The problem of aggression is often discussed in the light of genetic, constitutional, characterologic, or societal factors in the etiology of violent behavior, or in terms of biologic predispositions to violent actions that include organic, toxic, and ictal phenomena. Often, etiologically based discussions of aggression do not include adequate consideration of the violent person's interpersonal context generally or the family of that person in particular. Furthermore, it is rare to find that biologic, ictal, toxic, or characterologic factors are truly sufficient explanations of violent behavior. Useful explanation requires consideration of the context of intimate relations and threats to them, and of affects regulating the violent person's sense of standing among intimates. Moreover, a comprehensive discussion of etiologic considerations concerning the problem of violence, including the family genesis of aggression, falls short of being satisfactory if it does not consider the mechanism of action whereby the factor under discussion plays, enhances, releases, generates, or provokes violent behavior.
In discussing the family genesis of aggression, I in no way presume that biologic or societal factors are not important. Rather, it is my intention to point out that the influence of these "CtIOlOgIc" factors is manifested through attachment behaviors and affects that are related to them, not as some biologic or cultural influence independent of and transcending intimate attachments. I assume, therefore, that attachment behaviors, both developmentally and contemporaneously, encompass the influence of biologic and societal components that show up in the regulation of meaningful attachments between intimates.
A detailed appreciation for the role of shame is crucial for understanding aggression in the interpersonal context. Shame should not be thought of simply as another affect or another type of transaction. Shame is the affect that signals threats to the integrity of the self and the status of the self before others. The self to exist as such, requires an affirming bond with the other.1 The process of affirmation of this bond has been referred to by various authors as empathy, as mirroring (Kohut2), as deference (Goffman3), as recognition (Hegel4), or esteem. Shame is the master regulatory emotion signaling either danger to the status of the individual within the social bond, or the mark of extrusion from the social order - the end stage of narcissistic mortification.
Shame is of central importance in the work with impulsive and violent persons because such work repeatedly demonstrates that personality cohesion and the sense of self in the violent person are much more tentative and prone to disorganization than is commonly appreciated by the family or acknowledged by the violent person. That is to say, violent persons, especially the large percentage of such persons with vulnerabilities resulting from developmental arrests, usually have a pathological vulnerability to personality disorganization and are propelled to choose relationships, marriages especially, for the purpose of preventing that disorganization. Mate selection is strongly influenced by these persons' needs to mask their vulnerability and avoid shame. Such people risk being flooded with shame both because of their tendency to disorganize and because of their excessive need for others.5 Both of these propensities put them at high risk to be poor achievers, to be overly dependent on others, and to be at even greater risk for shame.
Our understanding of the significance of shame was greatly enhanced by two discoveries by major clinical investigators in the early 1970s. The first, put forward by Helen Block Lewis6 in 1971, is that shame that is unacknowledged by the person experiencing it turns into rage. The second major advance in our thinking, also put forward in 1971, was Heinz Kohut's2 elaboration of the tentativeness of the sense of self and of the vulnerability of persons with incohesive selves to disorganize and become flooded with shame if cohesion of the sense of self is not supplied by self objects.
These two discoveries have freed psychodynamic thinking to appreciate the role of shame in symptom formation.5,7 Major theoretical problems have arisen when aggression is looked at dynamically and attributed in an oversimplified way to guilt and fear, for example, because these formulations do not focus on aspects of disorganization of the personality and the status of the self and the use of persons to maintain personality cohesion. Guilt usually concerns real or fantasied transgressions. It reflects concern about the other, not about the integrity or status of the self Shame concerns deficits, inadequacies, unacceptability, or neediness that affect the basic integrity of the self or its acceptability in the context of social bond. Guilt tends to be internal; shame tends to take place before others or before the imagined gaze of the other. When one is exposed as empty, needy, a failure, out of control, dirty - one becomes ashamed. When one is exposed as transgressing in a way that harms the other, one feels guilty.
Shame, then, is always a potential concomitant of exposure before the other. Because of such risk, aspects of relationships that might be exposed as shameful are usually masked. People who are ashamed of themselves usually hide their shame in relationships that in some way mask the shame, project it onto others, or conceal it altogether. Consequently, the family becomes the center of collusive defensive operations that hide shame. Dynamic formulations that are based on guilt and fear presume that the whole issue of personality stability is in fact more simple and settled than it actually is.
