Living with the perpetrAtor

1. Living with the perpetrAtor Dr. Mark Farrall www.ignition-learn.com info@ignition-learn.com Twitter: @DrMarkFarrall

2. Living with the perpetrAtor What the research tells us

3. Dr. Mark Farrall • Director, ignition Creative Learning • Forensic Psychologist • Group psychotherapist • Group worker (MI 1997) • Member of international Motivational Interviewing Network of Trainers (MINT 1999) • Founder member/Vice Chair of Respect

4. My history in this work • 1994 – work with IPVA alongside Probation • 2000 - Consultancy support to UK probation – Duluth ‘pathfinder’ • 2003 - Developed ‘Action for Change’ 6 month IPVA group prog.- • - RADAR risk assessment instrument • - One to One pre-group programme • - Six month group programme MI & action • 2010 – ‘Choosing to Change’ for Relate • 2011 – Strength to Change’ for child protection • 2013 – NOTA Keynote

5. AIMS • ‘Living with perpetrator’ • Gender inclusive continuum • Motivations?

6. Some history ‘Feminist’ Gender inclusive - Psychologically & therapeutically informed - Family studies, heterogeneity - Ignoring the societal - Feminist activism, political, power & control, patriarchy - Crime studies, homogeneity - ‘One size fits all’, a priori,

7. Paradigm wars Gender inclusive research ‘versus’ feminism • “Do We Want to Be Politically Correct, or Do We Want to Reduce Partner Violence in Our Communities?” (Hamel 2010) • “The Gender Paradigm and the Architecture of Antiscience” (Dutton 2010)

8. What can we say from research

9. Partner Abuse State of Knowledge (PASK) • February 2010 beginning • 42 researchers, 17 topics • Papers since 1990+ (12,000 studies) Rates of male & female victimisation (Desmaraiset al 2012a) • One in four women, one in five men = symmetry, gendered effects Rates of male & female perpetration (Desmaraiset al 2012b) • Overall prevalence 24.5%, pooled prevalence = women more Bi-directionality (Langhinrichsen-Rohlinget al 2012a) • Almost 60% Risk factors (Capaldiet al 2012) • No major evidence of gender difference

10. Partner Abuse State of Knowledge (PASK) Motivations(Langhinrichsen-Rohlinget al 2012b) • Power & control 76% • Self-defence 61% • Negative emotion 63% • Communication/influence 48% • Retaliation 60% • Other 63%

11. Propensity to Intimate Partner Violence as a personality trait • Magdolet al (1997) • Moffitt et al (2001) • Ehrensaftet al (2004) • Serbinet al (2004) • Capaldiet al 2004 • All did longitudinal studies on peer cohorts-aggressiveness in females…..

12. Results • Female adult IPV is predictable (age 15) • Aggressive girls in Grade 1 (age 7) were most likely to seek violent boyfriends, to use IPV (Intimate Partner Violence) independently of boyfriend’s use

13. A gender inclusive continuum? Severity of behaviour/risk of harm LESS MORE ‘Situational couple violence’ ‘Intimate terrorism’ Johnson (2008) Severity of behaviour/risk of harm MORE LESS Respectful, equal, co-operative, ‘happy’ relationships Mostly respectful, equal, co-operative, relationships, but experiencing difficulties Acrimonious, conflictual, non-communicative relationships Situational couple conflict – violence and abuse both ways ‘Intimate terrorism’ Convictions? • Couples work if: • Really is two way • Want to stay together • No ‘fear of death’ Couples RELATE might see on a one to one basis Couples RELATE might see as a couple

14. A gender inclusive continuum? Severity of behaviour/risk of harm MORE LESS Respectful, equal, co-operative, ‘happy’ relationships Mostly respectful, equal, co-operative, relationships, but experiencing difficulties Acrimonious, conflictual, non-communicative relationships Situational couple conflict – violence and abuse both ways ‘Intimate terrorism’ Convictions? ‘Official’ intervention • Couples work if: • Really is two way • Want to stay together • No ‘fear of death’ Couples RELATE might see on a one to one basis Couples RELATE might see as a couple PASK: >60% of IPVA ‘low level’ >60% ‘bi-directional

15. So how do we explain…. • 41% - 57% of female homicides killed by (ex) partner • No reciprocity female to male (5%) (Smith. Ed.) (2012) • Gendered effects – violence in general committed by males, women injured worse • Family conflict versus crime studies

