Office for the Prevention of Domestic Violence

Information for Professionals

Understanding Domestic Abusers

Excuse #5: Traumatic Brain Injury

Injury-related violence

Traumatic brain injury (TBI) from falls, assaults, motor vehicle crashes, sports injuries, etc., can sometimes lead to aggressiveness and incidents of physical violence.

Injury-related violence can be mistaken for domestic abuse . For instance:

People who have a TBI often do not understand why they react the way they do, and may not attribute their behavior to their injury. However, there are two kinds of clues that an individual’s violence may be related to a TBI.

TBI does not lead to coercive control

Many people with brain injuries get arrested for violent or non-violent crimes,56 and many felons have suffered a TBI – often a childhood concussion – before their first run-in with the law.57 Childhood concussions are very common, often go unrecognized, and can lead to long-term problems with aggression and impulsivity,58 59 but they do not lead to an intentional pattern of coercive control, or domestic abuse.

Abusers who have a TBI

Some service providers mistake domestic abuse for injury-related violence, and some abusers use a TBI (real or fabricated) as an excuse for controlling behavior. Someone who insists “it’s because of my TBI” is likely to be making an excuse. For instance:

Abusers who sustain a TBI as an adult may become more physically violent toward their partner. They may also become violent toward others. Their violence and control tactics may become less predictable due to a decreased ability to sustain attention, follow through on a goal, or see connections between actions and their consequences, or due to the use of substances to deal with the effects of the TBI.61 

Implications for Intervention

If an individual who has a TBI becomes physically violent, their partner’s safety needs must be addressed.

Careful assessment is critical. Assessing whether a particular case involves injury-related violence or domestic abuse involves looking at the context, the individual’s behavior and attitudes, and the history of their injury. If the injured partner has none of the entitlement attitudes that underlie coercive control, safety plans may focus on seeking rehabilitation services or medication. Interventions aimed at changing abusive attitudes and behaviors are likely to make no sense to someone whose aggression is the result of a TBI, and they may increase his/her sense of frustration and helplessness.

Difficulty controlling aggressive impulses does not excuse hurting others. Individuals with TBIs who know right from wrong and are aware of their problems must bear the responsibility for working on modifying the behavior and avoiding situations that are likely to cause outbursts.62

Questions to ask yourself if your partner has a brain injury
If you answered “yes” to many of these questions…

Next: Other Forms of Intimate Partner Violence: Responsive Violence

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  1. Ibid.  Adapted from Chat with Pat 18.
  2. Ibid., Chat with Pat 12.
  3. McMorrow, M.J. (n.d.).  Behavioral challenges after brain injury, Brain Injury Association of America.
  4. Sarapata, M., Herrmann, D., Johnson, T. & Aycock, R. (1998).  The role of head injury in cognitive functioning, emotional adjustment and criminal behavior. Brain Injury: 12 (10), 821-842.
  5. Ibid.
  6. TBINRC, Chat with Pat 17.
  7. Brower, M.C. & Price, B.H.  (2001).  Neuropsychiatry of frontal lobe dysfunction in violent and criminal behavior:  A critical review. Journal of Neurology, Neurosurgery & Psychiatry, 71, 720-726. 
  8. Adapted from TBINRC, Chat with Pat 12.
  9. TBINRC, Chat with Pat 18.
  10. TBINRC, Chat with Pat 17.