Traumatic Origins of Intimate Rage

Donald G. Dutton

University of British Columbia

Dutton, D.G. (1999) The traumatic origins of intimate rage. Aggression and Violent Behavior, 4 (4), 431-44

Key Words. aggression, trauma, spousal assault

Abstract

I posit that a triad of childhood events found retrospectively in populations of batterers constitutes a powerful trauma source and that many aspects of the personality structure and function of intimately abusive men are best understood from a trauma- response framework. The trauma stressors include witnessing violence directed toward the self or the mother, shaming and insecure attachment (cf. Dutton 1995a; 1995b; 1995c; 1995d). Bowlby (1973) considered insecure attachment itself both a source and consequence of trauma. Since the infant turns to the attachment-object during periods of distress seeking soothing, a failure to obtain soothing maintains high arousal and endocrine secretion. Van der Kolk (1987) considered child abuse an "overwhelming life experience" and reviewed the defenses that children use to deal with parental abuse: hypervigilance, projection, splitting, and denial. Terr (1979) also described driven, compulsive repetitions, and reeneactments that permeate dreams, play, fantasies and object relations of traumatized children. Shaming, conceptualized as verbal or behavioral attacks on the global self has been found to generate life long shame-proneness or defenses involving rage. A combination of all three early experiences is traumatizing and evidence exists in adult batterers both for the presence of trauma symptoms and the childhood experiences described above. Conceptualizing the affective, cognitive and behavioral features of intimate abusiveness from a trauma perspective has many advantages over social learning models. A basis for the internally driven and cyclical aspect of the behavior becomes clearer as does the problems with modulation of arousal, anger and the high levels of trauma symptoms found in populations of abuse perpetrators. The narrow social learning definition of aggression as a reaction to an appraisal of controllable threat is broadened to include reactions to trauma: uncontrollable-unbluntable-inescapable aversive stimuli.

Traumatic Origins of Intimate Rage

Clinical Descriptions of Spouse Assaulters

Since the 1970’s, a body of clinical work has been amassed describing men who are abusive to their wives. Some of this material was provided directly through assessment of men court-mandated or self-referred for treatment (e.g., Ganley, 1988; Sonkin, 1987); other material was provided through descriptions of the actions and emotions of batterers provided by their wives (e.g., Walker, 1979). The general clinical profile that emerged from these sources was of a man who experienced disproportionate arousal and anger (Walker, 1979), went through cyclical tension accumulations followed by abusive outbursts and contrition (Walker, 1979), externalized blame for their actions (Ganley, 1988), experienced a restricted range of affect (Gondolf, 1985), with the exception of dysphoric states (depression) and exhibited high levels of masked dependency and emotional isolation (Sonkin, 1987) leading to extreme jealousy sometimes referred to as "conjugal paranoia." Several theories have been put forward to explain spouse assault and these have been reviewed and criticized elsewhere (Dutton, 1995b; 1995c), broad spectrum theories such as sociobiology and feminist sociology cannot account for individual differences between serially abusive, situationally abusive and nonabusive males. In this article, I examine the psychological theory that has been most influential in accounting for battering; social learning theory (Dutton, 1988, O’Leary, 1988). I argue that, although social learning theory serves well in establishing the imitative and self-reinforcing functions of the acquisition of aggressive habits, and the sustaining function of rationalization or "neutralization of self punishment", it does less well at accounting for the acquisition of private or internal events that are prominent in sustaining abusiveness. These include dysphoric states (depression, chronic anger), attributional styles (blaming of victim), defensive strategies such as externalizing and projection, insecure attachment styles, tendencies to ruminate and accumulations of internal tension. Since these phenomena are internal and unobservable, they are not "imitated" in the way that abusive behaviors are imitated. I argue that the behavioral imitation exists on a psychological substratum created by early trauma. This early trauma, which produced the psychological abuse-generating reactions described above, is itself caused by an interactive combination of events: exposure to physical abuse, shaming by a parent and insecure attachment. These events are particularly destructive to an immature ego, in the process of self-formation. I review literature on clinical and empirical studies of abusive males, and where available, compare the results of these studies to studies of trauma victims. It will be argued that identical profiles emerge, suggesting a trauma origin for intimate abusiveness. While much research on trauma victims has focused on victims of childhood sexual or physical abuse, I suggest that a combination of insecure attachment, exposure to physical abuse (witnessing or being victimized) and being shamed by a parent constitutes a potent trauma source.

The Emerging Profile: MMPI and MCMI Assessments of Abusive Males

Early assessments using the MMPI revealed profiles high on anger and depression, with anxiety about the perceived uncontrollability of these feelings (Sonkin, 1987). High levels of impulse control and acting out were also observed (Sonkin, 1987). Subsequent studies confirmed profiles with high Pd (Psychopathic Deviate) spikes usually in combination with elevation on Hy (Hysteria) or Pa (Paranoia) (Caesar, 1986; Hale, Duckworth, Zimostrad, , & Nicolas, 1988; Flournoy & Wilson, 1991; Else, Wonderlich, Beatty, Christie, & Staton, 1993). While the general interpretation of these profiles indicates impulse control, extreme dependency, depression, externalization and low self-esteem, many researchers emphasize the heterogeneity of batterer profiles.

Millon Clinical Multiaxial Inventory (MCMI-II) assessments of abusive men have reinforced this view (Hamberger & Hastings, 1986; 1988; Hamberger, Lohr, Bonge, & Tolin, 1996, Hastings & Hamberger, 1988). Using an MCMI-II assessment of 85 batterers in treatment, Hart, Dutton, and Newlove (1993) estimated that 80-90% had personality disorders, Hamberger and Hastings (1986) estimated 88% had diagnosable personality pathology. Hence, the evidence for personality disorder in batterer groups is strong. Herman and van der Kolk (1987), West and Keller (1994), and Dutton and Starzomski (1994) have shown how some personality disorders, especially Borderline Personality Organization (BPO), have origins in early attachment experiences.

Child abuse survivors are also more likely to be diagnosed with Borderline Personality Disorder (Brown & Anderson, 1991; Bryer, Nelson, Miller, & Krol, 1987; Herman, Perry, & van der Kolk, 1989). Dutton (1994) found BPO to be most strongly correlated with recollections of paternal rejection, physical abuse and shaming actions.

Limitations of Behavioral Models

Prior to the developing research on personality disorders in batterers, explanation of battering had made use of social learning paradigms (e.g., Dutton, 1988;; Ganley, 1989, O’Leary, 1988). These paradigms examined the acquisition of aggressive habits through prior exposure to violent role models in the family of origin, instigation of arousal-anger chains, rewards for aggression (through reduction of tension and "winning" arguments) and regulation of the aggressive habits through techniques for neutralization of self-punishment which included victim-blaming, denial and minimizing. Cognitive-behavioral treatment techniques (Ganley, 1981) were based on social learning models. Men who benefited least from such treatment models were men exhibiting personality disorders (Dutton, Bodnarchuk, Kropp, Hart, & Ogloff, 1997), including Antisocial PD and Borderline PD.

