Investigating domestic violence, predicting danger, and containing the anger

image_502116fc-2724-4fe0-bba0-c375c3c85c13.img_0646
Dr Michael Sefton
Domestic violence homicide results when victims decide to move on with their lives and inform a jealous, insecure spouse that they no longer want a relationship. October is Domestic Violence Awareness month. The risk is greatest when victims decide to leave. At first glance one might say “Lots of people break up and do not murder their spouse and family” according to Michael Sefton shown in the photo above. That is a fair statement, but it happens enough in the United States and elsewhere that domestic violence homicide must be considered in the most egregious cases of DV. Last week in Massachusetts a family was murdered because one spouse asked to be let go and people were stunned that they saw nothing to warn them of what was brewing.
“Domestic violence is not random and unpredictable. There are red flags that trigger an emotional undulation that bears energy like the movement of tectonic plates beneath the sea.” according to Michael Sefton (2016).
At what point does a potential victims begin to wonder whether she and her children are safe? We are lead to believe that abusive intimate partners cannot be held in jail unless they are in violation of an order of protection, AKA: restraining order. This is untrue. But time and again, violent and abusive partners stalk and ignore orders of protection – especially using social media tracking software and trolling social media sites like Facebook, Instagram, and What’s App to find victims and watch their activity. It is all about control, pathological jealousy, and instilling fear and terror. Restraining order’s are authorized by a district court judge who is on call night and day in most parts of the country. Restraining orders are not authorized unless substantial threat to the victim exists.  These orders are carefully crafted by investigating police officers whose reports highlight the exact nature of the violence and the reason the victim needs protection. “Protection orders are offered to the victim after the first sign of physical violence. It has been espoused that the police are not called until after the 6th or 7th episode of domestic violence” according to Sefton, 2016.  DV is a secret affair between members of a family who are often ashamed or embarrassed to come forward for help often until things gradually get worse – sometimes years into a pattern of violent dysfunction. Research is clear that separating spouses for the night does not positively impact the level aggression and risk in the household as much as the formal arrest of the aggressor.  What usually happens is the police break up the fighting couple by sending the aggressor off to the home of a friend or family member – less often to jail unless there are obvious signs of abuse. Arrest is mandated by law when physical signs of abuse are apparent. It has become all too often the case that hindsight – taken seriously – may have saved a life. It is when they are attempting to leave that 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, et. al. 2011) that occurred in June 2011. Lake’s husband and murderer was heard to state that “if you ever try to leave me I will kill you”.  In research conducted by this author and colleagues we learned that as soon as police leave the scene the risk for violence is increased. We interviewed a man who served 18 years for the murder of his wife and he described in vivid detail how he used nonverbal coercion to manipulate his wife while being interviewed by sheriff’s deputies in Maine. He admitted that as soon as the police were out of the driveway he strangled and drowned his wife for calling them. In our interview, he claimed that she was his best friend. In the end, there is always at least a single person who knows what is about to happen and often does nothing to stop it. Whether this unwitting duplicity stems from the cultural belief that what happens behind closed doors is “nobody’s business” or the conscious result of intimidation should not change the proper law enforcement intervention in these cases. Early incarceration provides opportunity to draft a viable safety plan for potential victims and in some cases, will instill a desire for change in the violent partner. In the meantime, substantive buy-in from police, legislators, judges, probation, and society needs to be fully endorsed for real change to happen and for safety plans to work and violent partners to be contained. 
Allanach, RA, Gagan, BF, Loughlin, J, Sefton, MS, (2011). The Psychological Autopsy of the Dexter, Maine Domestic Violence Homicide and Suicide. Presented to the Domestic Violence Review Board, November 11, 2011 Sefton, M (2016). https://msefton.wordpress.com/2016/07/20/the-psychology-of-bail-and-alternatives-to-incarceration/ Blog post: Taken October 9, 2019

Public Awareness Needed for Meaningful Jail Diversion

teachinginprison

“If mental illness drives the violent behavior than all weapons and substance use must be carefully controlled and eliminated.” Sefton, 2017

Westborough, MA December 21, 2017 Jail diversion is a hot topic across the country even here in Massachusetts. Since July, 2017 the Massachusetts Legislature has passed sweeping changes in the Criminal Justice System.  Locally and across the country, the numbers of persons incarcerated for minor offenses and drug crimes has grown in some cases exponentially. Many of these individuals have mental illness or drug abuse in addition to their criminality. The interaction between poly-substance abuse or dependence and exacerbation of underlying mental health symptoms is complex and multifactorial. The interaction of the two is sometime lethal as reported by the Globe Spotlight team It is the focus of mental health advocates and criminal justice experts nationwide as it pertains to jail diversion, alternative restitution and reduced police use of force. In Massachusetts, there is a move away from mandatory minimum sentences for all drug crimes except for those involving the sale and distribution of narcotics. Arguably, the impact on behavioral functioning when persons are gripped with co-occurring illness, such as alcoholism, is a recurrent problem for law enforcement and first responders. I have written about the impact of co-occurring illness such as alcoholism on mental and behavioral health is previously published posts here on Word press Human Behavior (Sefton, 2017). It is difficult to uncover which comes first – the addiction or the diagnosed mental illness and yet these are inextricably linked in terms of the strain on public resources and health risk to those so afflicted. Why is this important?

The importance of treatment for substance dependence and mental illness cannot be understated as violent encounters between law enforcement and the mentally ill have been regularly sensationalized. The general public is looking for greater public safety while at the same time MH advocates insist that with the proper treatment violent police encounters may be reduced and jail diversion may be achieved. The referral and treatment infrastructure needed to provide a continuum of care in this growing population is available in very few places across America.

Yet in places like Bexar County, Texas – including San Antonio and 21 other towns or cities – the county jail population has dropped by over 20 percent as a result of crisis intervention training for police officers and mobile mental health teams to intervene with those in crisis. I have seen this for myself during a visit with the San Antonio Police Department where I rode with two members of the Mental Health Unit – Officers Ernest Stevens and Joseph Smarro. These men are exemplary in their assessment and intervention skill for keeping identified subjects off radar screens and out of the revolving door of the county jail.  It takes ongoing training, medical and psychiatric infrastructure, community compassion, and active engagement with members of the community to fly under the radar and effectively reduce the jail population. When necessary those most in need must have 24-hour availability for detoxification, emergency mental health, and access to basic needs such as food, clothing, and medicine. In San Antonio, they offer so much more including pre-employment training, extended housing, interview preparation including clothes, and opportunity for jobs.

The unpredictability of behavior by those who carry a “dual” diagnosis has emerged as a confounding factor in the criminal justice system raising the specter of frustration over the limitations within the system. Jail diversion programs and treatment options are needed in order to retain public safety goals and provide for needs of the mentally ill and substance dependent. In Massachusetts, cities and towns are grappling with how best to intervene with the mentally ill in terms of alternative restitution for drug-related misdemeanor crimes in lieu of mandatory jail sentences that many crimes currently require. The Massachusetts legislature has taken up Criminal Justice Reform and passed a bill in late 2017 making changes in the mandatory minimum sentencing laws.  Some believe, as much as 20-40 percent of all incarcerated persons suffer with mental health diagnoses and are not getting the treatment they require. To provide a bare bones system would add billions to state and federal dollars spent on the needs of inmates at a time when measurable outcomes for in house care are limited.

In my practice, I see many cases of co-occurring pain syndromes with other physical debilities such as stroke or traumatic brain injury. Some of these cases are substance dependent and live lonely, chaotic lives.  Generally the emotional impact of two or more diagnosed illnesses yields a greatly reduced capacity for adaptive coping and puts a great stress on the individual system. The importance of addressing co-occurring substance abuse or dependence is now well recognized and with treatment can result in healthy decision-making, growth in maturity, and greater self-awareness. If legislators have a serious desire to reduce statewide numbers of incarcerated persons a comprehensive plan must be considered for both pre-arrest and post-arrest. Programs greater understanding of addiction and added treatment options must be explored through a joint public and private initiative.

Mental and Physical Health Screening

At time of arrest the individual must have some level of mental health assessment if mental illness is suspected or documented. When I was a police officer prior to 2015 we often asked the D.A. to provide a court clinic assessment of the suspect to rule out suicidal ideation or delusional thinking. This must also include a screening for dangerousness especially when a subject is arrested for intimate partner abuse. Next a health history questionnaire should be undertaken to screen for co-occurring illness – both physical and mental. If a diabetic suspect is held without access to his insulin he is at great risk of death from stroke. Similarly, a person arrested for assault who suffers from paranoid ideation is at greater risk of acting violently without access to psychiatric medication. Finally, an alcoholic brought to the jail with a blood alcohol level greater than 250 is at great risk for seizures and cardiac arrhythmias when delirium tremens begin 6-8 hours after his last drink. The risk to personal health in each of the scenarios above must be taken seriously and the obtained data should be factually corroborated. Police departments across the United States are pairing up with private agencies to provide in-house evaluation and follow-up of individuals who fall on the borderline and may not be easily assessed by the officer in the field.

Diversion Safety Plan with Mandated Revocation

Next, the probation and parole department must obtain an accurate legal history prior to consideration for bail. A nationwide screen for warrants and criminal history based on previous addresses is essential. In many places these are being done routinely. In the case of someone being arrested for domestic violence he may have no convictions thus no finding of criminal history. For these individuals the dangerousness assessment may bring forth red flag data needed for greater public safety resulting in protection from abuse orders, mandated psychotherapy, and in some cases, no bail confinement when indicated. Releasing the person arrested for domestic violence without a viable safety plan increases the risk to the victim and her family, as well as the general public – including members of law enforcement.

Bail, Confinement, Mandated Treatment

There is some thinking that higher amounts of bail may lessen the proclivity of some offenders to breach the orders of protection drafted to protect victims and should result in revocation of bail and immediate incarceration when these occur. Mandated treatment may be more successful when legal charges are held as leverage where after 6 months of sober living and regular attendance at 12-step recovery meetings charges can be dismissed or modified to each individual case.  This takes a complete overhaul of the front end of criminal justice system and requires buy-in by judges, district attorneys, and individual family members.

When it comes lack of compliance and repeated domestic violence, I have proposed a mandatory DV Abuse Registry that may be accessed by law enforcement to uncover the secret past of men who would control and abuse their intimate partners. This database would also include information on the number of active restraining orders and the expected offender’s response to the “stay away” order. In cases where the victim decides to drop charges there should be a mandatory waiting period of 90 days. During this waiting period the couple may cohabitate but the perpetrator must be attending a weekly program of restorative justice therapy, 12-step recovery and substance abuse education. Violations of these court ordered services are tantamount to violation of the original protection order (still in place) and victim safety plan and may result in revocation of bail. If the waiting period passes and the perpetrator has met the conditions of his bail than he may undergo an “exit” interview to determine whether or not the protection order / jail diversion plan may be extended or whether he/she has met all requirements.  In any case further police encounters will be scrutinized and prior charges may be re-instated or filed as needed.

Michael Sefton


Sefton, M. (2017) Human Behavior Blogpost: https://msefton.wordpress.com/2017/03/30/police-are-building-bridges-and-throwing-life-savers/ taken December 10, 2017

Maine man held without bail in case of DV

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/

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

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.


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