Podcast on Crimes Against Women
The Conference on Crimes Against Women (CCAW) is thrilled the announce the Podcast on Crimes Against Women (PCAW). Continuing with our fourth season, the PCAW releases new episodes every Monday. The PCAW serves as an extension of the information and topics presented at the annual Conference, providing in-depth dialogue, fresh perspectives, and relevant updates by experts in the fields of victim advocacy, criminal justice, medicine, and more. This podcast’s format hopes to create a space for topical conversations aimed to engage and educate community members on the issue of violence against women, how it impacts our daily lives, and how we can work together to create lasting cultural and systemic change.
Podcast on Crimes Against Women
What You Need to Know About Domestic Violence and Brain Trauma
Discover the connections between domestic violence and traumatic brain injury in this eye-opening episode. Our guest, Dr. María Garay-Serratos , a leading expert in domestic violence and traumatic brain injury, shares her powerful personal story and professional insights.
Dr. Garay-Serratos reveals the often overlooked traumatic brain injuries resulting from violence in the home, advocating for better recognition, screening, and treatment of these issues within healthcare systems. Our discussion will unravel the shocking truths behind the silent epidemic of domestic violence, the overwhelming statistics regarding reported crimes, and the long-term health implications for survivors.
Listeners will gain a comprehensive understanding of the urgency surrounding this topic and hear firsthand stories that highlight the necessity of systemic change. Join us in imparting hope, healing, and awareness as we explore the resources available for those affected by domestic violence and advocate for a future where everyone's health and safety are prioritized.
The subject matter of this podcast will address difficult topics multiple forms of violence, and identity-based discrimination and harassment. We acknowledge that this content may be difficult and have listed specific content warnings in each episode description to help create a positive, safe experience for all listeners.
Speaker 2:In this country, 31 million crimes 31 million crimes are reported every year. That is one every second. Out of that, every 24 minutes there is a murder. Every five minutes there is a rape. Every two to five minutes there is a sexual assault. Every nine seconds in this country, a woman is assaulted by someone who told her that he loved her, by someone who told her it was her fault, by someone who tries to tell the rest of us it's none of our business and I am proud to stand here today with each of you to call that perpetrator a liar.
Speaker 1:Welcome to the podcast on crimes against women. I'm Maria McMullin. Domestic violence, traumatic brain injury, also referred to as DVTBI, is a silent, unrecognized and often ignored epidemic suffered by scores of women who are in violent relationships or who have been involved in gender-based violent situations that comprised of trauma to the head. Unfortunately, unlike other individuals who endure head trauma or chronic stress from sports, motor vehicle crashes, falls, or from professions like the military or law enforcement, those who experience DVTBI do not receive the same level of medical detection, attention nor treatment, which regrettably leads to lifelong health problems, permanent brain damage, a destroyed quality of life and, ultimately, a tragic death. Quality of life and, ultimately, a tragic death. The awareness and response to DVTBI for individuals who encounter or work with victims and survivors is paramount. Not only does DVTBI negatively impact victims and their families, but can have a harmful economic bearing on society, with TBI medical and healthcare costing billions of dollars for treatment and or hospitalization. By promoting the hope of resilience and healing, this poignant yet insightful episode with a brain injury specialist and DV survivor will be a discussion that highlights the ways in which DV TBI goes unnoticed and unchecked, which hopefully leads to a higher calling of action by people, practitioners and policymakers.
Speaker 1:Dr Maria G-Saratos is a domestic violence, traumatic brain injury, chronic traumatic encephalopathy expert and thought leader. Her life's mission is to create global awareness to address the silent and unrecognized DVTBI-CTE pandemic. Dr Gray-Saratos is currently the founder and CEO of Panfila Domestic Violence Hope Foundation and the protagonist associate producer and DVTBIC-TE expert consultant for this Hits Home, a feature documentary released in 2023. Her work and story have also been the focus of various media social media articles, interviews, including NPR, the National Desk Spotlight on America and others. Prior to her current work, dr Gray-Serratos served as a C-level executive for over 25 years for various nonprofit organizations. She has her BA from Pitzer College and her master's degree and doctorate from USC Suzanne Dworak Peck School of Social Work. Dr Gray-Serratos, welcome to the podcast.
Speaker 3:Thank you. Thank you so much for having me. I'm just very honored to be here.
Speaker 1:I'm very honored to meet you and learn about your personal story and about your mother's personal story, because we'll be talking today about traumatic brain injury and related conditions and how those can be a result of domestic violence, and this is really personal to you because you witnessed it firsthand as a child. What I would like to do, before we even get started into the personal story and the journey that you've been on, I'd like to get a working definition of traumatic brain injury, as well as a definition for chronic traumatic encephalopathy.