Although social learning models provide reasonably comprehensive explanations for habitual wife assault, some limitations existed with the social learning perspective. Social learning theory developed from laboratory research based in a stimulus-response paradigm. As such, it focused solely on behavior or cognition and viewed these as reactions to external "instigators". However, as Dutton (1995a) pointed out, much abusive behavior is predatory and pro-active and serves intrapsychic functions such as ego-identity cohesion and or tension reduction. Dutton cited in Walker’s (1979) descriptions of battering episodes as erupting from inner tensions rather than in response to external stimuli. The man’s inner tensions lead to a change in his phenomenological appraisal of external stimuli. In chronic abusers, the stream of verbal and physical abuse serves an ego function of dispelling stored tension and preventing ego collapse. Dutton (1995a) described such men as "abusive personalities" and showed their personality contained a constellation of abuse-inducing characteristics including: chronic anger, rejection-sensitivity, externalizing defenses and dysphoria. These characteristics interacted to produce intimate abuse. For example, the dysphoria was often blamed on actions of the spouse generating heightened anger. This combination set the stage for abuse. The form of abuse (physical, emotional, etc.) was shaped by observational learning in the family of origin but the personality substratum and affect constituted private events which could not from mere behavioral mimicry. Other pathogenic processes must have been present to generate these internal reactions. Dutton (1995b) argued that the so-called "abuse cycle" comprised of tension buildup-explosion and contrition phases could be understood as an attachment-based form of personality organization similar to Gunderson’s (1984) notion of BPO.

In a series of empirical studies, Dutton and his colleagues found some developmental precursors to both abusive behavior and its personality correlates. These included witnessing physical abuse and victimization by shaming in the family of origin (Dutton, van Ginkel, & Starzomski, 1995). Dutton (1995a) argued that the triad of being shamed, insecurely attached and witnessing parental violence generated the abusive personality. This triad constituted an early assault on the sense of self comparable to traumatic stress. Subsequently, Pynoos, Steinberg, and Goenjian (1996) affirmed that events traumatic to children may be qualitatively different, in both the nature of the event and its effect, from those which generate trauma in adults. As they put it,
"By their very nature and degree of personal impact, traumatic experiences can skew expectations about the world, the safety and security of interpersonal life, and the child’s sense of personal integrity" (p. 332).

Amongst the "associated features" of the abusive personality were high levels of chronic trauma symptoms (Dutton, 1995d) and a "PTSD-like" profile on the MCMI (Dutton, 1995d), as well as a "fearful/angry" attachment style (Dutton, Saunders, Starzomski, & Bartholomew, 1994) and tendencies to externalize blame and view relationship conflict as caused by traits in the other person (Starzomski, 1993). Dodge, Pettit, Bates, and Valente (1995) found similar attributional styles (which they called social information processing deficits) in abused children during a five year follow up assessment.

Theoretical Connection to Prior Trauma

PTSD in children has been assessed and reported by Garbarino, Kostelny, and Dobrow (1991), Eth and Pynoos (1985) and Pynoos (1994) and has included the exposure to "chronic danger...the impact of acute or repeated intrafamilial traumatic experiences within the context of a more pathogenic family environment" (p. 66). They point out that the specific developmental phase at which the trauma is encountered can contribute to the long term impact of that trauma. McNally (1991) reviewed studies of special concerns in assessing PTSD in children, including age-specific features. Children, for example, re-experience trauma through repetitive play rather than through flashbacks (Terr, 1981; 1983).

Victims, the authors, point out, often become victimizers, although the specific mechanism through which anger is focused externally or internally is not well understood. Some longitudinal studies have related childhood victimization by physical abuse as a risk factor for later criminality (McCord, 1983; Pollock, Briere, Schneider, Knop, Mednick, & Goodwin, 1990; Widom, 1989), whereas others have related childhood victimization to suicide (Adam, 1994), depression (Parker, 1994) or "internalized disorders" (Carmen, Reiker, & Mills 1984). All studies found that children who were physical abuse victims were significantly more likely to commit crimes as adults. Duncan, Saunders, Kilpatrick, Hanson, and Resnick (1996) found that childhood physical assault was a risk factor for adult PTSD and the development of borderline personality in a national sample of women. The researchers did not give reasons for excluding men from their study. If the trauma source is limited to chronic physical assault by a parent, the affected sample constitutes about 25% of all adults (Straus, 1991, p. 226).

In recent years, a comprehensive body of research has developed linking childhood trauma to adult impulsivity, aggression and violence. The sources of this work are, amongst others, van der Kolk and his colleagues (e.g., van der Kolk, 1987; van der Kolk, McFarlane, & Weisaeth, 1996), and Cicchetti and his colleagues (e.g., Cicchetti & Toth, 1994; 1995). The former has focused on long lasting sequelae of trauma, the latter on childhood sequelae of developmental pathology. I will review the chief findings of this literature with a view toward mapping this work onto the psychology of the intimate abuser. Unlike learning theories which focus on behavior or cognitions that support behavior, trauma theory and research is more comprehensive and includes arousal disregulation, affective modulation problems, alternative explanations for information processing deficits and neuropsychological developmental problems

Witnessing/Experiencing Violence as a Source of Trauma

Much has been written about the long-term effects of physical abuse of children as a risk marker for long term abusiveness. In a national survey conducted in 1975, Straus, Gelles and Steinmetz (1980) found that boys who grew up in abusive homes were more likely to be physically abusive toward their own wives. Children who were themselves physically abused were more likely to be abusive. Boys, in particular, were likely to "externalize"; "being disruptive, acting aggressively towards objects and people, and throwing severe temper tantrums" (Jaffe, Wolfe & Wilson, 1990, p. 41). Carmen , Reiker, and Mills (1984) suggested that boys were more likely to identify with the aggressor in the abusive home. Lisak, Hopper, and Song (1996) found that most (70%) perpetrators of physical abuse had experienced victimization (physical or sexual abuse); however, most abused men did not become perpetrators.

However, abuse directed toward the child may constitute a narrow definition of trauma. Witnessing abuse between parents tripled the rate of use of physical abuse by men in the Straus et al. (1980) national survey. Carlson (1984) estimated that about 3.3 million children in the US annually witnessed parental violence. Jaffe, Wolfe, and Wilson (1990) reviewed studies which put the observation rate even higher (68%-80%). Landis (1989), Rossman (1994) and Lehmann (1997) found high levels of trauma symptoms in children who had witnessed their father assault their mother. Landis (1989) and Lehmann (1997) found that over half of the children in their samples exhibited PTSD. Factors such as the duration and frequency of the witnessed violence, and multiple separations (between parents) all enhanced the probability of development of PTSD. This finding is consistent with clinical descriptive studies of children who witnessed a parents murder, rape or suicide and which also found high rates of PTSD (Burman & Allan-Meares, 1994; Black, Hendricks, & Kaplan, 1992; Black & Kaplan, 1988; Eth & Pynoos, 1994; Malmquist, 1986; Osofsky, Wewers, Hann, & Fick, 1993; Pynoos & Eth, 1985; Pynoos & Nader, 1993).

