The hand that rocks the cradle

1. The hand that rocks the cradle George Hosking Domestic violence & abuse: Whose business? It’s everyone’s Adva conference, Dartington Hall, 29 November 2007

3. Anthropologist David Levinson Cross-cultural study of 90 societies around the world 16 communities: inter-personal violence absent or rare These societies came from all regions of the world (the Lapps the only Europeans) Violence is not inevitable

4. Key Finding: Two components to Violence 1) The propensity to be violent (personal factors) The triggers of violence (social factors) longer period between puberty and beginning work teenage alcohol consumption growth of TV viewing, modelling violent behaviour huge expansion in territory young males cover, without supervision reduction in stable marital relationships to provide consistent parenting growing drug consumption Social factors lead to violence ONLY when propensity is present Understand causes of violence

5. Key Finding: Two components to Violence Social Factors, Triggers, are like a fuse which lights a bomb Propensity to Violence is like an unexploded bomb WAVE’s approach: if we cannot reduce the fuses, let us remove the unexploded bombs. Intervene beforethe Propensity to Violence is installed in young children Understand causes of violence

6. 10% of elderly people in Britain subject to abuse and neglect 42% of murder/manslaughter cases involve a domestic dispute One third of domestic victims are children NSPCC estimated 3-4 children die at the hands of their parents or carers in the UK every week 2 through abuse or neglect Causes of violence: Deepest roots lie in the family

7. International studies trace roots of violence to: parental competence and family control methods (e.g. McCord) poor parental child rearing (e.g. Farrington) unskilled parenting (e.g. Capaldi and Clark; Kazdin, Loeber, Dishion; Rutter & Giller) harsh parental discipline (e.g. Patterson) power-assertive punishment (e.g. Cohen) Causes of violence: Deepest roots lie in the family

8. Dunedin study of all children born in 1972, to age 21 At age 3, an ‘at risk’ group identified by nurses At age 21, ‘at risk’ males, compared with others: 2.5 times as many with 2+ criminal convictions 3 times as many with anti-social personality 55% of their offences violent (18% others) 47% abused their partners (9.5%) Pathways to violence often laid down by age 3

9. Dunedin study: ‘At risk’ group offences much more serious (e.g. robbery, rape, homicide) Fewer females conduct disordered, but for those who were: 30% of ‘at risk’ group had teenage births (vs. 0%) 43% were in violent, abusive relationships Pathways to violence often laid down by age 3 “Immature mothers, with no strong parenting skills and violent partners have already borne the next generation of ‘at risk’ children”

10. Male aggressive behaviour highly stable as early as age 2 No other childhood factor predicts more of the variation in adult antisocial behaviour, than early aggression The earlier aggression is established, the worse the long-term outcome tends to be Serious anti-social behaviour highly resistant to change in school-age children and adolescents Aggression: an enduring trait

11. Works via neurons (brain cells) & synapses (connections) At birth: 50 trillion synapses - 1,000 trillion by age 3 Too many to be specified by genes: formed by experience Sculpted: Repeated use hard-wired; superfluous eliminated Implies very rapid learning via early life experience Understanding the infant brain

12. For evolutionary reasons, compared with other mammals, infant brain develops outside womb Flexibility in sculpting of the brain has survival value One infant develops acuity for hunting and survival Another filters out overwhelming urban noise Very sensitive to environmental experience Understanding the infant brain

13. Premature infants, touched and held on a regular basis gain weight more quickly greater gains in head circumference greater overall improvement Rats and mice in stimulating environments had 25% more synapses (rats), 15% more neurons (mice) Maternal depression, nicotine, alcohol all impede brain development Understanding the infant brain

14. Critical Windows Critical windows of time during which brain hones particular skills or functions Size of window different for different skills If the chance to practise a skill is missed during the window, a child may never learn it (or be impaired) Understanding the infant brain