Speaker 3:Absolutely so. Traumatic brain injury is defined as a bump, blow or jolt to the head or hit to the body. So it doesn't have to be just your head but to the body. That causes a head and brain to move quickly back and forth, that causes the brain to bounce around or twist right.
Speaker 3:There's chemical changes that are happening within the skull so it stretches there's. You know this movement that happens kind of like if you grab an egg and you shake it. Think of the egg, the shell, as the skull and what's in there is the brain. So that's what traumatic brain injury is. Chronic traumatic encephalopathy is connected to non-concussive repetitive head impacts and we're going to get more into that. But it is considered a progressive neural degenerative brain disorder and so there's a lot of symptomatology that comes from that and I think we're going to get into that. But that is the definition of what chronic traumatic encephalopathy is. In traumatic brain injuries I call it TBI and CT, because seeing chronic traumatic encephalopathy is a little burdensome sometimes.
Speaker 1:Yeah, it is a lot. Yeah, but thank you for clarifying that and the abbreviations as well, because that's what we'll be using throughout this conversation is TBI and CTE, and I did watch just to give people just a hint at what's ahead in this conversation. I watched a little bit of the documentary film and there's some good imaging in there to give you the visual of what is actually happening inside of the skull when you take it to the head or to the body and how the brain can actually move back and forth within the skull and cause that disruption to neurological activity and can also be a very serious injury. Let's dive in a little bit to your personal experience with TBI and CTE. Tell us about your home life when you were growing up and your personal story.
Speaker 3:Thank you, maria. So forgive me if I get a little emotional you know I don't tend to go into it, but I think for the context of this podcast it's really important and I'm just very proud of my upbringing. So I'm an immigrant. My family was an immigrant from a little town in Zacatecas called El Nino Jesus. We immigrated to the United States during the 1970s. I am the eldest of seven children and during the time that we got here the civil rights movement has just kind of, you know, started ending and the battered women's movement was about to initiate. So that time zone there was a lot of overt racism and discrimination and a complete lack of understanding of what domestic violence was or abuse towards children and women, no type of training taking place. And just to give you a little bit of context as to why I am so aware of what was happening in my family, I have the first recollection of the first TV episode when I was about four years old. I don't know if I was younger, but definitely by four years old I knew what was happening. So my reality as a child was forever shattered and I took on the responsibility of being the protector and just really trying to, you know, manage that issue. And just a little bit more background. I, as we came to the United States, I was hopeful that there would be services. So I, you know, I did talk to my mother several times, many, many discussions about leaving and seeking help and she told me that the services of the United States were not for her and were not created for help. And she told me that the services in the United States were not for her and were not created for her. So she just didn't feel that they were there for her.
Speaker 3:Obviously, because we came to this country during such a civil unrest and so much anti-sentiment towards immigrants, including ice rates, which are going on now, the stress in my family magnified, meaning that the stress my father was feeling was intensifying. So the abuse in the family was magnified. And there was one time when the police came to my family and to see what was going on, but again it was during the time when they were not trained for this issue. So my mother was in obvious distress but they did nothing for her and then they didn't ask to see the children. So there was just absolutely no care provided.
Speaker 3:I know that as children we were showing symptoms of what was going on, but teachers, priests and everybody around us just never really asked us what was happening, and there was no care provided. I think the police incident, though, really cemented the fact that we just didn't matter. So the violence was just very pervasive. In my home I often describe what was happening as a war zone, and I want to remind the reader, the audience, that there were happy moments, but it's so difficult as a war zone. And I want to remind the reader, the audience, that there were happy moments, but it's so difficult as a child to focus on this when the abuse was so pervasive. So that just gives you a little background about my family and my background.
Speaker 1:Yeah, thank you for sharing that with us. So all of this, it's been a really long journey, right For you and for your family and your mother, and it all has culminated. I'm skipping to the end, but we're going to work backwards. It culminated in a movement that you founded and a documentary film called this Hits Home, which is about TBI, cte and domestic violence. Obviously it's this personal story, right, violence. Obviously it's this personal story, right that inspired the film. Yes, yes. So how did you get connected to the director, sydney Skoshe, and have you know, get to work with her on this particular project?