16. ‘Family conflict’ vs ‘crime’ Crime studies, without exception, show much higher rates of assault by men, often 90% by men. Family conflict studies, without exception, show about equal rates of assaultby men and women. Crime studies also find a prevalence rate (for both men and women) that is a small fraction of the rate of assaults found by family conflict studies. Crime studies deal with only the small part of all domestic assaults that the participants experience as a crime, such as assaults which result in an injury serious enough to need medical attention, or assaults by a former partner (domestic violence) These occur relatively rarely and tend to be assaults by men – (‘gendered harm’) Family studies deal with ‘everything’ (abuse, controlling behaviours)

17. A gender inclusive continuum? Severity of behaviour/risk of harm MORE LESS Respectful, equal, co-operative, ‘happy’ relationships Mostly respectful, equal, co-operative, relationships, but experiencing difficulties Acrimonious, conflictual, non-communicative relationships Situational couple conflict – violence and abuse both ways ‘Intimate terrorism’ Convictions? ‘Official’ intervention • Couples work if: • Really is two way • Want to stay together • No ‘fear of death’ Couples RELATE might see on a one to one basis Couples RELATE might see as a couple PASK: >60% of IPVA ‘low level’ >60% ‘bi-directional

18. Motivations: What can we say from research

19. Culture, patriarchy, socialisation, observational learning, gendered toys, ‘rule of thumb’, media, sexualisation etc. Traumatic experience Social learning Intimate Partner Violence & Abuse Attachment Treatment Change Personality traits

20. "Violent husbands evidence more psychological distress, more tendencies to personality disorders, more attachment/dependency problems, more anger/hostility, and more alcohol problems than nonviolent men“ (Holtzworth-Munroe et al (1994) Traumatic experience Social learning Intimate Partner Violence & Abuse Attachment Treatment Change Personality traits

21. IPVA Perpetrator Typologies Descriptive dimension ‘Andy’ Generally Violent ‘Billy’ Borderline/Dysphoric ‘Charlie’ Family Specific Severity of violence Psychological & sexual abuse Extrafamilial violence Crime behaviour Personality disorder Alcohol/Drug misuse Depression Anger Moderate-High Moderate-High Low Moderate-High Moderate-High Low High Low-Moderate Low High Low-Moderate Low Anti-social or Borderline or None or Psychopathy Schizoid Passive-dependent High Moderate Low Low High Low-Moderate Moderate High Moderate

22. Treatment needs table

23. Propensity to Intimate Partner Violence as a personality trait • Personality characteristics and conduct disorder are more predictive of Intimate Partner Violence than gender (Ehrensaft, Cohen, and Johnson 2006) • A hostile, untrusting, ‘negative’ way of relating • Based in trauma & previous experience

24. "Violent husbands evidence more psychological distress, more tendencies to personality disorders, more attachment/dependency problems, more anger/hostility, and more alcohol problems than nonviolent men“ (Holtzworth-Munroe et al (1994) Traumatic experience Social learning Intimate Partner Violence & Abuse Attachment Treatment Change Personality traits

25. Attachment A primary motivation in all people is the need to seek and maintain contact with others. Since (as children) our well-being and survival depends on securing the protection of attachment figures, that relationship is our central concern throughout childhood, and... itsunresolved insecurities linger into adult life, including marriage and intimate relationships.

26. Positive view of OTHERS (You’re OK) Original carer response: Unpredictable but positive Preoccupied/anxious attachment ‘I’m not OK, you’re OK’ Original carer response: Predictable & competent Secure attachment ‘I’m OK you’re OK’ Positive view of SELF (I’m OK) Negative view of SELF (I’m NOT OK) Original carer response: Unpredictable and negative Fearful/Avoidant attachment ‘I’m not OK you’re not OK’ DISORGANISED Original carer response: Predictable & negative Dismissive/Avoidant attachment ‘I’m OK you’re not OK’ Negative view of OTHERS (You’re NOT OK) Bartholomew & Horowitz (1991) Four category model adult attachment

27. Attachment in IPVA • 40% dismissing attachment (versus 25% in the non-clinical population) • 30% preoccupied attachment (versus 10% in the non-clinical population) • 30% disorganized attachment (versus 5% in the non-clinical population) (Sonkin 2012) • Link between preoccupied attachment and intimate abuse • Link held for both psychological and physical abuse, and for both receipt and perpetration of abuse (Bartholomew et al 2005)

