Magazine article Clinical Psychiatry News

A Recent Paper Suggests That Violence Must Be Approached Multidimensionally. How Can Violence Be Conceptualized in a Way That Allows Us to Improve the Lives of Patients?

Magazine article Clinical Psychiatry News

A Recent Paper Suggests That Violence Must Be Approached Multidimensionally. How Can Violence Be Conceptualized in a Way That Allows Us to Improve the Lives of Patients?

Article excerpt

In the paper, Dr. Jessica Yakeley and J. Reid Meloy, Ph.D., argue that we should try to avoid using a single framework to explain why people kill, hurt others, or undermine the integrity of other human beings--and I think they're right. For many of us, it is easier to choose a conceptual framework, and view all violence and aggression through a single lens. But this would be a mistake.

The authors attempt to be comprehensive in their analysis of the origins of aggressive and violent behavior. For example, they discuss attachment theory as a major underlying factor in the expression of violence. And in fact, it is. The role of the mother in the preoedipal development of the child who becomes a killer or a predator is important. The mother who is unable to love her child and create a rich bond leaves the child vulnerable, and he or she becomes aggressive as a teenager or young adult. They never learn empathy.

Having been loved is an essential for someone to be able to empathize with another human being and to feel what the other person feels. I have taught and expressed the idea that trying to understand the violent person requires knowledge of their growing up, childhood experiences, and that hatred of parents who mistreat, undermine, and teach them to feel worthless is an important factor in the development of a violent person.

But as Dr. Yakeley and Dr. Meloy point out, the person's relationship with the father also might have a role in the development of violence. "Many violent individuals ... have histories of absent, abusive, or emotionally unavailable fathers, and the resulting lack of an adequate paternal introject, or at best a positive identification, renders the person perpetually trapped in a dyadic relationship with the mother where there is no possibility of another/third perspective" (Aggress. Violent Behav. 2012;17:229-39).

We know from the work of Dr. Vincent J. Felitti and his colleagues in the adverse childhood experiences or ACEs study that these experiences contribute greatly to the development of an aggressive child. In particular, witnessing domestic violence and cruel punishments are all factors in the kinds of fantasies that push a child in the direction of aggression.

When it comes to terrorists, the authors argue, "the homicidal superego demands are often manifest in several accelerating and evolving mental states." They go on to quote Dr. Meloy, who elaborated on this idea in an article he wrote a few years ago on the "violent true believer": "Within this identification arose a totalitarian state of mind in which omnipotence was idealized, intolerance of difference was magnified, hatred was exemplified, paranoia was rampant, and the entitlement to kill those who do not believe was embraced" (J. Pers. Assess. 2004;82:138-46).

The authors argue that within psychoanalytic theory and among practitioners, an appreciation for the heterogeneity of violent acts has been largely missing. "Most salient is the absence of an understanding that certain violent acts are neither anxiety- nor affect-based, but usually related to specific character pathologies, have relatively distinctive neurobiological underpinnings, and deserve psychoanalytic understanding."

They go on to discuss the different types of violence--for example, predatory and affective. …

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