Speaker 3:Absolutely. I love Sydney, but I got introduced to her by her father, dr David Dodek, who is a renowned neurologist. He is, as you can imagine, a friend and an incredible, significant person in my life. He is Professor Emeritus at Mayo Clinic and Consultant for Mayo Clinic International. He is also the Chief Science Officer and Chair for Atria Academy of Science and Medicine. He is an adjunct professor in the Department of Neuroscience Norwegian University, and I can go on and on.
Speaker 3:We were working on a project around domestic violence and traumatic brain injury and I felt compelled to share with him, and I felt compelled to share with him. He was the first person close to me that I shared why this issue was so near and dear to my heart and I had just gotten the first diagnosis of my mother's brain. So I shared that with him and he was very struck with it and he asked me Maria, I have a way that we can create a public massive awareness about this issue and hence he introduced me to his daughter, sydney Dodick. Professional name Sydney, scotia. You know she is amazing, beautiful producer, actress, director and I would add to that a tremendous advocate of domestic violence and TDI and CTE.
Speaker 3:So I met her during the time and was introduced to her by David, her father, while I was trying to get confirmation of my mother's neuropathology examination. So she asked me if we could track her journey in real time and, as you can imagine, there was lots of discussions about this discussion and the step it meant that I had to go very public in a very big way. So I was very fortunate to have amazing mentors and, um, we did the film and was incredibly proud of how sydney did the film. So that's how I came to to this, uh, to this wonderful documentary that can be easily watched if you google it, it's available and, uh, for free. If you're streaming on certain platforms that you have, you can access it.
Speaker 1:So and just a reminder. The documentary is called this Hits Home and it is on your website, which remind me the website again.
Speaker 3:Pamphilaorg P-A-M-P-I-L-Aorg.
Speaker 1:Okay, so people hopefully can find it there. You can also find it at the Conference on Crimes Against Women in May 2025. Let's talk a little bit more deeply about the film and your mother's story. What happened to your mother that caused TBI?
Speaker 3:So my mother was repeatedly hit on the head for over 40 years. So the symptoms manifested themselves quite early in her life and when I finally had her under my care and I took her to the neurologist that they insisted that it was Alzheimer's that she had it, and I agreed 50% with them. I disagreed that it was a complete diagnosis. So unfortunately CTE can only be diagnosed post-mortem and I had the opportunity to donate her brain for the advancements of science and brain science. So that's the significance is that we found the first neuropathology examination demonstrated or showed that she had CTE and Alzheimer's. So that was very significant. But then we had to really work towards confirming those results.
Speaker 1:How is CTE diagnosed?
Speaker 3:CTE is diagnosed post-mortem. You need to seek a neuropathology examination and usually you know in my mother's case she couldn't give consent. She didn't know what was happening. Cte really ravages your brain. You have a multitude of symptoms behavioral, cognitive, physical mood. You know so. You really can't make the decision to do that. Cognitive, physical mood you know so. You really can't make the decision to do that. I had a full power of attorney over my mother and there was a lot of reasons why I wanted to find out what happened to her. Yes, so either you give consent for your brain to be donated or your family, if they have dual power of attorney over you, might make the decision that they want to see what happened to you, because the behavior is so different and so erratic sometimes, from when you first meet somebody and say this is a wonderful human being, then it just drastically changes.
Speaker 1:What are some of those symptoms that a person might exhibit if they potentially have had traumatic brain injury? Could possibly have CTE.
Speaker 3:So traumatic brain injury. It is such a huge brain disorder. It's just you know you have mild, moderate to severe and then many definitions and types in that spectrum. So most people suffer mild TBIs. In fact, 80% of TBIs are mild. It is the leading cause of death and disability, not just in the United States but globally, so it's a public health crisis.
Speaker 3:The acute symptoms of mild TBI are the ones that we need to watch. If you had a mild TBI, which usually is some kind of nausea, you've been hit in the head or your body has been shaken in a way that your brain has been impacted Nausea, migraines, you want to rest, you're feeling dizzy and migraine headaches. So those are like the acute ones. It's these long-term effects that really go unchecked, because usually you know you might go to the doctor and get care if you think you have a mild TBI, but the statistics demonstrate that only 50% of people that think they've had a TBI actually go get care. So you have that Most people are not getting care. The long-term effects are physical, cognitive, behavior and mood, which includes sensitivity to light and noise, dizziness or balance problems, feeling tired or fatigued, foggy or groggy mind, you know, concentration problems, nervousness, sleeping problems, vision problems, words or letter jumping around. So you're having trouble thinking clearly.
Speaker 3:Migraine headaches are a huge symptom. So those are some of the symptoms. If you're having repeated head trauma or any type of trauma, you increase your chances of eventually possibly also having a progressive neurodegenerative disease. So traumatic brain injury is linked to Alzheimer's disease, for example. Parkinson's CTE is specifically linked to repetitive non-concussive head impacts. So that is how all of this is linked. Those are some of the symptoms.
