All Abuse is Physical Abuse - Neuroscience Proof and Tips to Help Survivors Heal

All abuse is physical abuse—even when there are no visible bruises.

In this episode of Hey Tabi, licensed trauma therapist and domestic abuse expert Tabitha Westbrook explains the neuroscience behind coercive control and why survivors often experience brain fog, memory problems, anxiety, emotional numbness, and difficulty concentrating long after the abuse has ended.

Drawing from current neuroscience research and clinical experience, Tabitha walks through how coercive control and chronic emotional abuse can cause real brain injuries, including emotional concussions and mild traumatic brain injuries (mTBI)—and why this is so often missed, minimized, or misdiagnosed.

If you’ve ever thought:

• “I should be better by now”
• “I know I’m safe, but my body doesn’t believe it”
• “My brain just doesn’t work like it used to”
• “Why am I still struggling?”

This episode may finally help things make sense.

In this episode, we cover:

• Why all abuse is physical abuse from a neuroscience perspective
• How coercive control changes brain function and blood flow
• Emotional concussions and trauma-related brain injuries explained simply
• Why survivors are frequently misdiagnosed with anxiety, depression, or ADHD
• Common brain-based symptoms survivors blame on themselves
• How healing is possible through whole-person, trauma-informed care
• Why rest, nervous system regulation,

At The Journey and The Process we strive to help you heal. Our therapists are trauma specialists who use evidence-based tools like EMDR, Brainspotting, Somatic Experiencing, and Internal Family Systems to help you heal - mind, soul, and body. Reach out today to start your healing journey. https://thejourneyandtheprocess.com/

 This book is for every Christian woman who has been harmed sexually, whether that happened in childhood, adulthood, or even within your coercive controlling marriage, and you're longing to feel safe in your body again. We talk about the hard stuff, shame, desire, faith, and even questions like, is this sin or is this trauma?

You don't have to untangle it alone. Body & Soul, Healed & Whole is for you. Get a copy here today - https://a.co/d/8Jo3Z4V

🎧 Subscribe to Hey Tabi for more expert conversations on trauma, faith, and healing.

Order Body & Soul, Healed & Whole: An Invitational Guide to Healthy Sexuality After Trauma, Abuse, and Coercive Control

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📩 Connect with Tabitha:
💻 Tabitha's Website - www.tabithawestbrook.com
📲 Tabitha's Instagram - www.instagram.com/tabithathecounselor
🎙️ Podcast Homepage - https://heytabi.buzzsprout.com

💻 The Journey & The Process Website - www.thejourneyandtheprocess.com
📲 The Journey & The Process Instagram - www.instagram.com/_tjatp

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👍 If this episode resonated with you, please like, subscribe, and share to help others who need this information!

🚨 Disclaimer: This podcast is not therapy and is intended for educational purposes only. If you're in crisis or need therapy, please reach out to a licensed mental health professional.

Need to know...

Chapters

• 1:19 Welcome And Core Premise
• 2:29 Coercive Control Causes Brain Injury
• 4:09 Hope And Non-Pathologizing Survivors
• 6:39 Neuroscience, SPECT, And Training
• 9:39 Symptoms Survivors Report
• 12:39 How Chronic Threat Rewires The Brain
• 19:09 Physical Assaults And Head Impacts
• 23:19 Emotional Pain Mirrors Physical Pain
• 26:49 Misdiagnosis And Better Questions
• 30:49 You Can’t Outthink An Injured Brain
• 33:49 Safety, Rest, And Rhythms

