Dangerousness assessment

Watch for the flying of the flags

Michael Sefton, Ph.D. Dangerousness assessment, Human Behavior, Relationships , ,

Terminal rage dissembled by increased red flag threats and violence

WESTBOROUGH, MA  November 2, 2014 A group of my colleagues and I were drawn into the chilling events of June 13, 2011 after Stephen Lake killed his family and then himself.  During the final moments of his life Lake laid out the death scene ostensibly to torture his spouse from whom he was estranged and ordered to stay away.  While police closed in, Lake killed and attempted to burn his victims in an act of emotional mayhem.

Arguably, the murderer in this case became blinded by anger and resentment at perceived disrespect and exclusion from the lives of his children. This anger had grown over the year since a protective order was issued following a violent episode in the family home. The perpetrator grew marginalized during the coming months becoming resentful and humiliated at missing key events like Christmas and an 8th grade commencement.  All the while he posted on social media sites his love for his family he grew depressed and disorganized.  12 hours before the violent ending he tearfully described feeling depressed to a family member and was advised to seek help.  Lake wrote 9 suicide notes that were found in the days after his death.

Renewed interest in retrospective study

The psychological autopsy revealed an increasing pattern of red flags in the weeks before the murder-suicide in Dexter, Maine. Greater awareness of these red flags may serve as a stopping and containment point for perpetrators of intimate partner violence.  In a sad retrospective, the Maine state Chief Medical Examiner cited that “in spite of some mental health treatment the extent of (the perpetrator’s) anger was not fully appreciated”. The research led to a call for no bail holds for some violent abusers and GPS monitoring for others.  After 3 years, these recommendations are finally beginning to emerge in the protection of victims of domestic violence in Maine. Mr. Lake was alleged to have violated the protective order more than twice.  His reported view of the “cost of divorce was the price of one bullet”.

Who can be expected to bear witness to red flags?

It is well documented that domestic violence is a secret happenstance that effects far too many families across the country.  Victims are expected to remain loyal servants of their spouses under the dissembling guise of love and devotion.  The findings published in the Dexter, Maine study reveal that people knew what to expect from Mr. Lake.  His unwinding was clear to some of his closest family members.  A paternal aunt was quoted as saying “I never thought he would take the kids” suggesting an awareness that Lake might kill his spouse and then himself – sparing the children.  Others believed Lake might commit suicide in front of his wife and children leaving them with the emotional specter of his violent death.  Instead, as the chief medical examiner cited the full extent of Lake’s anger was not appreciated.  In this case, as in many other retrospective studies of DVH red flags were not appreciated. Many believe that an order of protection is not effective in protecting victims from violent spouses who seem to ignore “stay away” orders seemingly at will and without consequence.  These are the red flags that require containment of the abuser and must serve as the frank evidence of elevated risk for domestic violence homicide.

The team of people helping 22-year old Elliot Rodger, a young man who went on a shooting rampage at the University of California at Santa Barbara in May 2014, all reached out to police and the media when they could not reach the estranged and overwrought man.  But they were too late as he had made his mark on history by then.  The the Virginia Tech shooting some red flags were missed.  Had the subtle clues the Rodger’s underlying mood been recognized the shooting may have been averted.  To read the blog from the UCSB shooting click here.

Mandated reporting for domestic violence 

As a civilized society there should be mandated reporting for those most at risk for domestic violence and the penultimate DVH as it becomes apparent.  Just as practitioners are mandated to report cases of suspected child abuse and elder abuse so too must we begin to take heed of the signs of domestic or intimate partner abuse and take action.  By doing this we may save the lives of those most effected by DV and arguably break the recurring cycle of domestic violence.  Some people wrongly believe there is nothing that can be done about domestic violence homicide. Others remark that “what happens behind the closed doors in a dysfunctional and violent household is no business of anyone else”.  To the extent that this draconian belief system prevails in the public understanding of DVH there is little chance of preventing this scourge.  As a result states are slowly changing their response protocols for DV and the police response to signs of abuse with mandated arrest for suspected perpetrators.

