The Role of Context in the Construction of Violence: Perspectives from Mentally Disordered Perpetrators Georgia Black (Institute of Psychiatry - work carried out as part of the MSc in Forensic Psychology at the University of Surrey) Dr Emily

Glorney (Broadmoor Hospital); Dr Miranda Horvath (University of Surrey)

Introduction and Aim of the study

Qualitative studies of violence take into account many personal, contextual and situational factors in their constructions, although most have focused on the victim perspective (Tilley & Brackley, 2005). The omission of the perpetrators’ perspective has left a void in the literature, compromising the quality of offence-based interventions. There has been just one study looking into violent mentally disordered perpetrator constructs of violence. This study found that existing theoretical models were not adequate in explaining how violence was appraised (Timberlake, Glorney and Lyons 2007). Participants constructed a definition that included the severity of injury to the victim, and how they were attacked. A significant gap in qualitative literature relating to violence is the decision-making process during violent acts, including whether weapons are used, how much force is used and what to do next (Michie & Cooke, 2006). This may help in the therapeutic context to account for discourses of minimisation (Smith, 2007) as, for example, perpetrators may perceive non-weapon crimes to be significantly less violent than weapon crimes. The aim of this study was to investigate how perpetrators of violence in a high-secure hospital constructed definitions of violence.

Method, Participants and Procedure

Interpretative Phenomenological Analysis (IPA) is a qualitative data analysis method which aims to gain an insight from the participant into how they make sense of their phenomenological experiences, or perception of the world. Nine British male mentally disordered perpetrators of interpersonal violence took part in this study. All were patients at a high security hospital in the south of England and were detained under the Mental Health Act (1983). Participants were interviewed in two stages. 1: a series of nine video clips were shown on a laptop screen and participants responded to a set of questions on a semi-structured interview schedule about what had happened, what each character was thinking and feeling, and how they might have approached the situation differently. 2: participants were given a card with a still from each clip on it and were asked to free sort the cards into groups of their choosing. They were asked to describe why they thought the clips were similar. They were then asked to sort the cards in order of how acceptable/unacceptable they perceived the behaviours in the clips to be.

Results: Table of superordinate themes and subthemes with examples of supporting quotations

Judgements of severity and being acceptable

Mr A: it was unacceptable because … the man actually gets severely hurt

Method of attack Mr F: Look I’m not after a proper fight, I’m just pushing and shoving

Levels of violence and what is appropriate

Mr C: He decides to drop the glasses and make a big issue of it, causes more frustr… confrontation than is needed

Responsibility Mr D: Some guy who was at the bar eating a loud, a packet of crisps very loudly […] so he came very violent

Justification Mr F: He actually has a grievance

De-personalisation and violence

Mr H: Because he is like someone who, authority with a badge and cap and things and bags and stuff, she’s thinking oh you bastard

Image, reputation and pride

Mr C: He thought he was a bit of an ‘ard man, a bit of a tough man and decided to you know, throw insults instead of saying it’s OK

Vulnerability and danger

Mr D: He seems a bit, seemed a bit sort of exploitedMr H: I think he’s scared the other guy might hurt him badly or whatever

Swearing and shouting

Mr B: He kind of aggravated the situation by shouting and ranting

Controlling anger Mr I: I think he walked out because his anger was boiling and he didn’t want it to boil over

Physical location of anger

Mr E: [He] got mad and took it out on someone else

Communicative difficulties resulting from anger

Mr C: That made her more angry […] and just not really wanting to listen to any other person’s point of viewMr H: [He’s] trying to talk to her, her father in the most respectful way possible which very difficult because he is actually, he looks like he doesn’t want to hear it

Determinism of personality

Mr I: He’s like a sort of an aggressive behaviour person, especially when he’s threatening to kill the person just over a parking ticket

Abnormal behaviour

Mr F: He’s just a nutterMr E: He’d be classed as a lunatic […] and a rebel and nutter

Theoretical and clinical implications

The most integrative model of aggression, the GAM (Anderson & Bushman, 2002) was challenged. New links were made between sections of the model and some sections were expanded or elaborated. The subthemes have also reinforced the need for multidimensional models or scales of violence. The ‘Processes Leading to Violence’, and ‘Arousal, Affect and Violence’ themes emerged through the inclusion of contextual variables in the methodology, such as speech. The importance of the interpersonal context of speech in violence is a significant addition to the literature. This highlights the subtlety afforded by the video vignette method and the possibilities for intervention and treatment, as this prompted participants to voice their thoughts and feelings about violent behaviour. Within offence-focused interventions, an awareness of the processes of judgement and the progression to violence might contribute to a strengthening of the therapeutic relationship a priority of the Good Lives Model (Ward & Brown, 2004). The subthemes relating to arousal and violence may be applicable to interventions such as social skills or anger management, integrating an understanding of the difficulties of communication while angry. There are several subthemes that are relevant to the CBT framework, especially those dealing with cognitive processes that facilitate violence, for example, responsibility, justification and depersonalisation.

Conclusions

Four superordinate themes were revealed: ‘Violence and Moral Judgement’, ‘Processes Leading to Violence’, ‘Arousal, Affect and Violence’ and ‘Individual Differences’. These were consistent with literature on aggression and violence (e.g. Smith, 2007) but placed additional emphasis on the social construction of violence and the importance of contextual variables. The subtheme of ‘Processes Leading to Violence’, Image, reputation and pride, is inadequately represented in current models of aggression. The need to fulfil a certain role in a specific context is somewhere between the constructs of ‘Person’ and ‘Situation’ of the General Aggression Model (GAM; Anderson & Bushman, 2002).

The indices of severity, method and appropriateness provide a starting point for a multidimensional model of violence as called for by Cooke and Michie (2000), and begin to describe decision-making in violent situations. The participants describe making choices about violent acts in terms of their severity, and there was an awareness of how physical actions could be perceived legally through the use of terms such as ‘assault’ and ‘GBH’. Physical actions were placed in order of severity by harm inflicted upon the victim. This may help us to understand decision-making in terms of intent to cause harm, because the offender chooses their actions on the basis of how much they want to hurt the other person.

The participants have offered a rare and useful insight into the experience of violence, including those actions considered to be violent, perpetrators’ appraisals of situations and what can be understood about decision-making pathways to violence. The ideas expressed by the participants relating to Vulnerability and danger and Responsibility demonstrate a social construction based on the awareness of blame. These subthemes have rich therapeutic implications due to the strong resonances with victimisation, blame-shifting and minimisation.

The participants constructed violence as being about moral judgement, dependant on cognitive and interpersonal processes. The themes also revealed the importance of individual differences and the interplay between personal constructs such as arousal, affect and personality, and interpersonal constructs such as communication, behaviour and how behaviour is perceived. These results demonstrate the importance of reassessing theories of aggression, such as the GAM. The study demonstrates how important contributions to therapeutic work can be made with small samples and qualitative analysis and the benefit of gaining perpetrators’ perspectives.

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