Transcript

SPEAKER_00: 0:40

Welcome to Hey Tabby, the podcast where we talk about the hard things out loud with our actual lips. We'll cover all kinds of topics across the mental health spectrum, including how it intersects with the Christian faith. Nothing is off limits here, and we are not take two verses and call me in the morning. I'm Tabitha Westbrook, and I'm a licensed trauma therapist, but I'm not your trauma therapist. I'm an expert in domestic abuse and coercive control and how complex trauma impacts our health and well-being. Our focus here is knowledge and healing. Trauma doesn't have to eat your lunch forever. There is hope. Now, let's get going. Welcome to this week's episode of Hey Tabby. I am so glad that you are here. Today I want to talk about a very important topic. And if you've listened to this show any length of time, you've heard me say at least once that all abuse is physical abuse because unless you can take your brain out of your body and stick it in a jar, then the abuse that you are experiencing or the coercive control that you are experiencing is impacting your brain. So I wanted to take a few minutes today to talk about that exact thing. So we are going to talk about how coercive control actually causes brain injuries. Now, before anybody panics, I just want to remind you that healing is in fact possible. So even if you have a traumatic brain injury due to coercive control, your brain can still heal. So I just want to start with that because I think sometimes when we talk about these things and we don't start with, hey, there is something positive there, we can kind of freak out. Maybe it's just me. Maybe I'm the person that does that. But I just want to throw it out there in case you are a little bit like me. And I don't want to pathologize survivors. This isn't your fault, right? So you never asked for abuse. You never wanted abuse to be part of your story. So there are things that happen that we can't control. So I just want to put that out there. And I'm not labeling any of the survivors that have experienced these things as damaged, right? But we do have to talk about the very real impacts of abuse. And this is really important because a lot of times what I hear from survivors are things like, my pastor said I wasn't hit, so it wasn't that bad. Or I was told that no one could help me, and yet I don't understand why I feel this brain fog or other things. So I want to give some really good information that is born out of research. So a lot of this comes from the neurosciences and the research that we find out there in the neuroscience field. I, if you have not heard, am training to be an Amen Clinic certified clinician, which means I'm learning how to read the brain imaging, the spectrum, which is a type of nuclear medicine that gives you an idea of brain activity and blood flow in the brain. And this is something that I'm really excited about because I think that it has the potential for survivors to have a deeper look at why some of the things are hard for them. Also, a lot of survivors end up sitting across from me, or they're in my DMs saying something like, I feel like I should be better by now. I've been out of this situation, it's not the same, but I'm still struggling. Or I know I'm safe, but my body doesn't believe it yet. Or I just don't think clearly anymore. Something has changed for me, or my memory is awful. I hear that one a lot. Like, I can't remember anything. Now, some of that is a bit of a shift for when we are aging and things like that. So, you know, there are gonna be some differences. You just about who we are and all those things. I know as we get older and if we're a little bit distracted, sometimes we put our keys in the refrigerator and we're like, oh, my keys are in the refridge. There you go. And I'm not talking about things like that. I'm talking about that super persistent type of brain fog and things like that. And it really breaks my heart so often when the survivors that I work with think, I'm broken, I'm just weak, I need to try harder, I'm lazy, I'm not faithful, all of those things, and none of those things are probably true. I think that the issue for some of us might not be that we're not trying hard enough, but that there's actually a brain injury there from what happened. So let's talk about what coercive control actually does. How does it harm us? First of all, it's not just emotional abuse. And if you're not watching me, I just air quoted that. And it's important to understand that by minimizing it, we're not talking about the full complement of how it harms. Not only does it harm our soul, it harms our relationships, it harms our relationship with God, because oftentimes, at least in this community, we know a lot of people have suffered a ton of spiritual abuse along with the other coercive control. It's part of the whole really awful package, if you will. But when you've got that constant monitoring, unpredictable punishment or outbursts or pejorative things done to you, you're always walking on eggshells, you're living in a distorted reality because of gaslighting. There are spoken and unspoken threats, and there's a slow erosion of your autonomy, safety, and your sense of self. That really takes a toll on your brain. So God made us really amazing. We are fearfully and wonderfully made. And our bodies and brains are going to try to survive as best they can. So our brain is going to dump out all of those fight, flight, or freeze chemicals that we know happen. So norepinephrine and adrenaline and cortisol and all of those things just go flooding into our bodies. And when we have high levels of that for a long period of