Risk assessment of those arrested for domestic violence is often overlooked.  However, police departments are teaming up with agencies serving the population of abuse victims like never before and are adopting tools to assess the likelihood of future violence when determining bail amounts. Bail commissioners must be educated about the cycle of abuse and domestic violence when assessing bail amounts.  The average abuse victim experiences 5-7 episodes of DV prior to calling the police. Police response to DV has slowly started to include a careful analysis of the history of aggressive events including the number and type of physical assaults that have taken place.  Some events are clearly more foreboding like choking to a point of unconsciousness, sexual aggression, threats of suicide, and the use of veiled threats of death if the spouse ever tries to leave. Other behaviors such as unrealistic jealousy may be the underpinning of current or domestic violence.  One victim told me that the abuse started as soon as she said “I do” 16 years earlier.

REFERENCES

Ronald Allanach et al., Psychological Autopsy of June 13, 2011, Dexter, Maine Domestic Violence Homicides and Suicide: Final Report 39 (Nov. 28, 2011), http://pinetreewatchdog.org/files/2011/12/Dexter-DVH-Psychological-Autopsy-Final-Report-112811-111.pdf.

Sefton, M. (2011) The Psychological Autopsy: Provides a host of pre-incident indicators. Blog:  http://www.enddvh.blogspot.com/2011/11/psychological-autopsy.htm, taken May 26, 2014.

Relationships, red flags and gun violence

Michael Sefton, Ph.D. Dangerousness assessment, Human Behavior, Relationships

Westborough, MA July 23, 2014  The pendulum of public opinion on gun ownership swings back and forth between those with the fierce belief about the inalienable right to bear arms granted by the U.S. Constitution and those who believe intuitively that fewer guns will result in fewer deaths.  The argument is not a simple one especially when it comes to people suffering with mental illness.  I read a paper authored by Liza Gold, M.D. in which Dr. Gold, a psychiatric physician is quoted as saying “most people with mental illness are not dangerous, and most dangerous people are not mentally ill” (Gold, 2013).  I agree with this point and have written about it in the past.  More recently, mass shootings have occurred when the perpetrator had a history of major depression and was receiving treatment.  These isolated cases fan the flames of misattribution that mental illness and gun violence are correlated.  It is important to remember the vast majority of persons receiving treatment for emotional problems are not violent.  It is true that fewer guns may result in fewer gun-related homicides but not necessarily the rate of death itself.

There is no single road map to understanding the complexity of human behavior in general and homicide in particular. If there were the rate of domestic violence homicide might be reduced to zero”, according to Michael Sefton (Sefton, 2013) .  Arguably, there are often signs or “red flags” that forecast the increased likelihood of a violent outburst. These include an increase frequency of aggression or threats of aggression, advanced substance abuse, marginalized demeanor, stalking, and defiance of an active protection from abuse order.  The presence of firearms in the homes of these individuals raises the risk of domestic violence homicide or DVH across the board.  “It is much easier to be anti-gun than to be anti-murderer, and to correctly structure the murder prevention methodology around the manner of murder (person) rather than mode of murder (bomb, arson, knife, gun, person, motor vehicle, strangulation, rope, poison, drowning, etc.)  absolutely necessary to keep people alive” according to Brian Gagan (2014).

As a psychologist, I am interested in the underlying triggers of aggression and the continuum of violence among intimate partners.  Those who would abuse grow unpredictably violent based on their own idiosyncratic attribution of a spouses motive and an internalized need for power and control.  The emotional inequity in these violent dyads calls for stopping the cycle of abuse early in the formative stage of the relationship.  Containment of individual abusers should take place when this fails and red flags such as physical violence, threats of death or threats of suicide are made.  Initially containment might be in the form of behavioral support, substance abuse education, and anger managment.

____________________________________

Gagan, B. (2014) Personal communication.

Gold, L. (2013) Gun Violence: Psychiatry, Risk Assessment, and Social Policy. Journal of the American Academy of Psychiatry and the Law, Volume 41, November.

Sefton, M. (2013) Roadmap to violence. Blog: http://www.msefton.wordpress.com. Taken 7-14-2014.

Sefton, M. (2005) The Evil that Kid’s Do. Exlibris, Philadelphia.

