The challenges of understanding brain injury as a result of Intimate Partner Violence (IPV)

BY: ALANA TIBBLES

Sports injuries are often the first thing that comes to mind when people think about brain injury. A close second, motor vehicle collisions.

As a brain injury researcher, I am ashamed to say I hadn’t considered another population of people which are at high risk of a brain injury: those who have experienced intimate partner violence (IPV).

It wasn’t until the Brain Injury Canada conference in September 2016 that I started to hear about research relating to women who had experienced brain injuries as a result of IPV.

Close up of hands clasping
PHOTO: PIXABAY

I’d like to take a moment here to note that persons of any gender may be either perpetrators of or victims of IPV. The majority of the studies I will be summarizing are regarding female survivors of IPV perpetrated by males. As more research becomes available we may gain further insight into other relationship dynamics. 

 Survivors of IPV

Anyone who has experienced injuries to the head and/or neck (including being shaken), should be assessed for a brain injury.

This includes people who have experienced strangulation, since brain injury can occur from lack of oxygen to the brain. People who are living with brain injury are at an increased risk of depression or anxiety and tend to experience frequent headaches, fatigue and dizziness. Many experience cognitive issues such as impaired memory and concentration as well as difficulty planning and making decisions.

Understanding these symptoms are the effects of the brain injury, and getting help dealing with them, may help a survivor make decisions regarding their living situation and plan to gain independence from a violent partner. It may also validate their experiences, knowing there are real health issues going on, and they are not ‘just making things up.’

Hospital Hallway
PHOTO: ERKAN UTU VIA PEXELS

The good news is that research is starting to focus specifically on how females recover from brain injuries and how brain injuries from IPV and other forms of assault may be different from those sustained in other ways (such as a car accident).

As such, survivors of IPV who have sustained a brain injury (and feel they are able to so) may wish to participate in research in order to help further our findings with the goal of increasing the information base for other survivors.

Social Support is Crucial

Social isolation and loss of relationships are too common after brain injury, and those who have strong social support networks in place post ABI are more likely to have better outcomes than those who do not.

A reliable support system may be even more important for women with a brain injury as the result of intimate partner violence. Not only will they be dealing with the effects of a brain injury, but they may be leaving a violent partner, and / or dealing with the emotional and psychological impacts of having survived intimate partner violence.

Women may require financial support, legal information and a safe place to stay (with their children, if applicable) and temporary or ongoing caregiving.

While it is important to screen for brain injuries from IPV, it is complicated by issues regarding how safe a patient feels disclosing IPV. Some patients may fear retaliation if their partner finds out they’ve talked about the abuse and some may fear for the safety and custody of their children.

picture of person's shoes in the fall leaves
PHOTO: PIXABAY.COM

Survivors of brain injury from assault (including IPV) are much more likely to suffer from post-traumatic stress disorder (PTSD) and often have lasting psychological trauma.   There is now an ongoing research project with the aim of introducing a toolkit for frontline workers serving women with IPV, to improve the experiences of both the women and the workers when discussing and addressing this sensitive topic.

Research Challenges

Research findings from other studies often help direct future research.  I would caution that while past studies can be helpful, the literature may be missing more than we realize when it comes to survivors of IPV, for the following reasons.

Participation

Some survivors may choose not to participate in research or discuss their experiences. Depending on how risky they feel disclosing the IPV may be, survivors may not be seeking out medical assistance after injuries or they may not be forthcoming with details about how it happened.

Loss of follow-ups

If survivors seek medical attention, they may not return for follow-ups depending on whether or not they are trying to avoid alerting their partner about their medical visits.

Lack of details about injury

Unlike traumatic brain injuries from sports injuries or vehicular accidents where there are witnesses or first responders to provide information about the incident, survivors of IPV may have to rely solely on their own memories of the event (which can be difficult for anyone with a brain injury). They may not know how long they were unconscious or how many blows to the head they have sustained. Having accurate details about an injury can be helpful for research, especially when it comes to understanding post-injury recovery patterns and outcomes. While definitely not the fault of the survivor, having missing data may make it difficult to reach conclusions about the recovery of this population.

Incomplete representation of population

A study by the World Health Organization (WHO) found there are different societal standards for what constitutes IPV in countries where women have fewer rights. Therefore IPV may be underreported in other cultures or countries where males are viewed as having the right to punish their wives. Ideally there should also be more representation in the research from other relationship dynamics, such as those with trans partners, same-sex relationships, relationships where the female is the perpetrator and the male is the victim and relationships where both partners are violent.

