Skip to main content Accessibility help
×
Home

Psychodynamic approaches to violence

  • Jessica Yakeley

Summary

The assessment and management of violent behaviour in mentally disordered patients are no longer the sole domain of forensic psychiatrists, but are increasingly part of the day-to-day work of all psychiatrists and mental health professionals. Violence risk assessment has become a huge industry, and although the importance of dynamic, as well as actuarial, risk factors is now recognised, a more systematic approach exploring the psychodynamics in the aetiology, assessment and treatment of violent behaviour is often lacking. In this article I revisit some of the key psychodynamic principles and concepts relevant to an understanding of violence, summarising the historical contributions of key psychoanalytic writers on violence and aggression, and exploring the ideas of more contemporary writers working in the field of forensic psychotherapy. A psychodynamic framework for working with violent patients is introduced, focusing on the setting and containment, specific therapeutic interventions and monitoring countertransference reactions.

LEARNING OBJECTIVES

  • Understand historical and contemporary psychoanalytic theories of the aetiology of aggression and violence
  • Utilise a psychodynamic framework for working with violent patients and offenders
  • Understand the use of countertransference in the risk assessment and treatment of violence

DECLARATION OF INTEREST

None.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Psychodynamic approaches to violence
      Available formats
      ×

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Psychodynamic approaches to violence
      Available formats
      ×

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Psychodynamic approaches to violence
      Available formats
      ×

Copyright

Corresponding author

Correspondence Dr Jessica Yakeley, Portman Clinic, 8 Fitzjohns Avenue, London NW3 5NA, UK. Email: jyakeley@tavi-port.nhs.uk

Footnotes

Hide All

In the previous issue of Advances, Jessica Yakeley & William Burbridge-James explored psychodynamic approaches to suicide and self-harm.