Shaming as a Source of Trauma

Similarly, shaming behaviours (especially in conjunction) with witnessing abuse and insecure attachment, can constitute a putative trauma source. Miller (1985), Lewis (1987), Lewis (1992), Retzinger (1991), Scheff (1987), Tompkins (1987), Wurmser (1981) have all commented on the "soul destroying" aspects of shame, an attack, on the global sense of self; what Shengold (1989) calls "soul murder". Lewis (1987) and others depicted shaming experiences as having lasting emotional impact and connoting an inherent and essential "badness" about the self.

Dutton, van Ginkel, and Starzomski (1995) found that recalled shaming actions by the parent (usually the father) were highly related to adult abusiveness. These tended to take the form of global attacks ("you’ll never amount to anything"), public humiliation or random punishment (conveying the message that the child was being punished for who they were, not what they did). Shame converts instantly to rage in what Scheff (1987) called the "shame-rage spiral", in an attempt to protect the self from what feels subjectively like looming annihilation. Dutton et al. (1995) found that when shaming behaviors are partialled out of the correlation between parental abuse victimization and current abusiveness, the correlation drops from (+.35, p <.05) to (+.18, ns). Partialling out physical abuse from parental shaming also reduces this correlation to non-significance suggesting an interactive or "emergent" effect of physical abuse victimization and experiences of being shamed that combine to produce adult abusiveness. The combined effect of joint exposure, especially when secure "soothing" attachment is not available may constitute a trauma source.

Insecure Attachment as a Source of Trauma

Bowlby (1969; 1973; 1977) described secure attachment as a necessary buffer against trauma. The distressed person engages in proximity seeking behaviors to the "attachment other" in order to reduce the impact of the trauma. Furthermore, expectations about relationship outcomes and the ability to self-soothe to reduce trauma effects are both consequences of attachment. Securely attached persons have more positive expectations, more optimism, even a more benign theology (Kirkpatrick & Shaver, 1992). Conversely, individuals with poor attachments, indicated by parental abuse or neglect have poor trauma resolution skills (Cicchetti & Toth, 1995; van der Kolk & Fisler, 1994). The relationship of secure attachment to psychological functioning was sufficiently recognised that by 1996, the Journal of Consulting & Clinical Psychology published a special issue on attachment and psychopathology. In that section (Jones, 1996) summarized "the studies in this special section demonstrate that an overwhelming number of individuals who are clinically diagnosable will be classified as having insecure attachments…attachment research is currently one of the most promising avenues in development and clinical research to the understanding of psychological antecedents of disordered behavior " (p. 6). In that same issue Lyons-Ruth (1996) reviewed attachment related studies of risk factors for early aggression, finding that attachment patterns, family adversity, parental hostility "were already evident in infancy and predictive of later aggression before the onset of coercive child behavior" (p. 64). An early risk factor included elevated cortisol levels at separation. Cortisol release from the adrenal glands is stimulated by stress. Klein (1980) noted that both panic attacks and depression in humans responded to treatment with tricyclic antidepressants and MAO inhibitors and postulated that both conditions are rooted in "neurobiological sensitivity to abandonment precipitated by early life experiences" (van der Kolk, 1987, p. 46). Lyons-Ruth (1996) concludes, "one of the best documented findings in the area of child psychopathology is the consistent relation between harsh and ineffective parental discipline and aggressive behavioral problems" (op. cit. p. 64).

As van der Kolk (1987, p. 31) puts it, "the essence of trauma is the loss of faith that there is order and continuity in life". Van der Kolk (1987) also demonstrated that secure attachment is essential for the development of core neurobiological functions in the primate brain. The development of the connection between attachment and neural development has been most fully explicated in Schore’s (1994) work Affect Regulation and the Origin of the Self. In this work, Schore develops a psychobiological model linking maternal behaviors (such as attunement) to specific neural development, specifically to those neural mechanisms that regulate emotion (such as the limbic system). Of note, is Schore’s observation that "shame is a powerful modulator of interpersonal relatedness" and has the capacity to "rupture the dynamic attachment bond" (p. 242). This point will be developed below. Recovery from shaming experiences involve both a seeking out of the attachment other and psychobiological processes. As Schore puts it:
"If the caregiver is sensitive, responsible and emotionally approachable, especially if she reenters into affect regulating mutual gaze visuoaffective (as well as tactile and auditory affect modulating) transactions, the dyad is psychobiologically reattuned, the object relations link (attachment bond) is reconnected, the arousal deceleration is inhibited, and shame is metabolized and regulated" (p. 243).

Maternal touch inhibits an accelerating hypothalamic-pituitary-adrenocortical stress response as well as secretion of glucocorticoid stress responses (Schore, 1994). Developmental endocrinological studies have shown that increased levels of touch and other somesthetic sensory modalities have both immediate and long term effects (Denenberg & Zarrow, 1971). Van der Kolk (1987) showed that in a variety of species the separation-distress call is mediated by endogenous opioids. Low doses of opioid receptor agonists powerfully modify both the distress call and the maternal response to it.

In a group of batterers, Dutton, Saunders, Starzomski, and Bartholomew. (1994) found that those with a "fearful" (insecure) attachment style self-reported the highest chronic levels of stress symptoms (r = +.51, p = .00001). Men who were in treatment for wife assault had high chronic trauma levels scores of 26 (sd = 9.8) (on the TSC-33), compared to 16 (sd = 7.9) for demographically matched controls. Dutton (1995b) found that all men’s self-report subscales of the TSC-33 (anxiety, depression, sleep disturbance, dissociative states and "post sexual abuse trauma-hypothesized) correlated with wives reports of men’s abusiveness. One of the mechanisms through which secure attachment may function to buffer trauma is through affect regulation. Both insecure attachment and trauma generate affect dysregulation, the effect of both in concert (as, for example in children abused by their parents) is to produce extreme dysregulation (van der Kolk, McFarlane, & Weiseath, 1996).

Combined Trauma Sources

Although witnessing parental violence, being shamed and being insecurely attached are each sources of trauma in and of themselves, the combination of the three over prolonged and vulnerable developmental phases constitutes a dramatic and powerful trauma source. The child cannot turn to a secure attachment source for soothing, as none exists, yet the need created by the shaming and exposure to violence triggers enormous emotional and physiological reactions requiring soothing. Furthermore, as Pynoos (1994) points out, traumatic exposure in childhood can occur during critical periods of personality formation "when there are ongoing revisions of the inner model of the world, self and other…these internal models, once organized, operate outside conscious awareness…they may result in isolated areas of decision making or behavior that are inconsistent with other personality attributes". (op. cit. p. 88). It is for this latter reason that the personalities of wife assaulters are often described as incongruent with their everyday persona.

