The Therapeutic Management of Violence

Abstract

VioLit summary: OBJECTIVE: The purpose of this paper by Federn was to discuss the therapeutic management of violence. METHODOLOGY: The article was a non-experimental exposition on violence management therapy based on the author's experience. FINDINGS/DISCUSSION: Frustration has been found to be a frequent cause of violence. The author stated that therapists must recognize frustration exhibited by patients before it turns to aggression. The author pointed out that therapists should help patients verbalize their emotions to reduce the tendency toward violence. Lack of empathy for victim was discussed as another reason for violence that can also be dealt with therapeutically. Anxiety and fear were also seen as precipitating factors of violence. Domination of others in which the violence has a peak, was defined as a sexual disorder. The author explained it needs to be treated with intensive psychotherapy. When the patient had self restraints against hurting another, the patient's frustration led to injuring himself or herself. In some cases a patient's self-injuring was an act of vengeance. Very disturbed youngsters were split into two selves where one self punished the other self. Some patients felt that some parts of their bodies didn't belong to them and therefore it did not matter what they did to them. The author felt masochistic patients were not treatable. AUTHOR'S RECOMMENDATIONS: The author stated that staff must at all times refrain from being violent and hurtful to patients and that the staff must use talk as a means to diffuse and prevent violent behavior. The author also made these recommendations to staff, avoid the use of physical restraints and keep calm in the face of a violent episode of a patient. The author suggested that institutions and therapists have established sanctions. (CSPV Abstract - Copyright © 1992-2007 by the Center for the Study and Prevention of Violence, Institute of Behavioral Science, Regents of the University of Colorado)