15. Critical Windows Synapse formation in visual cortex peaks at 3 months, finished by age 2 Auditory map formed by 12 months after this Japanese infant struggles to distinguish “L” and “R” Deaf children need language exposure before age 5 Emotionalbrain largely created in the first 18 months Understanding the infant brain

16. Infant brain acutely vulnerable to trauma If early experience fear: stress hormones wash over brain like acid Children’s brains reflect world in which they are raised If characterized by threat, chaos, unpredictability, fear, trauma development of neural systems for stress and fear responses altered Understanding the infant brain

17. Brains of abused children significantly smaller many areas dark on CAT scans (“black hole”) limbic system (emotions) 20-30% smaller, fewer synapses hippocampus (memory) smaller increased activity in locus coeruleus (hair-trigger alert) Understanding the infant brain

18. Understanding the infant brain

19. Alan Schore - 10-year immersion in thousands of scientific papers in neurobiology, psychology, infant development Shaped by the carer’s interaction style “The child’s first relationship, the one with the mother, acts as a template … permanently moulds the individual’s capacity to enter into all later emotional relationships”

20. Infant brain needs time to mature, so … Baby regulates inner world by aligning emotional state of mind with caregiver Empathic attunement acts like emotional umbilical chord Methods: Eye gaze, facial expressions, nonverbal signals Shaped by the carer’s interaction style

21. Attunement: parent and child emotionally in tune with each other Not mimicking: rather a correspondence of behaviour to their feeling state Responding to emotional needs leaving it feeling understood, cared for, valued Empathy begins with sense of “oneness” with the other – coming from attunement Keys: Attunement and Empathy

22. Lack of attunement means empathy does not develop Low maternal responsiveness at 10-12 months predicted: at 1.5 years: aggression, non-compliance, temper tantrums at 2 years : lower compliance, attention getting, hitting at 3 years : problems with other children at 3.5 years: higher coercive behaviour at 6 years : fighting, stealing Keys: Attunementand Empathy

23. Empathy the single greatest inhibitor of propensity to violence Established early by observation of parental reaction to suffering Babies show empathy by one year old. Not all develop this Abused toddlers react negatively or aggressively to signs of distress Keys: Attunement andEmpathy

24. Precondition for violence: person lacks inhibiting feelings Absence of empathy characteristic of violent criminals – worst psychopaths no emotion at all Ralph W described his feelings just before murdering 14-year old girl: “I had no feelings. I just felt empty – no love, hate, sadness, remorse” and just after: “I felt nothing”. (Gilligan Violence: Our Deadly Epidemic and its Causes) Keys: Attunement andEmpathy

25. Domestic violence perpetrators show lack of emotion, empathy “I was struck by … The emotional poverty of their thought and speech, the flat affect…They described actions that people performed, but those descriptions rarely entered the inner realm. My colleagues and I would talk facetiously of the men being in “emotional kindergarten” but it was not really a joke.” (Dutton, 1998) Keys: Attunement andEmpathy

26. MacLeod and Nelson studied 56 programmes designed to promote family wellness and prevent child maltreatment Most interventions are successful The earlier the intervention the better Prevention (proactive) had greater effect sizes at follow-up Reactive interventions tend to fade over time, relapse common Early Prevention works

27. ROOTS OF EMPATHY FIRST STEPS IN PARENTING NURSE FAMILY PARTNERSHIP SUNDERLAND INFANT PROJECT Early Prevention works

28. US Head Start: benefits $2.50-$10 per $1 invested Olds: home visiting paid back in 4 years, 5-15 all gain Rand: parent training highly cost effective approach to reducing crime - much cheaper than teenage supervision or prison Institute of Psychiatry: £70,000 per conduct disordered person vs £7,400 normal Early Prevention saves public money

29. When do we learn best? Source: J Heckman & D Masterov (2005) Ch 6, New Wealth for Old Nations: Scotland’s Economic Prospects

30. Implication for optimum investment Source: J Heckman & D Masterov (2005) Ch 6, New Wealth for Old Nations: Scotland’s Economic Prospects