This line of thinking should make clear why the source of shame in families is not limited to the effects of actual shaming transactions. My emphasis on the role of shame in violent families carries no implication that specific shaming transactions are entirely responsible for violent behavior. Sources of shame include:
* anything that contributes to a decreased sense of self or of personality cohesion;
* anything that increases awareness of need or excessive reliance on others to maintain personality cohesion or integrity;
* any increase of discrepancies of one's performance with one's ideals, especially if one's aspirations themselves are pathologically idealized or granthose;
* any increase in a preexisting sense of shame that is a result of developmental arrests from having been shamed in one's family of origin or from deficits that were accrued from family of origin;
* any increase in loss of control with consequent cycles of incohesion, shame and rage.
The link between shame and aggression depends on two fundamental assumptions: first, that violent persons, for the most part, have unusually rigid requirements for emotional distance from intimates to protect them from disorganization and an upsurge of a preexisting sense of shame; and second, that bypassed or unacknowledged shame turns to rage. My comments on the family genesis of aggression stem from this perspective.
Recent contributors in sociology following up the work of Lewis and others have pointed to shame/rage spirals and the escalation of conflict having to do with therapeutic or familial systems that generate shame that is not acknowledged. Using detailed analyses of verbal and nonverbal markers of emotion, Retzinger8,9 has found that angry responses in marital couples almost invariably follow shaming transactions. SchefF10 has described in detail shame/rage spirals that result from unacknowledged shame in the therapeutic situation.
I turn now to some specifics of the relationship of shame to violence in the family.
FAMILY OF ORIGIN
This section considers developmentally the genesis of shame and its transformation into rage. The next section discusses the family of procreation in which the predisposed person acts violently. Any of the factors below may contribute to the future violent person's sense of shame.
In the family of origin, anything predisposing the future violent person to increased shame, poor sense of self or decreased personality cohesion constitutes a fixation, which enhances the potential for shame later in Ufe. The origin of proneness to shame in adult individuals, then, is to be sought in the development arrests that result from upbringing in dysfunctional families. This may occur in a number of ways. Dysfunctional nurturance itself may result in developmental arrests and the lack of a stable sense of self Such lack of a stable sense of self in turn, predisposes the shame-prone individual to excessive reliance on others for maintenance of a sense of self This fixation to dyads (or in Kohutian terminology, selfobject fixation), because it renders the future violent person, in his or her own view, needier than others, predisposes to even more shame.
The shame-prone individual, then, has an exquisite vulnerability to being shamed, which results in an excessive need for other people to maintain a sense of self, which, in turn, engenders more limitations and failures, more shame, and more resentment. The sense of shame is further amplified by self-consciousness about deficits, feelings of emptiness or neediness, and states of fear and incohesion, which make that shame-prone person even more ashamed of the sense of emptiness and deficit. This sense of deficit, in turn, gives rise to the sense of having been cheated and, therefore, being one for whom the rules do not count because one has been treated unjustly. Freud,11 discussing "the exceptions," pointed to this character trait in people who are filled with a sense of injustice and rage over their personal deficits and who feel entitled to extract vengeance on intimates to somehow even the score for past injustices.
Yet another source of shame is an unconscious identification with a samesex parent who is held in contempt, especially by the other parent.12 Often the violent-person-to-be identifies with an underlying sense of shame of the same-sex parent who characteristically has dealt with feelings of shame and insignificance with violent behavior. The future violent patient identifies both with the underlying sense of shame and the violent behavior that attempts to compensate for it. Shame-prone persons attempt to handle their shame at times by intimidation, by control of objects through fear, and by behaviors that reinforce fantasies of turning the tables on powerlessness and helplessness and shame by reversals of humiliating situations with intimate persons. In such situations, it is the other person who feels intimidated, powerless, ashamed, or helpless.
Finally, of course, there is the direct shaming of the future violence-prone patient in the family of origin. A child who, for reasons having to do with larger family dynamics, becomes a scapegoat, is blamed, repeatedly criticized, or involved in overtly hostile intergenerational coalitions, becoming a confidante or an ally of one faction in the family at the expense of another, is at high risk to become the target of deliberate shaming transactions.
All of these factors combine in dysfunctional families to give the future violent person a sense of shame, of bitterness about deficits and poor role models, of rage at being poorly prepared for adult life, and the feeling of having been cheated, and, not infrequently, the propensity to act with oblivious vengefiilness on such feelings in ways that generate even more shame. Such a person has a more limited choice of relationships, which are generally chosen - mate selection, in particular - to reduce the sense of shame.
EAMILY OF PROCREATION
In the family of procreation, the predisposed violent person chooses a mate and enters the marital relationship with an inordinate need for transpersonal defenses against shame - that is to say, for collusive operations among intimates that, though never acknowledged as such, keep people from being too close or too far away. Mate selection in the predisposed individual, i.e., the need to choose a mate for protective reasons rather than for satisfaction, may enhance the sense of shame greatly.
