Handbook on Sexual Violence (50 page)

Frequent rehearsal of the safety plan is key. If time out is called by either partner, what happens next? Where do they go? If it is three o’clock in the morning and raining outside, what do they do?? What happens to the children, and so on? Rehearsal of the safety plan makes action in the moment more likely. When people are anxious, afraid or otherwise unhelpfully aroused, they are neither able to process information quickly, nor to problem-solve in novel, flexible and creative ways. They are more likely to fall back on old solutions and over-learned responses. Hence rehearsal makes it more likely that both victim and perpetrator observe the safety plan and call time out. It is important to take regular feedback from people about their attempts to calm and soothe themselves – what did they notice? What did it feel like as they calmed down, and so on? Similarly, the safety plan needs to include ways of calming down,

and then needs to address what happens next. So, when both are calm, do they return to the topic of conversation, for example, or do they wait until their next meeting with us, or take the issue to the stable third, or a trusted family member, and so on? Healing and making up after an argument need to be addressed so that issues are not left unresolved, or to fester and lead to resentment. Family members may wish to avoid speaking again of the topic that led to a violent escalation between them, for fear of reinvoking the violence. They may think this is protective and the safer option. Hence the need for careful, slow therapeutic work that helps to de-escalate fears and to manage conflict in a safe therapeutic context. It is hoped that these experiences scaffold attempts to heal and avoid misunderstandings for the future.

When it looks as if the safety plan is working, we can agree with the couple/family, and the stable third, that we proceed to other therapeutic matters. If the no-violence contract is broken, we do not abandon people, rather we convene a meeting with the stable third and the couple/family and decide what to do next. We may do individual work with the perpetrator, or recommend group work, or we may continue with safety planning depending on the judged severity of the violence. Severe violence may require a legal response rather than a therapeutic one.

1.(b) Risk assessment

We separate the management of risk from the assessment of risk. The management of risk enables us to think about, and respond to, others’ anxiety about the possibility of repeat violence, and clearly our safety planning work is therapeutic in intent. Similarly we assess the risk of future violence in order to help promote the safety planning. We look for signs of safety and give people credit for trying to stop the violence. We recognise that past violence predicts future violence and that this knowledge creates uncertainty and anxiety about the future. In assessing for risk, we take account of a number of factors, such as the frequency of episodes of violence, and the contexts within which violence occurs; for example, is the perpetrator of domestic violence also violent at work, in the sports hall, or in the pub? We want to observe, in our meetings, how people manage themselves in the heat of the moment, so to speak, when they are unhelpfully aroused, or discussing a conflict. Can they respond to our efforts to calm a conversation and give a good account of themselves? Do they show signs of empathy – can they suppress their own needs in order to listen to family members talk about upsetting events, and do they have a sense that the ‘other’ is the same as them, with the same feelings and attachment needs?

The risk assessment process is interwoven with the management of risk and safety planning, in feedback and conversational exchanges with relevant family members, over a minimum of six meetings. The conversation is informed by detailed questioning and exploration of experience as described above. It is not an heuristic, rather it is rooted in clinical judgement and experience, and the outcome of stopping the violence is determined with the family members, the stable third and other involved professionals. The safety plan is designed to help family members take responsibility for their behaviour and for safety.

As part of risk assessment, we want to explore reflective functioning and learn how family members might reflect on past events and learn from experience (Fonagy and Target 1997). For example, at the request of child protection social workers, we met a father who had been accused of physically harming his daughter, to assess his capacity to be a safe parent of his daughters. The father told us that he could remember nothing of his life before the age of 18 years, and that there was no point in us asking him about his experience of being parented. As far as we knew there was no organic reason for his memory loss. Thus we responded by asking him systemic questions about the effects of ‘not remembering’ on his ideas and practices of fathering, for example, where did he get his ideas from about being a father? Who/what has helped him develop his ideas as a father? If he cannot remember being parented, what helps him stand in the shoes of his children now, and understand their needs? If he cannot remember what he needed from a parent, as a child, what helps him think about his children’s needs developmentally? And so on.

We see it as our responsibility to manage the assessment/therapeutic process to help establish a secure base – a reflective space where people can think. When people are traumatised, frightened and/or anxious, they are slower to process negative information, become preoccupied with regulating their own internal states, and find it harder to read relationship cues – hence our responsibilities within the therapeutic alliance are clear, and we expect that people will develop their reflective positioning with our support. In any psychological intervention the development of a safe and trusting therapeutic alliance is considered necessary for change to occur, and in our work, most people have been subject to danger, harm and adversity at some time in their lives that has compromised their willingness and ability to trust. Thus we work hard to build trust in our working relationships with our clients, to support them in thinking about their own behaviour, feelings, thoughts, decisions and actions. Reflective functioning is thought to be essential for the development of empathy.

The capacity for empathic responding is also part of our assessment for safety. The development of empathy is the best protection against the propensity for violence. The ability to put yourself in the emotional shoes of the other, to recognise the other as similar to you, rather than lesser than you, to partly suppress your own needs in order to listen to what the other is saying when they are upset or talking about how we might be implicated in their upset can be described as empathy. This relational capacity is thought to arise out of the experience of attunement in early relationships with care- givers (Stern 1985). Such empathy is most often seen in how people listen and how they feel heard.

