The Effects of TBI and CTE Part 2

Chronic traumatic encephalopathy [CTE] is a progressive neurodegenerative dementia due to the cumulative effects of repeated TBI’s. A professional football player could have over 22 years of playing time, beginning with Pee Wee or Pop Warner, while ending in the NFL. It’s not clear why some players developed CTE and others did not. Unfortunately, there’s no treatment that stops or cures CTE. CTE progresses in 3 stages and becomes more severe with increasing age. CTE Individuals can develop ALS, dementia, Alzheimer’s and premature death. It was estimated that NFL players can receive 90 to 1500 blows to the head during a single season. Recently, Junior Seau of the San Diego Chargers made the news with his suicide. Former broadcaster Frank Gifford had a CTE pathology at autopsy. Currently, Tony Dorsett, Football Hall of Fame, suffers memory loss and other TBI symptoms. Moreover, the symptoms of PTSD and CTE overlap. As reported, some of the combat veterans diagnosed with PTSD may actually have CTE as well. Although our brain weighs about 3 pounds, this powerful computer mechanism interacts with perception, thinking, attention, emotions, and memory while influencing and directing behavior .This process becomes known as personality. A person with a brain injury, has severely impaired habits. What happens between the person and the environment after the injury is classified as a biopsychosocial model. The entire patient history should be considered when determining the overall impact/ recovery from TBI. By definition, a TBI is related to behavior. We may be walking under a tree when a pinecone drops and hits us in the head. We may be driving our car and have it collide with a deer or another vehicle. We may have been shook and hit by a parent or caretaker at a young age. Child abuse with children under four years of age are at the highest levels of TBI for that classification. We may enter and take a high risk physical job, choose not to wear a car seatbelt or protective helmet. At a young age, we may choose to play a high risk contact sport like football. As a high school graduate, we may even decide to enter the service to protect our country or give some other rationalization. Yes, experiencing a TBI is much too common. In conclusion, man is a dangerous {homicidal, sadistic, abasement, and suicidal driven} animal and has difficulty protecting himself from harm or injury. My friend, an All-American, all NFL Pro, with the Cleveland Browns and is a member of their Hall of Fame, played football for 22 years. Among many other things, he said “My memory is not as good as it used to be;” and “I would do it all over again.”

The Effects of TBI and CTE

Last week I attended a continuing education class titled “Brain Trauma, Concussion and Dementia.” This class was timely, interesting, challenging, scary, and detailed. Briefly, the following consists of information that I found relevant. 1. Traumatic brain injury [TB I] was defined as an alteration in brain function, or other evidence of brain pathology, caused by external force. 2. TBI is a major cause of death and disability in persons between ages 1 to 44. 3. Adults over 65 are in the highest risk category for TBI, but the age groups 5 to 9 and 15 to 24 are also high 4. Yearly economic cost of TBI has been estimated at $40-$60 billion a year. 5. Most common causes of civilian hospitalization for TBI’s, in the US, are falls; followed by motor vehicle accidents; followed by being struck by/against and then assaults. TBI results in a wide array of mental, emotional and physical deficits .It is not limited to the effects from injury to the frontal lobes .The frontal lobe area of the brain may present the greatest psychosocial impairments and most significant barriers to recovery .Injury to the frontal lobe results in a cluster of deficits in three major areas of functioning :Cognitive [short attention span, poor short term working memory, difficulty in planning and organization, problems in reasoning, abstract thinking, poor impulse control and social judgment, lack of empathy and impairment in understanding how other people think]. Emotional [angry outbursts, overly excitement, prolonged sadness, clinical depression, lack of fear in threatening situations and exaggerated fear in other situations]. Behavioral [compulsive behavior and lack of recognition of consequences, inability to respond to social cues with inappropriate social behavior, inappropriate aggression, out of context sense of humor, exaggerated laughing, exaggerated inappropriate sexual behavior, and the telling of pointless and boring stories]. These three areas are called the Frontal Lobe Syndrome. Two populations of TBI diagnosis come to mind- military service and sports. For the military service, blast {bomb} related TBI’s are a major concern. There were close to 28,000 medically diagnosed TBI’s battle related and non-battle related incidents in 2009 alone. The Department of Veterans Affairs reported that over 7% of veterans presenting for care had TBI with persisting symptoms. Can you imagine a Navy Seal, on a special assignment, with a TBI diagnosis? With a Frontal Lobe Syndrome, you are a danger to yourself, as well as a danger to your buddies. How many military suicides had an underlying TBI diagnosis? Being exposed to an explosion, now days, is much more dangerous and frequent than being shot. In one Marines study, in 2008, the ratio was 97, compared to 3%. Athletes in contact sports like football, rugby, ice hockey, baseball and softball are also have an increased risk of TBI. It has been estimated that 1.6 to 3.8 million individuals have sports related mild and moderate TBI’s, in the US, every year. Children under age 15 have twice as many TBI’s from sports as from auto accidents. Boxers and riders in equestrian events also have an especially high TBI risk. In sports, the greatest TBI risk, however, is for football players. The statistics suggest that 20% of high school football players and 40% of college football players have sustained TBI injuries. Unfortunately, a football helmet does not prevent a concussion To Be Continued