28. Attachment in IPVA • Early life separation and loss more strongly associated with adult DV perpetration than exposure to child abuse or parental violence (Corvo 2006) • Insecure attachment styles related to abusiveness. (Babcock et al 2000) • Fearfully attached men experience high degrees of chronic anxiety and anger. (Dutton et al 1994) • Attachment style related to disregulation of negative emotions in intimate relationships (Mikulincer 1998) • ‘Couple fit’ matters (Bartholomew et al 2005)

29. Positive view of OTHERS (You’re OK) Original carer response: Unpredictable but positive Preoccupied/anxious attachment ‘I’m not OK, you’re OK’ Original carer response: Predictable & competent Secure attachment ‘I’m OK you’re OK’ Positive view of SELF (I’m OK) Negative view of SELF (I’m NOT OK) Original carer response: Unpredictable and negative Fearful/Avoidant attachment ‘I’m not OK you’re not OK’ DISORGANISED Original carer response: Predictable & negative Dismissive/Avoidant attachment ‘I’m OK you’re not OK’ Negative view of OTHERS (You’re NOT OK) Bartholomew & Horowitz (1991) Four category model adult attachment

30. "Violent husbands evidence more psychological distress, more tendencies to personality disorders, more attachment/dependency problems, more anger/hostility, and more alcohol problems than nonviolent men“ (Holtzworth-Munroe et al (1997) Traumatic experience Social learning Intimate Partner Violence & Abuse Attachment Treatment Change Personality traits

31. Traumatic experience: physical abuse • Physical abuse - Sexual abuse - Battered mother - each increased the risk of victimization or perpetration of IPV approximately two-fold. - statistically significant graded relationship between number of violent experiences and the risk of IPV. • Among persons who had all three forms of violent childhood experiences, the risk of perpetration was increased 3.8-fold for men (Whitfield et al 2003)

32. Traumatic experience: Shame • 45% of wife assaulters met research criteria for PTSD and exhibited elevated levels of chronic trauma symptoms (Dutton 1995) • The source of trauma was physical abuse combined with shaming by the father and a lack of secure attachment to the mother. Hence, the latter could not provide buffering against the former (Dutton 1998, 2002). • Tangneyet al (1992) see shame as a mediator between the early experiences of assaultive men and their adult experience of anger and abusiveness. • Shame-proneness involving a "global, painful, and devastating experience in which the self, not just behavior, is painfully scrutinized and negatively evaluated" (Tangneyet al 1992 p. 599).

33. Traumatic experience: Shame • Shame-inducing experiences, which generate a shame-prone style, may be viewed as attacks on the global self and can produce disturbances in self-identity. • Shame-prone individuals have been found to demonstrate limited empathic ability, a high propensity for anger, and self reports of aggression(Wallace & Nosko, 2002) • Recollections of shame-inducing experiences by parents of assaultive men significantly related to the men's self-reports of anger and physical abuse (Dutton, van Ginkel, & Starzomski 1995) • “These features of an abusive personality (insecure attachment, borderline traits, and trauma reactions) have not been an explicit focus of treatment for spouse assault.” (Corvo, Dutton & Chen )

34. So what is living with the perpetrator like? • A hostile, untrusting, ‘negative’ way of relating • A stable, coercive, personality style • Volatile, touchy, angry, frightening, unreasonable • Cold, distant, controlling, uncaring, bullying, • Emotionally & psychologically abusive – physically to some degree

35. Thank you for listening • www.ignition-learn.com • info@ignition-learn.com • Twitter: @DrMarkFarrall

36. References 1 • Babcock, J., Jacobson, N., Gottman, J. & Yerington, T. (2000) Attachment, Emotional Regulation, and the Function of Marital Violence: Differences Between Secure, Preoccupied, and Dismissing Violent and Nonviolent Husbands. Journal of Family Violence, Vol 15, (4) pp391-409 • Bartholomew, K. & Horowitz, L. M. (1991). Attachment styles among young adults: A test of a four category model. Journal of Personality and Social Psychology, 61, 226-244.  • Bartholomew, K., Henderson, A., & Dutton, D. (2005). Insecure Attachment and Abusive Intimate Relationships. In Clulow,C. (Ed.), Adult Attachment and Couple Psychotherapy. The 'secure base' in practise and research (pp. 43-61). London: Routledge. • Capaldi, D. M., Kim, H. K., & Shortt, J. W. (2004). ‘Women's involvement in aggression in young adult romantic relationships’. In M. Putallaz & K. L. Bierman (Eds.), Aggression, Antisocial Behavior, and Violence among Girls. New York: Guilford. • Capaldi, D., Knoble, N., Wu Shortt, J. & Kim, H.( 2012) A Systematic Review of Risk Factors for Intimate Partner Violence. Partner Abuse, Vol.3 (2), November, 231-280 • Corvo, K. (2006) Violence, Separation, and Loss in the Families of Origin of Domestically Violent Men. Journal of Family Violence, Vol. 21, (2) pp117-125 • Corvo, K., Dutton, D. & Chen, W. (2009) Do Duluth Model Interventions With Perpetrators of Domestic Violence Violate Mental Health Professional Ethics? Ethics & Behavior, 19( 4), 323–340