time, we're essentially pickling in our own juices. And our brain isn't designed to live under that kind of pressure long term. In fact, we're going to talk about this in just a minute. The Amen Clinic has coined it emotional concussion because the impact to the brain is the same as if you were a football player and got your bell rung. So we'll get more into that in just a minute. But that is, oh my goodness, scary. So when we have this constant threat and we can't get out of it, and we're living in this constant survival mode, our brain gets stuck in that space and it begins to physically change. And if you have had developmental trauma, so trauma that started in childhood, then that is a lifelong thing. And this isn't just metaphorically, I'm struggling with my brain. Like this is legitimately physical changes. In this growing body of research that the Eamon Clinic shows in SPECT scans, they have the emotional concussion language happening. So when we've got chronic stress, prolonged fear, psychological terror, that sounds a lot like coercive control, doesn't it? And ongoing emotional harm, it really overwhelms our brain's ability to regulate itself. And this doesn't have to be a dramatic incident, although those do happen occasionally. And it doesn't have to have a visible injury. So it's not like you're going to have a black eye necessarily or something when these things take place. And there doesn't even have to be a single moment that you pinpoint that you're like, oh, that was the worst. Right. It's kind of the worst over time. It's that relentless over and over picking at you that is changing the structure of your brain. So when our brains are flooded with those stress hormones, like I said, cortisol, adrenaline, all of those things, the blood flow to certain areas of the brain begins to change. So the parts of your brain that are responsible for focus, emotion regulation, memory, language, decision making, they're not getting what they need to function well. And in these spec scans, you can actually see the way that they're done, where the blood is flowing or not. So when you see a lack of blood flow, it looks like a hole in the SPECT scan. So it looks like your brain with a hole in it. There's not an actual hole there, just so you know, in case you ever go look up a SPECT scan. But what it is is where the blood is just not flowing the way that it should. And then when we look at the areas of activation, we see it in places we wouldn't ordinarily see it. So for example, there's a strong diamond pattern of activity with post-traumatic stress disorder. So when you look at the brain, there's different areas lit up in that from neural activity where they would not otherwise be at rest. So when you're feeling that foggy, numb forgetfulness, exhausted, it's not that you just aren't trying hard enough. It's that your brain is maxed out and is struggling to keep up. And I really want to say this is something that's so important, I think, for us to understand about coercive control is that it causes essentially a mild traumatic brain injury. And now, mild is relative here because it really depends on what happened. So it can be a mild to a severe brain injury when there's coercive control. So let's talk about when there has been some sort of physical assault. So perhaps there has been strangulation, and this often takes place under the guise of sexual activity. Oh, this is what my partner needs to, you know, be able to come to orgasm or what have you. And so they're using strangulation. What it's really communicating to you is I can kill you anytime I want, right? So we know how dangerous strangulation is. If you have ever been in advocacy class that I help teach, then you have heard us talk about that at quite deep length. But any other physical things can also happen. So sometimes we've heard this story where a coercive controller will smack the victim on the back of the head. And it's not hard enough to leave a mark, but it's hard enough to move the brain. Maybe being slammed into a wall. So it's not being full-on punched, but being pushed into a wall or thrown down to the ground or tripped, objects being thrown that hit the person in the head, any type of a fall during an altercation. So even if the coercive controller doesn't outright hit you, but allows you to fall during an altercation or uses their body to move your body to help you fall, those kinds of things can happen. And then, like I said, the smacking on the back of the head or on the sides of the head, repeated minor head impacts. And Dr. Eamon explains this so interestingly. So if you kind of think of your brain itself, right? The noodle in your head, it's like a big soft gray blob, essentially, right? With lots of nerve endings and things like that in it. And the inside of your skull is hard and jagged. And our skulls have to be hard because that's what protects the brain. But when we're having that blob of gray matter sloshing around up in there, then it's hitting the sides of the skull and causing problems. And even in that, again, that's the physical impacts. And it may not look like what we think physical abuse is, but those are physical impacts. And then there are all of the things that are non-physical. So all of those repeated things, our brains, when we look at it, if we were to hook you up to a functional MRI and we were to poke your finger in a way that it hurt, it's going to register pain in your brain. And you're going to see that pain signal. If I hurt your heart in the same way, I hurt you emotionally in the same way, that functional MRI is going to look the same. So we register both physical and emotional pain the