Now, this is not to discount the value of research being done in this area. It is a historically under-represented group in the brain injury literature and researchers are now making great strides to shed light on how brain injury may differ for this population. It is hopeful that with continued research, we can tailor rehabilitation and support for this group with the aim of improving their recovery and quality of life.


 Alana is a researcher who recently completed her Master of Science degree at the Rehabilitation Sciences Institute at University of Toronto.  She has been studying brain injury for several years in topics including but not limited to: substance misuse, recovery, neurofeedback, sleep, and hospital-to-school transitions.  Her aim for her blog posts is to continue to learn about and promote learning about brain injury research, hopefully making it easier for interested persons (brain injury survivors, caregivers, loved ones, clinicians etc.) to access relevant information.

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The strength in her heart: Hero of Brain Injury Elizabeth Farquharson

BY: JENN BOWLER

Are you ready, heroes?  The BIST 5K is just days away!

Sign up or donate today: www.bist.ca/5k

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Meet Elizabeth Farquharson – the final hero we’re showcasing in our Heroes of Brain Injury Series – we can’t wait to see her and all the heroes on October 1st!

Our ABI hero Elizabeth Farquharson doesn’t need to run as fast of the speed of light to impress us, she’s worked in the field of brain injury for over two decades and is still going strong! Find out more about this amazing hero of brain injury below!

BY: JENN BOWLER 

 Elizabeth Farquharson
A true hero: Elizabeth Farquharson

 Tell us a bit about your work:

I have been a physiotherapist for 34 years and working in brain injury for about 20 of those years at Sunnybrook Hospital, as a clinician and more recently as a coordinator of care for trauma patients. I am a member of the ABI Network Transitions Committee and also have been involved in development of best practice guidelines for brain injury through the Ontario Neurotrauma Foundation. Despite the often devastating nature of trauma and brain injury, it has been a very rewarding career and I am often in awe of the patients and families that I have worked with. I admire the way people have managed to conquer so many obstacles and continue along chosen paths or find new meanings and different ways of doing things.

Why do you participate in the BIST 5K?

The BIST 5K is a way to support our brain injured patients and families and for our trauma ward to come together in a social event that is fun and inclusive. This year will be my fifth year participating!

I have run one year and walked all the other times – hoping one day there will be a prize for the slowest! I love that the BIST 5K doesn’t care how you do it; only that you do it. There are people cheering you over the finish line regardless of how fast or slow you are!

What does being a hero of brain injury mean to you?

It means doing your best to provide the best patient care that you can. It means supporting and advocating for your patients and families and being involved in that journey of recovery. Even if I’m only involved for a short time while they are part of the early acute care phase at Sunnybrook, it is still a privilege and honour to work with brain injured clients and families and see their progress and resilience. It is so rewarding when these individuals come back to visit us at the hospital, and we are able to follow their journeys.

What is your favourite part about Race Day?

It’s a lot of fun and I love meeting different people from survivors of brain injury to the whole spectrum of care involved in recovery. I love the park, the fresh air, the healthy competition and the family involvement!


Jenn Bowler is a social worker in the Trauma Program at Sunnybrook Health Sciences Centre and is a member of the BIST 5K Run, Walk, & Roll Committee.

Up, up and away! Meet Ellie Lapowich #BISTRUN’s heroic TOP fundraiser

What can’t we say about Ellie Lapowich? Not only does she sit on our Mix and Mingle Committee and is a proud BIST supporter – but Ellie also manages to be one of our (if not the top) fundraiser at our 5K each and every year.  We challenge you to take her on and see if you can beat her fundraising amounts this year! 

 
That’s just one reason why Ellie is an ABI Hero – read more about her below!
 
5K Poster 2017
Be an ABI Hero! Register today! www.bist.ca/5k
BY: JENN BOWLER

Tell us a bit about your work:

I have had the privilege of working with people who have sustained brain injuries for almost twenty years now. Since 2004, I have owned and operated Innovative Case Management Inc. (ICM), which is a community-based company that provides case management and occupational therapy services, as well as Catastrophic and medical legal assessments.

Why do you participate in the BIST 5K?