The Epidemic of Violence

In conclusion, it’s difficult to fully understand or even predict violent behavior of an individual with this personality, character trait. There are no simple answers. We can never fully understand unless we have insight into one’s genetic constitutional dispositions, traumatic brain injury [TBI], chronic traumatic encephalopathy [CTE] and health history, idiosyncrasies of family life, social, economic class status, religious, philosophical and moral traditions, urban, rural background within the spirit and philosophy of the culture, etc. Without fully integrating information from a broad spectrum, we have little understanding why certain traits become so persistent and deep-seated in that individual. Yes, it’s a difficult problem to figure out, but it can be done. The divisive numbing news cycle, after the fact, provide little in the understanding of the daily visual horrors. Name, age, ethnic background, marital status, employment, input from neighbors are merely statistics that do not tell the real story. The so-called experts, paraded on television, fill up airtime with banal words, speculating, lying, while making numerous assumptions. Everyone seems proficient at raising questions while employing fear. Further, throwing money at education, travel restrictions, more police and additional Internet surveillance are superficial and impotent measures at best. Our countries political system is toxic. Mention Republican, Democrat, conservative, liberal and negative emotions surface. Our economic wealth disparity continues to grow between the haves and have-nots. This generates negative emotion like anger. To experience sadistic trash, hate, lying, and fake information, visit social media. Cable news provides loud dribble, lack of depth, and repeats the same tune over and over. It’s almost like brainwashing. We do not hear much from our religious leaders regarding humanistic change. Instead, we are exposed to the religious zealots promoting irrationality, fear, lies and hate. At the moment, I’m not optimistic about the enormous sadistic, hateful life thwarting epidemic going on in our society. It seems like it’s increasing without enough diversions. However, I am not going out and buying a gun because that is irrational and it is not a solution.

The Epidemic of Violence Part 5

These exploitive sadistic killers can be described as having some of the following character traits. Character can be defined as a developed energy force .It’s the result of the unconscious conflict between “desire” and impulse and the forces or barriers {within the environment} interfering in getting what we want. These interacting forces include but are not limited to a life thwarting society, a hateful culture, socioeconomic poverty, authoritarian political, punitive governmental law and order, irrational , prejudicial educational teachings, discriminating economic institutions, and stressful anxiety threatening social upbringings as well. People are bombarded with economic and social inequalities, prejudice, and alienation models that depict the dehumanization of man on many fronts. There are many restrictions and controls that impinge upon us. We know, for example that the baby’s brain does not develop optimally without proper nourishment, warmth, touch, safety and freedom of movement. In other words, from the beginning, our lives can be readily compromised. A true malignant {there are degrees} sadistic character experiences some form of psychic pleasure in the killing, maiming, humiliating and torturing process. The impulse to inflict excruciating pain and destruction on another provides a sense of omnipotence, absolute control and power irrespective of whether or not it is achieved in hand-to-hand combat or on a helpless, unarmed opponent. There are no moral questions regarding morality, only the impulse and the irrationality of the act. The malignant’s internal conflicts, disappointments, emptiness, underlining impotence, are symbolically acted out in violence. One decapitates a head a as if it were a venomous snake. This individual type is actually fearful and has difficulty standing alone, weaponless on his two feet. Hate and human destructiveness over others are risked over one’s self-interest or self-preservation. The expression live by the sword, die by the sword fits here. Dying and/or self-destruction is more than likely the end result. If this path is followed, can the need, or drive for killing ever be satisfied? The passion or motivating force for destroying life is greater than the passion for living a humanistic way of life .Sad, but true. To Be Continued