Speaker 1:So is there an age limit or an age factor that relates to these disorders?
Speaker 3:abusive relationship or you're playing amateur sports or you are prone to falls, you are at risk for developing, obviously if you have trauma, tbi, but then you're at risk of developing progressive neurodegenerative diseases. But for CTE specifically this is the issue that I'm so focused on it has been found in the brain as young as 17 years old and because CTE the way it manifests itself with the tau proteins and the tau foals it takes several years for symptoms to show up. So that means that the 17-year-old most likely was playing some type of sport it could be football, anything that you can think of where the brain is being moved and just injured in that skull. If that individual was also sustaining some type of accidents at home or there was abuse in the home, that young brain is being damaged. So by the time of 17, he was diagnosed with CTE. Teen he was diagnosed with CTE. And if you think of the general population and abuse, children who are abused are also experiencing repeated head trauma. They are going unchecked. Tbi is considered a chronic condition that impacts the lifespan, just like CTE is. But because there is no education about that, we don't know these things. So children are being unchecked by the time they reach high school. It's no wonder that we have a hike in teen dating violence.
Speaker 3:So I hope that makes a good picture for the audience that you had a head trauma or repeated head trauma. We're just taking an example of at 3, 4, 5, 6, 7, 8 years old. Example of at 3, 4, 5, 6, 7, 8 years old. Well, those symptoms are going to take a while to show up as CTE or progressive neurodegenerative diseases on top of the TBI symptoms you're experiencing already. So there's layers TBI symptomatology, cte and other progressive neurodegenerative diseases and with abuse victims, we have depression, we have chronic stress, we have all these other comorbidities. So it gives you a good picture. But no, there is no age limit and everybody is at risk. Who's had head trauma?
Speaker 1:Yeah, because when we hear about TBI traumatic brain injury it's most often discussed around professional athletes, in particular, football American football, as well as with military service members, may also be highly susceptible to the impact of a traumatic brain injury, but it actually is incredibly common amongst victims of domestic violence, and it's an issue that really has only been talked about in recent years. And, to your point, is also an issue that the symptoms don't always show up right away, and it's very similar in that way to strangulation, because with strangulation with the hands around the neck, it can cause mild injuries that are not even detectable at first notice or examination, and so these things can slowly deteriorate and also shorten a woman's life Absolutely, and strangulation is a type of TBI.
Speaker 3:I didn't realize that. I think we've done a great job of educating people about strangulation. We have not done a good job of educating the public about what traumatic brain injury is in general.
Speaker 1:Yeah, I would agree with that, with the exception of, maybe, professional sports, like having had kids that play sports for schools and such they do educate parents about what the symptoms would be and what to look out for, and in recent years very recent years, at least at the club and high school levels, they are being super careful about how kids are protected when they're playing sports at school. Now, in this particular case, though, we're playing sports at school. Now, in this particular case, though, we're talking about domestic violence. There was no protection and there was no talking about it, and, to your point, nobody really seemed to care what was happening within your family's home. Did you have the opportunity to confront your father about the abuse of your mother?
Speaker 3:Throughout my life. I discussed it with him because it didn't make sense to me, the erratic behavior. So I did speak to him many, many times about his behavior and how he might be able to control it, and so what he shared with me is that he could not control it. He could not control his unpredictable impulsive behavior, his irritability and rage. So I discussed it many times with him and as I grew, obviously older, the discussions got deeper. So I, of course, I learned that he also was abused as a child at the hands of his father. So there was really horrific abuse going on.
Speaker 3:I suspect from the symptoms and what I saw in my father, that he also had domestic violence, TBI, dvtbi and potentially DVCT. And I say potentially because I suspect that in my mother and I had the authority to donate her brain to science. My father also passed away but I did not have the authority to donate his brain. I would have done so. So many times, many times, my father was very afraid that he. He was afraid of himself. He was afraid that he was going to kill somebody, not just his family, but just hurt somebody. He never got care.
Speaker 1:Yeah, that is incredibly challenging and it's a lot for you. I mean, you're the oldest of seven siblings and it's a lot for you to have carried all of these years and you've turned it into a movement with the documentary film and the information that you provide on your website and even as you work as a social worker. Let's talk a little bit about how to care for someone who has a traumatic brain injury and could potentially have CTE. What type of care is involved in that?