I have participated in the BIST Run for the past several years because it is a great event that raises much needed funds for the wonderful programs offered by BIST. It is amazing to see such a great turnout year after year as members of our community, along with their families and friends (and often pets), cover the 5k while enjoying the camaraderie this event promotes.

BIST 5k top fundraiser Ellie Lapowich
ABI Super Fundraiser Ellie Lapowich

What does being a hero of brain injury mean to you?

I think the real heroes of brain injury are our clients who have sustained these injuries and work incredibly hard every day to overcome the many obstacles they now have to face. I have had the good fortune of meeting some amazing people who are true inspirations. I believe that our clients’ loved ones and caregivers are also heroes.

What is your favourite part about Race Day?

My favourite part of race day is watching brain injury survivours triumphantly cross the finish line.


Jenn Bowler is a social worker in the Trauma Program at Sunnybrook Health Sciences Centre and is a member of the BIST 5K Run, Walk, & Roll Committee.

What we don’t like to think about, but need to prepare for

Do you ever think, what would you do if your spouse was in a serious accident?

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Theresa and Norm McColl at Theresa’s college graduation.

Who pays the bills? How are they paid? Do you have access to your spouse’s bank account?

And the big question: do you have a will and power of attorney (POA)? Do you know where they are?

If you answered ‘yes’ to these questions, I applaud you. You are prepared.

Regardless of our age, many of us think we’re too young to worry about the practical details of what would happen if we or our spouse were suddenly seriously injured or deceased. These are difficult topics to talk about, and we are like to think ‘it’ll never happen to me’. That’s what my husband, Norm, and I thought.

One day, we drove past a place that did wills and power of attorneys. Norm said, “We don’t need a will and power of attorney.”

But something in me felt differently, and I insisted we get them done.

I am so glad we did. A little while later, on Thursday, April 28, 2011 things changed for us forever when Norm was in a very serious car accident.

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This photo collage represents Norm’s passions before his injury. From top (R-L) logos from Guelph Storm Hockey, Kinsmen Club, Guelph Fire Department and Guelph Radio Station.

The pickup truck he was driving was T-Boned and ended up underneath a tracker trailer.

Norm was only able to mumble his name and where he worked before he lost consciousness. He was air lifted to Sunnybrook Hospital from where we live in Guelph. He had several broken bones, and we were soon to learn, a traumatic brain injury.

Until then, Norm lead a busy life. He worked at the firehall and had a radio show. He was, and continues to be, a Kinsmen.

Norm’s injury changed my world in countless ways, including the practical ones. Until then, he had been the bill payer and, in large part, the provider. In an instant, those duties became mine. I had no idea what to do, and I needed to find our POA.

All of our bank accounts and bills were under Norm’s name, and I needed the POA to gain access to them. Without the POA, who knows how long it would have taken before I could start to live and pay bills.

Norm and I at are 30th anniversary open house at the Elliott

A post shared by Theresa McColl (@mccolltheresa) on

I am very grateful Norm listened to me that day when we were out for a drive. I am glad that our wills and POA were in effect. If we had just said, “Oh, that’s just for old people,” and drove by, I would have been in a heck of a mess.

After hearing my story,  what are you waiting for? Are you prepared?

Please don’t wait, tomorrow, may be too late.


After her husband’s injury, Theresa went back to school to become a Personal Support Worker. She has taken courses in brain injury, and is now a full time caregiver. You can follow her on Instagram, HERE

How you can help a low cost physiotherapy program stay affordable

BIST members had the opportunity to learn about Team Theraputix’s ODSP Program – which allows people on fixed incomes to receive physiotherapy for just $50 a month – at a Community Meeting last fall.

At our meeting, many of us were amazed at the generosity of the program, which was created to ensure people who would otherwise not be able to afford crucial physiotherapy services, access the support they need. Many of Team Theraputix’s clients have brain injuries.

Like any private physiotherapy clinic, Team Theraputix is a business, they need to watch their bottom line in order to survive. But their ODSP Program literally puts people before profits. How often do you see a business do that?

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Victoria Tolmatshov (L) poses with Team Theraputix’s ‘Therapy Bear’ with BIST programs coordinator, Julie Notto (R) at our November 2016 Community Meeting

Now Team Theraputix needs your help – they are being forced to raise the cost of their ODSP program due to financial constraints. They don’t want to. As many of us know too well, when you’re on a fixed income, literally every penny counts. 