By the hand of a father’s son

Michael Sefton, Ph.D. Dangerousness assessment, Human Behavior, Relationships , , , , ,

Vermont patricide shows complex impact of veteran’s plight and DVH

WESTBOROUGH, MA  June 12, 2104  The Vermont killing of a veteran warrior this spring brought to light the high price being paid by military veteran’s who returned to civilian life unable to function.  Much has been published about the wait for treatment that many of the most needy veteran’s experience.  As Father’s Day approaches readers are urged to think about this case. It is particularly unsettling because the man’s death came at the hand of his son.  Kryn Miner, 44 was shot and killed by his son after threatening his wife and stating that he was going to kill his family.  Miner threatened his family with a gun a year before his death but the event was never reported to police. The shooting was called a justifiable homicide and no charges were filed against the teenage child who fired the fatal shots.  The child has not been identified out of privacy concerns and by all accounts may have saved the lives of his mother and 3 siblings.  The victim’s wife Amy has spoken out about the plight of veteran’s who are not getting the help they need. “The truth of the matter is if we can’t take care of our veteran’s we shouldn’t be sending them off to war” said Amy Miner.

The victim in this story was a 25 year Army veteran who returned from Afghanistan in 2010 after being deployed 11 times from 2007 to 2010. Miner was a career soldier and was well liked. He was shot 5 times in his Vermont home after threatening his family with a gun and throwing his son a loaded pistol saying “Do you want to play the gun game?” Mr. Miner had served tours of duty in Panama and Iraq as well.  He was suffering from the residual effects of a traumatic brain injury and experienced symptoms of post traumatic stress disorder. He was injured in combat after a blast threw him into a concrete wall. Ironically, after becoming dissatisfied with the V.A., Mr. Miner turned to the Lone Survivor’s Foundation for help and eventually becoming a spokesman for the foundation.  To his credit, Miner was committed to helping veteran’s suffering with emotional and physical symptoms from combat-related PTSD and was receiving treatment himself for this enduring injury.

The Department of Veteran’s Affairs is finding it difficult to manage the influx of veterans in need of care.  Ostensibly, the volume of cases exceeds the resources available at VA hospital and clinics throughout the country.  The Phoenix, AZ regional director has resigned because of the wait listing of patients and the obfuscation that occurred once the facts became known.

The story is one that compels the author to look at the complex interplay of domestic violence, guns, and the ongoing plight of war veteran’s.  The sheer number of men and women returning from the theater of war over the last decade is staggering.  It is estimated that 15 percent of these veteran’s are experiencing PTSD and/or the effects of traumatic brain injury from blast waves and other wounds. Arguably, this number may actually exceed 20-25 percent of all returning war veterans by some accounts.  The case of Mr. Miner is particularly troubling because it involved a history of domestic violence and criminal threatening that was never reported to authorities.  Had it been reported the Miner family may have been helped.

The immeasurable impact of this violence on the family may be reflected in the actions of one of its own – who must now live with the consequence of patricide.  The killing was justified according to the Vermont State Attorney General.  But how can one justify this when so young?  The killing of one’s father is often the manifestation of long felt anger, emotional pain, and in reaction to enduring humiliation.  The motivation in this case is not clear aside from the threat posed by Miner and the child’s immediate defense of a loved one – his mother and siblings.  Just how emotionally equipped this boy is to recover from this remains to be seen.  He will never forget what has happened to him and his family as long as he lives.  Each day this family must experience some loss and recurring trauma inextricably linked to the events of April, 2014.  Some responsibility lies with the victim who issued the threats and was armed with a gun.  He died by the hand of a father’s son that should never have been touched by such things.

 

 

Decisions on Bail for Domestic Violence

Michael Sefton, Ph.D. Dangerousness assessment, Health Psychology, Human Behavior, Relationships , , , , ,

THERE IS MOVEMENT TOWARD VICTIM SAFETY IN CASES OF DV

lakefoll0916_kc01-250x250
Michael Sefton (right) BDN photo

WESTBOROUGH, MA   Is there any coincidence that Democratic House Speaker Robert DeLeo has joined forces with Attorney General Martha Coakley to bring forth a new bill that will provide for stiffer bail conditions and tougher sanctions for repeat DV offenders?  This bill was brought forth just 2 weeks after the Massachusetts SJC ruled on the case of one abuser against whom a permanent restraining order has been in place for over 10 years.  In that ruling, a man against whom a protective order was written is seeking its dismissal under the broad assumption that he is no longer  a threat to the former girlfriend because he now lives 3000 miles away.  Not so fast said the Massachusetts SJC.

The Commonwealth’s highest court reviewed the historic data in the case record and made its decision based on the documented threat of violence the abuser posed and convictions for DV against more than one partner dating back to the 1990’s.  They voted against dismissing the permanent restraining order writing that victim safety is more important than the purported rights of abusive men.  In the SJC decision the limitations placed on the abuser based on having a “protective order” against him were the collateral consequence of the behavior they exhibited early on.  The abuser believed he was unfairly being prevented from owning a firearm and had limited opportunity to work with children because of the unfair restrictions placed on him by the permanent order of protection.  Furthermore, the SJC also acknowledged that the abuser must show “convincing evidence” that they have made substantive emotional and personality changes that render him no longer a threat to the estranged spouse.

