Coercive Control in the Context of Acquired Brain Injury

1. Introduction: Defining the Dual Vulnerability

This analysis examines the intersection of coercive control and Acquired Brain Injury (ABI) within the framework of English mental capacity law. When these two domains converge, they create a distinctive and profound vulnerability: one that challenges individuals, families, and the courts. Understanding the problem requires clarity about the component parts.

Coercive control is a sustained pattern of behaviour designed to dismantle a person’s autonomy. It involves manipulation, isolation, intimidation, and psychological dominance, not as discrete acts but as an organised campaign. Its defining impact is the erosion of independent will; decisions cease to reflect genuine wishes because they arise from fear, dependency, or pressure.

An Acquired Brain Injury, meanwhile, can disrupt executive function, memory, social cognition, and judgment. These impairments may fluctuate, creating variability in capacity and complicating any assessment of a person’s ability to make specific decisions.

The combination is perilous. ABI-related cognitive deficits heighten susceptibility to coercive tactics. Individuals may struggle to detect manipulation, resist pressure, or appreciate risk. Influencers may exploit memory impairment, disinhibition, or reduced problem-solving skills to consolidate control. For the Court of Protection, the challenge is to protect vulnerable adults from hidden coercion while preserving their right to make private, and even unwise, choices. The Mental Capacity Act 2005 (MCA) provides the legal structure for navigating this tension.

2. Coercive Control: A Pattern That Undermines Autonomy

Before turning to the legal framework, it is necessary to define coercive control with precision. Both the Court of Protection and the Family Court increasingly recognise coercive control as one of the most insidious threats to autonomous decision-making, often sitting alongside undue influence and duress but distinct in its persistence and breadth.

Coercive control is a pattern, not an event. It systematically infiltrates the psychological, social, and practical aspects of everyday life, with the single aim of subjugating a person’s will.

2.1 Core Features and Legal Characterisation

Coercive control is commonly defined by three elements:

• Sustained behavioural pattern: Repetition and continuity are essential features; isolated acts cannot capture its true nature.
• Beyond classic coercion: The behaviour often does not rely on explicit threats; instead, it operates through engineered dependency, emotional manipulation, and environmental restriction.
• Legally recognised harm: Its identification as a distinct form of domestic abuse strengthens its relevance under the MCA, which is designed to safeguard the very autonomy coercive control erodes.

2.2 How Coercive Control Manifests

The pattern can adopt many forms in both intimate and familial settings:

• Psychological manipulation: Belittling, gaslighting, and emotional destabilisation undermine confidence and suppress dissent.
• Social and financial restriction: Limiting contact with others, controlling money, obstructing access to information or services.
• Abuse within intimate or family relationships: Familiarity and proximity provide a platform for exerting dominance around care, contact, or daily decisions.
• Forced marriage: A stark example of coercive family pressure overriding personal will.
• Weaponising legal processes: Repeated, meritless applications used strategically to create pressure, maintain control, or punish non-compliance.

2.3 Implications for Mental Capacity Assessment

Coercive control complicates capacity assessment in three ways:

1. It distorts the decision-making process, even when cognitive ability appears intact.
2. It creates a situation in which the person’s apparently expressed wishes may not be authentic.
3. It requires the court to look beyond cognitive function and scrutinise whether the person can act on their understanding.

Protective interventions, including restrictions on contact, residence decisions, and Forced Marriage Protection Orders, are deployed to create space for authentic choice.

3. The Legal Framework: The Mental Capacity Act and the Court of Protection

The MCA 2005 governs decision-making on behalf of adults who may lack capacity. Its core principles anchor all judicial reasoning:

• Presumption of capacity: Capacity cannot be removed simply because a decision seems unwise.
• Decision-specific and time-specific assessment: Essential given the fluctuating profile of many ABIs.
• Best interests: Decisions must reflect the person’s values, wishes, and beliefs.
• Least restrictive option: Any intervention must intrude as little as possible on personal liberty.

The Court of Protection applies these principles while addressing coercion, undue influence, and safeguarding concerns. Its task is to determine whether a person’s decisions genuinely reflect their own will, or whether that will has been overridden.

4. Case Studies: Coercive Control in the Context of ABI

Judicial decisions illustrate how coercive control manifests in ABI and how the courts respond.

4.1 Re BU [2021] EWCOP 54

BU, a woman with vascular dementia, was allegedly subjected to coercive control by NC.

• Relational manipulation and isolation: The court examined whether her expressed wishes, particularly regarding contact with family, reflected her long-held values or were products of dependency.
• Financial vulnerability: Cognitive impairment increased susceptibility to financial exploitation, prompting scrutiny of her property and affairs.

4.2 London Borough of Croydon v KR & Anor [2019] EWHC 2498 (Fam)

KR, a man with a traumatic brain injury, was allegedly being subjected to coercive behaviour within his marital relationship.

• Residence and care as tools of control: The question of whether the couple should live together hinged on concerns about undue influence and domestic abuse.
• Blurring of caregiving and coercion: Dependency for care created a power imbalance that required judicial intervention.

4.3 MB v PB [2022] EWCOP 14

PB suffered a severe brain haemorrhage with substantial cognitive impairment.

• Implicit control: Restrictions on her husband’s contact reflected recognition that dominance can operate without explicit threats.
• Protective separation: The court prioritised PB’s emotional stability and decision-making environment.

5. The Court’s Response: Safeguarding Individuals with ABI

Two broad judicial responses emerge.

5.1 Capacity Assessment in the Shadow of Coercion

Coercive control forces the court to go beyond the standard functional test. It must ask not only can the person understand, retain, weigh, and communicate, but is the decision truly theirs?

Cases such as Re BU and Hull City Council v KF [2022] EWCOP 33 illustrate how the court evaluates context, influence, and the authenticity of expressed wishes.

5.2 Protective Orders

Where control is identified, the court uses tailored orders:

• Contact restrictions: As in MB v PB, prohibiting harmful influences from engaging with the vulnerable person.
• Residence orders: As in Croydon v KR, separating the individual from a coercive partner when risk is high.
• Other safeguarding measures: Including FMPOs (Forced Marriage Protection Orders) and wider family-law-based protections where relevant.

These orders are designed to reduce coercive influence and create conditions for authentic choice.

6. Conclusion: Balancing Protection and Autonomy

Individuals with an Acquired Brain Injury face a unique vulnerability to coercive control. Cognitive impairment can be exploited, resulting in decisions that do not reflect authentic autonomy. The Court of Protection, through the MCA 2005, carries the responsibility of navigating this terrain: identifying exploitation, disentangling authentic wishes from imposed ones, and protecting individuals without unnecessarily restricting their liberty.

The central challenge remains constant: determining when the state must intervene to disrupt coercion, and when it must step back to allow a person to exercise their right to make private, personal, and even unwise choices. This balance lies at the heart of mental capacity jurisprudence and reflects the courts’ commitment to both safeguarding and dignity.