31. Pattern of public spending on education in England & Wales over the life cycle, 2002/2003 Source: Speech by Charles Clarke, Labour Party Conference, Bournemouth, 30 September 2003

34. Every child should leave school trained in non-violent parenting and attunement with babies At first pregnancy, every parent to receive supportive coaching on successful emotional development of child Babies in “at risk” families monitored in first 3 years, with family support from regular health visitors Wave’s Recommendations

35. Government should increase share of resources for early interventions Large-scale implementation of a series of pilot studies of approved early interventions One British city / town as large-scale test area National violence prevention agency to co-ordinate, fund and drive early prevention strategy Wave’s Recommendations

36. Iroquois red Indians Javanese Kalahari bushmen Lapps Kurds The Central Thai Andaman islanders domestic violence: the realities

37. “Beat a woman and a horse every 3 days” (Serbian saying) “Your abuse is the ring in my ear, Your blows are my toe rings, If you kick me it is my pulse and rice, The more you beat me with your shoes The more we are united” (Indian love poem) domestic violence: the realities

38. In the UK: 530,000 domestic assaults p.a. – one per minute Spouse abuse occurs in 25% of marriages 10% of women report they suffer this annually 7% of wives experience severe violence on a regular basis domestic violence: the realities

39. Only 12% of domestic assaults reported to the police Only a small minority recorded Majority reporting violence suffer regular aggression 1/3 attacked more than 6 times a year Average female victim seriously injured four times a year 2 women killed per week domestic violence: the realities

40. 80% of children in violent families will witness domestic violence If spouse abuse occurs, a very high probability of child abuse also Witnessing mother assault  childhood conduct/personality disorders Witnessing an adult strike their single parent mother  more frequent and severe violence to mother Teenagers from violent homes more likely to abuse romantic partners witnessing domestic violence

41. Borderline Personality Organisation (BPO): Intense, unstable relationships with periodic undermining of the other, manipulation, masked dependency Unstable sense of self with intolerance of being alone Abandonment anxiety Intense anger, demandingness, impulsivity Highly cyclical mood swings Psychological profile of DV perpetrators

42. Borderline Personality Organisation (BPO): Degree of BPO correlated with: abusiveness (verbal, physical, emotional), anger, jealousy, tendency to blame women High level of trauma symptoms in BPO & assaultive men (depression, sleeplessness, anxiety attacks) The higher the trauma symptoms, the higher the BPO BPO arises early in life, with early physical abuse very frequent Psychological profile of DV perpetrators

43. Post Traumatic Stress Disorder (PTSD): Assaultive men closely match psychological profiles for PTSD Only differences: PTSD men feel worse, assaultive more aggressive Trauma symptoms related to the man’s early upbringing These men had little insight into the cause of their problems and avoided seeking help, believing “it will only make things worse” Psychological profile of DV perpetrators

44. Female explanations of the violence: He becomes irritable for no apparent reason He reacts with escalating verbal then physical abuse He is pathologically jealous He draws ludicrous conclusions about non-existent affairs He externalises blame for everything He is never wrong He goes through rising tension cycles unrelated to his surroundings Dutton analysis: Wife-assaulters

45. Female observations: “He’s like two different people” “He’s like Jekyll and Hyde” “His friends never see the other side of him” “I never know which one is coming in the door at night” “He’s like living on an emotional roller-coaster” Dutton analysis: Wife-assaulters

46. Expand role of criminal justice system to include treatment Intensive victim services Treatment for batterers Legal requirement to undergo treatment Emphasis on treatment and needs of children in violent homes Wave: domestic violence recommendations

47. Only 18% of those completing Dutton’s programme re-offended in next 5 years Effect sizes of treatment: Programmes for spouse abusers 0.30 Coronary by-pass surgery 0.15 Chemotherapy 0.09 Dutton analysis: does treatment work?

48. www.wavetrust.org ghosking@wavetrust.org For a copy of the presentation or the WAVE Report