The Epidemic of Violence Part 4

Aggression can be protective. It can be accidental like when the firing of a gun accidentally hurts or kills another. Sports has many examples of playful aggression or aggressiveness. Normally, the aim of playful aggression, in sports, is the exercise or mastery of the skill. It’s more often than not, not aimed at destruction nor motivated by hate. Athletes, as a rule, have a mutuality of respect for the other. Thank goodness for that because the game of football would be very different if played by slaves during Roman times. Self-assertiveness, can be expressed verbally. Using self-assertiveness as a means of communication, the individual can express his desires in a clear and non- ambiguous manner. Yes, non-hateful, positive aggressive communication has its place, especially within our competitive social economic capitalistic system. Often, however, we fail to witness appropriate self-assertive communication. Partly because of the senders inability or inexperience and the fact that an underlying emotion was present. When negative emotion is involved, communication becomes a trigger for oral aggression. Once it starts, it is difficult to stop that aggressive behavior. Let’s turn to another form of aggression. Survival of fittest may mean many things, and it may be in play here. On a side note, the primitive hunters in Prehistoric times, did not have a dental makeup associated with being carnivores or meat eaters. Anthropologists with tools of excavation and other means postulated that our ancestor’s diets were made up of 75 to 80% vegetarian [seeds, fruits, etc.]. Gathering food was easier back then and safer than hunting for it. Once we developed tools that changed. Aggression can be considered defensive as in fighting for freedom. Spartacus comes to mind. Roman slaves became gladiators as a form of entertainment, degradation and modeled their insignificance of being human. They were property. This Roman model demonstrated the overwhelming control and power of the sadistic behavior of the Roman master over the slave gladiator. Motivated in part for revenge and freedom, Spartacus and his fellow gladiators killed their captives and went on to war against the Roman legions. In essence, fighting for freedom resulted in more deaths, hate and sadistic vengeance against fellow man. To Be Continued

The Epidemic of Violence Part 3

Albert Bandera, a behaviorist, demonstrated the significance of modeling and/or imitation in explaining aggressive responses. For example, preschool children, in experimentation, were exposed to real life, fantasy movies or television models exhibiting aggressive behavior. Two groups of non-frustrated, nonaggressive preschool children, then observed a live adult model acting aggressively toward dolls in the experimental room. 90% of the children, in the experimental group, imitated the aggressive responses of the model, while none in the control group displayed such behavior. Remember, that an aggressive model’s behavior can and does generalize to other settings, situations and interactions. Just think of all the models of violence that are displayed over and over again in our movies, TV and video games. Not only are we learning about violent behavior and death, we are also viewing the disrespect between human beings. It’s okay to kill the” bad” guy, irrespective of the reason. Bad guys are dressed in black. Are there any of us who have not witnessed either a verbal and/or physical aggressive interaction between adults or parents? Are there any of us who have not witnessed an individual being yelled at or physically hit? Are there any parents who have not yelled, spanked, shook, or pinched their infant or child? We have witnessed over and over again plenty of models that have exhibited inappropriate aggressive behavior. Why do people demonstrate so much aggression and why is there an absence of love thy neighbor? Very early in the life of an infant, about six months, it has been was shown that parts of the baby’s brain [amygdala, hypothalamus] becomes activated in the presence of a stranger. It’s as if there’s an activating as well as a deactivating or inhibiting switch mechanism. When activated, the newborn cries. Crying is the infant’s self-protection or self-preservation mode of response. Obviously, it’s one mechanism available at that early age. Is crying an aggressive response? It can be more easily argued that excessive biting behavior in the infant is aggressive. Just ask a nursing mother. This biting behavior, in this developmental phase, is called h oral sadistic. Looking at animal behavior, as with a deer, the animal could fight, flight or freeze. Just today, I encountered a deer and her two offspring’s. The mother obviously was not going to fight. The three of them froze which is generally the behavioral response I find when I’m running on the trail. To Be Continued

The Epidemic of Violence Part 2

Although not a neo –Freudian, Henry A Murray postulated a number of human needs within his theoretical framework. Included in Murray’s list of needs were aggression and abasement. He defined aggression: to fight; to revenge an injury; to attack or kill another; to punish another etc.. Another related need was called abasement: to accept injury; mutilate the self; seek and enjoy pain, and punishment; to incorporate aggression directed towards self. Murray believed that needs were hypothetical .Further, a need was related to an underlying physiological process in the brain; and the expression of a particular emotion or affect. Moreover, various circumstances bring about or initiate this hypothetical construct. Thus, with Murray, we know that needs are related to goals that are affected by various conditions within the environment. To account for aggression as being exclusively molded by the influence of the environment, behaviorism took the mantle. In this view, man was supposed to have been born good and rational; but only under bad institutions and bad education, that he developed evil strivings. The notion of unconscious, ego, mind, will, and character etc. were extraneous and not needed to account or explain man’s behavior. A giant within this school of thought, BF Skinner postulated R-S [with R being the response and S being the reinforcing stimulus]. With his experiments, he demonstrated that with the proper use of a positive reinforcement [Pleasure] ratio, animal and human behavior could be significantly altered. If an apparent reward didn’t influence or modify behavior, then it was not seen as a reinforcement. When a reinforcement worked, it changed behavior. This school of thought believed that reward was superior and more effective than punishment .Punishment didn’t change the response, it only inhibited the response when the punisher was present. The negative behavior would surface when the punisher was absent, or out of sight. My Border collie is a good example of the efficiency of positive reinforcement. This young dog responds by licking my face, laying at my feet and wagging her tail when verbally praised. Verbal praise works terrifically in modifying and reinforcing the behavior that I want. She has never been slapped or hit. In my opinion, she’s a sweet and loving dog. To Be Continued