same in our brains. And when we have that over time, it changes the size and function of your hippocampus, of your amygdala, of all of these parts in your limbic system. So the back part of your brain, your feli-phely parts, it makes language harder. So in Broco's area, which is the language part that's in the prefrontal cortex of your brain, like up front, it does things to take language away and all of that. So what we see when we look at the scans of survivors are brain injuries that look a lot like you were hit in the head in a football game. And I think that's really important to understand. And this is something, if you have the ability to go and get your brain scanned, I definitely recommend it. It's a very costly procedure, I'll be honest. But if you're able to do that, if you have that sort of resource, it can be really helpful to take a look at what the impacts to your brain have been based on the abuse that you suffered. And so many survivors never get out evaluated. They never get scanned. They never even get asked about head injuries. And they never have a therapist that thinks, hey, maybe we need to talk about this. And I have to say, I'm grateful that in our practice, these are questions that we ask. And we are always thinking about traumatic brain injuries as part of what we do because we do work with so many survivors. But it's so important to really be able to at least understand that. Now, there are a lot of things that you can figure out, even if you can't afford to get a brain scan. That's something that we help people with all the time. That we can say, hey, here's some of your symptoms. It might be something like this. And there are things, again, that we can do to help your brain heal and to have its best chance at healing and getting the blood flow and the activity back in the right places. One of the things that's actually strongly recommended by the A-min Clinic is EMDR. And that is something that we are trained in. So we're trained in both EMDR and brain spotting in our practice because we do know that it works for people. When we also have that emotional and then there is a physical assault, then there is even more chance of a traumatic brain injury occurring for people. And again, this is something survivors don't often think about. They just think, I have this brain fog, I have all these issues, and I don't know what to do with it. So let's talk about some of the common symptoms that are prevalent when you have a mild to severe traumatic brain injury. You have brain fog, you can have memory problems, trouble focusing, difficulty making decisions, emotional volatility. So that's where, you know, it's hard to control your emotions. Regulation is difficult. Emotional numbness, depression that feels super heavy and flat, anxiety that makes you feel like you could like plug yourself in and light up a whole city. You might have sensory overwhelm. So you might have been like me. And when I was younger, bright lights and loud places didn't rattle me, but now they really do. And maybe even extreme fatigue. Now I will say about extreme fatigue, when we get out of a coercively controlling situation, sometimes we notice, especially as we heal, that we are very tired. And some of that is we just weren't able to rest while we were in that situation. So there can be a lot of things, and you really want to have somebody to sit with you and like help you parse all of this out. So we can go, hey, that might be part of this, it might also be part of this, and really help you have a really good recovery plan when you are out of that toxic environment. And what I want to say about all these things, because a lot of these are well, if you just prayed more, fasted more, right? That a lot of times it's like, oh, you just need to fill in the blank more. And it's not always seen as like, hey, this is actually an injury that happened to you in this destructive system. And we want to treat it as such. Survivors are often misdiagnosed, and gosh, we know that. If you've ever taken advocacy class, then you know how often we talk about how survivors are misdiagnosed with borderline personality disorder, bipolar disorder, all kinds of things that are not truths because clinicians don't know what to look for and what questions to ask. But thankfully, I'm seeing that get a bit better, which I appreciate. But goodness gracious, that is still so prevalent. We also see survivors diagnosed with anxiety disorders, depression, ADHD, all kinds of stuff. And we want to ask those deeper questions of what else might have been going on? Is there a history of coercive control? And if so, what did it look like? Or what does it look like if someone comes to us and they're still in that relationship? Is there any ongoing nervous system injuries or possibility for injuries? You know, are you getting smacked in the head a lot? Are you getting pushed? Is there ongoing emotional abuse happening to you? And then we want to look for is there some sort of possibility of a brain injury, whether that's mild, moderate, severe. We really want to look at that. And this is something I just want to say to you. You can't outthink an injured brain, right? We really do need to do some things that help us move toward healing so that we aren't just trying to be on that hamster wheel that isn't going to get us anywhere. And like insight alone is really helpful, but it doesn't repair your brain. And this is one of those things that I think is just really cool that God created in us that we are fearfully and wonderfully made. So neuroplasticity or the ability of our brain to change is a whole thing. And we can actually see that shift. So