Speaker 3:The care that's involved in that for traumatic brain injury really depends on the type of traumatic brain injury that has been sustained. Again, most of it is mild TBI. If it's moderate to severe, people usually end up in the hospital. Having said that, for abused individuals, women and children, they are experiencing moderate to severe traumatic brain injuries, but they're not seeking care for a lot of reasons. But really what you need is rest and then really long-term care because you want to really be aware of the manifestation of symptoms. So you can never get your brain back to baseline. You're never going to get that fresh brain that hasn't been so the damage is done. Right, the damage is done. The science is not there yet that they can repair brain cells, so the damage is done. So what you have to do, my recommendation, is be very vigilant of your symptoms. Track how much brain damage or traumatic brain injury you've had. Establish a good relationship with a good neurologist and track your symptoms so you can get treatment for your symptoms.
Speaker 3:Tbi was just recognized in 2024 in the United States as a chronic condition, meaning that a TBI impacts lifespan. So there's a lot of education going on right now among brain injury associations about this issue that it's a chronic condition. So it requires long-term care and at one point, if you start showing symptoms of progressive neurodegenerative diseases, you now have this added manifestation, sequelae of new symptoms. So you're going to have to think of what type of long-term care you're going to need. My mother, at one point, obviously could not take care of herself, and I know that's a very difficult discussion to have, it's very difficult discussion to have, it's very difficult information to hear, right, but you know, I believe that information is important, so then you can plan accordingly. I know I don't bring good news and I'm not sharing good news, but it's important for us to know what's going on so we can prepare. So that's what I recommend so we can prepare.
Speaker 1:So that's what I recommend. Yeah, I think you make a really interesting point because this is a very complex situation. When you have a person with traumatic brain injury who then begins to present that they can no longer care for themselves, and then the complexity of confronting that as their child and actually taking action to make sure that they get the care that they need, even if it's not the care that they necessarily want, and that long-term care plan or insurance is an important thing to think about early, even when there is nothing happening, just so that in the future one can be taken care of or your loved ones can be taken care of. Talking about treatment a little bit further, when a woman or any person really presents to a neurologist symptoms that may be because of a TBI right, do those doctors, is there a method in place or a process in place that they would specifically ascertain if this is a result of domestic violence or some type of abuse?
Speaker 3:Well, first of all, there are no standards of care for screening, treating or assessing for domestic violence, tbi or DVCT. So just because you're seeing a neurologist doesn't mean you're going to get screened for that. That is one of the reasons why we've made the film, the documentary, and I appreciate you saying trying to really have this movement of education and awareness, not just for the population that's at risk, but the entire service provision, including other critical stakeholders. So then you have, and I can speak to it, because that's what happened to my mother, and I know that when women reach out to me and say, Maria, I heard your speech, I heard, I saw the film. Please refer me to a neurologist.
Speaker 3:Neurologists are not aware of this correlation. Refer me to a neurologist. Neurologists are not aware of this correlation. So when I took my mother to get care, they were ignoring completely the history of traumatic brain injury and I was. People ask me well, why were you? Why did you want to know? I wanted to know because she's my mother and I wanted to get a complete diagnosis so I can give her comprehensive, needed care.
Speaker 3:I have the right to know and every woman, child, individual has a right to know what's going on with their health and sadly, the system of care, including healthcare, is not aware of this correlation and they're not screening routinely in a standardized way or assessing or treating. Then you have women who are really afraid of sharing what's going on, especially women who have children, because they know the repercussions. I'm a social worker, I've been involved in mandated reporting, so you have women who are very hesitant for many reasons not to share what's going on. So we have this kind of area where nobody's talking, nobody knows what to do. So that's what's happening. The ideal world would be where there is universal screening of TBI and CT as it relates to domestic violence, so then women, children and men like my father could get the proper care that they need and we might see a difference in behavior amongst everybody. Because for my mother, after I got the results, I still to this day think at what point did my mom, at what point was her brain so damaged that she could no longer make decisions that were in her best interest? And because my mom was so brain injured? I don't know, but I could tell you the symptoms were very, very early on, anyway.
Speaker 3:So we really have an obligation as a society to really create a comprehensive education awareness campaign about this issue, not just for individuals but the entire system of care. I know that the NFL is doing a great job. I work with Dr Nowinski we partner on things and I'm working very closely with Dr Anne McKee. I know what's being done in the military and contact sports, but the DV population and the entire other population is massive.