In attempting to understand violence in the family system, the clinician seeks to locate any upsurge of shame or decrease in personality cohesion in the context of the family process. Overt shaming within the marital relationship or family system, therefore, is only one among many sources of shame that are operative in the family process and is not always an essential concomitant of violence in the family. It is important to keep in mind that most violent acts have a natural history that is common to people who act impulsively in other ways, e.g., binge eating, overdosing, wrist slashing, or impulsive promiscuity.13 Seen in the context of the family, violence should be thought of in terms of the structure of impulsive action. In this manner, the clinician will better be able to distinguish between volatility, intimidation, and violence proper.
The concept of impulsive action presumes in the impulsive actor a predisposition to personality disorganization. The sequence of events that includes impulsive action is set off by a precipitating experience, that is, an upsurge of shame, deliberately inflicted or otherwise. Shame may result from a change in optimal comfortable distance from intimates - too much intimacy or too much separateness - that disorganizes the impulsive actor. The precipitating experience is followed by a prodromal or dissociative experience, sometimes subliminal and outside of the person's awareness, but often something that violent patients can describe if they are questioned about it. The patient who is aware of such experiences reports a sense of disorganization, confusion, or outright dissociation that may last from seconds to hours. This prodromal phase crystallizes into a felt need to commit a violent act. The act per se must of course be distinguished from volatility, which concerns the precipitant, and intimidation, which will be discussed below.
People talk more easily about their feelings of guilt than they do about their feelings of shame, so a person who has committed violent acts will more easily talk about remorse resulting from the act than shame over the personality disorganization and vulnerability to be disorganized by the precipitant. The latter engender a good deal of shame. Accordingly, expressions of guilt usually cover over the violent person's sense of shame. The violent act itself exerts an intimidating force on intimates. The prospect of violence controls people by intimidation. This result of the prospect of violence in many cases can also be considered its intent. It is a common clinical error to fail to distinguish violence itself from intimidation and from volatility.
Clinical phenomena can usefully be distinguished on the basis of this structure of impulsive action. Volatility should be seen in terms of the predisposition to personality disorganization and a heightened vulnerability to precipitating circumstances. Intimidation is not the same as violence itself and has to do with pathologic distance regulation, i.e., the control exerted over others by the prospect of future violence. Violence, of course, refers only to the actual act but is often confused with volatility and intimidation. Such confusion comes at great expense to clarity in research and clinical approaches to these problems.
If others in the violent person's circle of intimates have their own vulnerabilities that require transpersonal defensive operations, the situation becomes more complicated.7 A truly comprehensive view of the family genesis of aggression includes the vulnerabilities of all persons in the family system and the dovetailing of their defensive operations in ways that promote conflict escalation.8,9 Any formulation of the role of the family in the genesis of violence is incomplete without an understanding of the escalation of conflict. Unacknowledged shame gives rise to rage, which gives rise to an attack, one that often attempts to turn the tables on the humiliating experience by inflicting shame on the other. The shame that is not acknowledged by the other is usually responded to in kind by rage, counterattack, and so forth, until shame-rage cycles escalate to the point of violence. This pattern of conflict escalation that leads to domestic violence is common, but not ubiquitous.
Clinicians working with violent patients should be guided by an awareness of the relationship of shame to rage and violence in the interpersonal context so that the influence of family of origin and family of procreation can be considered in clinical pictures involving violence and so that some of the features of interpersonal relationships promoting shame-rage cycles and conflict escalation are not recapitulated in the therapeutic relationship. Comparison of a number of the violent person's relationship systems will often highlight personality vulnerability, shame-rage cycles, the control of intimates through intimidation, and the malignant effects of unacknowledged shame in the family process.
The therapist's empathie focus on the violent person's family of origin will often enable that person to acknowledge his or her vulnerabilities and shame-proneness without an unmanageable upsurge of humiliation. In family of procreation, shame or shaming transactions should be clarified and acknowledged.
Shame is often masked by more obvious rage or mtimidation. When intimidation is felt as an inhibiting or coercive force by family members or by the therapist, the therapist should interpret it as soon as possible. Intimidation is the fear of future violence that gives family members and therapists the sense of being helpless, inhibited, and controlled by a potentially violent person who seems to feel little or no apprehension about the consequences of future violence. Volatility refers to the excessive vulnerability to personality disorganization and ensuing shame-rage cycles. Intimidation and volatility should always be distinguished from acts of violence.
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