37. References 2 • Desmarais, S., Reeves, K., Nicholls, T., Telford, R. & Fiebert, (2012a) Prevalence of Physical Violence in Intimate Relationships, Part 1: Rates of Male and Female Victimization. Partner Abuse, Vol.3 (2), November, 140-170. • Desmarais, S., Reeves, K., Nicholls, T., Telford, R. & Fiebert, (2012a) Prevalence of Physical Violence in Intimate Relationships, Part 2: Rates of Male and Female Perpetration. Partner Abuse, Vol.3 (2), November, 170-199 • Dutton, D. (1995). ‘Trauma symptoms and PTSD-like profiles in perpetrators of intimate abuse’. Journal ofTraumatic Stress, Vol. 8 (2) pp299-316. • Dutton, D. (1998). The abusive personality. New York: Guilford. • Dutton, D. (2002) ‘Personality dynamics of intimate abusiveness’. Journal of Psychiatric Practice, 8 (4), 216 -228. • Dutton, D. (2010) ‘Do We Want to Be Politically Correct, or Do We Want to Reduce Partner Violence in Our Communities?’ Partner Abuse, Vol 1, (1) pp5-25 • Dutton, D., Saunders, K., Starzomski, A. Bartholomew, K. (1994) Intimacy-Anger and Insecure Attachment as Precursors of Abuse in Intimate Relationships. Journal of Applied Social Psychology, Vol. 24 (15) pp1367-1386 • Dutton, D., van Ginkel, C. & Starzomski, A. (1995) ‘The role of shame and guilt in the intergenerational transmission of abusiveness’. Violence & Victims, Vol. 10, pp121-131 • Ehrensaft, M., Moffitt, T. E., & Caspi, A. (2004). Clinically abusive relationships: Male and female perpetration rates and developmental antecedent’. Journal of Abnormal Psychology, 113, 258-270. • Ehrensaft, M.K., Cohen, P. & Johnson, J.G. (2006) Development of personality disorder symptoms and the risk for partner violence. Journal of Abnormal Psychology, Aug; 115(3), pp474-83

38. References 3 • Hamel, J. (2010) The Gender Paradigm and the Architecture of Antiscience. Partner Abuse, Vol 1, (1) pp82-91 • Holtzworth-Munroe, A., and Stuart, G. (1994). Typologies of male batterers: Three subtypes and the differences among them. Psychological Bulletin. 116: 476–497. • Langhinrichsen-Rohling, J., Misra, T., Selwyn, C. & Rohling, M. (2012a) Rates of Bidirectional Versus Unidirectional Intimate Partner Violence Across Samples, Sexual Orientations, and Race/Ethnicities: A Comprehensive Review. Partner Abuse, Vol.3 (2), November, 199-231 • Langhinrichsen-Rohling, J., McCullars, A. & Misra, T. (2012b) Motivations for Men and Women’s Intimate Partner Violence Perpetration: A Comprehensive Review. Partner Abuse, Vol.3 (4), 429-468 • Magdol, L., Moffit, T., Caspi, A., Fagan, J. & Newman, D. (1997) Gender differences in partner violence in a birth cohort of 21-year-olds: Bridging the gap between clinical and epidemiological approaches. Journal of Consulting and Clinical Psychology, 65(1), 68–78. • Mikulincer, M. (1998) Attachment Working Models and the Sense of Trust: An Exploration of Interaction Goals and Affect Regulation. Journal of Personality and Social Psychology Vol.74, (5), pp1209-1224 • Moffitt, T. E., A. Caspi, M. Rutter, and P. A. Silva. (2001). Sex Differences in Antisocial Behaviour. Cambridge, MA: Cambridge University Press. • Phillips, L. (2013). Evaluation of the Bracknell Forest Council Domestic Abuse Perpetrator Service (DAPS). Dartington: reason.