Speaker 3:We have an epidemic of traumatic brain injury, not just in this country but in the globe, and then we have an added DV, and abuse against women and children is so pervasive and we're missing this piece. I do want to highlight, though, that the science for DVTBI has been around since the 1980s, and the first case of DVCT among a female was there in the 1990s. Nobody did anything with that information, it just stayed there. So I think we also need to do a better job of disseminating information that is available and is there. I think my mother's case really is. We're trying to highlight it and raise awareness about it for many reasons, so then we could really create systemic change, right, create that awareness.
Speaker 1:Yeah, this podcast is part of that, creating that change and that awareness, and so is the documentary film. I think you're 100% correct that there's not enough awareness or emphasis on what's happening to domestic violence victims. What if someone listening, let's say, knows that she has experienced traumatic brain injury from mild, moderate so on? What could she do today to try to take control of her own health?
Speaker 3:Well, first of all, I think you know, as somebody who's living this and is at high risk for this. First of all, I want to recognize how difficult it is to hear this. Um, I've had to take a lot of pauses in my life to to really just kind of take this in. After I heard my mom's results, for example, it was very difficult to um to really like incorporate that information. What does that mean, not just for my mother but for me and my siblings? So I want to recognize how painful this information could be to hear.
Speaker 3:I want to encourage you to take a pause, take your time. Don't push yourself, be gentle with yourself and once you feel, okay, this, you're talking about me I recommend that you really track your symptoms, take an inventory of the type of traumatic brain injury you've had and get yourself really educated. You can go to palmphilaorg and get yourself educated about this TBI and CT and other progressive neurodegenerative diseases. I think the documentary is a very difficult watch. It's not an easy watch, especially if you feel that you are somebody who can relate to this issue. I recommend that you watch it with a trusted, safe friend so then you could process it afterwards and then, when you are ready, seek proper care. I would recommend that you see a neurologist and be ready to self-advocate for yourself, because that neurologist might not understand or really believe. You Point them to our website, point them to the documentary and other information that I know is going to be available at the conference so they can get educated. But that's what I would recommend.
Speaker 1:I think the self-advocating part is critical here, because it's really easy to give up when you walk into a doctor's office and nine times out of 10, that doctor doesn't look like you. Maybe you're a woman, the doctor's a man you feel like already you walk in with this bias of like, oh, this guy's not going to listen to me, and you could be very easily written off, as you said, and accept it because you don't know how to work through it. I would also say, if you have a trusted person in your life that can accompany you such as you had accompanied your mother and you made sure that you pushed until you got the answers answers the way that your mother could not advocate for herself that is another possibility for you to pursue some answers for yourself and the type of care that you want to receive. It sounds like a great plan, but I know it's hard.
Speaker 3:It's very hard. It's very hard and I agree with you 100%. Take a trusted friend, especially if you are feeling experiencing memory loss and having a difficult time. At one point you're going to have a hard time even writing things and information jumps at you. You can't read, you can't complete forms that the doctor may want. So having somebody that you trust and is a good confidant is really wise.
Speaker 1:Yeah, and just listening to all of this and thinking about the symptoms and that they really develop over time, I would encourage people you may have experienced traumatic brain injury in the past maybe not today, maybe not right now in an abusive relationship but in the past but start thinking about yourself and your own well-being now, before you may have symptoms later. And that's really the point you were trying to make with long-term care. That's really the point you were trying to make with long-term care and the fact that it's very hard to accept that you might possibly have this type of a condition that's silent at the moment but may affect you down the road.
Speaker 3:Absolutely. I think getting the fear factor freezes us. I recognize that yeah factor freezes us. I recognize that. I can't tell you how many times I had a pause to just exhale and bring my energy and center and balance myself and say what do we do with this information? So I agree with you as somebody who is struggling with these issues myself. I also think it's important again, the education Maria I can't emphasize recognize and educate yourself about the TBI symptoms but also the CTE symptoms. There's four stages of CTE. What are those stages? So the four stages are they're considered one, two and three and four and they're all impacting your behavior cognitive, physical and mood and they're clustered.
Speaker 3:So some of the things that you might feel are these persistent migraine headaches. That's what my mom had. So you have headaches for TBI, but now you're experiencing this profound other headaches that could be attributed to CTE difficulty concentrating, that could be treated to CTE difficulty concentrating, attention problems, nausea, short-term memory loss and eventually long-term memory loss, outbursts or explosive mood, depression, memory impairment, executive function problems, visual spatial dysfunction. Like your gait shifts that's one of the big things I noticed with my mom. Like oh my God, my mom's walk has changed. Her gait has been the balance, vestibular balance issues you feel like you're going to be. You're always falling apathy, motor skills, the uncontrollable rage, language difficulties, suicidality, because you're losing control of who you are. So now you're having these thoughts. Then you have these substance disorders, because you're trying to self-medicate right. Then there's the dementias that come in right, and then Parkinsonism. Excuse me, you have the mask phase, the gait, the shuffle, moving, the rigidity, the freezing, the postural instability and again the shuffling of steps.