Effects of Trauma

Trauma, battering and the sense of self. Given the exposure to insecure attachment and shaming described above, it is not surprising that batterers share another effect in common with diagnosed trauma victims; an unstable sense of self. (cf. Pynoos, 1994). As developmental psychopathology has demonstrated in several studies, inner representations of self can be weakened or distorted by trauma (see also Cicchetti, Cummings, & Greenburg, 1990), including insecure attachment (Cicchetti et al., 1990) or shaming (Lewis, 1971). Dutton and Starzomski (1994) found Borderline Personality Organization to be common in batterers. On a self-report scale for BPO devised by Oldham,Clarkin, Appelbaum, Carr, Kernberg, Lotterman and Haas (1985) batterers generated a mean score of 72 (11.7) compared to a mean score for diagnosed BPO males of 74 (Oldham et al., 1985). Self-referred batterers (who typically initiate therapy during a contrition phase of an abuse cycle (see Dutton, 1995a), have mean scores of 74, identical to diagnosed borderlines. Borderlines have identity diffusion (an unstable, empty sense of self) as a central clinical feature of their makeup and identity diffusion is one of the three factors of the Oldham et al. (1985) scale. As described above, the insecure attachment contribution is a lack of positive introjects or self schemata that preclude the batterers ability to self soothe during stress. Instead, batterers use alcohol and drugs, and ruminate on the wife’s causal role in their unhappiness (Dutton, 1995a).

Trauma and arousal. The younger the age at which trauma was experienced, and the longer its duration, the more likely people are to have long term effects with the regulation of arousal, anger, anxiety and sexual impulses (van der Kolk, Roth, Pelcovitz, & Mandel, 1993). Also, the inability to self regulate extends to an inability to inhibit action when aroused, an inability to focus on appropriate stimuli, learning disorders, attentional problems and uncontrollable feelings of rage (Pitman, Orr, & Shalev, 1993). Furthermore, the problems with hyperarousal are not merely classical conditioning. Stimuli that have no conditioned association to the traumatic experience can trigger emergency responses (Pitman, Orr, & Shalev, 1993). As van der Kolk, McFarlane, and Weisaeth (1996) point out, there are at least two different abnormal levels of psychophysiological response in people with PTSD: conditioned responses to specific reminders of the trauma and generalized hyperarousal to intense but intrinsically neutral stimuli. The first involves heightened physiological arousal to sounds, images and thoughts related to specific traumatic events. These can be desensitized through treatment but this desensitization does not affect general hyperreactivity (Shalev & Rogel-Fuchs, 1993). People with PTSD continue to misinterpret innocuous stimuli as potential threats (van der Kolk et al., 1996).

A number of clinical reports indicated that batterers either self-reported high arousal (e.g., Margolin, John, & Gleberman, 1988) or were described as physiologically aroused and agitated (Walker, 1979). Gottman et al. (1995) measured physiological arousal in batterers in vivo during conflicts with their wives. They found two patterns of arousal in wife assaulters; one with a flat, unemotional "cool" display in the course of conflict, accompanied by decreases in heart rate (Type 1), described by Jacobson (1993) as "vagal reactors". The other (Type 2) demonstrated heart rate increases during conflict. Both Saunders (1994) and Tweed and Dutton (under review) reported a sub group of batterers who were high on arousability and impulsivity and who exhibited strong arousal-related emotional displays. Browning and Dutton (1986) found that batterers reacted with exaggerated arousal, anger and anxiety (compared to control group males) to videotaped "abandonment" scenarios of a woman asserting independence from a man.

van der Kolk (1988) also described two opposite arousal patterns as consequences of trauma. The first, psychic numbing, refers to an emotional constriction, isolation, anhedonia and estrangement. The second, was characterized by hyperreactivity and explosive outbursts. Van der Kolk and Ducey (1989) found that Vietnam veterans with PTSD demonstrated these two basic patterns on Rorschach tests. After seeing "traumatic percepts" their responses were either severely constricted or extremely intense (and appropriate to the original event).

Trauma and anger. Trauma victims have difficulty controlling anger (van der Kolk, 1988). Early theories of trauma saw this inability as central to the trauma response (Kardiner, 1941; Lindemann, 1944). Veterans with combat-related PTSD exhibit anger regulation deficits (Chemtob, Novaco, Hamada, Gross, & Smith, 1997). The authors describe some of their clients as "ball of rage" clients who have regulatory deficits in the cognitive, arousal and behavioral areas. They link anger to a "survival mode" of functioning activated when threats are sensed. Because people with PTSD are primed to identify threat, they engage in survival mose anger more rapidly. The spreading activation of threat schemas strongly potentiates anger. Anger schemas are integrated mental representations representations that entail appraisals of threat. As an individual detects "evidence" of threat, anger and aggression are potentiated. When they are potentiated, the threat system is further activated resulting in a "self-confirming vicious cycle" (op. cit. p. 29) which can only be interrupted early in its’ activation by detection of disconfirming evidence. (Anger management treatment for batterers includes techniques that enable reframing and self monitoring to accomplish this interruption). Once the system escalates to survival mode, it is far more difficult to regulate.

Wife assaulters also exhibit anger regulation deficits (Maiuro, Cahn, Vitaliano, Wagner & Zegree, 1988; Beasley & Stoltenberg, 1992; Dutton & Starzomski, 1994, Boyle & Vivian, 1996). Dutton (1994; 1995b) found anger to be an "associated feature" of what he termed an "abusive personality" and highly correlated with both personality features and behavioral acts of abusiveness. Dutton argued that in wife-assaulters anger had an origin in attachment insecurity. He pointed out that Bowlby (1973) viewed the initial function of anger as an attempt to restore a lost attachment . In Bowlby’s view anger became dysfunctional when its expression served to alienate the attachment other. Dutton (1995b) argued that this was what occurred during the tension building phase on an "abuse cycle’: an attachment yearning led to a psychological "arching away" that included verbal abuse, emotional distancing and ruminative critical thinking about the intimate partner. This rumination led to greater alienation and eventually to an outbreak of physical abuse as a tension-draining devise. This process is similar to that described by Chemtob et al. (1997) as a self confirming vicious cycle, except that its focus and content are intimacy related. Dutton pointed out how this phasic anger release model had been described by Gunderson (1984) as a central feature of borderlines and that BPO was significantly related to intimate abusiveness in males. A more extreme form, Borderline Personality Disorder has been shown by Herman and van der Kolk (1987) and others to have had a traumatic family origin.

Trauma and personality disorder: MCMI profiles. The MCMI-II (Millon, 1987) has been used to develop a profile of men independently assessed as having PTSD. An "82C" profile (passive-aggressive/avoidant/borderline) was found to be typical of Vietnam vets diagnosed with PTSD (Hyer, Woods, Bruno, & Boudewynns, 1989; Robert, Ryan, McEntyre, McFarland, & Lips, 1985). As Figure 1 demonstrates, Vietnam Vets were beyond the 85% percentile on both Avoidant and Passive-Aggressive personality disorder (as well an Anxiety and Dysthymic Disorders).

