Should Emotional Trauma Be Considered a Traumatic Brain Injury?

By Christopher Feltner, Training Architect

According to the website for the National Institute of Neurological Disorders and Stroke, a Traumatic Brain Injury (TBI) is defined accordingly:

“Traumatic brain injury (TBI), a form of acquired brain injury, occurs when a sudden trauma causes damage to the brain. TBI can result when the head suddenly and violently hits an object, or when an object pierces the skull and enters brain tissue.  Symptoms of a TBI can be mild, moderate, or severe, depending on the extent of the damage to the brain. A person with a mild TBI may remain conscious or may experience a loss of consciousness for a few seconds or minutes. Other symptoms of mild TBI include headache, confusion, lightheadedness, dizziness, blurred vision or tired eyes, ringing in the ears, bad taste in the mouth, fatigue or lethargy, a change in sleep patterns, behavioral or mood changes, and trouble with memory, concentration, attention, or thinking.  A person with a moderate or severe TBI may show these same symptoms, but may also have a headache that gets worse or does not go away, repeated vomiting or nausea, convulsions or seizures, an inability to awaken from sleep, dilation of one or both pupils of the eyes, slurred speech, weakness or numbness in the extremities, loss of coordination, and increased confusion, restlessness, or agitation.”

I remember training staff at a facility that served a wide variety of individuals including a population considered to be medically fragile. In the beginning, staff referred to trauma similarly to how we define it in Ukeru. The staff working exclusively with the medical-based population saw trauma in terms of Traumatic Brain Injury (TBI). For them (at least initially), they saw trauma as something that occurred from a major physical event that impacted the brain and the affected person’s ability to function. This training occurred 6-7 years ago.

Since this training, much has been learned about emotional trauma and its effects on the brain which can further impact a person’s overall physical health as well as their mental health. This is important because I believe there is an argument to made that all trauma should be considered a traumatic brain injury. Keeping on track with the above definition of TBI, many of the described symptoms can also occur with physical and emotional trauma as well as neglect.

We have learned much about trauma’s impact on the full development of (and, in some cases, atrophy) of the human brain. Research has consistently shown trauma’s impact on parts of the brain like the Prefrontal Cortex, Amygdala and Hippocampus. This, in turn, has an impact on how the person acts and reacts to people, places and experiences. Hypervigilance leads to prolonged stress which can lead to cardiac-based complications. The effects of trauma leads many to unhealthy habits and behaviors in an attempt to cope which can lead to other health problems.

Keeping all this in mind when we look at the definition of TBI, shouldn’t we consider traumas that occur in abusive and neglectful situations to be TBIs? Particularly, since the definition of TBI considers levels of affection (mild, moderate, severe). In general, it is time for society to stop viewing emotional and physical abuse and neglect as social ills that we just need to “get over” and finally accept the profound effects of these traumas.