The bill proposed by Speaker Rober DeLeo asks for tougher bail conditions most notably a 6 hour delay before an alleged abuser may be released from custody.  The highly publicized case of Jared Remy who was released from custody hours before be allegedly killed his live-in girlfriend served as a stimulus to the proposed change in the law.  An important consideration not mentioned in the proposed bill is that to do with subjects with known violence in their history and how best to protect victims from revenge abuse once the abuser is released from custody.  Presumably, the new bill affords potential victims the opportunity to put in place a safety plan and affords those making decisions about bail added training about the cycle of abuse, red flag predictors, and greater access to the history of violence of the person in custody.

Unfortunately, the bill does not go far enough in its current raw form to assure that victims of violence receive the needed protection once they decide to break away from dangerous and dysfunctional entanglements.  It is this time when abuse victims are at greatest risk of death due to domestic violence as in the case of Amy Lake, a victim of domestic violence homicide whose case was carefully studied in the Psychological Autopsy of the Dexter, Maine Domestic Violence Homicide (Allanach, 2011) that occurred in June 2011.  Maine has been reviewing bail conditions since this unique study made over 50 recommendations for reducing the incidence of domestic violence homicide in that state.   This report was presented to the Governor’s Domestic Violence Homicide Review Panel in November 2011.  Only recently was a domestic violence suspect held without bail for his history of felony assault and battery on his spouse and a prior domestic partner for over 20 years.  In that case, the abuser was arrested three times in one month for violating an active order of protection during which time he threatened to kill his estranged wife.

Red Flags and Bail Conditions

In Massachusetts, Speaker Robert DeLeo warns that red flags often foreshadow an abuser’s behavior giving clues as to the intentions and the proclivity toward violence.  These are facts that are well described in the literature on DVH.  It is suspected that perpetrators ostensibly inform others about their intentions and all to often, these individuals do nothing to stop the violence.   In a prior paper, I have argued that a domestic violence registry may be useful for keeping track of those who repeatedly abuse or batter their domestic partners.  This would be similar to the sex abuse registry that requires those adjudicated for sexual abuse of children must register whenever they move from place to place.  I have also written extensively on the need for containment of those at highest risk to offend including a pertinent history of physical violence e.g. choking coupled with threats of death, access to firearms, prior violation of an order of protection, the presence of more than one simultaneous protection order (multiple victims), and other forms of coercive control such as destroying personal mementos like favored Christmas ornaments and personal photographs.   A pattern of substance abuse further elevates the risk for domestic violence and DVH.

There are changes taking place in the way in which domestic violence is handled in many states here in the U.S.  Bail conditions are being reviewed with more stringent constraints being placed upon abusers including no bail containment of the most egregious and violent cases.  Further options like GPS monitoring and a domestic abuse registry are being considered in some jurisdictions.  Some experts are calling for added training for judges and greater access to DV history before making decisions about bail conditions.  Arguably, these examples will all add to greater victims security but do very little when emergency protection orders are issued by judges during the night.  Police are frequently asked to present information to an on-call judge in an effort to provide immediate protection following a suspected incident of DV.  This information is critical in conveying what risk exists to the victim or potential victims.  Many police agencies are using dangerous assessment tools to compile and enumerate the red flags that may be the harbinger of terminal rage and the end of one’s timeline somewhere.

Ronald Allanach et al., Psychological Autopsy of June 13, 2011, Dexter, Maine Domestic Violence Homicides and Suicide: Final Report 39 (Nov. 28, 2011), http://pinetreewatchdog.org/files/2011/12/Dexter-DVH-Psychological-Autopsy-Final-Report-112811-111.pdf.

Maine man held without bail in case of DV

Michael Sefton, Ph.D. Dangerousness assessment, Human Behavior, Parenting, Relationships , , , ,

Judicial_Review_02WESTBOROUGH, MA March 30, 2014  The Portland Press Herald reported on the case of Jason Lawrence who is being held without bail for domestic violence.  He is a repeat offender whose violence against women can be traced back to 1997.  Is anyone surprised that the well-being of victims in this case were not considered by the judicial system who twice released Mr. Lawrence into the community. Finally, the perpetrator’s actions convinced someone he was the real deal and is being held without bail in Maine. At what point does the well-being of victims and potential victims rise above the abuser’s right to bail?  Some circumstances warrant the containment of those who exhibit abject cruelty over and over.  Many states including Massachusetts are beginning to realize how emotionally dehiscent an abuser can become.  The case in Maine is the first I have seen to hold a violent abuser without bail in that state.

