues it is much better to discuss and work these out with the person before they return home.
Do not take the abuse personally – this will only interfere with your ability to implement effective behaviour management. However it pays to look at what the triggers were in each case and see if these can be minimised.
Treat each occurrence as an isolated incident. A person with a brain injury may not remember their abusive outburst yesterday. Try to find out what the triggers were and minimise these in future where possible.
Keep in contact with your support systems – you need to have people with whom you can discuss problems of family abuse.
Have a family meeting whereby all members are trained to treat family abuse in a consistent manner to keep the person from learning to use family abuse as a method of manipulating the family.
Join a support group in your area so that you can find out how others have handled this problem. Do not allow yourself to live in a reign of terror. If problems persist, you may need to consider professional support with a programme geared at behavioural management. Your local Brain Injury Association should be able to refer you to specialists in this area.
The Last Resort
Finally, a brain injury can never be an excuse for domestic violence. If all fails after professional support, then you may need to begin looking at other options. In some cases the person with a brain injury will continue to regularly assault their partner despite professional support and a behaviour management program. Often the only option left is eventually to leave and take out restraining orders to prevent further violence after leaving.
Your State Brain Injury Association should be able to link you with agencies who can advise you on legalities, emergency accommodation and restraining orders, and also help to provide supports for the individual with the brain injury.
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