Evil Deeds

There are a lot of repressed, angry people out there but not all of them are homicidal. This seems to me to be the difficulty that we face as practitoners and as a society. How do we predict who is just angry and who is homicidal? There were signs with these killers and yet, many people have the same ideations but do not actually pursue them. And how do we reach them to get underneath their rage and anger if they are not compliant with treatment?

Good questions, Sharilyn. This is always a difficult--but commonplace--task: to distinguish the dangerously homicidal patient from the simply angry but not necessarily dangerous. If you are a practicing clinician, you are familiar with some of the ways we try to make this determination. But you also know that statistically speaking, psychologists are far from perfect in predicting violence or dangerousness, doing so only a little better than would chance. An inexact science, but a crucial clinical skill, one which is gradually improving. As to treating such patients, especially non-compliant ones, that again is difficult. But even initially non-compliant or resistant individuals can often be engaged in psychotherapy with the right approach. And this is equally true of the angry or potentially homicidal person: The key to effective therapy is not to focus on "getting underneath their rage and anger," but rather acknowledging and accepting their rage and anger directly and openly at first, and staying with it. This is something I discuss at length in my book if you're interested, and also in an article you can find online titled "Violence as Secular Evil."