Recently, the SJC in Massachusetts denied to remove a protective order that has been in  place over 10 years.  He claimed to have “moved on” and wanted to work with children and own firearms – arguably two rights surrendered when domestic violence allegations have been proven against you.  The SJC called the rights of abusers to have protective orders dropped years later – as the collateral consequence for the years of documented abuse (Sefton, 2014).

In the June 2011, Dexter, Maine homicide, one police officer was heard to say he had never before been so afraid for a victim of domestic violence and in spite of those fears and having access to firearms, Steven Lake was released from custody with little bail. The subsequent Psychological Autopsy conducted in 2011 by 4 current or former law enforcement officers identified red flags – just like those exhibited by Jason Lawrence – as being highly predictive of domestic violence homicide (Allanach et al., 2011). Mr. Lake killed his family and then himself in June 2011. People knew this was his ultimate intention and said nothing until the terminal rage he concocted resulted in the deaths of 3 innocent citizens from the state of Maine. Red flags were identified in the post hoc analysis of the case and were presented to the Domestic Violence Homicide Review Panel in November, 2011 in Augusta.

Does anyone doubt what Mr. Lawrence’s ultimate intention was in the 3 weeks between arrests? His anger and marginal behavior were escalating by the day. It did not matter to Lawrence that a protective order was in place.  A “no contact” order means nothing to a man who believes all control has been taken from him.  Arguably, when a district attorney identifies someone as “one of the worst domestic violence individuals ever” – as in this case, those words should be key is setting the parameters for bail. Greater discretion for bail is necessary in this case just as when a police officer believes a victim is not safe from her purported abuser. Ultimately, the premonition of the deputy sheriff in northern Maine came true on the morning of June 12, 2011.

Mr. Lawrence is not afraid of the police or being sent to jail because he has no limits on what he can do. He does as he pleases and containment is the only correct solution.  Red flags were apparent as far back as 1997.  The valid predictor of future violence is past violence. regrettably, the secrecy of victims and those who choose remain silent are the one’s who might stop domestic violence.  And as a society we must do something to bring a voice to these individuals because to do nothing is unthinkable.

Read more from the Bangor Daily News:

http://bangordailynews.com/2011/11/28/news/piscataquis/report-details-dexter-family-murder-suicide-calls-for-new-way-of-handling-of-domestic-violence-cases/

Citation:

Ronald Allanach et al., Psychological Autopsy of June 13, 2011, Dexter, Maine Domestic Violence Homicides and Suicide: Final Report 39 (Nov. 28, 2011), http://pinetreewatchdog.org/files/2011/12/Dexter-DVH-Psychological-Autopsy-Final-Report-112811-111.pdf.

Sefton, M.S., Collateral Consequences, taken on 3-30-14,  https://msefton.wordpress.com/2014/03/11/collateral-consequences-stay-away-orders-that-are-forever/

“The underpinnings…

Quote Michael Sefton, Ph.D. Active shooter, Dangerousness assessment, Health Psychology, Human Behavior , , ,

“The underpinnings of violence are often present in some form or another and may be represented by marginalized demeanor and extremist views and often ignored by those in the cross hairs” according to Michael Sefton, Director of Psychological Services at Whittier Rehabilitation Hospital in Westborough, MA.

This quote represents a recurring belief about the evolving coping skill of an active shooter until the very end according to M Sefton.  The terminal event is often preceeded by growing fury and red flag signs of anger.  It suggests that greater awareness by outside observers of sudden changes in mental status should be recognized along with the utilization of stopping and containment protocols and coordination of care in or out of the state correctional system.

Aftermath Intervention: Police first to the threshold

Michael Sefton, Ph.D. Dangerousness assessment, Human Behavior , , , , ,

Necessary first steps for bringing chaotic families in from the margins

NEW BRAINTREE, MA  Domestic violence happens in family systems that are secretive, chaotic, and dysfunctional.  This lifestyle pushes them into the margins of society – often detached from the communities in which they live.  More often than not, this is the way they choose to live.