39. References 4 • Serbin, L., Stack, D., De Genna, N., Grunzeweig, N., Temcheff, C. E., Schwartzmann, A. E., (2004). ‘When aggressive girls become mothers’. In M. A. Putallaz & K. L. Bierman (Eds.) Aggression, Antisocial Behavior and Violence among Girls (pp. 262−285). New York: The Guilford Press • Smith, Kevin (Ed.) Osborne, S., Lau, I. & Britton, A. (2012)Homicides, Firearm Offences and Intimate Violence 2010/11: Supplementary Volume 2 to Crime in England and Wales 2010/1. London: Home Office • Sonkin, D. (2012) Domestic Violence and Attachment theory: Clinical Applications to Treatment with Perpetrators. www.danielsonkin.com//articles/sonkin82405.html • Tangney, J., Wagner, P., Fletcher, C. & Gramzow, R. (1992)‘Shamed Into Anger? The Relation of Shame and Guilt to Anger and Self-Reported Aggression.Journal of Personality & Social Psychology, Vol.62 (4) pp669-675) • Wallace, R., & Nosko, A. (2002). Shame in male spouse abusers and its treatment in group therapy. Journal of Aggression, Maltreatment, & Trauma, 7(1/2), 47-74 • Whitfield, C., Anda, R., Dube, S. & Felitti, V. (2003) Violent Childhood Experiences and the Risk of Intimate Partner Violence in Adults. Journal of Interpersonal Violence, Vol. 18 (2) pp166-185.

40. The ‘cycle of change’ (Exit?) Behaviour no longer a problem? Pre Contemplation Not thinking about it as a problem Relapse A longer-term return to the previous behaviour Contemplation Maintenance The consolidation of gains and effort; keeping it going Ambivalence Beginning to think about change Lapse A short-term return to the previous behaviour, or ‘giving up trying’ (Decision) Action Making plans and giving it a go

41. Key tasks Phase I : Engagement (4 – 6 sessions) • Engage • Explore ambivalence • Develop intrinsic motivation to change • Agenda match – strategy with position on cycle of change Phase II: Behaviour change (8 – 10 sessions) • Engage – agenda match • Link Protagonist goals/priorities with materials • Structure an individual learning experience OARS Skills

42. Ignition 1: Engagement & Ignition 2: Treatment • Motivation & treatment • Broadly cognitive-behavioural basis • MI as a core approach & core skills • Strengths (not deficits) based approach • Combined with teaching skills • Aiming to provide models/skills/tools for self-sufficiency after programme ends

43. Programme structure Phase 1: Engagement (5-6 weeks) ENDASSESSMENT 1 2 3 4 5 6 Fixed order & contents but can do more/fewer Treatment formulation Phase 2: Behaviour change (8 - 10) ? ? ? Penulitimate 1 2 Final ? ? ? Fixed Fixed Flexible, max. 6

44. Results from Phillips (2013) • Independent evaluation of combined Ignition 1 and 2 from local authority child protection setting (programme referred to as DAPS – Domestic Abuse Perpetrator Service) • Pilot over 2 years

45. Key findings from external evaluation of Ignition 1 and 2 (Phillips 2013) • AIM: to reduce numbers of children taken into care • “The programme is meeting its objectives, and is impacting positively on perpetrators, partners/ex-partners and staff” (p1) • “The programme should continue and be extended” (p1) • 45 children downgraded safely from Child Protection Plan to Child in Need (no upgrades)

46. Quality of lifeSpecific findings from external evaluation (Phillips 2013, p7) 4 Impact on perpetrators: Changing behaviour • “All of the perpetrators & partners interviewed stated that the programme had helped them to prevent further abusive behaviour… to learn practical coping strategies” • “…partners reported that the programme had helped perpetrators to cut down or even stop drinking & using drugs” • “…listening skills had improved and [the men] were now more willing to to try to understand other’s perspectives”

47. Quality of lifeSpecific findings from external evaluation (Phillips 2013, p7) 4 Impact on partners & families “…partners reported that they no longer feared perpetrators and felt happier, safer, more secure and more equal in their relationships” “Most perpetrators and partners felt that their relationships with their children had improved as a result of the positive change in perpetrators attitudes and behaviour, encouraged by the programme” “Partners felt that the reduction or cessation of abuse encouraged by the programme had helped children to feel less afraid and anxious, and had promoted more positive family relationships”

48. Why it works? • Fidelity – it is ‘real MI’, not something calling itself MI • Spirit – non-judgemental acceptance • Integrated – thinking, feeling & behaviour on a complex change target (IPVA) • ADDED BENEFIT • The MI repairs damage done by other professionals • Men/families who have ‘dropped out’, re-engage with services – reduces ‘hidden harm’ • Links to sexual offending?