Understanding violence

There are potentially significant absences in Professor Fonagy's otherwise illuminating editorial on the developmental aspects of violence, and he neglects to consider other related theories (Fonagy, 2003).

The word ‘father’ does not appear in his review and this would seem a major absence in the context of research showing consistent absences of stable paternal figures in those exhibiting antisocial behaviour, which is itself associated with violence (Pfiffner et al, 2001). It is particularly puzzling, as Professor Fonagy has himself explored the possible role of the absent father in the development of violent propensities (Fonagy & Target, 1995).

It is also perhaps premature to dismiss (or pathologise) the use of the term ‘psychopathy’. The literature, which includes distinguished psychoanalytic contributions (Reid Meloy, 2001), as well as explorations of possible biological factors (Dolan, 1994), suggests that the term has considerable utility in research, treatment and risk management, as well as potential dangers (Edens, 2001).

Other social aspects of violence are also not explored, including group dynamic aspects, which are possibly best illustrated by the breakdown of normal social mores in conflict and war. A relatively recent example is the Rwandan genocide, where individuals capable of perpetrating atrocities were then able to return to everyday existences.

Fonagy's review was also clearly concerned with violence at a population level and in relation to normal development. He does not consider, however, the important question of how violence in people with mental disorders might potentially differ from that in the general population, and how this issue needs continuing exploration by mental health professionals.