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Responding to Violence, Suicide, Psychosis and Trauma

The Dangerous Behaviour Masterclass 3 – Mapping Violence

Sorry for the delay. In the last Masterclass a distinction was made between Difficult and Dangerous behaviour. We have to go into this in greater depth, but at this point in the Masterclass we are simply in the process of mapping out the terrain and identifying important processes and principles. In this mapping process, one dimension can be “dangerousness” while another might be “form.” There are some others, but at this stage let’s just think one step ahead. “Form” describes the type of behaviours involved.

Typically on training courses participants express a concern about a form of behaviour or type of person(s). “What if they are drunk”, “I deal with addicts”, ” I’m really concerned about a stalker”, “Well that’s okay, but what if you’re surrounded by a gang of thugs”, “I can deal with most situations, but what if they are completely crazy?”, “What if someone is completely on a mission to do you some harm?” – and then the additional concern “What if I lose it (panic, freeze, react inappropriately, lose control of myself)?”

All these situations, and more will be dealt with in this Masterclass. Here we will briefly consider “Form” or the perceived type of behaviour with which we might be confronted. I say “perceived” because there is an extremely complex interplay between what goes on in the minds of the protagonists during a conflictual situation – again an issue to which we return.

If Difficult-Dangerous is the “depth” dimension, then what is the breadth? This is the more common arena for academics and there are many formulations to choose from. I choose to go my own way, not out of arrogance but because I arrive at the situation from a different position. I want to know what to do when confronted with all these frightening situations not just to explain them.

For this reason, I see violence as something in motion, and therefore something must be pushing it forward. What could be these “forces?” None of us would worry if they were were static – I could be supremely confident if I knew the person in front of me wouldn’t hit me. The next question, obviously, is then what pushes the behaviour into violence. I have thought about this – motives, drivers, incentives, urges, impulses – actually, in most cases we will never know.

None-the-less, in-practice, it turns out to be very helpful to be able to assess what is driving the aggressor’s behaviour – but a different language is necessary. Here I am suggesting that we label aberrant behaviour as either: Dysphoric, Psychotic or Psychopathic. These are not mutually exclusive – obviously someone could, for example, be impassioned through a delusional belief system. The important practical question is – what is is driving the behaviour? If, somehow, we could remove the driving force, perhaps the behaviour would lessen?

These driving forces, I have briefly described below (their intricacies we will explore later)

This is the most common form most people will encounter. It is fueled or driven by emotion (usually unpleasant and several). It happens because the principal prontagonistics are overcomed by anger, frustration, humiliation, annoyance, irritation, euphoria, etc – and these overide thoughts or other considerations.
Mental health issues affect one in four of us. It is important to notice also that 80% of violent crime is perpetrated by people with no psychiatric history – alcohol is by far the best predictor of violence. Most psychiatric patients are more worried about what others may do to them than what they may do to others. None-the-less, violence does occur when people become disturbed though drugs, severe intoxication or florid psychosis – and here it is often the fear of the unknown rather than the actual danger that fuels our concerns. The driving factors are confusion, delirium, delusions, hallucinations. Each may be associated by terrifying and potentially violent outcomes, but the question we have to ask is “what is the driving force?” For example, what would be most effective – dealing with the “voices” or reducing the anxiety?
This is behaviour primarily driven by a goal which in the perpetrator’s mind supercedes all other consequences. Often professional criminal activity is ascribed to this grouping. It is important to understand that we are not talking categories of people here, only of behaviour. I don’t suspect that Wayne Rooney considers the feelings of the opposition’s goalie as he slams the ball into the net! This behaviour is primarily predatory but could equally apply to white collar business people and not involve any interpersonal violence.

There is still much more to know! In the next Masterclass we will explore the relation between Dissociation and Violence, and then following that Violence, Dissociation and the Brain. Then we can begin to put the whole picture together again and describe, in detail, good effective practice in violent dyadic situations. From there we will consider issues such as gang/group/ violence, bullying, crisis teamwork skills, personal control issues, post-incident reactions and support – interspersed with with anything interesting and relevant I can throw at you!

Hasta la vista!
Dr Iain Bourne
IMPACT Training & Consultation Ltd

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