The abusive spouse makes his efforts known within the system by his barbaric authoritarian demands.  He keeps his spouse isolated as a way of controlling and manipulating whatever truth exists among these disparate family members.  The consequence of this isolation leaves women without a sense of “self” – alone an emotional orphan vulnerable to his threat of abandonment and ultimately, annihilation.

In previous blogs, I have published some of the obvious psychosocial consequences of this coercion, including the lack of employment, a paucity of extended family support, no source of independent financial resources, and limited social contacts.  Any sign of independence, signals to the abuser that he has not done enough to demoralize his intimate partner.

Successful intervention for these families must slowly bring them back from the margins into the social milieu.  Sometimes this happens when teachers attempt to engage parents in a dialogue about the child’s particular needs or when children demonstrate an interest in team sports.  Arguably, the resistance to this is so intense that the violent spouse will pull up stakes and move his family at the first sign of public scrutiny.  Why?

The underlying threat to the status quo raises anger and resentment in a narcissistic abuser who, like Snow White, expects one hundred percent loyalty and compliance.  All signs of independence are squashed – usually punished out of fear and loathing that is always percolating.

Police officers are regarded as the front line first responders to family conflict and DV.  For better or worse, the police have an opportunity to effect change whenever they enter into the domestic foray.  This affords them a window into the chaos and the opportunity to bring calm to crisis.  In many cases, the correct response to intimate partner violence should include aftermath intervention when the dust has settled from the crisis that brought police to this threshold.  When this is done it establishes a baseline of trust, empathy, and resilience.

There are inherent problems with any notion that police officers will return to the scene of bad domestic calls where there may have been a violent arrest only days before.  This stems from the adversarial model that exists in most law enforcement agencies where follow-up to criminal activity is rarely conducted by front line officers.   Many departments delegate follow-up investigations to detectives or in rare case civilian personnel.  This schism lacks fundamental adherence to the community policing mantra of building relationships between the police and its citizenry.

Community policing has long espoused the partnership between police and citizens.  The positive benefits to this create bridges between the two that may benefit officers at times of need – including the de facto extra set of eyes when serious crimes are reported.  But the model goes two ways and requires that police return to their calls and establish protocols for defusing future events meanwhile processing and understanding the current actions of recent police encounters. When done effectively the most difficult families may be kept off the police radar screens for longer periods of time that can be a good thing when it comes to manpower deployment and officer safety.

Domestic Violence Homicide: What role does exposure to trauma play in terminal rage?

Michael Sefton, Ph.D. crisis intervention, Dangerousness assessment, domestic violence, domestic violence homicide, Human Behavior, Relationships , , , , , ,
IMG_2126
Sgt. Michael Sefton in NBPD Humvee used for patrol and search/rescue

First responders experience trauma as job-related way of life

WESTBOROUGH,  MA December 1, 2013 There is a new question in my mind about the exposure to trauma, e.g. war-related PTSD and the possibility that it plays a role in domestic violence and domestic violence homicide later on.  While this link may be plausible, there are no scientific truth to the notion that DVH is caused by one’s exposure to war or on-the-job exposure to horrific events.  Scott D. Jones of Arlington, MA was a decorated paramedic who responded to a mass homicide in 2000 in which 7 people were shot in an episode of workplace violence. He would go on to kill his second wife and family 14 years later after repeated episodes of severe depression and suicidal behavior and domestic violence toward his first wife.  These behaviors were the first red flags of an impending emotional breakdown and terminal rage.

Returning veterans and those in the police and EMS service witness suffering and anguish that are outside of the normal human experience rendering them vulnerable to recurring trauma and a host of physical and emotional ills. Some believe the prevalence of PTSD among EMS first responders (including EMT paramedics) is as high as 16 percent (DeAngelis, 1995, p.36).  Most services require critical incident debriefing after incidents that are particularly catastrophic – especially those resulting in death of a member of service or the death of a child.  These sessions have been shown to reduce the incidence of post-incident symptoms by offering support and context for individual responders as to their individual role in the event. It is not psychotherapy although emotions are often evoked as remembered details emerge and become palpable.