1. Responsibility
   

   As explained above, safety in relationships is our highest context marker, so we are looking for signs of safety in how people talk and in what they do. We are always prepared to give people credit for trying. Part of this emphasis on safety is an extension of how we are all helped, in our development, to take responsibility for behaviour that causes harm to others alongside the
   

   development of a sense of entitlement to one’s own safety and the support of others’ entitlement to safety – to live without fear of the people we love. We expect perpetrators to acknowledge there is a problem to be solved, and to recognise that their behaviour has a relational impact – that any behaviour that frightens, threatens and intimidates others affects the quality of perpetrators’ own relationships with their family members in terms of how safe and trusting others can feel around them. In making the safety plan, we use a minimum of six sessions, as said earlier, and during this time there is an opportunity for people to develop their sense of responsibility and own their behaviour and its effects. This is our responsibility, to help them develop their accountability for their actions, and this is also their main responsibility, to themselves, to their family, and to professional and legal services.
   

   We do not interview the children in front of their parents/carers until we are clear that the parents take responsibility for safety seriously, and have been shown to do this through their actions. We might talk to the children separately or as a sibling group, but we do not ask the children to talk about the effects of living with fear until we know the parents are psychologically able and ready to really listen to what their children are saying. In our experience it is often the children who call for help during an attack, from neighbours, the police, extended family or so on. Many of the children we meet have developed a capacity to take action and to seek safety and for that reason they like to be included in safety planning discussions. In one family we met, the older daughter of 13 years ran to a neighbour’s house to phone the police for help when she overheard her father sexually assaulting and trying to kill her mother. Her father was arrested, but in subsequent meetings between her mother and the social services, where her safety was discussed, she was not included in any of the discussions. When we met her she told us she protested at this exclusion by refusing to co-operate with the social worker. A careful exploration and appreciation of her understanding of safety, and how she had tried in the past to keep her mother safe, and took action in the past to call for help, paved the way for her to co-operate with her new social worker.
   

   We do not ask children and young people to make themselves emotionally vulnerable in a conversation until we are reasonably sure that it is safe for them to do so. Similarly we may support a traumatised parent in listening to their child talk about the effects of witnessing a violent attack on the parent. During these early safety planning discussions with the adults we are listening for evidence that the parents understand that violence has the potential to frighten and traumatise their children. This can be poignant; for example, we sometimes meet women who have comforted themselves as mothers by saying, ‘I take the violence and the children do not know . . . ’ In these moments we talk to the women about the research on the effects of domestic violence on children (Vetere and Cooper 2005). We tell women that research estimates that two-thirds of violent attacks are actually witnessed (Moffitt and Caspi 1998), but that we think the children always know. Even if they are at school or with their grandparents during an attack, they do not believe their mothers (or fathers for that matter!) walk into doors or fall down the stairs. We talk to parents about the development of children, and how children monitor
   

   the well-being of their parents and their parents’ relationship, as it has profound implications for the safety, well-being and psychological development of the child. We track when and how children might get involved in attacks, by trying to prevent the escalation of an argument, and what the children are learning about relationship safety and how adults get on together.
   

   We listen carefully to the words people use when talking about their violent behaviour towards others, and when talking about safety. It is in the talk that responsibility and explanation meet, where it is possible to minimise and deny our actions or the effects of our actions, where explanation can be used to dilute responsibility, or to slip away from responsibility with excuses and promises. As systemic thinkers we track how people talk and what words they use and we raise questions about how social realities are constructed in the talk about violence. We meet women who tell us they deserve to be hit, so we deconstruct the word ‘deserve’. It is as if the woman thinks others are entitled to hit her. Where did that idea come from, we ask, as you were not born thinking like this? Similarly, if language is used to minimise the violence or the effects of violence, we pause in the session, notice the words, and deconstruct their use in the here and now, and the effects of their continued use over time. There are many examples to note. For example, a man may say, ‘I only hit her.’ We ask about the word ‘only’ – what does ‘only’ look like, and if I were there what would I see? Was your fist open or clenched – where did you hit her, and what did that feel like, and so on . . . ? We pause and walk around in the description, thus highlighting the seriousness of the ‘hit’ and the effects of the ‘hit’. This offers an opportunity to reflect and deconstruct the ‘taken-for- granted’ in people’s lives. In another example – a woman might say, ‘I just hit him.’ Similarly we would be curious about the use of the word ‘just’ as it too minimises and denies the impact of our actions towards others.
   

   The point to be made here is that we use language to minimise and deny the import of our behaviour and its adverse effects on others, and our task is to track such use of language and help people see where and how they minimise violence. Such linguistic deconstruction can be used with all forms of violence in all intimate and family relationships.
   

   We notice how people describe their experience of anger, as if it builds up or explodes in an instant, with phrases like, ‘I go from 0 to 100 in 10 seconds.’ We deconstruct this idea of speed of arousal and also ask the partner to comment, who often tells us, ‘but I saw the tension building all day.’ Similarly people describe anger as ‘losing it’ – we ask what was gained, not lost, by using violence. Who loses and who gains? Another example comes from our first meeting with a divorced father, who hit his 16-year-old daughter. He told us: ‘She knows I love her, the silly cow, she knows I won’t hit her again.’ We asked him, ‘What does she know?’ He has put this in the framework of love, but what actually does she know, we ask. The father looked at us in return and began to deconstruct his use of language, thoughtfully, and to acknowledge that his daughter could not know she was safe. In another example, we met a man and woman in a first meeting, where she said to him, ‘You hit me.’ ‘I didn’t,’ he replied. ‘You did,’ she said, ‘you hit me!’ ‘I didn’t’, he said, ‘I didn’t hit you like a man.’ Although we might recognise some
   

   control of his violent behaviour in this description, the woman understood this to mean that she was not safe in the relationship and decided to separate from the man. The woman worked with a women’s refuge shelter worker and we helped the man, at his request, to understand his behaviour, to take better control and to make sure this could not happen again. They managed a safe separation.
   

2. Collaboration