A commentary by an assistant manager at the Cridge Centre for the Family who deals with intimate partner violence and is a brain-injury co-ordinator.
Maybe things start as typical bickering among couples, or maybe the rage blows up out of nowhere. The aggressor slaps, pushes and punches before grabbing their partner around the neck, squeezing tight as they gasp for air.
And in that moment, a life just might change forever. Restricted blood flow to the brain caused by strangling leads to a brain injury. The “invisible” injury may go unrecognized by the person who has been hurt, and likely undiagnosed. But its impact will play out on their lives in countless destructive ways.
The Cridge Centre for the Family in Victoria is one of the few community organizations in Canada providing dual-stream supports for women who have experienced a brain injury as a result of intimate partner violence.
But as we were reminded during a recent training event on the impact of being strangled by your intimate partner, the 20 women we serve — and the many more who want help but who we can’t currently accommodate — are only the most obvious faces of a hidden and deeply stigmatized issue.
In Canada, intimate partner violence rates are the highest ever, affecting 354 of every 100,000 Canadians — a 13 per cent increase in the past seven years.
Some 142,000 people are experiencing violence right now at the hands of their intimate partners, with women making up almost 80 per cent of the victims.
Over a lifetime, 44 per cent of women and girls who have ever been in a relationship will experience intimate partner violence — about 6.2 million Canadians over age 15.
Women with a history of physical or sexual abuse as a child are twice as likely to experience it. That’s a frightening fact for the future, as family violence in Canada has increased by almost one-third since 2018.
But most of these victims of violence will never report the crimes being committed against them to the police. A third of them won’t tell anyone at all. And even those who do report may have no idea they have suffered a brain injury from the violence, whether from being strangled or from being thrown into a wall, punched in the head or knocked out.
Research and public surveys have confirmed that only 20 per cent of victims of intimate partner violence contact police. Among those who do, the thought of possibly having a brain injury won’t occur to many.
First responders and emergency-room professionals often won’t have that thought either. Brain injuries from intimate partner violence have been occurring for as long as there has been abuse, but the science is comparatively new and public awareness extremely limited.
Few health professionals have been trained to look for the signs of a brain injury in victims, especially if there are no obvious physical injuries.
Strangulation is particularly dangerous, both as an injury and as a red flag that the level of violence is intensifying. While other violence-caused brain injuries affect particular areas of the brain depending on how the victim was attacked, the lack of oxygen caused by strangulation impacts the entire brain.
“We used to think all abusers were equal. They are not,” says Casey Gwinn, co-founder of the San Diego-based Training Institute on Strangulation Prevention, which led the training in Victoria.
“Our research has now made clear that when a man puts his hands around a woman’s neck, he has just raised his hand and said: ‘I’m a killer.’
“So when you hear ‘he choked me,’ now we know you are at the edge of homicide.”
Being strangled increases the risk of a stroke, days or even weeks after the assault. There’s a one-in-20 chance that strangulation will injure an artery in the neck.
What can be done? Most urgent is greater awareness of the chilling fact that two-thirds or more of people experiencing physical violence at the hands of their intimate partner have incurred a brain injury.
That awareness is needed across the spectrum of people dealing with this issue, from the victims themselves to police, medical professionals, community organizations housing and supporting survivors of intimate partner violence, child-welfare systems and employers.
Equally urgent is a greater understanding of the risks when violence includes strangulation. Strangling can cause great harm without leaving a single mark.
Careful and consistent assessment is vital to ascertain the extent of the impact of an assault — and how multiple assaults typical in intimate partner violence pile on top of each other to create even more complex problems.
But underlying all efforts is the critically important need to lift the stigma of being a victim of intimate partner violence. We will never end the violence as long as the vast majority of those experiencing it are left to wonder if anyone will believe them.
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