What is the link between unresolved trauma and DV? It is well-known that a high incidence of substance abuse exists among first responders.   “The emotional wellness of emergency service workers is at risk. Stress and grief are problems that are not easily detected or easily resolved. Severe depression, heart attacks, and the high rates of divorce, addiction, and suicide in the fire and EMS services proves this” according to Peggy Rainone who offers seminars in grief and surviving in EMS. To what extent this behavior evolves from on-the-job experience is subject to debate but chronically high levels of stress contribute markedly to marital discord, job conflict, and a host of physical anomalies like hypertension.

kids_imagesThe link between chronic stress and behavioral health is well-known.  Does this link extend to higher risk for domestic or intimate partner homicide?  The recent case of domestic violence homicide in Arlington, Massachusetts raises the specter of DVH in first responders. In this case, a decorated paramedic allegedly killed his children, his wife and then himself.  The abuser had a history of physical and emotional abuse as reported by a first wife.  There was a history of alcohol abuse.  The abuser was involved in a whistle-blower case against his employer that was slowly making its way through the courts.  But outwardly, he and his family seemed happy. What might trigger such an emotional and deadly maelstrom?  What triggered the terminal rage that released this decorated man – creating a monster?

In some cases, post incident analysis of the psychological forces acting on the abuser is necessary and will provide insight into the chain of events that pulled on the trigger. There is no single answer but a host of identifiable “red flags” likely contributed to the loss of control associated with DVH.  A thorough psychological autopsy may uncover factors leading to unresolved anger and the many unknown variables driving violent behavior. I have previously published blogs on the psychological autopsy and its utility.  The benefit of a thorough PA has value for all of mankind.

  2. DeAngelis, (1995, February). Firefighters’ PTSD at dangerous levels. Monitor, pp. 36-37.
  3. Rainone, P. (2013) Emergency workers at risk. Taken 12-1-2013 (website) http://www.emsvilliage.com/articles/article.cfm?ID=176.

Active shooter evoke images of horror – fear

Michael Sefton, Ph.D. Active shooter, Dangerousness assessment, Human Behavior ,
Image
DC shooting scene taken off news channel

Right now in Washington DC, Metropolitan police officers are searching for the motive to today’s shooting onslaught that took place at a heavily guarded Naval facility in the southeast section of the nation’s capitol.  Arguably, Washington DC has the highest per capita number of law enforcement officers in the country.  Between federal law enforcement agencies like ATF, FBI, National Park police, Capitol police, and the full complement of highly trained Metropolitan officers, the city is well guarded.  Or so we thought.

The active shooter call is one that no officer ever wants to get.  It requires fast action, teamwork, and herculean bravery like no other call.   The “active shooter” refers to just that – ongoing, systematic slaughter of innocent civilians with the specific purpose of violence and murder.  These events start and end quickly averaging only 7-10 minutes before the shooter is dead.  Usually killed by his own hand but not before the execution or injury to scores of men, women and children.   Most police officers have taken the active shooter training programs that evolved after the Columbine HS shooting.  Since then, officers are trained to “move to contact” – go find the bad guy – do not to wait for special weapons teams as the former response zeitgeist once required.  Many behavioral scientists believe shooters give off clues before they act on their violent plans.

The active shooter has become an all too frequent happenstance that we cannot ignore.  In a blog published in April, 2013 information became apparent about Jared Loughner’s change in mental status and growing detachment from others (Sefton, 4-24-13).  People suspected that Loughner was becoming a danger to himself and others.  Unfortunately, there was no in-depth assessment of his mental status before he went on the bloody rampage.  Loughner plead guilty to the Tuscon shooting of Rep. Gabby Giffords and killing or wounding 18 others.  He is serving 111 years in prison.

WHAT HAPPENS TO THE HUMAN EXPERIENCE

The repeated exposure to horrific events  such as the DC Navy base shooting and too many others raise the risk of making toxic our collective conscience toward the images and horror and loss of life.  People feel denuded and afraid when they hear about shooting events such as these but something more needs to be done.  What drives these individuals?  In the coming weeks or months more information about the apparent shooter will become known.  Behavioral experts will make assumptions about his motive and the underpinnings of the violent onslaught.  “The psychological autopsy is a detailed analysis of the pre-incident emotional comportment and behavior of the violent decedent although this is rarely done” according to Michael Sefton.   More of these studies should be undertaken to establish high risk conditions that may create stopping and containment points for derailment of action and greater understanding of those with a proclivity toward terminal violence – such as what happened today.

What is certain is the need for each of us to be more aware of our surroundings and to those who might do us harm.  When confronted with evil it is incumbant upon each of us to think and take aggressive action that may save your own life and the lives of others.