Figure 1 demonstrates that men in treatment for wife assault also show peaks on Avoidant (80th percentile) , Passive-Aggressive (86th percentile) and Borderline personality disorder. Dutton (1995) pointed out these similarities in batterers and PTSD-diagnosed veterans. The specific trauma source for the batterers was not clear from Dutton’s (1995a) study, although some early potential stressors were reported by the men: shaming and rejection but fathers, insecure attachment to mothers, witnessing parental violence and experiencing parental violence. Dutton (1995a) suggested that this combination of stressors was traumatic.

________________________

insert Figure 1 here

________________________

Trauma and cognition: Social information processing skills deficits (generation of aggressive cognitive responses). Developmental research has linked early trauma (i.e., physical abuse) to the use of aggression among children, and has demonstrated that this relationship is mediated by social information processing skills. As an example, consider the longitudinal Child Development Project conducted by Dodge, Pettit, and Bates (1995), in which a large, representative sample of children was identified prior to kindergarten and then followed over time. Children who had been physically harmed by an adult during the first five years of life were four times more likely to engage in externalizing (acting out) behaviors by the 4th or 5th grade. One mediator of this relationship was the social information processing of the child. In response to videotaped standardized vignettes depicting conflicts with peers, abused children demonstrated more information processing deficits that predicted externalizing behavior than did other children. These included tendencies to be distracted from relevant social cues, to presume hostile intent on the part of peers (i.e., a hostile attributional bias), to choose aggressive responses to situations, and to evaluate aggressive responses as leading to successful outcomes. All four of these tendencies were more likely among abused children and were predictive of externalizing or aggressive actions. Parallel deficits in social information processing can be found among adult male batterers.

When compared with nonviolent samples, male batterers generate less competent (constructive, problem resolving) and more aggressive responses to negative wife behavior and may not be able to generate more competent responses. In two independent studies, Dutton and Browning (1988) and Holtzworth-Munroe and Anglin (1991) presented maritally violent and nonviolent men with standardized stimuli depicting marital conflicts; subjects were asked what they would say or do in each situation. In both studies, violent men were less likely than nonviolent men to generate competent responses and were more likely to choose aggressive responses. Holtzworth-Munroe and Anglin (1991) also asked the men what would be the best thing to do and found that violent men were unable to generate competent responses when thus asked to do so. In both of these studies, violent men were particularly likely to generate incompetent, aggressive responses when presented with scenes that could be interpreted as wife rejection or abandonment; fewer violent-nonviolent group differences were found in response to scenes depicting wife engulfment (e.g., wife wanting more closeness and intimacy with the husband) or conflicts that were neutral with regards to issues of intimacy and closeness. Starzomski (1994) assessed abusiveness, attachment style and attributions for conflict in a group of 19 year old male college students. Using the Relationship Attribution Measure (RAM: Fincham & Bradbury, 1992), Starzomski (1993) found a number of "distress maintaining" attributions that were associated with abusiveness and insecure attachment. Abusive-insecurely attached men who were asked to report on the causes of negative behaviors in their girlfriend, saw these as more likely to be intentional, selfish, blameworthy and to persist into the future. These dimensions of conflict construal, in turn, were related to high levels of persistent anger.

In summary, maritally violent men demonstrate social information processing skills deficits (i.e., generation of aggressive responses, inability to generate conflict resolving responses) in response to marital conflicts, particularly marital conflicts depicting wife rejection or abandonment. These findings suggest that violent men, when faced with conflict situations, evidence a variety of social information processing skills deficits that increase the risk of physical aggression. These findings parallel those from developmental research (i.e., Dodge et al., study) linking the experience of physical abuse in early childhood to social information processing skills deficits to aggression.

Litz, Weathers, Monaco, Herman, Wulfsohn, Marx, and Keane (1996) has demonstrated information processing deficits in veterans with PTSD by using the Stroop procedure where threatening and non-threatening words are shown to subjects in various colors. Subjects take longer to name the color of threatening words, presumably because of the draw on attentional resources with threatening words. A replication of this study with batterers would be of great interest, especially one using words that connoted abandonment, shaming or violence.

Trauma and aggression. Controlling aggression is a focal issue for many trauma victims (van der Kolk, 1988). Traumatized children have trouble modulating aggression, tending to act destructively towards themselves (Ross, 1980) or others (Green, 1980). Many traumatized children have temper tantrums and fights with siblings and schoolmates (Green, 1980; Ross, 1980, Lewis et al., 1979; Lewis & Balla, 1976).

A gender difference exists with girls more likely to aggress towards themselves (Green, 1980) and boys against others (Carmen, Riecker, & Mills, 1984), presumably because of differences in identification with the aggressor. Green (1980) viewed the victimization-aggression link as a deriving from both a compulsion to repeat the trauma and identification with the aggressor, this latter process served to replace feelings of helplessness with omnipotence. As Fromm (1973) put it, sadism is "the transformation of impotence into omnipotence" (op cit. p. 323). Dutton (1995b) found significant correlations between batterers self-reports of trauma symptoms on the TSC-33 and wives reports of the man’s use of physical aggression. Furthermore, batterers had chronic trauma symptom levels that were significantly higher than matched controls.

Other Trauma Sequelae. In addition to the various trauma sequelae described above, responses to trauma include anxiety and depression (van der Kolk 1987, p. 46) which in turn generate social-behavioral effects. Depression, for example, is often accompanied by social withdrawal and a loss of pleasure in human company. Batterers are often described as socially isolated (Sonkin , Martin, & Walker, 1985). Dutton (1995b) found that batterers had high depression scores on the TSC-33. Pan, Neidig, and O’Leary (1994) examined 11,000 Us Army men and found that, for every 20% increase in depressive symptomatology, the odds of using moderate physical aggression (e.g., pushing) against their wife increased by 30%, and the odds of using sever physical aggression (e.g., beating) increased by 74%.

Social Learning and Trauma Theory: Mapping Trauma onto the Tree Paradigm

Social learning theory posits a tree paradigm (see Figure 2), where behavioral choice points are determined by a) the perceived "controllability" of the aversive event (based on event appraisal and b) personal notions of self-efficacy (Bandura, 1979). If the aversive event is perceived as "controllable" a variety of behaviors may be invoked which have agency (externally directed action) as their common feature. These include achievement, assertiveness, increased striving and aggression. Hence, in social learning theory, aggression is an agentic response which occurs when an appraised event is viewed as controllable. If the aversive event is appraised as uncontrollable the person tries to "blunt" or decrease the level of intensity of the aversive stimulus (see Turner, Fenn, & Cole, 1981), failing this the victim tries to escape or, if the escape route is blocked, lapses into passive withdrawal or learned helplessness (apathy, depression, resignation, psychosomatization).

