walkitout (walkitout) wrote,
walkitout
walkitout

A Few Remarks about Domestic Violence

So, that’s been in the news again.

Someone who I have a lot of respect for argued that just kicking people out of a group/firing them/wtf for engaging in domestic violence does little or nothing to solve the problem. They need help; we should get them that help.

My immediate reaction was: we don’t know _how_ to help people who resort to violence against the people they live with and love. We’ve been trying for a while now, and it is not obvious that we are getting better at it. Our best solution is to help the person or people who are most likely to suffer severe injury or death at the hands of a batterer to get away from that person and make a new, separate and hopefully better life elsewhere.

But then I thought, hey, I’ve had that opinion for a while now, and years have gone by and new things (presumably) have been thought of and tried. Maybe I should do a little research. Here are some things I found.

Here is the most common model of treatment (?) mandated by jurisdictions around the country when a batterer encounters the criminal justice system.

http://en.wikipedia.org/wiki/Duluth_model

We are attaining consensus that this model does not work.

Other than “it’s the patriarchy, stupid”, other theories for why people beat up those they live with include substance abuse, attachment problems, personality disorders and the horrible childhood experiences that lead to the aforementioned.

Here’s an example of the personality disorder theory (specifically BPD, but you can find similar research for narcissistic personality disorder, antisocial, etc. DSM V has rewritten personality disorders to capture the idea that there are some traits characteristic of all personality disorders, and then after that, there is huge variation. That’s worth remembering):

http://www.medscape.com/viewarticle/778969

People who meet the criteria for Borderline Personality Disorder are more likely than people who don’t to say they have done things we typically characterize as domestic violence. This makes sense; the criteria includes inappropriate and intense anger or difficulty controlling anger and physical fights. Sort of a duh thing, actually, yet still somehow invisible for a long time, probably because we were busy thinking of the perpetrators of domestic violence as Bad Guys as opposed to mentally ill.

Here’s a chilling paragraph:

"The findings of this investigation indicate that when treating individuals with BPD, it appears clinically relevant to assess not only self-directed aggressive behavior but also externalized aggressive behaviors. These externalized aggressive behaviors may connect with various medical and legal issues that need to be taken into account during treatment, either medical or psychiatric. They also may be an indirect indication of an individual's ability to tolerate stress in a treatment relationship and thereby may indicate any potential risk of danger to the clinician.”

Violence against clinicians is a real thing. A real real real thing. When we suggest that people who commit violent crimes should be helped, we probably should reflect on the cost and risk to the people assigned to deliver that help.

Which brings me to the next part of my exploration. How does domestic violence interact with attachment problems?

That is a bit of a rat hole. The existing programs to rehabilitate batterers who come in contact with the criminal justice system have statutory or regulatory requirements to adhere to one of a short list of approaches. None of those approaches are attachment oriented, and they also don’t do a great job of sorting batterers by type. And type of batterer appears to be real. There are a bunch of people working on attachment and domestic violence, both as a way to understand why it is so difficult to end relationships that are incredibly dangerous to one or more parties, and also as a way to understand why batterers do what they do.

This article displays one of the major problems with using attachment theory as part of a therapeutic process:

http://www.academia.edu/1479492/Domestic_violence_revisited_the_application_of_attachment_theory

They picked a fundamentally “easy” case: a single instance of domestic violence and, at least as near as I can tell, one that didn’t make it anywhere near the criminal justice system and they presented as a couple.

It’s impossible to imagine going from this to a relationship in which there are felony charges and someone with multiple broken bones.

It’s clear (at least to me), the main reason we focus on firing and kicking out of the group those who batter: we were very sympathetic in some high profile cases in recent decades. A man who had a very sad childhood, who displayed charisma and intelligence and athletic prowess to a degree that he was truly a hero to many. Kind and gentle in many interactions, yet he had a Problem in intimate relationships that people found revolting. The general public was prepared to ignore it for a while, and then go along with the current victim who was sure that he was misunderstood and that things were better. Then dead body, or broken body or horrifying sexual assault or whatever, and all of a sudden we feel like our compassion and forgiveness has been abused and taken advantage of. We often turn on both the batterer and the batterer’s current or most recent enabler/victim at the same time (even if that victim is now dead).

We've compressed that process, so now we basically just require solid evidence that the battering is not a one-off, and is not “minor”. If two people want to push each other around, we’ll keep ignoring that (<— this actually might be a real problem, that we are ignoring this kind of interaction). But as soon as there is a hospital visit or the cops get involved, we want them gone. And we want them gone because when it gets to that point, there’s maybe a 40% recidivism rate. And we are sick of getting emotionally involved with dyads that are going to devolve into a murderer and a victim. It's not pretty and it's probably not particularly moral or ethical, but it is a form of self-preservation.

What is good public policy in this context?

Well, the single most effective thing that can be done to reduce intimate violence is to address substance abuse issues. If you can get a person who is prone to intimate violence to reduce or eliminate their use of mind altering substances, you can usually reduce their impulsivity which usually reduces the frequency and intensity of violence. Alas, this is sort of replacing one difficult to solve problem with another difficult to solve problem. There are almost always underlying mental health issues; if they are not addressed, then we’ll probably eventually wind up right back where we started.

Washington State did a really great job of analyzing various treatment approaches to domestic violence.

http://www.wsipp.wa.gov/ReportFile/1119/Wsipp_What-Works-to-Reduce-Recidivism-by-Domestic-Violence-Offenders_Full-Report.pdf

They determined that a variety of programs _other than Duluth model_ are somewhat effective at reducing recidivism. They also found that a lot of domestic violence offenders commit crimes other than domestic violence, thus opening up other options for treatment including those designed to prevent recidivism more generally.

We are still at the very beginning of figuring out how to help people who commit domestic violence to _stop_ committing domestic violence (and also to not commit other crimes as well). We actually do not have good evidence on what programs work, altho we increasingly know that Duluth model does not affect recidivism. We need to stop with the Duluth model, and focus on other approaches, while carefully tracking outcomes. Over time, we will find things that work and then we can mandate best practice as it evolves. This is how we learn. This is how good policy is made.

In the meantime, I don’t see anything reprehensible at all about firing people from high-profile positions if they are involved in criminal behavior. Period. End. If you are a prominent person, you are supposed to behave according to group norms. If you don’t, we don’t want the rest of the group thinking that what you are doing is somehow okay.

ETA: How did I forget to add this? I have a lot of issues with football. Recently, head trauma has been in the news a lot. And not just with American Football, but also with soccer. If batterers are already having trouble with emotional reactivity, impulsivity, and other frontal lobe issues, putting them at risk of TBI and concussion seems just Wrong. Wrong, Wrong, Wronger than Wrong.
Subscribe
  • Post a new comment

    Error

    default userpic

    Your reply will be screened

    Your IP address will be recorded 

    When you submit the form an invisible reCAPTCHA check will be performed.
    You must follow the Privacy Policy and Google Terms of use.
  • 1 comment