You can help Team Theraputix by attending and making a donation at their Barbecue on Saturday August 5th, at the Team Theraputix Office or by sending an e-transfer to: info@teamtheraputix.ca

And you can read why and how Victoria Tolmatshov, owner of Team Theraputix, decided to start the ODSP Program, below. Let’s do what we can to keep this amazing program going.

BY: VICTORIA TOLMATSHOV

Imagine, for a moment, that you or your loved one have sustained a traumatic injury. Imagine getting that phone call from the hospital or being rushed there. Imagine that your family is in a state of crisis, but doing everything to keep it together. Imagine that conversation with the doctor when you are told that your life will never be the same again.

Fast forward to the discharge from the hospital. There is nothing else they can help you with. You take a few days to settle into your new life. You start making phone calls. You realize that OHIP will not take you very far. You realize that your journey will be very difficult.

You finally find a private rehabilitation centre which can offer you assistance in your recovery process. You become hopeful. Now, imagine seeing how much this new hope will cost you and suddenly your heart drops into the pit of your stomach. You realize that you do not have that kind of money. Imagine feeling that disappointment while pushing back tears.

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Team Theraputix in action (Photo courtesy of Victoria Tolmatshov)

I have sat across the table from too many individuals to count who are in that very situation. My heart broke watching them leave my clinic knowing that there was nothing I could do to help. Constantly reminding myself that this is a business and there was a fee for services- just like everywhere else. I stayed awake at night thinking about these people. Rehabilitation is just one of many things a person with a traumatic injury has to deal with and there weren’t any options available to make the process easier.

In January of 2014, after another meeting with a family unable to pay for our program, I decided that it would be the last time I ever disappointed someone in need of help.

I started doing my research and found that most people who were unable to afford private therapy were receiving Ontario Disability Support. I was shocked to find out that the maximum funding was just over $1100.00 per month. I realized that we live in a society where many people in a vulnerable situation just fall through the cracks and do not receive adequate support from the government.

I decided to make a difference. I created a low cost physiotherapy program for those receiving ODSP. The program offers one on one physiotherapy two to three times per week (eight to twelve per month) for $50.00* per month.

Team Therapeutix Therapy Bear shows physiotherapy treatment on owner Victoria Tolmatshov
Therapy Bear demonstrates physiotherapy treatment on Victoria Tolmatshov

I am unbelievably proud of this program and all of our clients who have made amazing progress finally getting the help they need and deserve.

I am happy to know that we can now offer people options and I am overjoyed knowing that I will never have to disappoint someone in need of my help again.

*Victoria wrote this piece before needing to change the fee structure of the program.

Victoria Tolmatshov is the owner of Team Theraputix

Support The Team Theraputix OSDP Program!

Barbecue – Saturday, August 5th, 12-4 pm, Register HERE

send an e-transfer to: info@teamtheraputix.ca

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Our miracle: my family shouldn’t have survived Carbon Monoxide poisoning

BY: SHELLEY TAYLOR

Seven years ago, Shelley’s family survived what should have been a fatal carbon monoxide leak in their house. She writes how her faith has helped her family survive and thrive in the seven years since.

Shelly Trammel standing outside her church
Shelley Taylor

In the blink of an eye, so many memories vanished. I wish I could have chosen which memories I could keep and tossed out the ones I wanted to forget. I know the memories which remain are what make me who I am today. I would be a different person right now breathing, talking, and living if I didn’t retain some of the things I lived as a child and as a young adult.

Valentine’s Day 2010 would turn into a complete game changer for my family, a day we will never forget. I’ve documented this day in words so if the day comes that the memory is gone I can always, reflect back on our second chance at life.

We were experiencing a Texas Winter and the six inches of snow which covered our town knocked our power out for three days. Fed up, on the third day we ran a generator out in the front driveway with the garage door and windows open. The Fire Chief later told us that the lack of wind and frigid air that day meant the gas settled into our home via the eave troughs instead of blowing away.

That night, my daughter, Taylor, woke suddenly to someone screaming her name. She jolted up in bed, tried to stand and quickly realized her legs wouldn’t hold her up. She fell to the floor.

Shelley and Taylor pose in their living room
Shelley and her daughter Taylor

From there, she crawled to her door and tried to stable herself but couldn’t and collapsed again, all the while having the frightening feeling of tunnel vision where you can’t really hear or see.