Trauma theory suggests a different classification. A traumatic event is an aversive event which cannot be either controlled, blunted or escaped and traditionally the reactions to this event have been conceived of a passive withdrawal. Yet the evidence I reviewed above suggests that aggression does occur, albeit with a temporal delay as a result of exposure to uncontrollable-unbluntable-inescapable aversive stimuli. This suggests that the social learning analysis may have too narrowly classified aggression due to a focus on immediate "reactive" aggression. Aggression may occur more broadly than social learning conceives.

__________________________

Insert Figure 2 here

__________________________

References

Adam, K. S. (1994). Suicidal behavior and attachment: developmental model. In M. B. Sperling, & W. H. Berman (Eds.), Attachment in Adults: Clinical and Developmental Perspectives. New York: Guilford.

Bandura, A. (1979). The social learning perspective: Mechanisms of aggression. In H. Toch (ed.), Psychology of crime and criminal justice (pp. 298-336). New York: Holt, Rinehart & Winston.

Beasley, R., & Stoltenberg, C. D. (1992). Personality characteristics of male spouse abusers. Professional Psychology: Research & Practice, 23, 310-317.

Black, D., & Kaplan, T. (1988). Father kills mother. British Journal of Psychiatry, 153, 624-630.

Black, D., Hendricks, J. H., & Kaplan, T. (1992). Father kills mother: Post Traumatic Stress Disorder in the children. Psychotherapy &. Psychosomatics, 57, 152-157.

Bowlby, J. (1969). Attachment and loss. Vol. 1, Attachment. New York: Basic

Bowlby, J. (1973). Attachment and loss. Vol. 2, Separation. New York: Basic.

Bowlby, J. (1979). The making and breaking of affectional bonds. Londod: Tavistokk Publishing

Brown, G. R., & Anderson, B. (1991). Psychiatric morbidity in adult inpatients with childhood histories of sexual and physical abuse. American Journal of Psychiatry, 144(11), 1426-1430.

Browning, J., & Dutton, D. G. (1986). Assessment of wife assault with the Conflict Tactics Scale: Using couple data to quantify the Differential Reporting Effect. Journal of Marriage and the Family, 48, 111-115.

Bryer, J. B., Nelson, B. A., Miller, J. B., & Krol, P. A. (1987). Childhood sexual and physical abuse as factors in adult psychiatric illness. American Journal of Psychiatry, 144(11), 1426-1430.

Burman, S., & Allan-Meares, P. (1994). Neglected victims of murder: Children’s witness to parental homicide. Social Work, 48, 28-34.

Caesar, P. L. (1986). Men who batter: A heterogeneous group. American Psychological Association, Washington, DC.

Carmen, E. H., Reiker, P. P., & Mills, T. (1984). Victims of violence and psychiatric illness. American Journal of Psychiatry, 141, 378-379.

Carlson, B. E. (1984). Children’s observations on interparental violence. In A. R. Roberts (Ed.), Battered women and their families (pp. 37-56). New York: Springer.

Chemtob, C. M., Novaco, R., Hamada, R. S., Gross, D. M., & Smith, G. (1997). Anger regulation deficits in combat-related Post Traumatic Stress Disorder. Journal of Traumatic Stress, 10(1), 17-36.

Cicchetti, D., & Toth, D.L. (1994). Rochester symposium on developmental psychopathology, Vol.5: Disorders and dysfunctions of the self. Rochester, New York: University of Rochester Press.

Cicchetti, D., & Toth, S.L. (1995). A developmental psychopathology perspective on child abuse and neglect. Journal of American Academy of Child Adolescent Psychiatry, 34(5), 541-565.

Cicchetti, D., Cummings, M., & Greenburg, M. (1990). An organizational perspective on attachment beyond infancy: Implications for theory, measurement and research. In M. Greenberg, D. Cicchetti, & M. Cummings (Eds.), Attachment during the preschool years: Theory, research and intervention (pp. 3-49). Chicago: University of Chicago Press.

Denenberg, V. H., & Zarrow, M. X. (1971). Effect of handling in infancy upon adult behavior and adrenocortical activity. Suggestions for a neuroendocrine mechanism. In D. N. Walcher & D. L. Peters (Eds.), Early childhood: The development of self regulatory mechanisms (pp. 40-74). San Diego: Academic Press.

Dodge, K., Pettit, G.S., Bates, J.E., & Valente, E. (1995). Social information-processing patterns partially mediate the effect of early physical abuse on later conduct problems. Journal of Abnormal Psychology, 104(4), 632-643.

Duncan, R. D., Saunders, B. E., Kilpatrick, D. G., Hanson, R. F., & Resnick, H. (1996). Childhood physical assault as a risk factor for PTSD, depression and substance abuse: Findings from a National survey, American Journal of Orthopsychiatry, 66(3), 437-449.

Dutton, D. G. (1988). Profiling wife assaulters: Some evidence for a trimodal analysis. Violence and Victims, 3, 5-30.

Dutton, D. G. (1994). Behavioral and affective correlates of Borderline Personality Organization in wife assaulters. International Journal of Law and Psychiatry, 17, 265-277.

Dutton, D. G. (1995a). The batterer: A psychological perspective. New York: Basic Books.

Dutton, D. G. (1995b). Trauma symptoms and PTSD-Like profiles in perpetrators of intimate abuse. Journal of Traumatic Stress, 8, 299-316.

Dutton, D. G. (1995c). Domestic assault of women: Psychological and criminal justice perspectives (2nd edition). Vancouver, BC: UBC Press.

Dutton, D. G. (1995d). Intimate abusiveness. Clinical Psychology: Science and Practice, 2, 207-224.

Dutton, D. G., Bodnarchuk, M., Kropp, R., Hart, S., & Ogloff, J. (1997). Wife assault treatment and criminal recidivism: An eleven year follow-up. International Journal of Offender Therapy and Comparative Criminology, 41(1), 9-23.

Dutton, D. G., & Browning, J. J. (1988). Concern for power, fear of intimacy, and aversive stimuli for wife assault. In G. Hotaling, D. Finkelhor, J. T. Kirkpatrick, & M. A. Straus (Eds.), Family abuse and its consequences: New directions in research (pp. 163-175). Newbury Park, CA: Sage.

Dutton, D. G., Saunders, K., Starzomski, A., & Bartholomew, K. (1994). Intimacy-anger and insecure attachment as precursors of abuse in intimate relationships. Journal of Applied Social Psychology, 24, 1367-1386.

Dutton, D. G., & Starzomski, A. (1994). Psychological differences between court-referred and self-referred wife assaulters. Criminal Justice and Behavior: An International Journal, 21, 203-222.

Dutton, D. G., van Ginkel, C., & Starzomski, A. (1995). The role of shame and guilt in the intergenerational transmission of abusiveness. Violence and Victims, 10, 121-131.

Else, L., Wonderlich, S. A. M., Beatty, W. W, Christie, D. W. & Staton, M. D. (1993). Personality characteristics of men who physically abuse women. Hospital and Community Psychiatry, 44(1), 54-58.