Speaker 3:So it's some of the symptoms are very similar to TBI, but some of them are vastly different to TBI, and so that's important is educate yourself about what these symptoms are so that you could track them.
Speaker 3:And again, I know it's very difficult to hear this and you might just want to isolate. I urge you to try to balance yourself, to bring back that fight in you, because the longer you wait the symptoms just are going to get worse. So getting treatment is important, so they can alleviate some of the symptomatology you are experiencing and hopefully you are functioning better in life, because these symptoms are going to impact your daily living Parenting, keeping a job, going to school, keeping appointments. If you go to shelter, you're not going job, going to school, keeping appointments. You know if you go to shelter you're not going to be able to comply with programs, and so then you might be terminated. Many of the women, as you know, end up on the streets with housing insecurity or homelessness, where they are at risk of more traumatic brain injury. So please, please, try to get treatment for the symptoms.
Speaker 1:So to that point, you mentioned shelter. What should shelter professionals, law enforcement and others who are like, in many ways, a first responder to domestic violence incidents? What should they be looking for when they first encounter a person who may have TBI? When they first encounter a person who may have TBI Because you know, strangulation is a big one, that's a big abuse tactic and she may have been strangled and makes a domestic violence call and now law enforcement is there but they are not able to see the obvious signs of a strangulation.
Speaker 3:Yeah, I think you know, what I would recommend is developing really universal screening tools, screening tools for first responders, because they're not going to be really to do it.
Speaker 3:Like directly related to TBI that they're experiencing, like the acute symptoms, the nausea, the migraines, the vomiting, you know, just the dizziness. Those are usually symptoms of traumatic brain injury, okay, and either the person recognizes them themselves or the person visualizing or looking at the impacted individual can recognize them, because the person who's experiencing them really might just say this is not a big deal. But that's where the professionals come in. If you're seeing these symptoms, then you can screen and then refer. I think if you ask an abused woman if she's had traumatic brain injury, I think most women who are in relationships that are abusive tend to minimize that level of abuse that they've experienced and they don't understand what traumatic brain injury is.
Speaker 1:They don't understand, you know, yeah, I think I wouldn't understand it either if I was in that situation and you know I'm standing here consciously speaking to you and how could I have a traumatic brain injury?
Speaker 2:And.
Speaker 1:I think it's that definition. We go back all the way to the beginning of the conversation is what is it? It's not just for athletes, right? It's everyone.
Speaker 3:Exactly. And then you have these non-concussive head impacts. It's not TBIs that don't show symptoms. So again, professionals asking for symptoms, noticing symptoms, and then you know, I always think that well, you don't really need to know if this woman is being abused, but if the symptoms are showing up, you have an ethical obligation to make the referral for assessment and treatment.
Speaker 1:Absolutely how close are we are to having those types of screening tools?
Speaker 3:I don't think we're close enough because there is a lack of education among the system of care, behavior, health, mental health, law enforcement. We're just not there. I think that the NFL, the military and amateur sports are doing a phenomenal job. There are legislation and policies that are addressing TBI and what to do when a child that's playing a sport it needs to do. Policies across the country, in all 50 states. We don't have any legislation that's been passed or policies that are addressing DBE and TBI, much less DBE and CTE. It's just not happening. So that's why I am so thankful for being on the podcast and I'm so thankful to be presenting at the conference, just very honored to be doing this to educate and create awareness. So I thank you, maria, for what you're doing and this opportunity.
Speaker 1:Oh, it's my honor to work with you and other survivors on this and other issues related to gender-based violence. Tell us about the presentation you're going to give at the Conference on Crimes Against Women.
Speaker 3:Absolutely. It will be a presentation very much about what is traumatic brain injury and CT as it relates to abused women. We're going to go over definitions much more in depth, right, then we're going to really cover what are the symptoms and how do you track this. Then I will cover, as well as what are treatments that are available, what can we do together to address it in a comprehensive way, so strategies around that. We will be showing clips of the film and reminding people, obviously, that there's going to be a screening and then the screening we're going to have a panel of experts to really respond to the audience. So it'll be a lot like what we're talking about, what we've discussed here, but more in depth and more in a presentation style format, and I do want to have some breakout groups to just make sure that the audience has an opportunity to practice what we're talking about.