Footnotes

References

Hide All
Adshead, G, Moore, E, Humphrey, M, et al. (2013) The role of mentalising in the management of violence. Advances in Psychiatric Treatment, 19: 6776.
Alwin, N, Blackburn, R, Davidson, K, et al. (2006) Understanding Personality Disorder: A Report by the British Psychological Society. British Psychological Society.
Barratt, E, Stanford, M, Felthous, A, et al. (1997) The effects of phenytoin on impulsive and premeditated aggression: a controlled study. Journal of Clinical Psychopharmacology, 17: 341–9.
Bateman, A (1999) Narcissism and its relation to violence and suicide. In Psychoanalytic Understanding of Violence and Suicide (ed Perelberg, R): 109–24. Routledge.
Bateman, A, Fonagy, P (2016) Mentalization-Based Treatment for Personality Disorders: A Practical Guide. Oxford University Press.
Bion, WR (1959) Attacks on linking. International Journal of Psycho-Analysis, 40: 308–15.
Bion, WR (1962) Learning from Experience. Heinemann. Reprinted Karnac Books, 1984.
Black, DW, Baumgard, CH, Bell, SE, et al. (1996) Death rates in 71 men with antisocial personality disorder. A comparison with general population mortality. Psychosomatics, 37: 131–36.
Blumenthal, S, Huckle, C, Czornyj, R, et al. (2010) The role of affect in the estimation of risk. Journal of Mental Health, 19: 444–51.
Campbell, D (1999) The role of the father in a pre-suicide state. In Psychoanalytic Understanding of Violence and Suicide (ed Perelberg, R): 7386. Routledge.
Carroll, A (2012) Good (or bad) vibrations: clinical intuition in violence risk assessment. Advances in Psychiatric Treatment, 18: 447–56.
De Zulueta, F (1994) From Pain to Violence: The Traumatic Roots of Destructiveness (1st edn). J Aronson.
Department of Health and Home Office (1999) Managing Dangerous People with Severe Personality Disorder: Proposals for Policy Development. Home Office and Department of Health.
Douglas, KS, Hart, SD, Webster, CD, et al. (2013) HCR-20V3: Assessing Risk of Violence – User Guide. Mental Health, Law, and Policy Institute, Simon Fraser University.
Fairbairn, WRD (1952) Psychoanalytic Studies of the Personality. Tavistock Publications.
Fonagy, P, Target, M (1995) Understanding the violent patient: the use of the body and the role of the father. International Journal of Psycho-Analysis, 76: 487501.
Freud, S (1905) Three essays on the theory of sexuality. Reprinted (1953–1974) in the Standard Edition of the Complete Psychological Works of Sigmund Freud (trans & ed Strachey, J), vol 7: 123246. Hogarth Press.
Freud, S (1915) Instincts and their vicissitudes. Reprinted (1953–1974) in the Standard Edition of the Complete Psychological Works of Sigmund Freud (trans & ed Strachey, J), vol 15: 109–40. Hogarth Press.
Freud, S (1917) Mourning and melancholia. Reprinted (1953–1974) in the Standard Edition of the Complete Psychological Works of Sigmund Freud (trans & ed Strachey, J), vol 12: 243–58. Hogarth Press.
Freud, S (1920) Beyond the pleasure principle. Reprinted (1953–1974) in the Standard Edition of the Complete Psychological Works of Sigmund Freud (trans & ed Strachey, J), vol 18: 164. Hogarth Press.
Freud, S (1923) The ego and the id. Reprinted (1953–1974) in the Standard Edition of the Complete Psychological Works of Sigmund Freud (trans & ed Strachey, J), vol 19: 366. Hogarth Press.
Gilligan, J (1996) Violence: Our Deadliest Epidemic and its Causes. Grosset/Putnam.
Glasser, M (1996) Aggression and sadism in the perversions. In Sexual Deviation (3rd edn ) (ed Rosen, I): 279–99. Oxford University Press.
Glasser, M (1998) On violence: a preliminary communication. International Journal of Psycho-Analysis, 79: 887902.
Glover, E (1933) The relation of perversion-formation to the development of a reality sense. International Journal of Psycho-Analysis, 14: 486504.
Hale, R, Dhar, R (2008) Flying a kite – observations on dual (and triple) diagnosis. Criminal Behaviour and Mental Health, 18: 145–52.
Hare, RD (2003) Manual for the Psychopathy Checklist-Revised (2nd edn). Multihealth Systems.
Health Inequalities National Support Team (2011) Offender Health: Reducing Health Inequalities through Improving the Health of Offenders. Department of Health.
Joseph, N, Benefield, N (2012) A joint offender personality disorder pathway strategy: an outline summary. Criminal Behaviour & Mental Health, 22: 210–7.
Klein, M (1935) A contribution to the psychogenesis of manic depressive states. International Journal of Psycho-Analysis, 16: 145–74.
Klein, M (1946) Notes on some schizoid mechanisms. International Journal of Psycho-Analysis, 27: 99110.
Martin, RL, Cloninger, CR, Guze, SB, et al. (1985) Mortality in a follow-up of 500 psychiatric outpatients. I. Total mortality. Archives of General Psychiatry, 42: 4754.
McMurran, M, Howard, R (2009) Personality, Personality Disorder and Violence: An Evidence-Based Approach. John Wiley & Sons.
Meloy, JR (1992) Violent Attachments. Jason Aronson.
Meloy, JR, Meloy, MJ (2002) Autonomic arousal in the presence of psychopathy. Journal of Threat Assessment, 2: 2133.
Meloy, R, Yakeley, J (2013) Antisocial personality disorder. In Gabbard’s Treatments of Psychiatric Disorders (eds Gabbard, GO, Gunderson, J): 1015–34. American Psychiatric Publishing.
Menninger, KA (1968) The Crime of Punishment. Viking.
Minne, C (2008) The dreaded and dreading patient and therapist. In Psychic Assaults and Frightened Clinicians: Countertransference in Forensic Settings (eds Gordon, J, Kirtchuk, G): 2740. Karnac.
Odgers, CL, Caspi, A, Broadbent, JM, et al. (2007) Prediction of differential adult health burden by conduct problem subtypes in males. Archiches of General Psychiatry, 64: 476–84.
Perelberg, R (1995) A core phantasy of violence. International Journal of Psycho-Analysis, 76: 1215–31.
Piquero, AR, Shepherd, I, Shepherd, JP, et al. (2011) Impact of offending trajectories on health: disability, hospitalisation and death in middle-aged men in the Cambridge Study in Delinquent Development. Criminal Behaviour and Mental Health, 21: 189201.
Raine, A, Meloy, JR, Bihrle, S, et al. (1998) Reduced prefrontal and increased subcortical brain functioning assessed using positron emission tomography in predatory and affective murderers. Behavioral Sciences and the Law, 16: 319–32.
Stanford, M, Houston, R, Mathias, C, et al. (2003) Characterizing aggressive behavior. Assessment, 10: 183–90.
Welldon, E (1996) Group-analytic psychotherapy in an out-patient setting. In Forensic Psychotherapy: Crime, Psychodynamics and the Offender Patient (eds Cordess, C, Cox, M): 6382. Jessica Kingsley.
Winnicott, DW (1954) Metapsychological and clinical aspects of regression within the psychoanalytic set-up. Reprinted (1991) in Through Paediatrics to Psycho-Analysis: Collected Papers. Karnac Books.
Winnicott, DW (1971) Playing and Reality. Tavistock.
World Health Organization (2002) World Report on Violence and Health. WHO.
World Health Organization (2014) Global Status Report on Violence Prevention. WHO.
Yakeley, J (2010) Violence: A Contemporary Psychoanalytic Approach. Palgrave MacMillan.
Yakeley, J, Meloy, R (2012) Understanding violence: does psychoanalytic thinking matter? Aggression and Violent Behavior, 17: 229–39.

Related content

Powered by UNSILO

Psychodynamic approaches to violence

  • Jessica Yakeley

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed.