Risk Assessment for Violence, Playing the Odds

By Joyce Alexander, RNP (Retired)

I recently bought a book, Violence Risk and Threat Assessment: A Practical Guide for Mental Health and Criminal Justice Professionals, by J. Reid Meloy, Ph.D. I actually bought it to give some “credence” to the statistics I put into my letter to the parole board protesting the release on parole of the Trojan Horse-Psychopath that attacked our family,

Of course this book is directed, as the title says, to professionals, and to assess risk of violence. But since we are dealing with psychopaths, it is, I think, a good idea for us to be able also to look at the assessment for possible violence in our own psychopaths when we thwart their desires, or kick them to the curb. We need to answer the questions, “Is my psychopath likely to respond with violence? If so, how?”

Most violent individuals are not violent all the time. In the introduction, the author illustrates that “just because an abnormality (in behavior) ”¦ only shows on occasion, does not mean it has gone away.” (My emphasis.)

A “false negative” is when you decide that your individual will not be violent, and you are wrong. You may pay for this decision with your life. A “false positive” is when you think your individual will be prone to violence, and they are not. Being prepared for violence, even if your individual psychopath does not turn out to be physically violent is, of course, the safest way to play it. If you are going to err, erring on the side of caution is the best course. False positives are less damaging to us than false negatives.

There are also different kinds of “violence.” Not all violence that does damage to us is physical. Psychopaths can become financially violent and deprive us of our income, our estate, and a hundred other violations that we can all imagine.

Contributors to violence

Dr. Meloy uses what he calls a bio-psycho-social model for Violence Risk Assessment to assess an individual’s risk for violence. This consists of the biological aspects, the psychological aspects and the social aspects of the individual in question.

The first, the psychological domain, contains such things as gender, age, past history of violence, frequency of violence, how recent have they been violent, and severity of past violence, paranoia, intelligence, anger, fear problems, and the frequency and intensity of them, as well as control of impulses. Of course, the psychopathy and other attachment problems will weigh in heavily on this.

The second, the social or environmental domain, looks at the family of origin violence, economic instability and poverty, WEAPONS HISTORY, weapon skill, interest and approach behavior, as well as alcohol and or psycho-stimulant use.

The third domain is the biological one. Is there a history of head trauma, or major mental disorder (like untreated bi-polar disorder).

Dr. Meloy also emphasizes that the MOST IMPORTANT factor in his judgment is the history of past violence. The best predictor of future violence is a history of past violence.

Questions to ask yourself in doing your own “risk assessment for violence” in your psychopath are: How “provoked” is your psychopath by losing you? Do they have the paranoid personality disorder, in which they feel “that everyone is out to get them,” with a long memory for imagined slights or wounds from those people “out to get them”? Are they chronically angry, fearful and jealous? Some forms of illegal drugs will also contribute to paranoia, and as the use of drugs and the interest and reliance on weapons goes up, so does the risk of violence. Dr. Maloy mentions the killing of Nichole Brown Simpson, where she was not only killed, but after death her body almost beheaded. He says that drugs, along with the rage, could have easily lowered the threshold for the abandonment rage which probably motivated the killer.

Fear and stalking

Dr. Meloy also goes into the lack of difference between biochemical reactions to both fear and anger. Both cause the same reaction within the body. How intense is the anger response in the person you are evaluating? How does the person handle anger?

Dr. Meloy differentiates between two different kinds of violence by illustrating his text with a story about a cat.

We have all seen a cat, cornered by a dog, with its hackles raised, its tail up, hissing and spitting. That cat is emotionally reacting in a violent way to the fear inside it that it is going to be attacked by the dog. (This is called “affective” or emotional violence in reaction to a perceived threat.) Once the perceived threat is gone, the cat will quickly return to a state of calm. The purpose of this kind of violence is “threat reduction.”

The second type of violence illustrated with another story of a cat is the predatory violence, which is planned and purposeful and goal directed.

The planned and purposeful (or predatory) violence has a minimal or absent autonomic arousal, (which is the hair standing on end, the hissing and spitting etc.). As you observe the cat in predatory violence—such as stalking a mouse or bird—the cat is calm, cool and collected. It is focused on a goal as it stalks the prey. It tries to keep its purpose (violence) hidden and it tries to keep the prey from realizing that it is prey.

The brain chemicals released in each of these states of violence are completely different. The emotionally generated fear induced violence is a defense mechanism. It can still be a threat to anyone who is the perceived enemy, but it quickly subsides once the threat is gone.

With predatory violence, the predator is goal directed to do violence to the prey. They may plot and plan and take quite some time to stalk and corner the prey. The predator may strike without warning. Unlike emotionally (fear) induced violence, predatory violence is not time limited and the stalking may go on for days, weeks, months or years.

Knowing which type of violence your psychopathic adversary is involved with at any given moment can help you assess what your course of action should be. If the Psychopath is showing the “cornered cat” response, for example for being confronted in a lie, your best response is to just “back off” and let them calm down when the perceived threat is removed. If the psychopath is stalking you; emotionally, financially, or physically, they will not be so obvious to spot as the enraged cat. Once you have determined that the person you are dealing with is a psychopath, or likely one, you must assume that the person will engage in predatory violence on some level. The fact that this stalking and predatory violence may be very subtle does not make it any less dangerous.

In the short term, cornering one in a threatening manner (confrontation of any kind) can produce an emotionally violent response or even physical attack, but in the long term, the predatory violence can do more damage to us, body and soul. We need, I think, to assess the state our psychopath is operating in, and learn when to back off with confrontations, and when to prepare ourselves for “out of the blue” attacks when they are in a predatory state.