Eth, S., & Pynoos, R. S. (1985). Post Traumatic Stress Disorder in children. Washington, DC: American Psychiatric Press.

Eth, S., & Pynoos, R. S. (1994). Children who witness the homicide of a parent. Psychiatry, 57, 287-306.

Fincham, F.D., & Bradbury, T.N. (1992). Assessing attributions in marriage: The relationship attribution measure. Journal of Personality and Social Psychology, 62, 457-468.

Flournoy, P. S., & Wilson, G. L. (1991). Assessment of MMPI profiles of male batterers. Violence & Victims, 6(4), 309-320.

Fromm, E. (1973). The anatomy of human destructiveness. New York: Fawcett

Ganley, A. (1981). Participant’s manual: Court mandated therapy for men who batter-A three day workshop for professionals. Washington, DC: Center for Women Policy Studies.

Ganley, A. L. (1988). Feminist therapy with male clients. In M. Dutton-Douglas & L.E.A. Walker (Eds.), Feminist psychotherapies: Integration of therapeutic and feminist systems developments in clinical psychology, (pp. 186-205). Norwood, NJ: Ablex Publishing.

Ganley, A. L. (1989). Integrating feminist and social learning theories of aggression. In L. Caesar & K. Hambeger (Eds.), Treating men who batter: Theory, practice and programs. New York: Springer.

Garbarino, J., Kostelny, K., & Dobrow, N. (1991). No place to be a child: Growing up in a war zone. Lexington, Mass: Lexington Books.

Gondolf, E. W. (1985). Men who batter: An integrated approach for stopping wife abuse. Holmes Beach, CA: Learning Publications.

Gottman, J., Jacobson, N. S., Rushe, R. H., Short, J. W., La Taillade, J. J. & Waltz, J. (1995). The relationship between heart rate reactivity, emotionally aggressive behavior and general violence in batterers. Journal of Family Psychology, 9, 1-41.

Gunderson, J. G. (1984). Borderline personality disorder. Washington, DC: American Psychiatric Press.

Hale, G., Duckworth, J., Zimostrad, S., & Nicolas, D. (1988). Abusive partners: MMPI Profiles. Journal of Mental Health Counseling, 10(4), 214-224.

Hamberger, L.K., & Hastings, J. E. (1986). Characteristics of male spouse abusers. Is Psychopathology part of the picture? Paper presented at American Society of Crimiology, Atlanta, GA.

Hamberger, L.K., & Hastings, J.E. (1988). Characteristics of spouse abusers consistent with personality disorders. Hospital and Commnity Psychiatry, 39(7), 763-770.

Hart, S. D., Dutton, D. G., & Newlove, T. (1993). The prevalence of personality disorder amongst wife assulaters. Journal of Personality Disorders, 7(4), 328-340.

Hastings, J., & Hamberger, K.L. (1988). Personality characteristics of spouse abusers: A controlled comparison. Violence and Victims, 3(1), 31-48.

Herman, J. L., Perry, J. C., & van der Kolk, B. A. (1989). Childhood trauma in Borderline Personality Disorder. American Journal of Psychiatry, 146, 490-495.

Herman, J.L., & van der Kolk, B. (1987). Traumatic antecedents of borderline personality disorder. In B. van der Kolk (Ed.), Psychological trauma. (pp. 111-126). Washington DC: American Psychiatric Press.

Holtzworth-Munroe, A., & Anglin, K. (1991). The competency of responses given by maritall violent versus nonviolent men to problematic marital situations. Violence and Victims, 6, 257-269.

Jacobson, N.S. (1993). Domestic violence: What are the marriages like? American Association for marriage and Family Therapy, Keynote Address, Anaheim, CA.

Jaffe, P., Wolfe, D. & Wilson, S. K. (1990). Children of battered women. Newbury Park, CA: Sage.

Jones, E. E. (1996). Introduction to the Special Section of Attachment and Psychopathology: Part 1. Journal of Clinical and Consulting Psychology, 64(1), 5-7.

Kardiner, A. (1941). Traumatic neuroses of war. New York: PB Hoebe, Inc.

Kirkpatrick, L. A., & Shaver, P. (1992). An attachment-theoretical approach to romantic love and religious belief. Personality and Social Psychology Bulletin, 18(3), 266-275.

Klein, D. F. (1980). Anxiety reconceptualized. Comprehensive Psychiatry, 6, 411-427.

Landis, T. (1989). Children in shelters: An exploration of dissociative processes and traumatization in some children. Boulder: University of Colorado.

Lehmann, P. (1997). The development of PTSD in a sample of child witnesses to mother assault. Journal of Family Violence, 12(3), 241-257.

Lewis, D.O., & Balla, D.A. (1976). Delinquency and psychopathology. New York: Grune and Stratton.

Lewis, H.B. (1971). Shame and guilt in neurosis. New York: Internation Univeristyies Press.

Lewis, M. (1992). Shame: The exposed Self. Hillsdale, N.J. : Erlbaum.

Lisak, D., Hopper, J., & Song, P. (1996). Factors in the cycle of violence: Gender rigidity and emotional constriction. Journal of Traumatic Stress, 9(4), 721-744.

Litz, B. T., Weathers, F. W., Monaco, V., Herman, D. S., Wulfsohn, M., Marx, B., & Keane, T. M. (1996). Attention, arousal and memory in Post Traumatic Stress Disorder. Journal of Traumatic Stress, 9(3), 497-519.

Lyons-Ruth, K. (1996). Attachment relationships among children with aggressive behavior prblems: The role of disorganized early attachment patterns. Journal of Consulting and Clinical Psychology, 64(1), 64-73.

Maiuro, R. D., Cahn, T. S., Vitaliano, P. P., Wagner, B. C., & Zegree, J. B. (1988). Anger, hostility and depression in domestically violent versus generally assaultive men and nonviolent control subjects. Journal of Consulting & Clinical Psychology, 56, 17-23.

Malmquist, C. P. (1986). Children who witness parental murder: Post-traumatic aspects. Journal of American Academy of Child Psychiatry, 25, 320-325.

Margolin, G. John, R. S., & Gleberman, L. (1988). Affective responses to conflictual discussion in violent and nonviolent couples. Journal of Consulting and Clinical Psychology, 56(1) 24-33.

Miller, S. (1985). The Shame Experience. Hillsdale, N.J. : Erlbaum.

Millon, T. (1987). Manual for the Millon Clinical Multiaxial Inventory-II. Minneapolis, MN: National Computer Systems.

McCord, J. (1983). A forty year perspective on effects of child abuse and neglect. Child Abuse and Neglect, 7, 265-270.

McNally, R. J. (1991). Assessment of Post Traumatic Stress Disorder in children. Psychological Assessment, 3(4), 531-537.

O’Leary, K. D. (1988). Physical aggression between spouses: A social learning theory perspective. In V. van Hasselt, R. Morrinson, A. S. Bellack, & M. Hersen (Eds.), Handbook of family violence.p31-56, New York: Plenum Publishing.