The thud of her fall woke me up and I ran to her. My then husband, Charlie, heard from the living room and he and I met at her doorway and found our daughter lying, lifeless and facedown. Not knowing what’s wrong with your daughter, when its too dark to even look her in the face is the worst thing I have ever felt.

Charlie was shaking her and trying to get a response. He sent me to get a flashlight that was on my nightstand. We were beside ourselves with fear. On my way to the bedroom, I started feeling as though I was losing control, and as the seconds passed I knew I had to let Charlie know something was seriously wrong with me. I had the flashlight in hand, and started running back to the hall, but the closer I got to Charlie, the further away he seemed. Everything was spinning out of control and I was losing awareness of where I was.

I knew if I didn’t make it back to him he wouldn’t know to come find me.  When I turned the corner to the hallway I collapsed face first without my hands or arms to brace me, falling onto the metal flashlight and cutting my forehead open, exposing the skull. Charlie was searching in the dark for the flashlight as it had rolled when I fell and I was trying to tell him I felt blood running down my face. Things were completely out of control.

Once he found the flashlight, with one look he said he had to get me to the hospital.  I said, “What is wrong with Taylor, doesn’t she need to go?”

Somehow in my head I knew she had started this whole ordeal and my mommy intuition kicked in. I was more scared for her than me!

Shelley Taylor poses for a selfie

Meanwhile, Taylor was drifting in and out of consciousness. Charlie managed to wake her, and told her she had to go get a towel to put on my head to help with the bleeding, which was now pulsing out of control from my head. We were all covered with my blood. How she made it to the bathroom to retrieve a towel is beyond any of our comprehension.

Immediately after she returned, Taylor lost consciousness again.  Charlie dragged her over and propped her on top of me, against the wall as I was having convulsions and banging my face into the floor.  My eyes were rolling back in my head, and Charlie yelled at me not to die on him.

Charlie called 911 and first to respond were the police. They used their flashlights and the first thing they saw were my bloody handprints in our hallway where I tried to stand, and Charlie covered in my blood. Needless to say, they turned their suspicions onto Charlie.

Shortly after the fire department arrived, and the Fire Chief began asking different questions. Charlie explained we were using a generator and immediately the Chief went to the truck to get the carbon monoxide detector. The truck was parked at the street and within steps of entering our driveway the readings on the detector began to rise quickly, so much that the Chief went back to the truck to recalibrate the device as he was not believing the high readings. Once again, walking in the driveway up to our front door the readings began to creep higher and higher. Upon reaching the door he called for his crew to exit the home and began to get Charlie, Taylor and our dogs out. A couple of paramedics were left inside with me to get me stable enough for transport to the hospital. Once outside, they realized that Taylor had “started” this whole incident and the firefighters told Charlie they wanted her checked out as well. I left by ambulance and Charlie and Taylor in his truck.

On route to the hospital, through nothing other than God’s grace, Taylor made some of the scariest and bravest phone calls she’s ever made to my sisters alerting them of what had happened and seeking their immediate help.  She was much too young to understand what was going on or what was wrong with her mom, she just knew they had to get there quickly!

Several firefighters went above and beyond the call of duty and stayed at our home to open windows and stay and watch our dogs for sickness and make sure they were in a safe place before leaving.

Once at Mansfield Methodist Hospital they checked mine and Taylor’s blood gases and they were “through the roof”. Worse, my daughter’s levels were much higher than mine.

They began preparing us to be transported to Dallas Methodist Hospital to get in their hyperbaric chamber. First my head had to be stitched up, 15 stitches total, and I had to have a CT Scan to make sure I was transportable. Then off we went, on the ice, Taylor and I in the ambulance, her sitting and me on a stretcher both with oxygen on.

Upon arriving at Dallas Methodist Hospital, a doctor explained the procedures for going into the hyperbaric chamber, which was difficult to understand considering everything. I must add that at some time after our arrival we found out that the family which had just been in the chamber all died, except the father!

I was terrified for Taylor and myself!  Taylor and I are both very claustrophobic, but we are survivors after our approximate three hour stay in the hyperbaric chamber.

Two Ambulance rides, one CT scan, two blood gases, two Hyperbaric chambers, 15 stitches and one concussion later, we survived!  Nothing says ‘I love you” like a brain injury on Valentine’s Day.