just because you're like, wow, you've literally just described my entire existence, that does not mean that you cannot heal. And I just want to keep saying that. I know that I've said that a few times, but I think when you're in the thick of it and you're really trying to be in a different place, man, we just do not love pain. Pain is so hard. And we're like, I just want out of this. I never asked for this. I also can't think because my brain isn't braining as well as I would like it to. And it can feel really disheartening, but I want to keep saying over and over, I wouldn't bring this up if we couldn't heal it, right? If we couldn't get to a better place. And does that mean it will be perfect? No, maybe not. Like we live this side of heaven, but it can definitely get better. And I want to just keep encouraging that. So we do want to follow a whole person healing model. So brain health is really overall health if we look at it. We want to not only think about how the brain is being impacted, but also the overall body. And unless you forgot, the brain is in fact a body part. We do need it. It is an organ in the body. We want to care well for our nervous system and our relationships. And we also want to look at the meaning that we're making out of things because that matters as well. But healing starts with safety, both internal and external. We have to have a sense of safety in order to move forward. Now, if you're Like, gosh, I can't get out of my situation. So I don't know how I'm gonna get safety. There are things that you can do that can create as much safety as possible. And again, it won't be perfect, but it can be enough, right? And I think that we don't want to forget that God is with us in it. He's going to give us what we need for it. And that can be potentially getting out of that space, or if we're in it doing the best that we can while we are still in it, if we stay in it. So really getting some of that safety requires slowing down and not pushing harder. And this is so hard for so many of us who are survivors. We're like, let's just do the thing. Give me the thing to do, and I'm gonna go do the thing. And sometimes we have to do the thing, and also then we have to have a nap. And that's completely fine. So we need to find a healthy rhythm. We really want to work on nervous system regulation. So this is all of the grounding things and all of that. If you haven't listened to it lately, we have an entire episode of grounding techniques that you can use, you can practice to help you get back into your body, help that nervous system calm down just a bit. You really want to, if you're gonna be in therapy, have a trauma-informed therapist who actually knows what they're doing, and that they are brain aware, that they are aware that there can be traumatic brain injury here and that they're gonna help you walk through that. We always recommend a medical evaluation where you can get it. Again, if you can get yourself a spec scan at one of the A-min clinics, I highly recommend it. If there's a way for you to pull that off, I definitely recommend it. If we make the referral for you, you do get a small discount. It's still a lot of money to do it. But if you would like me to make that referral on your behalf, shoot me a message. I'm happy to make that referral so you at least get a little bit of money off of it. And you really want to have compassion for your limits. We have talked so much on this podcast about being gracious to you, having an invitational posture toward yourself. We have an entire episode on self-compassion and why it's important and how to walk in that space. And so we really also want to start there. When we have self-compassion, it does open us up to receive more healing because we're not striving, right? We're not continuing those patterns with our brain that make it so difficult. And I want to remind you, especially if rest was weaponized for you, that is not avoidance. Real rest is treatment, it helps us heal. Remember that the Sabbath was made for man and not man for the Sabbath. And that means that God knew you need to have a nap and a snack, just like Elijah did. And so he gave us a whole day for it. In fact, it's in his top 10 lists of rules, right? In the Ten Commandments, remember the Sabbath day and keep it holy. What that means is to take that break, to remember that we are finite and that we need rest. And look, I am preaching to myself here. This is an area that I inherently struggle with. I am a doer by nature. I am definitely a driven individual. And I really have to remember how badly my brain and body need to rest. And so that's something that I am telling myself as I tell you that this is something that we need to remember that rest is holy. And it was created by God who knows what we are made of and knows our frame. So healing isn't forcing forgiveness or just letting it go or shaming yourself for maybe being reactive or feeling anxious. I remember a long time ago, a therapist told me that there is no such thing as an overreaction. There's just a reaction. We just have to figure out why the feelings were big. And I love that because it takes all of that shenanigans that we get sometimes about, oh, your emotions are too big, and says, Well, no, let's look at why they're big and maybe let's regulate them. But they're trying to tell us something. So let's ask the question what are we being told? We also don't want to push exposure to things or push new things until our nervous system is ready. If you've ever done EMDR therapy, you might be like, Why are we still learning grounding things? Like, I just want to do the tappy tappy reprocess y things. And I hear