Oldham, J., Clarkin, J., Appelbaum, A., Carr, A., Kernberg, P., Lotterman, A., & Haas, G. (1985). A self-report instrument for borderline personality organization. In T.H. McGlashan (Ed.), The borderline: Current empirical research [Monograph], (pp. 1-18). The progress in psychiatry series. Washington, DC: American Psychiatric Press.

Osofsky, J. D., Wewers, S., Hann, D. M., & Fick, A. C. (1993). Chronic community violence: What’s happening to our children? Psychiatry: Interpersonal and Biological Processess, 56(1), 36-45.

Pan, H. S., Neidig, P. H., & O’Leary, K. D. (1994). Predicting mild and severe husband to wife aggression. Journal of Consulting & Clinical Psychology, 62, 975-981.

Parker, G. (1994). Parental bonding and depressive disorders. In M. B. Sperling & W. H. Berman (Eds.), Attachment in adults: Clinical and developmental perspectives. New York: Guilford.

Pitman, R. K., Orr, S., & Shalev, A. (1993). Once bitten, twice shy: Beyond the conditioning model of PTSD. Biological Psychiatry, 33, 145-146.

Pollock, V. E., Briere, J., Schneider, L., Knop., J. Mednick, S. A., & Goodwin, D. W. (1990). Childhood antecedents of antisocial behavior: Parental alcoholism and physical abusiveness. American Journal of Psychiatry, 147(10), 1290-1293.

Pynoos, R. S. (1994). Post Traumatic Stress Disorder: A clinical review. Lutherville, Maryland: The Sidran Press.

Pynoos, R. S., & Eth, S. (1985). Children traumatized by witnessing acts of personal violence: Homicide, rape, or suicide behavior. In S. Eth, & R. S. Pynoos (Eds.), Post Traumatic Stress Disorder in Children (pp. 17-44). Washington: American Psychiatric Press.

Pynoos, R. S., & Nader, K. (1993). Issues in the treatment of Post Traumatic Stress Disorder in children and adolescents. In J. P. Wilson & B. Raphael (Eds.), International Handbook of Traumatic Stress Syndromes. New York: Plenum.

Pynoos, R. S., Steinberg, A.M., & Goenjian, A. (1996). Traumatic stressin childhood and adolescence: Recent development and current controversies. In B. van der Kolk, A. C. McFarlane, & L. Weisaeth (Eds.), Traumatic stress: The effects of overwhelming experience on mind, body and society, (pp. 331-358). New York: Guilford Press.

Retzinger, S.M. (1991). Violent Emotions: Shame and rage in marital quarrels. Newbury Park CA: Sage Publishing.

Robert, J.A., Ryan, J.J., McEntyre, W.L., McFarland, R.S., & Lips, O.J. (1985). MCMI characteristics of DSM-III PTSD in Vietman veterans. Journal of Personlity Assessment, 49, 226-230.

Rossman, B. B. (1994). Children in violent families: Diagnosis and treatment considerations. Family Violence and Sexual Assault Bulletin, 10, 29-34.

Saunders, D. (1994). Posttraumatic stress symptom profiles of battered women: A comparison of survivors in two settings. Violence and Victims, 9(1), 31-44.

Scheff, T.J. (1987). The shame-rage spiral: A case study of an interminable quarrel. In H.B. Lewis (Ed.), The role of shame in symptom formation, (pp. 109-149). Hillsdale, NJ: Lawrence Erlbaum & Associates.

Schore, A.N. (1994). Affect regulation and the origin of the self. Hillsdale, NJ: Lawrence Erlbaum & Assoc.

Shalev, A., & Rogel-Fuchs, N. Y. (1993). Psychophysiology of PTSD: From sulfur fumes to behavioral genetics. Journal of Nervous and Mental Disease, 55(5), 413-423.

Shengold, L. (1989). Soul murder. New York, NY: Fawcett Columbine.

Sonkin, D. J. (1987). The assessment of court-mandated male batterers. In D.J. Sonkin (Ed.), Domestic violence on trial: Psychological and leagal dimensions of family violence (pp. 174-196). New York: Springer Publishing.

Sonkin, D. J., Martin, D., & Walker, L. (1985). The male batterer: A treatment approach. New York: Springer.

Starzomski, A. J. (1993). Attachment style, affect, and the construal of interpersonal conflict. Unpublished Masters’ thesis. Department of Psychology, Univeristy of British Columbia.

Straus, M. (1991). Beating the devil out of them: Corporal punishment in American families. New York: Lexington.

Straus, M.A., Gelles, R.J., & Steinmetz, S. (1980). Behind closed doors: Violence in the American family. Garden City, NY: Anchor Press/Doubleday.

Terr, L. (1979). Children of Chowchilla: A study of psychic trauma. Psychoanalytic Study of the Child, 34, 547-623.

Terr, L. (1981). "Forbidden games": Post traumatic child’s play. Journal of the American Academy of Child Psychiatry, 20, 741-760.

Terr, L. (1983). Chowchilla revisited: The effects of psychic trauma four years after a school-bus kidnapping. American Journal of Psychiatry, 140, 1543-1550.

Turner, C., Fenn, M., & Cole, A. (1981). A social psychological analysis of violent behavior. In R. B. Stuart (ed.), Violent behavior: Social learning approaches. New York: Burnner/Mazel.

Tweed, R. & Dutton, D. G. (1998). A comparison of impulsive and instrumental subgroups of batterers. Violence and Victims, 13(3), 26-43.

van der Kolk, B., McFarlane, A. C., & Weisaeth, L. (1996). Traumatic stress. New York: Guilford.

van der Kolk, B. (1987). Psychological trauma. Washington, DC: American Psychiatric Press.

van der Kolk, B. (1988). The trauma spectrum: The interaction of biological and social events in genesis of the trauma response. Journal of Traumatic Stress, 1(3), 273-290.

van der Kolk, B., & Ducey, C.P. (1989). The psychologicao processing traumatic experience: Rorschack patterns in PTSD. Journal of Traumatic Stress, 2(3), 259-274.

van der Kolk, B., & Fisler, R. (1995). Dissociation and fragmentary nature of traumtic memories: Overview and exploratory study. Journal of Traumatic Stress, 8(4), 505-525.

West, M., & Keller, A. (1994). Psychotherapy strategies for insecure attachment in Personality Disorders. In M. B. Sperling & W. H. Berman (Eds.), Attachment in adults: Clinical and developmental perspectives. New York: Guilford.

Walker, L. (1979). The battered woman. New York: Harper & Row.

Widom, C. S. (1989). Child abuse, neglect, and adult behavior: Research design and findings on criminality, violence and child abuse. American Journal of Orthopsychiatry, 59, 355-367.

Wurmser, L. (1981). The Mask of Shame. Baltimore: John Hopkins University Press.

Figure 1

MCMI-II Profiles for Batterers and Men Diagnosed with PTSD

Figure 2

Social Learning Theory Schemata for Learned Responses to Aversive Life Events