My sister, Kimberley, moved in with us for about a month. Physically I was trying to heal my head, but mentally I was left with a traumatic brain injury.  I started over with kindergarten flashcards, looking at an apple and saying library, and my friends and family completed most of my sentences. They scooped Taylor and I up and helped us heal.

My neurologist told me that people don’t survive what we went through and there really aren’t patients like Taylor and I.  He said he didn’t know how to treat me. I cried and he was visibly shaken. Through his honesty, he became a great comfort to me as I struggled with memory and cognitive skills. We became a little closer that day and I knew he had chosen the right career.

On another of my early visits, he took his hand and made a fist and began knocking on my forehead. He said the poison goes into your brain and destroys whatever it attaches to and we have no control over what functions it destroys or limits.

To this day, my short-term memory is horrible at times, and I’ve lost so many precious memories.

Taylor and I have a saying when it comes to trying to remember things, we just look at each other and say, “Did we have fun?”

The one who remembers says to the other, “Yes, we had fun!”

That’s all that matters. But, to be alive, in whatever capacity, is amazing!  I continue daily to deal with migraines, balance, breathing, vision, memory or the lack thereof. These are daily struggles for both Taylor and I.

I have fallen more times than I’ve stood, and had injuries that ranged from Band-Aids to orthopaedics visits. For six years, my greatest challenge was breathing, but now I struggle with a chronic migraine.  Right now, I am close to 100 days straight of my head hurting. Every day at some point I struggle to breathe and coughing has become my norm. Some days are better than others. Sunny days are my friend. On cold, wet days I lean on my faith for every breath I take.

The more I talk the worse my coughing gets and I talk so much for work. Recovery continues every day for me and Taylor and luckily her Dyslexic brain is used to accommodating skills and this continues to be her saving grace on a daily basis.  She is young, so strong, her faith is incredible, and healing has come differently for her, but memory and migraines are big battles for her.  I’d love for you to pray for her right now.

image2           Many days are challenging and bring a stream of tears but I try my best to remember that God knows the plans for me and Taylor.  He knew the breaths that would follow would bring challenge, He knew this, He knew.  Through it all, truly through it all I will trust Him.

God used this disaster to dissolve a broken marriage and link my life with the most amazing man, through merging tears, broken hope, and many answered prayers.


Taylor Trammell graduated in May with her Associates degree and will soon be an American Sign Language Interpreter. 

Shelley Taylor will publish her book, “With My Last Breath, I’d Say I Love You: When your FAITH and HOPE slip, GRACE wins every time” March 1, 201

 

8. Follow her on Instagram @shelleylovesTaylor

The pain of post-ABI boredom

BY:  ALISON

After my concussion, I lived in ‘stimulation jail’ for several months (and, when my symptoms require it, I still do.) The boredom I felt was at times more insufferable than the plethora of pain and other concussion-related symptoms I experienced. 

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photo credit: Alyssa L. Miller The Safety of Fear via photopin (license)

During the acute recovery phase of a brain injury, patients are often instructed, quite literally, to do nothing. Some endure this ‘jail’ for a few days to weeks. Others remain confined for much longer with no foreseeable end in sight.

I would risk worsening my symptoms just to do something, anything to help pass the time. My family would then get angry at me for overexerting myself. I didn’t know how to explain to them that boredom was causing me real pain and suffering. They assumed that I was exaggerating, until now.

Recently, a psychology experiment found that most people would rather self-inflict physical pain than be bored.

Subjects were placed alone with their thoughts in sparsely furnished rooms for 15 minutes. As to be expected, most of the subjects indicated that they did not enjoy “just thinking” and preferred to have something else to do.

What surprised the investigators (but not me), was that a majority of the subjects preferred to have an unpleasant activity than no activity at all. Prior to the start of one experiment, male and female volunteers received a single electric shock.

42 volunteers said that they would pay money to avoid being shocked again. However, when those same volunteers were left alone for only 15 minutes in a room devoid of distractions other than the option to receive electric shocks, 67 per cent of the males and 25 per cent of the females chose to self-administer at least one shock.

So the next time someone invalidates your experience with boredom or confinement, you can smile and politely tell them about this study.

Mind Yourself with Alison is a collection of self-help tips, research, and personal experiences dedicated to helping people thrive after brain injury (or other trauma). You can read her other articles HERE.