you. But unless your nervous system is ready for that and ready for the true reprocessing and getting into the trauma, it's not going to be good for you. I have done a lot of what I call EMDR cleanup on clients who they had a therapist that went too fast and outpaced their nervous system. And it was really detrimental. And so we want you to have that gentle, safe place to land when we are doing that deep reprocessing. And so there is a lot of grounding, a lot of regulation that we teach to help you have exactly that. And we certainly do not want to spiritually bypass. Well, God says, do not fear. So why are you anxious? Well, I mean, if you have been living with a bear for 25 years, feeling fear is actually pretty helpful, I would think. And so we don't want to spiritually bypass ourselves and say we're just not being faithful or we're not doing enough or whatever it is. When we walk in a rhythm of healing, we are honoring consent. We are honoring our choices, we are honoring capacity, and we're honoring God's timing. And again, I would love to say that this is, you know, take two verses and call me in the morning, or a checkbox here or there. We do these three things and then we're golden. And unfortunately, that is just not how healing works most of the time. And that can be a really tough situation. And I want to say also that this isn't a spiritual failure, right? I think sometimes that we can get into that and we don't realize that we are actually spiritually bypassing ourselves because we got used to that. So we want to lean into a healthier rhythm for things. We definitely want to get good medical care. There are supplements that can help it with brain function. You know, I think you've probably heard about omega-3 fatty acids and things like that, fish oil pills and whatnot. Those can help with brain and help do all these things. So definitely speaking with a really good doctor or functional medicine doctor to talk about like, hey, are there things I can do from this perspective? Walking and exercising is so helpful for getting blood flow throughout the body, including, you guessed it, our brains. And a lot of times we struggle with healthy levels of exercise, whether that is I don't do enough or I do too much. So high-intensity exercise can also be unhelpful in helping our brains, and we can do more damage than we realize and we don't realize we're doing that. So you really want to at least get a good baseline with people that know what they're talking about. This is why we do our best to have a team approach when we're working with someone. So if there's a chiropractor and a functional med doc and us, and maybe a yoga therapist or, you know, a massage therapist, we want to be talking with everybody so that we can say, hey, what are you seeing? What are you seeing? and make sure that we are tailoring treatment for the client that's in front of us. Not for the client on a piece of paper in a textbook, but the real living, breathing image bearer of the living God that is in front of us, we want to know what will help you best. And good teammates are gonna do that with you. As we land the plane today, I want to say that this is something that we need to think about. If you're a therapist listening to this, I really encourage you to get educated on traumatic brain injury and emotional concussions. There are some great articles out there about it and looking at those things so that you can best help your clients. If you are a survivor and you're like, wow, this makes things make sense. I would encourage you also get some evaluations if you can, talk to your therapist or your coach about these things and say, oh my gosh, like I learned this on this podcast. Could we talk about it? I have some questions, and see what kind of treatment plan you can come up with with your team to help you have the best functioning brain possible. Not only is healing good for our bodies and our souls, but also for our minds, right? For all of our body parts, all of our neurology, all of our physiology and our spirit, healing is good. And just a reminder that God knows and he wants to heal you. I think sometimes when we're survivors, one of the things that we say to ourselves is, I know God can, but does he want to? And the answer is he does. And again, it may not be where we hope to be this side of heaven, but I will say that God is going to intervene and that our brains can, in fact, heal. And I want to say it again, now that I've given you the neuroscience evidence of it, that all abuse is physical abuse, even if you can't see bruises, even if you don't have any other broken bones or anything like that, because the brain is being negatively impacted in coercive control. And unless you can take your brain out of your body and stick it in a jar, it is a a body part, a physical body part, and B, it is being harmed by the dynamics of coercive control and the complex trauma that it creates. So I hope that this episode has been helpful for you. I hope this maybe put words to something that you felt but couldn't quite explain. And I just want to remind you that healing is possible and God wants to do that. And I'm so glad that you have been here with me this week on Hey Tabby. Don't forget to like and subscribe. If you haven't, please leave a review on your favorite podcast platform. And we'll see you again next time. Thanks for joining me for today's episode of Hey Tabby. If you're looking for a resource that I mentioned in the show and you want to check out the show notes, head on over to tabithawestbrook.com forward slash hey tabby. That's H-E-Y-T-A-V-I, and you can grab it there. I look forward to seeing you next time.