Speaker 1:Yeah, because you have a diverse audience there, right, you have law enforcement advocates, prosecutors, survivors, educators, other professionals who work directly with victims of gender-based crime, and then you have people like me who just I like learning. So it's a very diverse audience. You know, in your experience as a person who immigrated to the United States from another country and now, having gone through this with your mother and all the medical treatment and really pushing for answers and getting them right, you really did work to make sure you got a resolution Do you feel like the services for people who maybe English is a second language to them or some other diversity do you feel like services are as available and accessible to them as it might be for others?
Speaker 3:No, we have health disparities and disparities in domestic violence. We know that women from ethnic and racial backgrounds have higher incidence of domestic violence. It is the same thing for traumatic brain injury. So the DV populations is high risk for TBI, as we've shared, because of the abuse that goes on in episodes of DV. But racial and ethnic groups are also high risk for that.
Speaker 3:Then we have health disparities within that, which means that my mother had less access to proper care, meaning she's not getting diagnosed, proper treatment and the outcomes for prognosis are very bad. So we're really having to face more added barriers based on a lot of issues of intersectionality, some of the stuff that we talked in the beginning. So the fight for my mom was excruciating. For me To get answers was very difficult and I think you know part of the reason I decided to go and do the documentary and be doing this work is because I don't want others to have the experience I had.
Speaker 3:It was singularly with my family trying to do a treatment plan and care plan for my mom because we didn't find a bilingual, culturally responsive and respectful neurologist. That was just not available and I doubt that that is a universal resource right now in the country for women of color and communities of color that are struggling with just DV itself is so monumental. But then there's experiences and symptoms that they have no idea what's going on. So I think a lot needs to be done and I am hopeful, maria, because I do see movement, and I'm hopeful that with these venues and going to the conference and some of the work that I'm doing, I am hopeful that we are seeing progress and that we will offer more solutions for racial and ethnic populations and for the general public period.
Speaker 1:Yeah, I'm really encouraged by not only the work that you're doing but the breadth of all of it and the collaborators that you have to kind of just address this issue and in a 360 kind of way, because it's not just, it's not just the db, it's not that you have a tbi from db, and it's more than that, it's the, the whole cultural part of it.
Speaker 1:It's uh, services in a native language which are super important. You know, I work for genesis, women Shelter and Support, and we have bilingual services as well as interpretations to services and staff that we partner with, and that makes all the difference. The culturally sensitive part makes all the difference. And you're right, there is a huge disparity in healthcare of finding a person who really would understand you enough on all of those levels to take your symptoms seriously and get testing done and and you know, help you achieve a diagnosis and a treatment plan. Tell us your website again so that people can go there, cause I'm I don't know if everyone wrote it down but let's get your website website again, and so people can at least take a look at that and get a sneak peek at the film.
Speaker 3:Absolutely. It's Panfila, which is my mother's name P-A-N-F-I-L-Aorg. So you, if you go on it, you will see just an introduction to this issue, to this issue. I am affiliated with Dr Anne McKee, which is the lead premier on traumatic brain injury and CT. She's a brain scientist, a neuropathologist. She is in charge also of Unite Brain Bank, which is the largest brain dissipatory in the world, so we're affiliated with him.
Speaker 3:So if you want to find out about brain donation, we're linked to her and we just worked on a collaborative on a brochure specifically for the domestic violence population. So if you're thinking of doing that, a neuropathology is very expensive. It is free if you're at risk and you go through their system. So we're linked to that. There's resources and if you are a professional, meaning that you are doing research, we have all the articles where we get the information. There is also a page for resources, several links to the documentary, and I'm building it more because we're developing other partnerships, because it's a comprehensive issue that needs to be dealt with in a collaborative approach with multidisciplinary individuals and it needs to be coordinated. So once we provide services to an individual, it's a coordinated approach and not a singular approach. So, yes, palmphilaorg, please go to it, and we are happy to support and provide services.
Speaker 1:Thank you so much for giving us that information, for talking with me today and sharing your story and your mother's story, and I look forward to being with you at the Conference on Crimes Against Women.
Speaker 3:Thank you so much for having me. It's just a privilege, it's an honor, and I look forward to meeting you as well at the conference and meeting the rest of the other participants that will be attending. We can't wait. I'll see you there.
Speaker 1:Thank you. Thanks so much for listening. Until next time, stay safe. The 2025 Conference on Crimes Against Women will take place in Dallas, Texas, May 19th through the 22nd at the Sheraton Dallas. Learn more and register at conferencecaworg and follow us on social media at National CCAW.